Obamacare

Well, we’re back from vacation and we spent our break playing a lot of roleplaying games and if there is one thing we have learned it is that every party needs a good healer. That is true whether you are a Level 1 Warrior or a Level 17 Civil-Engineer. However, the US Senate is looking to repeal Obamacare, aka the Affordable Care Act. So, seeing as we are back from break -with fuzzy heads and lingering colds- we thought now would be a good time to explore this keystone healer act in detail. Is it “Good?” Is it “Evil?” Or is it just “Lawful Neutral?”

Wand of Lesser Health Care
In order to explain Obamacare we need to take a look at what came in ages past. In those days of yesteryear, -2010- 1 in 6 Americans did not have health insurance. That is about 50 million uninsured people, and if they broke a leg or got deathly sick their only option was the Emergency Room and high medical bills. When these bills couldn’t be paid the costs usually got deferred by hospitals by passing it on to those of us with health insurance. That is one of the reasons why the amount we spend per person on health insurance, $8,745 -according to the Organization for Economic Co-operation and Development – is at least $4,000 more than the per-capita expenditures in countries like Australia, Canada, France, Germany, Japan, and the UK.

Before Obamacare, health insurance premiums were rising at about 10% per year. In comparison, the housing market in New York City increased by 20% between the beginning of 2001 and the end of 2010. That is about 2% on average a year, but it doesn’t stop there. Health premiums were even higher if you had a pre-existing condition, such as cancer or being a woman. In fact, the number one cause of bankruptcy in the United States was because of medical expenses. Over 75% of people declaring bankruptcy for medical bills had insurance, and -on top of all that- you could be kicked off your health insurance plan if you were sick, which sounds… absurd. An insurance company used to be able to kick you off for getting sick… you know the very thing you paid them to help you with. That would be like a Rogue who refused to disarm traps. It’s your damn job, Todd. If you didn’t want to deal with traps you shouldn’t have chosen to be the Rogue. Children were also kicked off their parent’s health insurance by the age of 24 or younger depending on individual health plans.

Since taking affect in 2010, Obamacare has righted some of these wrongs. Children can now stay on their parent’s health insurance until the age of 26. You cannot have your health insurance plan cancelled if you get sick. You cannot be charged more if you are a woman or have a pre-exisitng condition. You cannot now be denied health insurance because of a pre-existing condition. Birth control is now covered under insurance for women. 20 million people now have health insurance who were not able to get it before. There is also evidence to suggest that health care premiums have risen slower under Obamacare then they would have otherwise. These are all objectively good things -and it is worth remembering that- but Obamacare is not perfect.

In the Eye of the CL13 Beholder
In August 2008, 82% of Americans were dissatisfied with their health insurance and were looking for an overhaul of the system. yet, in 2016 people who overwhelmingly wanted Obamacare gone voted for Trump. In fact, 74% of Republicans want the Affordable Care Act repealed, but why?… Here is where it gets more complicated than memorizing all your Level 16 Wizard Spells. The numbers and benefits of Obamacare get a little murky when you start to look at them through the eyes of the average American. It is legitimately debatable if the ACA has benefited or hurt middle of the road Americans.

About 12.7 million people are now buying health insurance through State marketplaces or Healthcare.gov. More than half of all Americans still get their insurance through work. About a third of Americans are on Medicare or Medicaid. The rest are still uninsured. Overall, only about 4% of Americans are on the Obamacare exchanges, and in the past year their Obamacare premiums rose 22%. Yet, subsidies also rose, meaning that most people getting health insurance through the ACA will not have to shoulder the full cost of that hike in 2017. Unfortunately, those subsidies come from somewhere, and that is the taxpayer. Now there are indications that those healthcare premiums are lower than they would have been without Obamacare, but that has been disputed by conservative analyzers.

This whole debacle shows the weaknesses of Obamacare, like the soft underbelly of a mountain troll. Taxes have increased thanks to the ACA, but mostly for higher wage earners and the healthcare industry. Those along with the new mandates that force health insurance to cover sick people -we know its an odd thing- do mean that some costs have filtered down to middle-income and lower-income consumers and business owners. The paperwork has also become more complicated, especially in regards to the Individual Mandate, filing for exemptions, and filling out tax forms. More to the point, because of mandatory insurance laws for businesses some employers have cut workers’ hours so as to avoid giving them health insurance. For those people who are getting bare-minimum health insurance through their employers, they do not qualify for the marketplace, even though they could get better coverage there. Similarly, there is a not-so-insignificant population of Americans who do not qualify for healthcare subsidies, but who are still forced to purchase healthcare on the exchange at the higher price… And yes, under Obamacare, some people had to give up their doctors.

