Red Queen Policy

by Dave Schuler on January 27, 2014

An interesting point is made in this article: as of this writing the PPACA has resulted in a net decrease in the number of persons with healthcare insurance in California of more than a half million. In other words the number of persons insured under the PPACA in California would need to double between now and March 31 just to get back to where we were before the PPACA took effect.

Sadly, it doesn’t matter. The PPACA’s supporters support the imagined idea of the law rather than what it actually accomplishes.

{ 20 comments… read them below or add one }

Ben Wolf January 27, 2014 at 4:21 pm

And many of those same supporters will decry other initiatives because they might be “too messy”.

jan January 27, 2014 at 4:58 pm

Here’s a look at the latest Obamacare replacement plan, as put forth by Senators Coburn/Burr/Hatch.

steve January 27, 2014 at 6:12 pm

1) The GOP will not support a replace plan if they gain power. Repeal, of course.

2) it needs to be scored. It has some positives. We need to see real numbers, like how much it will subsidize low income buyers. Looks easy to game with the continuous coverage rule. If insurers must offer coverage, must it be affordable. How do you fund the high risk pools? Having had a relative die waiting for years to get into a high risk pool, this needs to be clarified as it is an issue.


jan January 27, 2014 at 6:52 pm

1) The GOP will not support a replace plan if they gain power. Repeal, of course.

I think they have no choice. Any replacement plan offered may seem like an impotent plan to current supporters of the PPACA — much like how other GOP proposals in the last few years have been viewed. But, HC is front and center on the table now, and something different from the same old, same old will be pushed.

According to Forbes analysis the CBH plan will be budget neutral, and not expected to reduce the deficit. Outside economists, Doug Holtz-Eakins’s were named as being the ones elected to score this HC proposal. The article also stated that insurers themselves were expected to help fund state’s high-risk pools. However, finding funding is also problematic for the PPACA at this stage, isn’t it? Isn’t that why the topic of insurance company bail-outs is so frequently discussed?

steve January 27, 2014 at 7:26 pm

The ACA was designed with funding built in. The GOP has been reluctant to fund anything. Medicare Part D, passed w/o any funding was ok. If they want to turn this into a real plan, they will need to specify funding, which is why I think they wont really to try to pass it. They can probably get H-E to score it for them since he is on their side, but they need to get CBO scoring and use real numbers.

Which is all not to say I am already opposed to the bill. It has some merits. However, like the PCA and every other “plan” they never get it scored, never get specific and never give us real numbers. The only reason to think they might be remotely serious is because Coburn is working on it.


steve January 27, 2014 at 7:28 pm

Dave- You have convinced me. We have started a five year project and after 6 months we are not even halfway through. I am pulling the plug.


Red Barchetta January 27, 2014 at 9:16 pm

“We have started a five year project and after 6 months we are not even halfway through. I am pulling the plug.”

That’s a pretty convenient comment, steve. I don’t recall anyone from you to Michael to Obama to…………anyone telling us about 5 years. To the contrary, all kinds of grandiose claims were made about cost control, retention of plans and doctors, and all those who would be covered. Kumbaya.

This leaves us with an uncomfortable choice. Were we flat out lied to in Orwellian fashion “for our own good?” Or is it something more straightforward, its just FUBAR.

Given the raft of lies and absurd explanations on NSA, IRS, Benghazi and economic performance the first option shouldn’t be discounted. However, neither lies nor FUBAR reflect well on this administration.

Dave Schuler January 27, 2014 at 10:20 pm

The project started in 2010 not last October. You’re just supporting my point—there’s no way to measure progress because the objectives and timeframe keep changing.

steve January 28, 2014 at 7:27 am

????2010? If that is the timeframe you want to use, then it looks like the parts of the ACA in effect from 2010 until 2013 have been pretty successful, or at least successful enough to make it into GOP plans. . Note that nearly every GOP “plan” now incorporates the idea of keeping kids on parents plans until age 26. The ones that want to keep the high risk pools (see above) are using what was in the ACA from 2010-2013. (I dont think that worked very well, but maybe it will work better just because the GOP manages it.)

People actually buying insurance started in October.


... January 28, 2014 at 7:49 am

Dave- You have convinced me. We have started a five year project and after 6 months we are not even halfway through. I am pulling the plug.

Wow, that is disingenuous as Hell. The law was passed on March 23, 2010. The Administration has had years to work on this, the resources of the federal government, and a President that doesn’t give a goddamn whether or not Congress does anything because he has a pen. But you are claiming that Obama only started work on this on August 1, 2014?

Wow, that’s even more dishonest that “If you like your plan you can keep it. Period.”

Well, okay, it isn’t that dishonest, because it isn’t that consequential. But Lord, that ain’t exactly accordin’ to Hoyle, either.

... January 28, 2014 at 8:07 am

People actually buying insurance started in October.

