The Conservative Critique Of ObamaCare

…was basically correct:

["Liberal"] Kapur’s argument amounts to the following: Democrats passed a law that had and still has insufficient public support (points 1 and 4), that cannot achieve its goals without unconstitutional means (point 2), that did not allocate the necessary resources to accomplish its objectives (point 3), and that lacks and still lacks even minimal support across the political aisle (all four points).

That sounds very much like the conservative critique of ObamaCare. At this point it’s fair to say that ObamaCare opponents have won the argument. Of course, since supporters won the political battle three years ago (and Obama won re-election), this monstrosity is now the law of the land, ensuring that both sides’ victories will have been Pyrrhic.

And then there’s this:

It has become very clear to everyone involved who is analytical and not ideological that the rational strategy, for both large and small firms, is to cease providing health care insurance to employees.

No company wants to admit that they are considering eliminating health insurance as an option, or be the first one to drop their health insurance plan, but once a competitor does so, the preference cascade will begin. The clear sentiment is “We will not be the first one to drop our health insurance plan, but we would be a close second.”

The coming preference cascade for employer group health plans is what the Democrats fear the most, because Obamacare was sold to the masses as “if you like your health insurance plan, you can keep it.”

Which was always a lie, of course.

I think the Democrats will be reaping a whirlwind in the next two election cycles.

46 thoughts on “The Conservative Critique Of ObamaCare

  1. RS

    No, the Democrats will be protected by the progressive media, who will shift the blame AWAY from progressives and towards business.

    This cycle will continue until it becomes clear to a brainwashed generation of Americans that they are POORER than their parents.

  2. Daveon

    “Reaping a whirlwind” Tes keep telling yourself that. An repeat after me. It’s the messaging NOT the message.

  3. BlueMoon

    “I think the Democrats will be reaping a whirlwind in the next two election cycles.”

    Rand, I hope you are correct. That is what should happen…in a nation with a significant majority of voters who are well-informed and reasonably intelligent. The folks who turned-out in 2010 to give the Republicans a majority in the House should be motivated enough to turn-out again in the same or larger numbers in 2014. The big wild-card as I see it for 2014 is: Can POTUS’s 2012 machine be cranked-up again to turn out large majorities of the Democratic hard-core and Democratic leaning interest groups, and a majority of the so-called “low-information voters,” to vote for Democrats who will promise to revise PPACA to give relief to those who get slammed by it this year and next? In other words, can the Democratic Party “buy” enough votes with promises of PPACA cost relief to re-take the House and maintain or increase its majority in the Senate? (And PPACA “cost-relief” as I describe it above means the PPACA will likely increase the Federal budget deficit, not decrease it as claimed when PPACA was enacted. Unless all those evil millionaires pay more taxes, of course.)

    1. DaveP.

      Actually, the big wild-card for 2014 is: will the GOP work as hard to discourage and alienate its own voter base as it did in 2012? Because if it does you might as well get used to saying “President Hairplugs”.

      1. Der Schtumpy

        DaveP,
        short of shooting peoples dogs, dating their wives / husbands and getting caught, raping their children, HOW much worse can the GOP get!? Oh, wait, I just answered my own question, by giving them a game plan.

        I said, when McCain got the nod that the GOP was dead, and again when Romney got it, that the GOP was OFFICIALLY dead and should go away as an entity. As far as having a ‘platform’ of beliefs and working for those beliefs, they fail on every issue. The very fact that ANYONE would call themselves a Republican, then be able to hide inside the party, while voting for things like Obamacare and these gun laws, shows the RNC has no teeth.

        I’d like to see a group so rabidly tied to the Constitution that they’d buy newspaper, TV, radio, and internet time to CALL OUT anyone with a (whatever letter defines the NEW party) and pitch them out of the party.

        1. Jim

          As far as having a ‘platform’ of beliefs and working for those beliefs, they fail on every issue

          The Republican platform is low taxes for the rich, and less business regulation. They have been very faithful to that platform, despite it not being very popular with the voters.

          The Republican platform is not smaller government, less debt, civil liberties, a Gilded Age interpretation of the Constitution, less immigration, anti-abortion, anti-gay rights, etc. Those are priorities for some of the voters who support the GOP, and GOP candidates pay them lip service, but they are easily abandoned when the real priorities — the financial interests of wealthy businesspeople — are on the line.

          would call themselves a Republican, then be able to hide inside the party, while voting for things like Obamacare

          I believe that exactly one Republican voted for Obamacare (Joseph Cao, R-LA). The GOP is remarkably disciplined. They don’t fail for lack of zeal, they fail because their priorities are extremely unpopular.

          1. Michael Kent

            “The Republican platform is low taxes for the rich…”

            That’s disingenuous Jim, and you know it. The Republican tax platform is lower taxes for the poor, rich, and everyone in between.

            “They [the Republican priorities] don’t fail for lack of zeal, they fail because their priorities are extremely unpopular.”

            The Republican priorities are extremely unpopular? You say that in a thread about ObamaCare?

            ObamaCare couldn’t pass the Senate without the Senate Majority Leader bribing members of his own party to vote for it.

            One million people showed up on the National Mall to try to prevent its passage.

            It loses by a 2-1 margin when put to a vote of the people.

            28 states have sued the federal government in an attempt to prevent its implementation.

