02/10/2014 10:54 am ET Updated Apr 12, 2014

Why Can't We Defend Obamacare? Catch-22, That's Why

A simple, effective, dishonest argument that is used against the American Healthcare Act is that it is "socialist". A simple, effective, honest rebuttal to that argument would be that it is "not socialist enough". Uh-oh.

Defenders of Obamacare say, instead, that the plan is market-based, and that its foundation was laid at conservative think tanks. They say that in order to prove that far from being socialist, it is actually a right-center solution. Which is true. That proof is supposed to be a great argument in favor of the ACA. Which, if the point of the Act is affordable healthcare for all, it is not.

Some people I know are complaining about having to give up their old plan and settle for something no cheaper that provides inferior coverage. The individual mandate is proving to be somewhere between clunky and naive. We are still failing to cover millions and millions of people forcing them to resort either to more expensive healthcare solutions, inferior healthcare solutions or both. Those don't sound like problems associated with a socialist plan. They sound like problems associated with a market-based plan.

Could these real problems with the ACA be a result of the absence of a public option? Could they be the result of its complete lack of resemblance to a single payer system?

Can the elected officials who passed and are trying to defend Obamacare suggest anything like that? No. They have boxed themselves into a corner. They need to be all-American and defend market-based solutions. They need to deny some of the core weaknesses of the law they passed. They cannot tell some of the most fundamental truths.

A plan that is not single-payer and has no public option is not socialist. Perhaps I should not even call plans of that kind socialist: Otto von Bismarck and Margaret Thatcher were quite happy with State-dictated universal healthcare systems and I doubt even Ted Cruz would call them leftists. But if it helps explain what would work: What's wrong with socialism? Plans in Social Democracies are efficient, decent, fair and have been running for a long time.

You don't have to be from the far left of the political spectrum to believe that predominantly market-based solutions to national healthcare are inherently flawed. Nor that anything less that universal healthcare is inhumane. Except, apparently, if you are an elected official in the U.S.A.
Heaven forbid we say that excellent affordable healthcare for all is a human right that trumps free market capitalism.

Just because the ACA is better than what came before it doesn't mean it is good. It certainly doesn't mean it is good enough. The right can call out all the problems and label them as they wish. Never mind that they laid the groundwork for those problems: We cannot call them out for that because... we'd be admitting we are socialists!

The reason it is not working is because it is not socialist enough. The easiest way to knock it is to call it socialist. Thanks a lot Joseph Heller, thanks for providing such a brilliant universal explanation of governmental behavior. I read it regularly:

Yossarian looked at him soberly and tried another approach. 'Is Orr crazy?'

'He sure is,' Doc Daneeka said.

'Can you ground him?'

'I sure can. But first he has to ask me to. That's part of the rule.'

'Then why doesn't he ask you to?'

'Because he's crazy,' Doc Daneeka said. 'He has to be crazy to keep flying combat missions after all the close calls he's had. Sure, I can ground Orr. But first he has to ask me to.'

'That's all he has to do to be grounded?'

'That's all. Let him ask me.'

'And then you can ground him?' Yossarian asked.

'No. Then I can't ground him.'

'You mean there's a catch?'

'Sure there's a catch,' Doc Daneeka replied. 'Catch-22. Anyone who wants to get out of combat duty isn't really crazy.'

There was only one catch and that was Catch-22, which specified that a concern for one's safety in the face of dangers that were real and immediate was the process of a rational mind. Orr was crazy and could be grounded. All he had to do was ask; and as soon as he did, he would no longer be crazy and would have to fly more missions. Orr would be crazy to fly more missions and sane if he didn't, but if he was sane he had to fly them. If he flew them he was crazy and didn't have to; but if he didn't want to he was sane and had to. Yossarian was moved very deeply by the absolute simplicity of this clause of Catch-22 and let out a respectful whistle.
'That's some catch, that Catch-22,' he observed.

'It's the best there is,' Doc Daneeka agreed.'

From Catch-22 by Josesph Heller