June 27, 2015

After Thursday's decision, the right answer to right-wing nonsense criticizing the Affordable Care Act ought to be a simple declaration: It's here to stay, so stop lying about it and start helping to make it better.

But we're not quite there yet, so the least I can do is offer up some facts for Bill Maher.

Mary Katharine Ham, conservative writer and Affordable Care Act hater, made an appearance on Maher's show to leave a few right-wing talking points behind. As I said, the only real response is to gently take her hand and tell her it's time to get over it.

Instead, she got to go on and on with untruths and distortions about the law, so I thought I'd give Bill Maher some tips on rebutting her.

About the increase in emergency room visits. On that, she's correct. There has been a slight increase, but not for the reasons she supposes. Some of it relates to states that haven't expanded Medicaid. Some of it relates to a primary doctor shortage. Everything will not be perfect overnight, but it is improving.

Some of it relates to actions from doctors themselves, who seem to have forgotten their "do no harm" pledge in favor of one that says "make more money." In California, for example, there is a large medical group actively working to recruit primary care doctors out of primary practice and into their HMO which actively refuses ACA policy reimbursements. Some doctors -- too many -- have opted into that.

As to her point about people not liking Obamacare, that's just a convenient talking point intended to fluff her own participation in the ACA Haters Noise Machine. As President Obama pointed out yesterday, many people don't even know they're benefitting from the ACA, because their insurance comes via their employer. Even though it's vastly improved, it's not an exchange-based policy and so they don't realize the benefits come from the same place the exchanges do.

Ham closes by declaring that there isn't an unlimited supply of health care, as if that somehow suggests that we should create a false construct where some have it and others don't.

One feature of the ACA is that it contains all sorts of ideas for how to broaden access -- community health centers, nurse practitioners, physician's assistants and so on -- as well as undertaking an education process so people live lives of wellness rather than sickness. If that happened, then that limited supply we have could be utilized more efficiently.

As for her claims about Pharma benefitting, I'd suggest she look to her own side about that. We had a Senator who wanted to negotiate drug prices with Canada, and that idea was killed by a handful of corporate Democrats holding hands with all the Republicans in the room. So let's not go holding that one over Obama's head.

The bottom line with all of this? There will always be haters clinging to the last threads of that which they know best -- hating. But the time has come for them to move on from it.

The best thing Maher or anyone on this panel could have done would have been to cut her off and remind her that it's here to stay and she needs to get over it.

Or they could just print this out and hand it to her.

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