So, I’ve got this student in one of my classes; let’s call him Joe. Joe is brash and abrasive. He’s spent his life doing hard work in harsh conditions. He’s a smoker (and probably a drinker). My impression is that he’s not exactly amenable to doing the kind of thinking that will get him over what I see as the roadblocks he sets up for himself. I think he thinks of himself as an “old dog,” and I present a particular challenge to him not only because of the class I teach (he’s not in community college to become a better writer; he’s made that perfectly clear), but also because of the energy I present.
Every class starts with a writing warm-up in the form of a quote that I ask the students to think and write about. Today’s quote was from Jonathan Swift: There are none so blind as those who will not see. Here’s Joe’s response to that prompt:
To see is the ability to acknowledge what is happening around and in front of you. When you can not see because you think you already have the answers, then you are destined to stumble around blind without a clue.
Those who simply will not see are entwined in an ignorant bliss, unaware of what is happening around them or the impact (or the negative impact) that there (sic) decision will make. A prime example of this i that pinhead sitting in the white house. He refuse to see what a negative impact the ACA will have on the economy. He refuses to negotiate to solve problems or simply ignores the problem either through ignorance or simply failure to see what is happening around the country.
When I went around the room asking what everyone wrote, Joe read his paper. As I do with most of the kids’ responses, I challenged him about it. I asked him to give me an example of the ACA having a negative impact on the economy, and he responded that employers are limiting employee hours and that it’s just bad. I told him that, if this was something he was really invested in, he should do some research about it because I wasn’t sure that he could find evidence to support that claim. Then I moved on to the next student.
When I got Joe’s paper this morning, he’d included an addendum, scrawled in larger letters and clearly showing some frustration at my resistance to his ideas:
IF THE ACA IS NOT HAVING A NEGATIVE IMPACT ON BUSINESSES, THEN HOW COME ALL BUSINESSES HAVE RECEIVED A WAIVER? OPEN YOUR EYES and see that businesses are going to part-timers and dropping health care to employees. If the ACA is really good, how come Congress refuses to give up there health care plans for the new one? How many Dr.s have retired in the last year?
Since I very often write notes on the students’ responses (and because I KNOW that Joe reads every word I write on his papers), I composed this for him:
A couple of things here, Joe;
First, while I appreciate your passion for the topic, I want to warn you against name calling in your professional writing. It’s perfectly acceptable – desired, even – to disagree with someone; disagreement gives us an opportunity to investigate other points of view and to shore up our own understanding of our positions. It is not acceptable, however, to be disrespectful to people who disagree with you. Even if you believe someone to be despicable, calling them names isn’t going to do anything to bolster your credibility. Remember the Booker T. Washington quote we worked on last week; “you can’t hold a man down without staying down with him.” Calling the President (or anyone else) a “pinhead” (or any other name) is going to diminish your credibility in the eyes of someone who might want to genuinely hear what you have to say.
In terms of addressing your complaints, I want to encourage you to do some research about the ACA and see if you can clarify and support some of the claims you’re making. For starters, your assertion that “businesses are going to part-timers and dropping health care to employees” isn’t supported by the figures. In fact, the recent trend in part-time employment is that it’s been going down, not up (see here for a chart: http://www.epi.org/blog/obamacare-isnt-causing-increase-part-time/). While there is some anecdotal evidence to support that claim – folks like the man who owns Papa John’s and says that he “can’t afford” to provide health care to his employees are behind a lot of that noise – there’s no reputable, statistical evidence to support that the ACA is causing employers to cut back worker hours. What’s more, the cry that the ACA is imposing a hardship on employers rings entirely false because the provision that would require employers with more than 50 employees to provide health care coverage doesn’t even kick in until 2015 (see here: http://www.cleveland.com/business/index.ssf/2013/09/charges_obamacare_is_causing_e.html)
Your assertion that “all businesses have received a waiver” is untrue, and is being spread as an issue by some less-than-reputable organizations and media outlets. There are waivers, but they’re specific to both particular provisions of the health care law and to certain companies and organizations.