The preparations for that should have begun no later than March 24, 2010. The method for signing up should have been tested and largely functional long before October 1, 2013. Problems with people losing their insurance should have been addressed earlier, and not just for those fortunate souls (and businesses) who have bought the ear of a Congressman.

As it is, the plan touted has resulted in fewer covered people in California than before. Mostly because of ineptitude in the initial launch. And there’s not reason to think that what is true for California isn’t true for the nation as a whole. And given that California did NOT pass on the state portions of the plan, this cannot be viewed as the intransigence of ‘red’ states.

This was touted as something that would allow people to keep what they liked if they were already covered, which was a lie and they HAD to have known that or be as stupid as my neighbor. This was touted as something that would lower a family’s premium’s by $2500 a year, which was wrong, although perhaps given the average level of competence/intelligence in the Obama Administration they really believed this. This was touted as something that would extend coverage to 45,000,000 uninsured people (or thereabouts). That number has been revised downwards steadily ever since the bill became a law.

So, currently the law has resulted in fewer people with coverage than before*, at greater expense, and with the promises of what it would do scaled down. That’s some law you got there.

* This despite the numerous exemptions and waivers and delays that have been granted to various connected parties. One wonders exactly how many people wouldn’t have insurance now because of the PPACA if not for these changes, some of which the Administration resisted to the point of shutting down the government.

TastyBits January 28, 2014 at 8:12 am

To my conservative friends:

I would suggest a different approach. Rather than trying to predict the future, you should assess the past. Start with the stimulus.

The stimulus package was put together by people who were unqualified. The extent of the economic crisis was predicted by people who were unqualified. In both instances, these people were too unqualified to know what the basic qualifications were for the job.

Obamacare was put together by people who were supposed to be qualified. We will not know how qualified they were for some years. We do know the people who designed the Obamacare website were unqualified, and they were too unqualified to know what the basic qualifications were for the job.

We do not know the future, but we do have a trend.

... January 28, 2014 at 8:14 am

The stimulus package was put together by people who were unqualified.

Which one? There were at least two under two different regimes, though Obama’s has gotten most of the press because of its size, timing and ultimate author.

... January 28, 2014 at 8:18 am

TB’s comment raises a good point. We can’t expect this Administration, which is the Democratic A-team, allegedly, to do a competent job. At least half the nation would not expect a Republican Administration to do a competent job either, after the second Bush Presidency. So perhaps giving more power to the federal government to actually get into everyone’s medical care isn’t such a great idea.

Who knew?!

TastyBits January 28, 2014 at 8:21 am


One thing at a time.

Dave Schuler January 28, 2014 at 8:36 am

I’ve been pretty consistent about how I evaluate the PPACA: it’s a success by its own proclaimed standards if more people have healthcare insurance than did before the bill was passed and if the enrollments result in a program that is actuarially sound. The time that I think is reasonable is the end of open enrollment, March 31. At this point and by that standard it’s not a success and it’s hard to see how it will become one. I’ve repeatedly asked strong advocates of the PPACA for their standards and timeframe for success without receiving any answers.

My concern about the law has always been that it was a law that was enacted solely with political goals and objectives, its contents have been dictated by purely political considerations. The implementation schedule was clearly purely political, and according to all accounts the implementation has been interfered with repeatedly for purely political reasons. At some point it seems to me that you’ve got to wonder if the law has no measurable, material objectives at all, only political ones.

Note that I recognize that politics must be taken into account. That’s not the same as politics being such a dominant factor that all other considerations are subordinated to it.

... January 28, 2014 at 8:53 am

My concern about the law has always been that it was a law that was enacted solely with political goals and objectives, its contents have been dictated by purely political considerations.

They’re playing to their skill-set. They are professional politicians, after all, and not professional governance experts.

Incidentally, I have just recently discovered the British show Top Gear. (Of their 350,000,000 claimed viewers, I wasn’t.) But now I’m taking to watching it in big batches. (Thank you BBC America!) Occasionally they will have a member of Parliament on, or even a minister of some sort. It is distressing to see how easily MPs handle debate, both in terms of their rhetorical abilities and their mastery (at least relative to others) of the subjects at hand. I don’t think I’ve ever heard a single American politician that had such an easy ability with facts and rhetoric on any topic. We really do reward those with the most ability to say and know nothing in our system. Which was fine when the federal government was 3% of GDP, not so much now.

TastyBits January 28, 2014 at 8:58 am


Dave commented on this about Europeans generally, and that Americans lack it.

... January 28, 2014 at 11:17 am

TB, what is truly distressing isn’t that American pols lack these abilities so much as one gets the impression that they (the ones we’ve got) couldn’t develop these abilities if they had to. Take the four main leaders in Congress, and the President and Vice President. Do you think any of them could withstand the rigors of Britain’s Parliamentary debates even if they had started when younger? Those just aren’t skills we select for.

America only very rarely has its best people go into politics.

TastyBits January 28, 2014 at 11:53 am


Our best people have answered the most standard answers on the standardized tests. Original thought is specifically excluded, and original thought requires supporting logic, premises, etc.

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