Daniel Henninger writes at the WSJ:
A political idea, once it becomes a national program, achieves legitimacy with the public. Over time, that legitimacy deepens. So it has been with the idea of national social insurance.
While I recognize that as the fear of ObamaCare’s opponents and the hope of its supporters, I don’t think it’s completely correct. Social programs retain popular support as long as the people receiving the benefits don’t need to pay for them. That’s ObamaCare’s great weakness. It depends on people who won’t receive benefits paying for them anyway.
Nonetheless I agree with Mr. Henninger’s prescription:
The odds of ObamaCare’s eventual self-collapse look stronger every day. After that happens, then what? Try truly universal health insurance? Not bloody likely if the aghast U.S. public has any say.
Enacted with zero Republican votes, ObamaCare is the solely owned creation of the Democrats’ belief in their own limitless powers to fashion goodness out of legislated entitlements. Sometimes social experiments go wrong. In the end, the only one who supported Frankenstein was Dr. Frankenstein. The Democrats in 2014 should by all means be asked relentlessly to defend their monster.
Republicans and conservatives, instead of tilting at the defunding windmill, should be working now to present the American people with the policy ideas that will emerge inevitably when ObamaCare’s declines. The system of private insurance exchanges being adopted by the likes of Walgreens suggests a parallel alternative to ObamaCare may be happening already.
If Republicans feel they must “do something” now, they could get behind Sen. David Vitter’s measure to force Congress to enter the burning ObamaCare castle along with the rest of the American people. Come 2017, they can repeal the ruins.
I don’t oppose ObamaCare; I am merely concerned about it. My concern is that it is not healthcare reform, merely a system of subsidies for healthcare insurance. The healthcare system remains desperately in need of reform and I worry that ObamaCare postpones that reform rather than facilitating it. Time will tell. Sadly, policy-making by crisis, a very flawed process, looks more likely now rather than less so.
Reasoned comments from Daniel Henninger, as well as the follow-up analysis. By Dave.
I also am in total agreement that congressional elites and their staffs join the public in experiencing Obamacare personally.
Perhaps I have misinterpreted certain comments here in the past. But my impression is that the notion is to muddle through the crisis this policy presents and everything will work out. Balls.
You all know what I do. 20 years. I’ve seen umpteen attempts to justify and make work ill informed or constructed policy decisions. It never works. Better to scrap it and cut your losses. A bitter pill, but the right decision. A view based on 20 years of being in the firing line of making good and bad policy decisions. (Heh. Compared with Obama’s several years of voting present and 5 of being in over his head in the big chair.)
These are just the rationalizations of incompetent executives who fucked it all up and now want to cover their tracks. And so is ObamaCare. The Keystone Cops could hardly do worse.
Its ill conceived, its legislatively illegitimate, its financially and managerially unsound, and morally bankrupt. Its classic government.
I don’t agree with shutting down the government, although I think the whole argument is a political charade – we could fund everything but, but the Dems will tether government with ObamaCare. But that’s just politics.
Is there anyone here who can give me an argument as to why the unions and big labor are exempted from ObamaCare, other than the obvious: to make this work, screw Joe Average and protect my voting constituencies?
“Is there anyone here who can give me an argument as to why the unions and big labor are exempted from ObamaCare”.
I don’t understand you. The unions are pissed because they are exempted from the ACA, that is, they are pissed because their high-priced insurance is not eligible for subsidies under the law.
I would have thought you would be OK with that ruling.
Am I missing something? Like a long list of social programs that went away? Like a list of things which once moved into the “government” basket were later transferred back to the “deal with it yourself and screw you” basket?
I’m not getting it. All government programs are paid for by taxpayers. Of course it’s true that sometimes those taxpayers are future taxpayers, but okay, so?
You act as if Obamacare is chiseled into stone and adjustments for future needs are simply impossible. We’ve changed SS and Medicare repeatedly. That’s how they remained popular. We’ll do the same with Obamacare.
Yes, many programs have gone away over the years. Here’s some examples: the WPA, the CWA, the CCC, NRA, PWA, AFDC, long-term care insurance.
Yeah, but that program never got off the ground. It was passed as Title VII of the ACA, but they could never figure out to make it work. Secretary Sebellius told Congress she wouldn’t set up the program because she could not see any way to make it sustainable. I’m not sure it’s a candidate for social programs that have gone to the wall. This one didn’t even get out of the box.
That’s a different long-term care insurance program than the one I was thinking of which is the one that was enacted and abolished during the Reagan Administration.
Hmmm. Editorial license, huh? I was speaking of long-term care insurance.
So was I.
BTW, can anyone think of modifications to the Social Security Title II program from its basic New Deal structure? I can’t think of much other than COLAs and rate increases. That doesn’t really support the idea that ObamaCare will reform the healthcare system via its constant evolution.
Your examples are depression era stuff? What’s the relevance of that?
In this fantasy world where Obamacare simply collapses or disappears or is defunded, what then?