Rolling a Perception Check
So, in the end what does this all amount to? Every year America shells out a Dragon’s hoard of money to the insurance industry and Obamacare has not changed that very much. Even President Obama has admitted that. The law is not perfect and in need of fixing. The ACA has failed to insure all Americans, as only about one-third of eligible Americans are actually enrolled. It has failed to reduce healthcare premiums in any significant way or curb outrageous pharmaceutical and medical costs. Lastly, taxpayers -mostly high-wage-earners- subsidizes about $6,000 per formerly uninsured person. However, we ask that you don’t label it as a failed system just yet.

Part of the flaws of Obamacare came because it was a compromise law between Republicans and Democrats. It was not a single-health payer system, but it was also not an entirely free-market solution. It was a potion of lesser health, which only restores about 1d8+1 hit points. Strengthening certain aspects of the law can make it more effective in combating high costs and premium increases. It can also go farther to offer protections for low and middle-income households. Unfortunately, that all requires rational thought and debate, which is something so rare as to almost be Legendary in the US Congress these days. Donald Trump, our Orc-War-Chief-Elect and his clan of Republicans have made a career of calling for the appeal of Obamacare, no “ifs” “ands,” or “buts.” This “baby with the bath-water” solution fails to recognize the good of Obamacare. Instead of tearing it down we should all be working to improve it going forward, because it is not an entirely failed system.

You see, if there is one real benefit from Obamacare, it is that the law has changed our conversation. It is no longer about: “whether every American deserves healthcare,” but instead is about: “how do we make sure every American can have healthcare.” Women, pre-existing conditions, young adults, and low-income earners now all have a rhetorical and agreed upon right to be insured in our national conversation. We just need to figure out a better way to improve on what already exists, keeping the positive mandates while doing away with the bad ones. The Affordable Care Act is not the end goal that Democrats hoped it would be, but at least it was a step in the right direction. So maybe we should all calm down, ignore the propaganda of both sides; and think of the ACA as the first level on a long road to something better… Maybe even a Prestige Class.

*Disclaimer: A lot of this has been a simplification of our health insurance policies, and we apologize if we have made it too simplistic, as health insurance is a radically dense and labyrinthine subject matter. It is filled with pits, dungeon bosses, and a fair share of traps… which Todd refuses to disarm. Nat died because of you, Todd. He died.

GM: Welcome. Most other networks and news outlets are concerned with how the political candidates fair in debate or at town hall meetings, but here we don’t care about any of that. At the NYRD we believe that there is only one true test of leadership and teamwork, and that is why we have asked the top 5 presidential hopefuls -and Jeb Bush- here to play a rousing game of Dungeons and Dragons. Now, let’s meet our adventuring party. Please introduce yourself and tell use something about the character you created.

TRUMP: I think I will go first. I have made a great character, absolutely the best and most creative here. I’m a financial wizard so I figured let’s make it official and just become an actual wizard. I’m human, because of course I am, look at me. My character’s name is Trump the Best, which is a very imaginative name. I don’t know where I come up with these things. I am also the richest character here. What can I say, I like the gold.

CRUZ: I think I am going to go next. Now, I respect the Wizard Trump…

TRUMP: He’s the best…

CRUZ: I respect him, but we all know that wizards are pagans. I am a God-fearing citizen and that is why I chose to play a priest today. I like the sound of that. I am also a 6’5″ human male that weighs a strapping 200 pounds. My character, Father Thor Cruz, is very muscular, just like ripped all the way down his stomach. He has great hair and a chiseled attractive jawline. All the women of the surrounding villages want to be with him, but of course he is devoted to the Lord and does not partake in the pleasures of the flesh.

GM: Senator, I can’t read your handwriting. What god is your character worshiping?

CRUZ: Why the Lord Jesus Christ, of course.

GM: Because it looks like you wrote Lesus.

CRUZ: I didn’t. I wrote Jesus.

GM: There is no Christianity in the world of Dungeons and Dragons.

CRUZ: Not yet. That is all the more reason why the work of Father Thor Cruz is needed in this heathen world.

GM: Fine… but I’m writing your god down as Lesus.

CARSON: I’m going to go next.

