The World Ends Tomorrow

Civilization as we know it has only 24 hours left. Those who doubt that can cling to a faint hope offered by Barack Obama’s favorite physician/writer.

During the health care debate in 2009, the President made his staff read a New Yorker article by Dr. Atul Gawande dramatizing the borderline thievery sanctioned by America’s fee-for-service system: about two communities in Texas, one with the second-highest per-capita Medicare costs in the country, twice those of a neighboring city with no discernible health benefits as a result of doctor-owned hospitals, surgery centers and diagnostic-test facilities.

Now Dr. Gawande reports that “as of October 1st, healthcare.gov is scheduled to open for business. A Web site where people who don’t have health coverage through an employer or the government can find a range of health plans available to them, it resembles nothing more sinister than an eBay for insurance. Because it’s a marketplace, prices keep falling lower than the Congressional Budget Office predicted, by more than sixteen per cent on average. Federal subsidies trim costs even further, and more people living near the poverty level will qualify for free Medicaid coverage.”

As the Tea Party fights to shut down the government over such infamy, whether or not the new law of the land will help the catastrophically sick and uninsured depends on where they live, with some states (California, New York, Minnesota, Maryland) complying and others (Indiana, Texas, Utah, South Carolina) doing everything they can to obstruct implementation.

Now the critical moment is at hand in a clash between John Boehner, who interned sweeping out his father’s saloon, and such as Dr. Gawande, a Harvard professor who directs the World Health Organization's effort to reduce surgical deaths.

As Republicans keep pointing out, it’s still a free country. Choose your own care giver and hope for the best.

Update: In one respect, GOP no-nothings have succeeded: Polls show most Americans know little about the Affordable Care Act, and much of that is wrong.

Less than half of the uninsured plan to get coverage through a state or federal exchange, a low number that may result from lack of knowledge about them, since 7 in 10 say they are “not too or not at all familiar” with these health insurance exchanges.

Those for whom Obamacare could mean life or death have been brought into suicidal confusion by vicious Tea Party lies.