I recommend looking at the charts that David Leonhardt presents in his latest New York Times column. I found them interesting and revealing. Take this one, for example, which illustrates the changes in the number of people with health care insurance since 2008:
about which he writes:
Since taking office, Trump has tried to undermined the Affordable Care Act, causing a rise in the number of Americans who do not have insurance.
I think he places a lot more stock in intentions than I do. A stronger message might be that quite a few people won’t purchase health care insurance unless compelled to do so. Or that a relentless advertising campaign (one of the things funded by the Affordable Care Act and which ended in June 2015) has an effect.
At any rate read the whole thing. I don’t think the charts are quite as damning of Trump as he seems to and a lot harder on Obama.
The exchanges never worked and were supposed to be at the heart of the ACA. Competition and consumer choice, we were told, would eventually do away with employer-based insurance because people just love doing their taxes and answering dozens of questions, then pulling a slot-machine lever to see what they get.
Except the competition never appeared and the insurers demanded subsidies to “stabilize” the exchanges. When Trump threatened the subsidies the veil came off, and here we are.
Centrist technocrats like the crew behind the ACA are incapable of designing any simple or elegant solution to any problem on the face of the earth.
So, after all the noise and turmoil, the number of people lacking insurance is unchanged.
Early during the ACA debate, it was pointed out that the 15% of Americans lacking health insurance could be broken down into: about 5% wealthy enough to pay their health costs out of pocket; 5% healthy young people who didn’t need health insurance (only catastrophic accident insurance); and 5% working poor, who did need it.
Instead of dealing with the 5% who actually needed insurance, Obama proceeded to create a monster program that ensnared everyone, and, moreover, a program that increased costs for nearly everyone.
The 5% that needed insurance could have been covered by changing the income tests in Medicaid to allow working poor access to the program. That is still an option.
The inclusion (kidnapping?) of the wealthy and healthy young was intended to provide subsidies to the elderly. That is the only reason for including them.
“Obama proceeded to create a monster program…â€
Obama’s objective wasn’t to insure people, with the possible exception of those with preexisting conditions. His goal was to complete step one in a total takeover of the healthcare system. His loose lipped professor/advisor told us so.
That wasn’t his objective, either. His objective was to burnish his resume by getting a program enacted that could plausibly be pointed to as “health care reform”. To do that sops needed to be thrown to the groups that might rise to oppose it—insurance companies and physicians, etc. Whether it worked or not didn’t really matter much.
I’d like to see the companion graph over time of those forced into health insurance who don’t want any of it.
“That wasn’t his objective, either. His objective was to burnish his resume by getting a program enacted that could plausibly be pointed to as “health care reformâ€. To do that sops needed to be thrown to the groups that might rise to oppose it—insurance companies and physicians, etc. Whether it worked or not didn’t really matter much.”
That is beneath you. Many people thought it would work. I am pretty sure Sean McCoy didn’t have the goal of losing his football game. He thought his plan would actually work. I think this line of thinking gets us back to quoting Grayson, you know, Republicans just want poor people to die. That may be the end result of their plans, but I dont think that was the goal. Most of them believe their plans will work.
Steve
Did the Obama Administration ever submit a detailed plan to Congress? Or did they say “enact something for me to sign”?
As with the ARRA, they were less concerned with the details than with getting something through the Congress.
It may be that there were people who thought it would work. That doesn’t make much difference to the conclusion one way or another. My take on the Obama presidency is that it was purely political.
You can make that argument for anything that involves anyone. In general I just don’t see where that line of reasoning gets you. It is a fact that Democrats/liberals have long advocated for health care reform. I would wager that you just don’t get to be a leader of any sort in the party if you don’t really believe that health care is an important issue. Given the constraints of the politics and the players involved, that was the best plan they were going to pass.
To take another example, do conservatives like Drew really believe in smaller government? I think he/they really do. Then why do they keep voting for a party that runs up our debt and increases spending? Because politically what choice do they have. Democrats certainly aren’t going to make government smaller (though they are less likely to run up the debt for spurious reasons). So conservatives keep voting of the GOP hoping that at some point the party gives them what they want as that is the best plan they have.
Steve
No. There is a difference between being political and being purely political. Every administration is political but IMO the Obama Administration was the most purely political of my lifetime.
Where we mostly differ is that I don’t think you understand how the House works. You think that the House made concessions to entice leaners. I think that the House leadership got exactly what they wanted and they were more interested in giving the president a bill to sign than they were in its practical impact. That’s not to say that they were completely indifferent to its practical impact, just relatively indifferent.