GM: Oh, I’m sorry Dr. Carson. I thought you were asleep over there.

CARSON: No, just resting my eyes. I want to roll the dice and buy some property.

GM: No, Dr. Carson, this is not Monopoly. Just tell us what you wrote down on the character sheet in front of you, please.

CARSON: Oh, of course. I am a human rogue, because everyone knows how good I am with knives. We all know the story of the time I stabbed someone. If you do not believe it, you may ask my mother. It also says here that my name is Dr. Benjamin son of Car, because he is also a trained doctor. He’s very skilled at things like doctoring and foreign policy.

GM: Dr. Carson, you put none of your skill points into healing? How are you claiming your character is also a trained a doctor?

CARSON: Oh you know. He’s just very good with people. Now before we start I need some of those letter tiles that we all get.

GM: Again, Dr. Carson, this is Dungeons and Dragons, not Scrabble… oh forget it. Governor Bush, please go next… Governor?

BUSH: Oh, yeah, sure. I am a human bard. My name is Turtle.

GM: Is that it? You don’t want to make some kind of profound or borderline narcissistic statement?

BUSH: No, I’m good.

GM: Okay. It is also worth pointing out that the game so far consists of four human males, but I guess no one should really be surprised by that. However that will change as we move across the table to our two remaining players. Secretary Clinton, would you like to start and bring some gender diversity to the group?

CLINTON: Actually I chose to make my character a male human as well.

GM: …Why?

CLINTON: I did a survey on Twitter and most of my supporters put more faith in the reliability and leadership of male fantasy characters like Harry Plotter or that man from Lord of the Ring, uh… Viggo something. See, people like to think that I’m not hip and “with” the times, but I also enjoy popular entertainment, just like the youths of today.

GM: Wouldn’t it be better if you played a strong female fantasy character, like Hermoine or Lady Galadriel?

CLINTON: You’re right, but do you think that would play well in Middle America?

GM: I don’t think anything we are doing here today is going to play well in Middle America.

CLINTON: Oh what the heck. I am a female, and I am proud that I am can be chosen as your first female adventurer on this party. In fact, I am going to Tweet this out, but if people disagree can I change my character’s gender later?

CRUZ: You cannot change the gender of your character once the game starts. The Lord made you a man or a woman and that is his will. To change your gender after the game has begun is to defy that holy will…

GM: …I would need to check the core rulebook…

CRUZ: The only core rulebook any of us need is the Bible.

GM: And I just realized I don’t actually care… Secretary Clinton, what is your class?

CLINTON: According to Facebook, I am a human barbarian named Clintina of the Hill.

GM: My head hurts all of a sudden. Senator Sanders, what is your name.

SANDERS: I’m Bernie.

GM: No Senator, what is the name you wrote on your character sheet?

SANDERS: Don’t patronize. I’m not an old man you know. My character’s name is Bernie. He’s a ranger and a damn good one too. I am also Elvis.

GM: I think you mean to say that you are also an elf.

SANDERS: Oh, is that what that says. I don’t have the right glasses on. I thought it was odd that I got to pick to be Elvis, not that I minded. You know I loved his music growing up as a poor kid in Brooklyn. I used to sit in my room at night…

GM: …Moving on… All six of you find yourself sitting in a tavern known as the Plow and Pundit. It is located in the center of a village called Washing Town, DC. The smells and noises are almost overwhelming, stale liquor with the earthy scent of soil and a long day’s work. People would normally be drinking, laughing, and celebrating the end of the harvest season, but you all notice that tonight is a melancholy one. There has been a murder in town, the beloved mayor, Lord Barry the Just, has died under mysterious circumstances. The powers that sent you to this town believe that foul play is afoot and have tasked you with solving the mystery surrounding the death of Lord Barry.

TRUMP: Let me just stop you right there. Are there any mosques located in this town? I bet it was terrorism. Boom, I’m a genius. I win this game.

GM: No one person wins Dungeons and Dragons. You need to play as a group… And there are no mosques in the city…. That’s unnecessarily racist and inflammatory.

CARSON: I bet the murder was committed by Colonel Mustard.

GM: Dr. Carson, we are not playing Clue.

SANDERS: Tell me this, what are the economic policies of Washing Town? Is there a large gap between the wealthy land owners and the minimum wage earners? What does the stable boy make an hour? What’s going on here?

