"Obamacare" was initially perceived as a derogatory term advanced by opponents of health care reform. Yet, the term is now commonly used by both conservatives and liberals as a way to refer to the Patient Protection and Affordable Care Act. As the government shutdown crisis unfolded, politicians, the media, and ordinary citizens debated the pros and cons of "Obamacare." The shutdown is now over, and it is widely reported that congressional Republicans failed to repeal, defund or postpone "Obamacare." The legislation may stay the same but its derogatory label has stuck.
The change in attitude partly comes from President Obama, who has sought to coopt criticism of the Affordable Care Act by embracing the term "Obamacare." In 2011, Obama even said "That's right - I care," in an attempt to dismiss those who have vilified "Obamacare." In retrospect, this seems like a dubious strategy. While the label "Obamacare" is not negative per se, there are multiple reasons why it undermines health care reform.
1) The word "Obamacare" ties the law's popularity to Obama's popularity: Indeed, if you are not an Obama supporter, how could you be for "Obamacare"? By definition, "Obamacare" cannot be popular insofar as Obama himself is relatively unpopular. Besides, tying the name of a major legislative reform to the name of a politician is questionable. Should Medicare be called "Johnsoncare" because it was passed under President Lyndon Johnson?
2) "Obamacare" implies that the Affordable Care Act is an Obama pet project:
While Obama has embraced this legislation as a politically-feasible reform, he hardly came up with it. In fact, the Affordable Care Act is modeled on past Republican proposals for a market-friendly reform that would hardly dismantle the current health insurance system. America is essentially the only Western democracy where insurance companies can profit from basic health care coverage.
3) "Obamacare" suggests that health-care-for-all is an Obama idea or a liberal idea:
In reality, all developed countries except America have long had universal health care systems that go much further than the Affordable Care Act. All leading right-wing parties in Europe, Canada, Australia, New Zealand, and Japan have supported universal health care for decades. The vast majority of conservatives in other democratic countries do not consider universal health care a "liberal" policy.
4) "Obamacare" suggests that health care reform is not a serious policy matter:
The label "Obamacare" was partly intended to mock the Affordable Care Act. Yet, the vast majority of health care law and policy experts worldwide agree that a form of universal health care is the best policy. Using a frivolous term like "Obamacare" obscures the serious need for reform in a country where scores of ill people have been denied medical treatment or ruined by medical bills.
5) The term "Obamacare" arose as part of a disinformation campaign: Labeling the law as "Obamacare" is a key part of the strategy of opponents of health care reform. This strategy has also entailed fear-mongering by using other misleading catch-words like "socialized medicine," "death panels," and a "government takeover of health care." It has likewise entailed misrepresenting basic facts. For instance, John Boehner claimed that "Obamacare" will wreck the "best" health care system worldwide -- a blinkered view considering that 75 million Americans were either uninsured or critically under-insured before reform. By contrast, all other developed countries manage to provide universal health care with generally better or equal health results than America, which still has by far the highest overall health care costs worldwide.
In sum, the Affordable Care Act should not be called "Obamacare," especially by its supporters. The fact that the media and much of the American public have accepted this derogatory term exemplifies the success of hard-line Republicans in framing the terms of the political debate. By the same token, referring to Medicare, Medicaid, and Social Security as "entitlements" -- a term largely promoted by opponents of these programs -- is misleading.
However, certain state governments are currently trying to implement the heath care law by avoiding self-defeating references to "Obamacare." Kentucky, will notably implement health care reform under the name "Kynect" while Idaho's program is named "Your Health Idaho." This pragmatic approach makes more sense than referring to reform as "Obamacare."
The Affordable Care Act has so far survived a shutdown crisis, a Supreme Court challenge, and two elections. Unless it is eventually repealed, it will shape American society for decades. This law is not fundamentally about Barack Obama but about much broader issues, which is another reason not to call it "Obamacare."
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