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The Affordable Care Act


I’m currently in a class called Leaders and Leadership. one this semester’s classes. It doesn’t have a direct link to my concentration within SAIS’ International Relations program, but it’s a topic I love and I decided taking it would be a small gift to myself.

This week we talked leadership through the lens of the recently-enacted Affordable Care Act. Whether you like the bill or the president, Obama’s leadership in bringing this to fruition cannot be denied. If the essence of leadership is bringing people to a place to which they are not themselves ready to go, he did it. Through explanation, patience, yelling (probably), compromise, and all the other tactics it takes to win people to one’s side.

​Obviously there were plenty he did not need to convince and some he never would regardless of how much time he spent on it. But it was the people in the middle – and the wider public – that he focused on doggedly. The former he won. The latter is more of a mixed bag thanks to the sensationalized disinformation campaigns out there about death panels and government takeover of the medical industry. But he never wavered and went to incredible lengths to openly and transparently explore one of the most complicated sectors of our economy. Television interviews. Public speeches. Televised working groups. Consultations. He and his team never stopped. And now they’ve passed once-in-a-lifetime legislation because of it.

As a personal note, I’m all for the kinds of reforms the bill implements. I think it’s a bit of a Trojan horse, implementing health care policy disguised as market mechanisms, but it’s about as close as you can get to such a workable solution. While I am not fully on board with taxing people as a consequence of not carrying insurance, I understand the role it plays in keeping the structure in tact. And I believe the tradeoff is worth it if it expands health care to those who need it most. Being one medical incident away from near permanent financial ruin is not something with which we should be content in this country. Nor should we blindly accept that some people are just supposed to “lose” in an economic model like ours, especially when their numbers are growing as rapidly as they have been in modern times. It’s unacceptable.

As this episode played out over the last year plus, I’ve examined the two windows in my life in which I did not have medical insurance coverage, because I didn’t think I needed it and because I didn’t have the money for it. In one of them, I was running around a foreign country where hazardous risks were more prevalent. Not my smartest move, and had a few things gone one or two degrees in a different direction, who knows what kind of condition I’d be in, physically and financially. This legislation doesn’t solve everything but it certainly is the biggest and best step taken to try and move in that direction. And it saw the light of day because of leadership.

I’m likely signing off for the remainder of the semester. It’s kicking my ass and leaving little time for much else.

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