GM: That’s almost a good question, Senator. What you all know is that Washing Town is a farming community and there is a large social disconnect from those in power and the men and women who live in the village itself. Washing Town is run by the Lord Mayor who is the wealthiest land owner. In fact, in order to even be elected as mayor it almost unnervingly traditional that you be the one with the most money and the most backing of the other rich land owners and special interest groups.

TRUMP: Boom. I’m the new mayor. Trump the Best is by far the best wizard and the richest man in this little crappy village. I mean come on. Who else would it be?

GM: Mr. Trump, you currently have 30 gold. That does not make you the richest man.

TRUMP: Do you know how much gold is actually worth?

CLINTON: Who do all the people think committed the murder. I bet it’s going to be just like the time Darth Vader killed Benjamin Kenobi in Star Wars.

GM: That is an oddly out of context reference, but actually a good question, Secretary Clinton. You can roll your dice to make a Gather Information check to spend an hour to talk to the people around town and get their impression of the situation, but I should tell you that as a barbarian you do not have the best of Charisma…

CLINTON: Oh, what else can I do as a barbarian?

GM: You are mostly a fighter. You have a rage ability that let’s you gain extra strength and hit points in battle when you get angry.

CLINTON: Oh, I never get angry, unless other people think it is appropriate that I do so.

GM: Rage just one of the barbarian’s abilities. It doesn’t mean you have to be angry…

CLINTON: Can we change the name of it to Restrained and Appropriate Anger. Rage sounds like it would not play well on the East coast.

GM: …

CLINTON: But I am still going to poll the people about what is going on. <Rolls  a d20> I got a 14. Is that good?

GM: It’s good enough.

CLINTON: Good, because I also want to ask the people if they feel as if they can trust me and what would help them see me as more trustworthy.

GM: Clintina of the Hill wanders off and starts talking with people around the tavern, asking them information on the death of Lord Barry and also if they think they can trust her and what she can do make them trust her more. That will take an hour, so what is everyone else doing during that time. Governor Bush?

BUSH: I’m a bard, so I have a guitar or something, right?

GM: Yes.

BUSH: I just want to sit there and pluck at it.

GM: Okay, so the Governor is fiddling as Rome burns around him.

BUSH: (Shrugs)

SANDERS: I go up and talk with the woman waiting on tables.

GM (Bar Wench): Hello sir, what can I get you, roast mutton, honey mead?

SANDERS: “Noble waitress. I am Bernie son of Eli, and I want to ask you about how much money you make by working here?”

GM (Bar Wench): “Uhh… The owner let’s me take a loaf of the day old bread with a little gravy every night.”

SANDERS: “That is outrageous. Simply outrageous. What about healthcare and pension benefits?”

GM (Bar Wench): “I got sick once with the black cough and I got to leave for an hour to go see the local healer, but Mr. Dorrsman only gave me a half of loaf for the day.”

SANDERS: This truly astounding. It’s like we’re living in medieval times.

GM: Well…

SANDERS: I turn to address everyone else sitting in the tavern. “Noble people,” I say. “Noble people you toil and work in the fields and the shops and the taverns of this town every day and what do you get for it? A half a loaf of bread and a bit of gravy? This is unacceptable. The minimum wage of everyone in this town needs to be raised. How can people expect to raise a family on a single loaf of bread and a bit of gravy. It should be two loaves and a slab of lamb. 99% of you are breaking your backs and are starving, while 1% gets to keep all the gold and lamb meat for themselves. This is not how societies are meant to work and this is not how it will work as long as Bernie the Ranger is in town.”

GM: …Uhhh, roll your Diplomacy, I guess.

SANDERS: Where is this dice thing? <Rolls the D20> What does it say. I can’t see it.

GM: You rolled a 16 with an additional bonus of 3 from you Diplomacy skill makes it a 19. As you talk to the crowd more and more people begin to listen to what you are saying. Some even begin cheering and shouting in agreement.

TRUMP: This is stupid. This whole thing is stupid. I want to turn to the crowd and say, “Listen. Some people are just rich and successful because they are better than other people. I mean look at me. I started out with practically nothing. My millionaire father did very little to help me get where I am today, very little. Now look at me. I’m a successful wizard with gold in his pocket.”

GM: Roll your Bluff.

TRUMP: Why?

GM: I am pretty sure most of what you just said was a lie.

TRUMP: <rolls the D20> Bang, I got a 4.

GM: You failed the roll.

TRUMP: Isn’t this like golf? Incidentally, I own a lot of golf courses.

