Chester “Trip” Buckenmaier III, MD,
COL (ret.), MC, USA

For many, including myself, the political upheaval that has characterized the 2016 campaign and election has been unsettling. Nevertheless, as I write this, we are poised for another bloodless radical change in the American government power structure, a routine achievement that makes our constitutional democracy the envy of the world. I understand the singular importance and significance of this quadrennial change in leadership, and I am proud to count myself among the protectors and defenders of the Constitution that gives rise to this feat of government magic.

Perhaps it is one of the unique attributes of being an American in that you can love and defend the constitutional system with your labors—some with their lives—but not necessarily agree with what that system engenders in either politicians or policy. Even more incredible is that the same Constitution that brings about these political changes protects the individual citizen’s right to protest those changes without fear of reprisal, possibly bringing about favorable change (to that individual’s way of thinking) during the next peaceful exchange of political power. As a student of human nature and history, I find these facts about our society baffling, when viewed through the egocentric and tyrannical lens of the human saga through time, and incredibly fortuitous if you are blessed to call yourself an American today. 

So with that settled, I would like to exercise my First Amendment right to express my concerns over recent congressional actions regarding the Affordable Care Act (colloquially known as Obamacare). Readers of this column will recall that I first commented on Obamacare in a November 2013 editorial1 as I sat in a hospital waiting room while my middle daughter underwent major surgery. Obamacare was new at the time and promised healthcare coverage for an additional 20 million Americans. Since unpaid medical bills are the No. 1 cause of bankruptcies in the United States, I could easily empathize with those going through the same emotional trauma of having a sick child and not having healthcare insurance.

Back in 2013, I could not have predicted (or hardly imagined) the political storms of 2016 or how Obamacare would become a right-wing example of excessive government regulation, as opposed to a plan for getting many uninsured Americans health insurance. So what happened with Obamacare during the past three years to engender such zeal by the current Congress to repeal the law as a first priority with the new administration?

There were plenty of missteps following the enactment of Obamacare into law, with the disastrous Affordable Care Act sign-up website being one of the most visible. To state the Obama administration botched this vital program element would be a classic understatement, and this error certainly did not inspire confidence in the American public or Congress to the new plan. Notwithstanding this miserable start, the fact today is that fewer than 9% of Americans remain uninsured, and an estimated 20 million Americans now have health insurance because of the law. Even more encouraging is that the slope of healthcare cost increases has been at a slower rate since establishment of the program than at any similar time period since 1959, when records of this type started to be collected.2

To be clear, I am not suggesting that Obamacare is an unqualified success. It is not. Premiums for many Americans have increased significantly, and many more are not satisfied with the plans they can afford. Then again, to label Obamacare a miserable failure is disingenuous and just plain wrong. 

I would imagine when Ecclesiastes 9:4 was first penned, most dogs from that ancient era would have been seen as odious scavengers living off of the dregs of human society, not the family members they have evolved into today. I am not insensitive to the opinions of many American’s that Obamacare is akin to “feral dog” of a government program, and we deserve a proverbial “majestic lion” of a healthcare insurance system for our population. I have always maintained that healthcare is a fundamental human right and it is the responsibility of any enlightened and responsible government to extend this right to all citizens in the modern era. Clearly, we have already decided to provide healthcare to all of our citizens since people in the United States, regardless of their insurance status, are not left in the streets to die from disease or trauma. So to my way of thinking, we already have a socialized system of medicine in America. It is just terribly expensive and inefficient. Now we are just trying to figure out how to pay for it.

Obamacare, for all its faults, is a tentative step in the right direction toward providing a standard of healthcare coverage for all Americans. As I write this, Congress is busy repealing Obamacare, with no clearly stated plan to replace this coverage. Perhaps Obamacare is a “dog” of a piece of legislation, but it is a live and working law that benefits millions of Americans. If there is a more sexy “lion” piece of legislation to replace Obamacare, I am all for it, but I would prefer we keep the dog around until the lion actually shows up. 


  1. Fixing healthcare and fixing the economy are two sides of the same coin. US Medicine. November 2013, Editor-in-Chief.
  2.  http://obamacarefacts.com/2016/12/19/obamacare-white-house-report-december-2016/. Accessed 18 January 2017.