Monday, July 09, 2012

ObamaCare - it whirls - it twirls - it hops - or not.

I was intrigued by Guy Boulton's article on what appear to be wildly conflicting characterizations of what ObamaCare "will do." He reports on various explanations for this, including claims by some that the administration has "failed to sell" the plan and others who blame our contentious political environment.

The argument that "we just haven't explained things well" is a time-honored dodge in American politics. It is almost always wrong. The number of speeches given by the President in support of the new law is exceeded only by the number of rounds of golf he has played. He's selling. The public is not buying.

It is certainly true that our political environment is fraught with contention, although I'm less certain that this is anymore true today than it has been at many times in our history.
I'd suggest that one of the reasons that we can't agree on what ObamaCare "does" is because no one really knows.

The Affordable Health Care Act is - and I date myself here - a Rube Goldberg machine on steroids. For those of you who are unfamiliar with him, Goldberg was a cartoonist who drew far fetched and complicated devices that would accomplish simple things - say peeling a potato - in convoluted ways.

ObamaCare is an enormously complex contraption built on a series of assumptions and deferred decisions. It assumes that one can force insurance companies to cover everyone at a price largely unrelated to the risk presented by an insured -  if only everyone would buy insurance. It presumes that everyone will buy insurance if only we can impose a penalty - no, a tax - that is not as high as the policy will cost. It gambles that more employers will provide health insurance and that the cost of a health insurance policy can be lowered if only we mandate that polices must cover more with less cost sharing and if only we can penalize - er, tax - employers who fail to provide these more expensive policies - again, at a level that is less than the cost of purchasing the policies.

It asks us to assume that Medicare costs can be reduced by appointing a panel of experts who will "do stuff" that won't involve rationing care. What is that stuff? No one knows.

As Mona Charen recently wrote, ObamaCare is a 2700 page law that creates  "159 new boards and commissions; more than $500 billion in new taxes (and counting); the Independent Payment Advisory Board, a rationing board whose decisions are unreviewable by the courts and practically untouchable by Congress itself; restrictions on religious liberty; Medicare cuts; affirmative-action mandates for medical and dental schools; huge new authority over one-seventh of the U.S. economy for the secretary of health and human services, and open-ended regulations of the way doctors and others perform their jobs."

In her book, The Truth About Obama Care, Sally Pipes writes that the Affordable Health Care Act contains "a dizzying array of rapidly moving parts. Some whirl clockwise, others twirl counter-clockwise and even more leap up and down like pogo sticks." Putting aside how we might attribute which movement to which provision, the point is that the law contains numerous provisions that could prove disastrous if they don't go together "just so" and others designed to do contradictory things that it is hoped will come out "just right."

But it's worse than that. Writing in the Claremont Review of Books, Charles Kesler writes that Nancy Pelosi's infamous statement that we must "pass the bill, so that we know what is in the bill" is a misnomer. Reading the bill tells you precious little about what will actually be done.Most of that is left to subsequent rule making.

And it gets even worse. The Affordable Health Care Act was passed in 2010. Almost all of its provisions were designed not to go into effect until after the President runs for re-election this year - in 2012.
When does that ever happen? Here we have what we are told is the biggest and bestest reform ever. It is so good that we better not let the public experience its many blessings until after President Obama is safely re-elected.

Why do you suppose that is? Here's a hint. It wasn't because the Obama administration thought that a more rapid implementation of ObamaCare goodness would make the 2012 campaign too easy. It isn't because they wanted to give the Republicans a break so as to make the election more "sporting."

In light of all this, is it any wonder no one can agree on what ObamaCare "will do?"

Cross posted at


Anonymous said...

I wonder why a conservative think tank and your party's nominee, who you'll vote for, made it so complex, Rick.

Maybe your party will actually come up with an alternative some year, and maybe they won't run away from it if a Democrat passes it.

Anonymous said...


The beauty of our federal system is that the states can serve as "laboratories of democracy." Over 98% of adults in Massachusetts now have health insurance, and 99.8% of children in Massachusetts have health insurance. Massachusetts residents are overwhelmingly happy with Romneycare.

So we don't need to speculate. We have Romneycare to examine. It works.

Thank you, Governor Romney! Thank you, Heritage Foundation!

John Foust said...

Law is complex, and it didn't stop you, did it Professor?

jp said...

"Almost all of its provisions were designed not to go into effect until after the President runs for re-election this year - in 2012."

Is it thinkable the AHCA designers felt phasing in provisions over time was the prudent way to implement a program of this size?

Anonymous said...

Rick I'm curious, do you have a "conservative" alternative to Romney/Obamacare that would provide health insurance to 30 million + people who otherwise would be covered by the Emergency Room?

Does it involve anything other than tort reform and high risk pools which have already been shown not to substantially solve the problem?

Do you even accept the idea that 30+ million uninsured people is a problem? Or is it TS for them, let them go read a bible so they can prepare for the afterlife?