For example; the ACA eliminates the ability of insurance companies to cap the total amount of medical bills they would pay for each policy holder. Those so-called “mini-med” plans charge customers very low premiums, but offer few benefits and require that the insured pay out of pocket for anything that exceeds a very low annual cap. That provision was due to kick in next year, but the Department of Health and Human Services recognized that some insurance companies weren’t going to be ready to phase out those policies in that time, so HHS gave them more time to keep workers from losing coverage altogether while their employers searched for alternative plans. (see here for the Centers for Medicare and Medicaid Services report on this exemption: http://www.cms.gov/CCIIO/Resources/Files/approved_applications_for_waiver.html)
Earlier this year, the Internal Revenue Service announced an even broader exemption, delaying the requirement that companies with 50 or more full-time workers offer health benefits that met a minimum standard for coverage until 2015 (this is what I referenced in my “part time workers” explanation above). The agency did so, it said, because a lot of employers complained that they wouldn’t be able to comply with reporting requirements (see here for the IRS information: http://www.irs.gov/uac/Questions-and-Answers-on-the-Individual-Shared-Responsibility-Provision). Notice that the businesses’ complaints were about reporting on coverage, not in providing it. In fact, most small businesses already provide health care coverage to their full-time employees, so the ACA doesn’t affect them at all (see here for a full report: http://kff.org/private-insurance/report/2013-employer-health-benefits/).
Your complaint that “Congress refuses to give up their health plans for the new one” isn’t quite accurate, either. Congress is not required to give up their health care plans, and neither is anyone else who already has coverage. All the ACA does (as regards insurance coverage) is require that people actually have health insurance. The exchanges are designed for those who can’t get adequate or affordable coverage through their employer. The ACA makes it so that individuals who have to buy their own insurance (and some small firms) would be eligible to participate in state-based exchanges, which would offer a range of health insurance plans for purchase (unlike pre-ACA insurance shopping; it was difficult – and SUPER expensive – for individuals and small businesses to purchase insurance as single entities. Don’t forget, too, that these exchanges are made up of private insurance companies; that’s important to remember when someone’s telling you that the ACA is “socialized medicine”).
Those who already get insurance through their employers, Medicare, Medicaid, the military’s Tricare insurance program, or the Federal Employees Health Benefits Program wouldn’t be required – or even eligible – to participate in the health care exchanges. All federal employees, including members of Congress (and the President), fall under the FEHBP. Those who have coverage from a large employer wouldn’t be eligible, either, unless their coverage didn’t meet minimum benefits criteria or was deemed to be unaffordable.
Finally, I couldn’t find any reputable source that confirms that doctors are going to retire over the implementation of the ACA. Neither could I find accurate numbers about the rate of physician retirement (this was as close as I could come: http://www.lewin.com/~/media/Lewin/Site_Sections/Publications/3027.pdf). I did find, though, that one out of three practicing physicians in the United States is over the age of 55, and many of them are expected to retire in the next 10 or 15 years. If you can point me to evidence that doctors are retiring rather than participate in the health care changes (something that wasn’t published by World Net Daily, Liberty News or Fox), then please do and I’ll review my position on this.
We should also consider that the ACA is going to expand access to medical care for millions of people who don’t currently have such access. That means that the demand for doctors is going to increase. Expanded coverage is predicted to increase the number of annual primary care visits between 15.07 million and 24.26 million by 2019. Assuming stable levels of physicians’ productivity, between 4,307 and 6,940 additional primary care physicians would be needed to accommodate this increase (see here for the citation for those figures: http://onlinelibrary.wiley.com/doi/10.1111/j.1468-0009.2011.00620.x/full).
I want to encourage you to put your energy and passion to good use on this issue, but remember that it’s sometimes difficult to argue about something when we are too wrapped up in our feelings about it. A good argument comes from a place of respect, inquiry, logic, and evidence. Try taking a step back and a deep breath, then go looking for evidence to support your position. Work from a position of facts, and keep the name-calling under your hat.