GM: The crowd starts to get angry at Trump the Best. They look ready to take their rage out on you, Mr. Trump, and the rest of your group.

TRUMP: “Listen, all I’m saying is that I’m better than you all and you need people like that. I mean think about it. Without people like me who’d protect you from…” What are things that happen in this little make-believe world of yours?

CLINTON: Oh, I know this because I know how to connect with the young voters. It’s Christopher Lee and that big eyeball.

TRUMP: “Right who would protect you rabble of peasants from the Christopher Lees of the world and floating eyeballs and those green guys with the axes…”

GM: Orcs?

TRUMP: “Yeah Orca. Orca are your real problem here, not the rich. Aren’t you tired of Orca coming in a stealing your money and taking your jobs? They’re the real enemy. They’re the real people you should be mad at. I bet they were the ones that killed this mayor fellow of yours. I say we round up all the Orca we can find and ship them back to Orc Mexico or where ever it is they come from.” There and I’ll roll again. <Rolls a d20>

GM: You got a 20. That’s a critical success.

TRUMP: See, the only reason I rolled so low in the first place was because you never explained that this game wasn’t like golf.

GM: Part of the the crowd begins to nod and cheer at what you’re saying, and many of them start to break bottles and look for weapons.

TRUMP: Now these are some smart villagers, that’s what I say. I tell them, “Now you should go find some Orca and we’ll deport them back to where they came from.”

GM: Half of the crowd exits the tavern in a frenzy of shouting and cursing, looking more like a lynch mob than a thoughtful party of engaged citizens.

TRUMP: There. Problem solved. I win again.

GM: The small remainder of the crowd is still standing by Bernie the Elf talking about starting a parchment-writing campaign to get the minimum wage of the village raised.

CRUZ: Now this is all well and good, but I think we are losing the essence of why it is we came here.

GM: I can’t believe I am saying this, but you are right, Senator Cruz.

CRUZ: We need to teach the people of this village good Godly values, and Father Thor Cruz is just the one to do it, what with his large biceps and rugged good looks.

CARSON: Maybe we should, like examine the body of the dead man. I am a doctor, you know. I can pull those pieces out of him without touching the sides.

GM: That’s Operation, and I have to believe you’re doing this on purpose now? You can’t possibly be this unaware of how things work by this point in the game?

CARSON: I have been coming in and out, but I say never underestimate a person. That is why I am going to go find the body of the dead mayor and perform an autopsy.

GM: Once again, Dr. Carson, I feel the need to remind you that your character has no points in any skills that come close to being useful for doing anything like that.

CARSON: It’s fine. I have my knives.

GM: Is anyone else going to go with Dr. Benjamin son of Car?

SANDERS: I want to stay here and help the townspeople organize a petition to invoke some real economic change in their lives.

GM: Okay… Mr. Trump, Senator Cruz, Governor Bush?

TRUMP: Sure it might be worth a laugh.

CRUZ: I would like to go out into the town and perform some missionary work as well as see if any of the ladies would like to commune with Father Thor Cruz.

GM: I thought you said your priest was celibate?

CRUZ: I am and it drives the ladies wild, just like my toned and tanned buttocks.

GM: Governor Bush?

BUSH: I guess.

GM: Governor, I need to ask, do you even want to be here? It kind of seems like your not even trying? In fact, for the majority of the time most of us have barely even registered that you’re here at all. I think you need to ask yourself, “Is doing this really what you want from life?”

BUSH: I mean, sure I want to be here. My father and brother said I should try and I definitely like the idea of being in the game, but you know I never thought about it like that before… Is this really what I want to be doing? I mean playing this game is hard, and if I were to be honest I am only doing it because it seems like a family tradition, but I don’t know… I think I am going to wander off and spend some time alone to think. <Gets up from the table.>

GM: Okay, Turtle the Bard wanders out of the tavern to find a quiet place to think and Governor Bush has walked out of the room…

CLINTON (from the next room): Can I go see the body too?

GM: No, you are still gathering information.

CLINTON (from the next room): Can I meet them there when I’m done?

GM: Fine. Whatever, and what are you doing in our kitchen?

CLINTON (from the next room): According to a survey on BuzzFeed you need snacks when you play these sorts of games. I am getting a bag of Doritos and a bottle of something called Sierra Mist. Does anyone else want any?

GM: Secretary Clinton please come and sit down… and bring in the Doritos.

CLINTON: <She takes her seat.> Well  I think we are having a good and a suitably humanizing time.


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