Do you believe we’ll suddenly un-insure people who gained coverage under Obamacare? So the working poor, the older children, the people with pre-existing conditions, they’re all just going to do what exactly?
Walk through what would happen — realistically, in the actual world not in the Fox News parallel reality — and you begin to see what a ridiculous fantasy this is. It’s not going to happen. We are not going back to status quo ante.
Which means whatever would follow the GOP’s successful prayers would be more government. Obamacare is the least government-run health care we will ever see. (Probably why Red’s much-missed Mitt Romney helped to invent it.) From here on in, it goes more government, not less. If you disagree, show me how that happens in the actual political world as it might realistically exist in 3 years. “I’m running on a platform of stripping away your 22 year-old daughter’s health insurance?”
And Dave, have you noticed that the much-maligned CBO projections were actually overly pessimistic in 94% of states? Isn’t that a reason to suspect that this may actually push costs down? Some of the plans are actually cheaper than just the employee contribution portion of employer-based plans.
You mean the Medicare Catastrophic Coverage Act? Yeah, I remember that now. Wealthy Medicare beneficiaries raised holy hell that there was to be a surtax on them to cover the costs. You’re right, the act was passed in 1988 and repealed in 1989. Vox (Subsidized )Populi, Vox Something (I guess).
Dave:
Funny how you went with SS and not Medicare, the more directly relevant example. Because of course you know Medicare has been played with.
As for SS, there’s SSI. I know what you’re going to say: that’s not really SS, it’s just administered through the SS administration. Irrelevant: people see it as part of SS. Then there’s the disabilities thing, ditto.
And, by the way, rate changes are not exactly minor adjustments unless septupling is minor. In addition, it’s gone from being a program meant to allow the elderly to scrape by for the one or two years they’d survive after retirement, to a system designed to buy condos in Florida for people who live 30 years in retirement. That’s a minor change? That’s a huge change.
Now you’re sputtering, Michael. One of the programs I mentioned was repealed in the 1990s, one in the 1980s. I named “a long list”. Perhaps you should be more specific in what you’re looking for.
We don’t enact new social programs very frequently so it’s hard to come up with recent programs that have been abolished.
Meanwhile, please identify how Social Security has changed repeatedly.
He’s sputtering a lot these days.
I think we’re posting past each other. I went into the dramatic changes in SS above. Can you shiw me a post-Obamacare scenario that goes anywhere besides deeper into government?
Thus thing is happening. It takes effect in a few days. It’s already had effects in Medicaid expansion and older kids. Soon a cohort of people who’ve not had insurance will. I don’t see how that gets rolled back.
Red:
Well, why don’t you take a stab at telling us just how you see things playing out in this “post-Obamacare” world you long for?
You guys are living in the past. You’re pining for 2006 when we talk real estate, and now you want/expect what, exactly? To see Obamacare repealed and replaced by. . . what? What that could actually happen in the actual world in which we actually live?
Give me the 3 or 5 or 10 step plan for what happens the day after Obamacare implodes, explodes, flops, whatever the fantasy is. As a guy who writes fantasy, I’m actually interested. So tell me your fantasy, Drew.
It could fail. The states under GOP control have been actively trying to sabotage the ACA. There will be a constant stream of bad news coming out of those states, hyped by sympathetic media. The states that want it to work got behind when it went to court. It will go smoothly in 10-15 states.
Would we be willing to take away insurance from people once they have it? Look at who would be getting that insurance. Mostly the poor and those with illnesses which make it impossible to afford insurance. There is no evidence that the GOP is especially interested in those groups. Someone keeps saying it is money, bombs and God. Well, the God group only cares about abortions and gay marriage. They wont object if it gets repealed. Money will campaign for it and bombs wants a bigger military. When the GOP takes back the White House (they cant keep finding candidates as bad as Romney and McCain forever) they will repeal it I think.
Steve
Steve:
That would be me. Money, Bombs and Jesus. Although I think those lines are being redrawn in the current low-grade civil war in the GOP.
I think the candidate sufficiently extreme that he’d call for throwing single mothers and their babies, blacks and Latinos and the self-employed and every 20 year old on his mom’s health insurance would be unlikely to win a general election. So I doubt whoever runs in 2016 will be dumb enough to put this front and center. It would put them on the side of the rich and the white, again.
The Democrats will hold more than 40 seats in the next Senate, by any calculation. So the GOP would have to take the White House, as well as the Senate. And then they’d have to decide what to actually do about health care. Because then they would hold actual power. And then. . . they would tiptoe away and start a nice easy war somewhere.
Neither side is really satisfied with the PPACA. Even those who defend it also admit that it is just a first step and I have no doubt that progressives would dump the PPACA in a heartbeat for single payer.
I think it’s unlikely that the PPACA will get “rolled back,” but there is more than one way to skin a cat. A program with so many moving parts can be “reformed” and “amended” into something completely different. If the GoP had half a brain they would do just that – undermine the law with little amendments.
Progressives, on the other hand, want to “build” on the PPACA but what they really want is to replace it with single payer.
