Tuesday, March 27, 2012

Why Obamacare?

“Don’t look for it, Taylor.  You may not like what you find.”
—Maurice Evans as Dr. Zaius in Planet of the Apes

The Supreme Court is hearing arguments this week on Obamacare.  This is the single most important case the Court has taken up in 40 years (yes, even more important than the 2000 election debacle), and maybe ever.  As we follow the proceedings, I have a few questions the implications of which those of you who support the legislation Obamacare should give some honest thought.

1.         If Obamacare was such a good idea, why did it have to be crafted in secret, without opposition input, and rammed through without meaningful discussion?

President Obama campaigned in 2008 in part on a promise of transparency, particularly with respect to healthcare reform:

“That’s what I will do in bringing all parties together, not negotiating behind closed doors, but bringing all parties together, and broadcasting those negotiations on C-SPAN so that the American people can see what the choices are, because part of what we have to do is enlist the American people in this process.”

He was supposed to be the great uniter, leading us all in a new bipartisan chorus of kum-bah-ya.


Turns out the signature achievement of his administration to date has been the single most divisive, partisan, and rancorous federal endeavor since Vietnam.  Part of that is due to the Tea Party movement, and Congressional Republicans listening to the overwhelming voice of their constituents telling them not to give in.  But the bulk of it stems from the Democrats’ haste to enact the bill and almost complete exclusion of the Republicans from the process.

In fairness, President Obama did invite Congressional Republicans to a one-day “summit.”  He stared blankly at them and nodded as they outlined some compromise proposals, then proceeded to announce that he and the Democrats were going to move forward with their plans whether the Republicans got on board or not.  Like everything else with this President, “bipartisanship” means his way, or the highway.  The final healthcare legislation was crafted almost entirely behind closed doors—no Republicans allowed, thank you—and the 2,600+ page monstrosity was passed with many in Congress having never actually read the thing.  Recall then-Speaker Nancy Pelosi admonishing us that we’d have to "pass the bill so you can find out what's in it."

Why, if it was such a good idea, was so much of its crafting kept out of the public light?

2.         Why can’t any member of Congress articulate constitutional basis for it? 

As I reported a couple of weeks ago, when asked about the constitutional authority for Obamacare, Representative Kathy Hochul (D-NY) told a town hall meeting on February 24, “[W]e’re not looking to the Constitution on that aspect[.]”  She’s not alone in her disregard for the supreme law of the land.  Representative Phil Hare (D-IL), told a Tea Party activist at a town hall meeting in 2010, “I don’t worry about the Constitution on this.”  When CSN surveyed members of Congress back in 2011, many Democrats could not cite a provision in the Constitution conferring authority for the health care law, with responses ranging from the evasive and arrogant (“nobody questions [the constitutional authority]”—Senator Patrick Leahy (D-VT)), to the ignorant (citing the nonexistent “good and welfare”—Representative John Conyers (D-MI)—and “health”—Senator Roland Burris (D-IL)—clauses), to the honest “I don’t know”—Senators Bob Casey (D-PA), Daniel Akaka (D-HI), Jack Reed (D-RI), among others.  

These people all took an oath to uphold the Constitution.  Why, then, when asked where the Constitution grants the authority to enact Obamacare is the response almost always something to the effect of “I don’t know and I don’t care”?  If the Court tips in an activist direction it may ultimately find (or create) constitutional support for Obamacare.  But Congress should have already done that at the time it passed the bill.

3.         Why, if this was such a good idea, was it sold to the American people with so many demonstrable lies?

Cataloging all of the lies, half-truths, and distortions published as part of selling Obamacare to the public would take an entire column in itself.  Let me focus on three of the bigger ones.

First, the primary driver behind the healthcare bill was the supposed urgent crisis of upwards of 50 million Americans being without medical expense insurance—ignoring, of course, the fact that not long ago that virtually no one in the United States (or anywhere else) had such insurance.  The truth, however, is that of those 50 million (actually, 46 and change, but who's counting?) some 9 million or more were actually not Americans, but illegal aliens.  Another 10 million were only temporarily without insurance for a short period of time.  14 million were already eligible to be covered by Medicare or Medicaid and for whatever reason were failing to register.  And 9 million or so were people making more than $75,000 a year (and thus capable of affording insurance if they wanted it) who were simply electing not to carry insurance.  The real number of long-term uninsured Americans is actually more like 8 million or fewer; in other words Obamacare proponents have exaggerated the scale of the supposed problem more than five-fold.  Furthermore, these 8 million people already have access to—and many of them use—“free” medical care at any hospital ER, which are required by law to treat them regardless of ability to pay.

Second, the President famously and repeatedly promised that “if you like your health care plan, you’ll be able to keep your health care plan, no matter what.”    In point of fact, non-grandfathered plans will have to conform to the mandates of the bill, meaning that no matter how much you like your plan, the minute it so much as changes a premium to reflect inflation—which happens with most plans annuallyit’s going to have to be altered to follow Obamacare.  But more to the point, once the new plan requirements become more expensive to employers than the penalty for not providing insurance—a 100% certainty—most will drop coverage altogether and simply pay the fine; surveys already show as many as 30% of small businesses say they will drop coverage, and the mandates haven’t even taken effect yet.  And, in fact, the CBO estimates that millions of Americans will be shifted from their employer-provided plans (i.e., their existing coverage) to the state-run exchanges or to Medicaid.

You’ll be able to keep your health care coverage—except when you don’t get to keep it.

Third, President Obama also swore that he would “not sign a plan that adds one dime to our deficit, now or in the future, period.”

Read my lips.

Unfortunately, that statement was never true, either.  The CBO said back in 2010 that the program was probably going to cost at least $115 billion more than originally estimated at the time it was passed.  The CBO now says Obamacare’s insurance coverage provisions will have a net cost of “just under $1.1 trillion” between 2012 and 2021. 

4.         Why did they need to do it this way, when it would have been cheaper and simpler simply to give out a voucher-based subsidy?

Perhaps the most important question I want you Obamacare supporters to ask yourselves is why did it have to be this way?  If the real objective was to ensure medical expense insurance coverage for indigent Americans, that could have been done through a direct subsidy.  $2,000 a year for 8 million people is $16 billion—not chump change, but a hell of a lot cheaper than the law Congress enacted.  And more effective, too.  Obamacare was supposed to provide coverage for indigents, but those are the very people exempted from its requirements.  Indeed, the CBO estimates that even with Obamacare, by 2016 there will still be approximately 26 million nonelderly people without insurance.

Does the water around you seem to be getting warmer?  Did you Obamacare supporters ever question why Congress needed to implement a law written in secret and for which most of Congress cannot articulate constitutional authority, and then lie to the public about both the scale of the need for the legislation and its immediate effects, when a cheaper, more effective, and far less intrusive alternative was available?  Have you wondered what it was they were really seeking to accomplish?  Have you given any thought to what the longer term implications might be if this authority Congress is claiming with Obamacare is carried to its logical conclusion?

Or are you not normally that inquisitive?

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