Obama and Pelosi: We’ve found out what’s in Obamacare, alas.
By Matthew Continetti
"With Obama-care entrenched, Democrats feel free to gripe,” read the headline in Politico.
And gripe is the word. Senator Maria Cantwell of Washington gripes that
the administration won’t subsidize Americans “just above the poverty
level.” Senator Bill Nelson of Florida gripes that the administration
“negotiated away” funding for insurance co-ops. Senator Ben Cardin of
Maryland gripes that Obama-care doesn’t address the national crisis in
pediatric dentistry.
Some Democrats are doing more than gripe, though. They are trying to change the law. Politico
says that senators Amy Klobuchar and Al Franken of Minnesota, Bob Casey
of Pennsylvania, and Joe Donnelly of Indiana have joined forces with
Republicans to sponsor the repeal of Obama-care’s medical device tax. In
the House, 24 Democrats have cosponsored a similar bill. And 10 House
Democrats have joined another Republican bill that would repeal
Obama-care’s Independent Payment Advisory Board.
This comes after 76 Democratic representatives and 41
Democratic senators voted in 2011 to repeal Obama-care’s onerous 1099
reporting requirements (a repeal President Obama signed into law). And
after 172 Democratic representatives and all but three Democratic
senators, as part of January’s deal to avert the fiscal cliff, voted to
repeal Obama-care’s long-term insurance program, the so-called CLASS
Act. Invented by Ted Kennedy, the CLASS Act was an unworkable and costly
Ponzi scheme. Which, come to think of it, is a pretty fair description
of Obama-care. Just don’t expect the law as a whole to suffer the same
fate—at least as long as Obama is president.
Still, Democrats are becoming disillusioned at the law’s
failure to achieve its ideal of quality health care for every American
that doesn’t add to the deficit, reduces medical spending, and promises
employees the right to stay on the company plan.
And so they’re trying
to clean up the mess they’ve made.
For decades, critics of the American health care system
have identified two major flaws in its design. First, there is the
problem of universality. Not everyone has health insurance. This creates
a “free rider” issue: Americans without health insurance end up in
emergency rooms, and the rest of us pick up the tab. It also offends our
sense of equity and compassion.
Second, there is the problem of affordability. The amount
of money America spends on health insurance far exceeds the amount spent
by other postindustrial nations. Americans pay through their noses for
health care. One 2009 study, by President Obama’s Council of Economic
Advisers, suggested that increases in employer health premiums have
crowded out wage growth, leaving us poorer. Meanwhile, government
spending on Medicare and Medicaid is behind our exploding long-term
debt.
The Affordable Care Act was sold as a way to solve both
problems. What it really does, though, is extend, sloppily and
expensively, a right to health insurance to all. It’s a law that deals
with the universality problem, not the spending problem. The
cost-cutting measures it does contain are mainly experiments that will
take years to evaluate. Yes, the rate of growth in health care costs has
remained stable for the last three years. But that is more likely the
result of the recession, and of experiments in private networks, which
began before Obama-care. Most of Obama-care has yet to take effect. The
problem of rising health costs remains.
And liberals are noticing. In January, David Goldhill, a
Democratic business executive, published a book-length treatment of
American health care that concludes, “Nothing in the [Affordable Care
Act] changes the fundamental incentives that have so warped our health
care system.” In late February, CNN pundit and Democratic strategist
Donna Brazile tweeted: “Just got off the phone with my health care
provider asking them to explain why my premium jumped up. No good
answer!” Later that month, journalist Steven Brill published an article
in Time magazine investigating the high price of health care and criticizing the Affordable Care Act.
Expect the grumbling to become more pronounced as the
administration struggles to implement Obama-care. The 2014 deadline for
the individual mandate and state- and federal-based health insurance
exchanges is looming, and there is no guarantee the government will meet
it. We may be better off if it doesn’t. What might happen, for
instance, if universal coverage is not achieved despite the mandate?
What might happen if employers slough employees off to the exchanges? If
costs rise as demand increases? Imagine what Donna Brazile will be
tweeting then.
Unless conservatives and Republicans offer their own solutions to the
twin problems of universality and affordability—solutions that begin a
long process of introducing real price discovery and consumer choice
into health care—liberals and Democrats will use Obama-care’s flaws as
the basis for additional government intervention. They will double down
on the flawed insurance model. Their inability to realize unrealizable
ideals through politics will provoke . . . well, more politics.
Liberal griping will give way to liberal law-making. You’ve been warned.
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