So either way the PPACA as it currently exists will probably not be around for very long.
“If the GOP had half a brain they would do just that – undermine the law with little amendments.”
Or, rather than undermine it, they could fix it to work the way they want. They could expand HSAs and increase deductibles. They could expand competition across state lines. (They should do this soon so I can make a bundle before I retire.) They could do tort reform (LOL). They could do just about everything they claim will bring down costs. However, my prediction remains that if they get enough votes they will just repeal the whole thing. I think Michael is wrong. They really dont think they will be harming the people who vote for them.
Steve
A map of the “Suicide Caucus,” the GOP dead-enders. It could double as a map of poor rustic white folks.
http://dish.andrewsullivan.com/2013/09/27/who-the-suicide-caucus-represent/
That’s Drew’s GOP: hillbillies in hick towns he wouldn’t be caught dead in.
Drew lives in a “Suicide Caucus” district.
i>”They could do tort reform (LOL).”
The trial lawyers, who donate primarily to dems would have none of that!
I can’t tell how sarcastic you were, Steve, but prodding insurance company premiums into more competitive stances, along with supporting HSA implementation has long been championed by conservatives. True, nothing has resulted from any GOP brain trust towards real tangible HC reform. But, I don’t see where the other side of the aisle has been helpful in supporting a more free-market approach, either. What the progressives want is a nationalized health care system. Anything else is ridiculed and denied. Also, high deductibles (catastrophic health insurance) is something my family has opted for in order to contain our own costs.
BTW, HHS’s most recent insurance premium calculations has been touted as being below the CBO’s projections. On the surface that’s a positive story. However, those projections were in no way tied into people’s current premium costs. Furthermore, according to a recent WSJ article, both the CBO’s projections and the HHS’s numbers remain higher than what many currently pay for their insurance policies. These people will now be redirected (mandated) to higher premiums. This is especially true for the younger and healthier crowd — the ones who our government bestowed the financial mantle of making this health legislation viable. How high will the satisfaction quotient be when that happens? Conversely, how fiscally sound will this health program be if youth opts for paying a minimal tax (fee) for not joining an exchange, until a medical problem arises requiring them to do so?
Remember, the CBO’s projections relied on high participation rates of the younger population to produce their raw data. If young people don’t meet these high sign-up expectations, then it will render the CBO’s projections inaccurate, as well as those recent numbers issued by the HHS. And, as we all know, the CBO develops it’s financial projections on what it’s fed. If those figures prove to be pie-in-the-sky, then so will all these initial, hopeful rates being assembled by the government.
As for the slowing of medical costs, indicted by Kaiser’s analysis, it is really not known if such a decrease has been influenced by the enactment of the PPACA, or simply because of the unrelenting recessionary times we’ve experienced for 5 years.
The problem with the ACA is that it’s such a complex, convoluted mixture of laws, taxes and regulations, that was unilaterally passed by one party, and continues to be misunderstood and rejected by the majority in this country. It seems to be guided by a calculus based on untested projections, ideological hypothesis, and constant partisan posturing and bickering. How can something so wrongly instigated and brewed go right?
“Conversely, how fiscally sound will this health program be if youth opts for paying a minimal tax (fee) for not joining an exchange, until a medical problem arises requiring them to do so?”
They dont pay anything now. Limited windows for joining will help solve this. Again, the WSJ does not compare similar policies. You can buy policies that cover very little for next to nothing. No one disputes that. They can buy those cheap plans, then declare bankruptcy and we all pick up the costs when it doesnt cover their illness.
“But, I don’t see where the other side of the aisle has been helpful in supporting a more free-market approach, either. ”
It’s called trading. They could have gotten something if they had been willing to vote for the compromise. Was not happening. A lot of people who follow health care policy, left and right, liked the Wyden-Bennett plan. Guess what happened to the Democrat who supported this and to the Republican who supported this? Who got primaried?
Steve
“They dont pay anything now. Limited windows for joining will help solve this. “
My 26 year old son has his own high deductible catastrophic HC policy. Recently he received a letter from his insurance company saying that some of his current policy complied with the new Obamacare mandate, while portions did not…and, to contact them for more coverage details. His policy doesn’t come up for renewal until 4/14, so those details will have to be addressed at that time — the implication being that more coverage equalled more money.
I do think the devil will be in these yet-to-be-revealed details. I also project that most of these millenials will decide to go with the flow, and simply pay the smaller tax amount, in lieu of dealing with exchanges and obligating themselves with higher monthly premium costs. My son may be one of those, even though he has had his own policy since he was 21.
I do agree with you that both R’s and D’s own the slow response to health care reform. However, the road less traveled has been formulating reform around the free market, even though this is the path mostly verbalized by the GOP, just as much as nationalized health care has been the vision of progressive dems.
Wyden has not only offered more reasonable ideas about HC reform, but has also teamed with Ryan in looking into reconstructing medicare issues, addressing not only the needs of seniors but also those younger generations behind them who are concerned about funding being available for their own healthcare in the future.