            Massachusetts — known informally as the People’s Republic of — elected a Republican — to Ted Kennedy’s Senate seat — in order to be the 40th vote against ObamaCare.

            ObamaCare is without a doubt the most hated law in America. People hate it, Jim. Even the Democrats are beginning to notice.

          2. Leland

            Jim must really be panicked about this.

            ObamaCare is without a doubt the most hated law in America. People hate it, Jim. Even the Democrats are beginning to notice.

  4. Jim

    Isn’t a move away from employer-tied insurance a good thing? That was the 2008 GOP plan, and I seem to recall Rand being in favor of it then.

    1. newrouter

      Isn’t a move away from employer-tied insurance a good thing?

      yes to a free market system not a statist boondoggle with death panels

      1. Leland

        Yeah, big difference between a fascist healthcare system and a free market healthcare system in terms of moving away from employer-tied insurance. I’m fairly sure Rand was against the fascist kind and considering he had recently read Liberal Fascism, I’m sure he noted the Democrat healthplan as such.

    2. Matt B.

      Fair warning: This is all off-the-cuff analysis. Disentangling insurance from employment seems like the kind of thing that would be good if we had done it a long time ago, and managed to bring down the costs of private insurance to a level where someone above a certain minimum level of income can afford it. The coupling, in today’s environment, creates perverse incentives (unemployed people don’t want to work for employers that don’t or can’t provide it, and employers who do provide it use it as leverage to overwork employees, for instance).

      One of the difficult problems posed by this whole current scenario is that employer-tied health insurance was originally, to my knowledge, not a nationwide top-down policy decision but the result of competition between employers seeking to attract talent by offering increasingly-valuable benefits packages. But as with taxes and withholding, the more people that get their subsidized insurance directly through their employer–and therefore do not have any real notion of how much it costs or how much they would need to save to pay for it otherwise–the more expensive it becomes, because the consumer becomes increasingly insensitive to price changes. So prices go up and up to the point where private insurance off the shelf is extremely expensive or burdened with caveats and requires government subsidies to afford.

      We’re still in a place, I think, where consumers remain insensitive to price increases in insurance costs, except for those consumers whose employer doesn’t already offer it, or the very poor. Unfortunately, it’s that very price insensitivity which hurts the people who need it most (those whose employers don’t offer it, and the poor). Obviously, traumatically decoupling insurance from employment would make people a LOT more price-sensitive, but it would also have the side effect of making a lot of people lose insurance or try to get government subsidies (which is the ultimate goal of single-payer proponents anyway).

      Further complicating this is the fact that lots of people don’t actually make a distinction between health insurance and health care. I’ve had some frustrating discussions with friends who literally did not seem to know the difference. This is why we have the frankly deranged debate over pre-existing conditions, with proponents making the health-care equivalent of the argument “If your house burns down, you should be able to buy homeowner’s insurance after the fact and get the insurance company to pay to rebuild it.” Insurance is not the same as care, too many people don’t know the difference, and proponents of ACA are in no hurry to educate them.

      1. George Turner

        As I understand it, employer provided health care became the norm under FDR when companies were under mandated wage caps, especially during the war, so they had to compete for employees with perks and benefits instead of actual pay.

        1. Jim

          And after the war the IRS ruled that employer-payed premiums were tax-deductible, which is a huge subsidy.

          So it’s a historical accident, with a lot of negative effects, and it won’t be easily undone. By setting up affordable alternatives for individuals and the self-employed, Obamacare is a major first step. The obvious next step would be to further limit, or eliminate, the tax break for employer-provided insurance.

          1. Leland

            The first step is foolish. Setting up government affordable alternatives is a disaster. It simply should have never been tried.

            The second step should have been tried first. Eliminating artficial price controls, which is what subsidizing causes, help bring costs into proportion to what people are willing to spend.

            Government provided healthcare is a misnomer. A government has no means to provide healthcare. It can only tax and regulate others to provide healthcare. Once those regulated decide it is not worth obtaining the education necessary to provide healthcare for the reward of indentured servitude to the government; they’ll do other things. Oh sure, some will always be willing to feign the education to take the reward; but that’s how we ended up with the DMV like government services.

          2. Jim Breeding

            “And after the war the IRS ruled that employer-payed premiums were tax-deductible, which is a huge subsidy.”

            Not taxing something is not a subsidy. Unless the govt is making direct payments, it is not a subsidy.

          3. Michael Kent

            The proper way to fix this situation is to make privately obtained health insurance tax deductible as well, so that everybody has tax-deductible health insurance.

            If you then want to eliminate the tax break, reduce the overall income tax rate at the same time so that it is revenue-neutral for the poor and middle class.

            There’s no need to totally screw up the health care system.

          4. Leland

            Breeding,

            It is true what you say. However, I think the other Jim was referring to how tax breaks are used to manipulate social behaviour. Yet, I don’t think that Jim has ever been in favor of a flat tax that has no deductions. Indeed, he seems to have always pushed for this type of manipulation of our taxcode, so I suspect he was disingenious in his concerns over this kind of manipulation, thus being careless in terminology.

            I however apologize if my response suggested that I consider tax breaks to be subsidies. In this case, I consider the “tax breaks” to be incentives to do things an otherwise free market would not choose absent those incentives. There’s all sorts of incentives, but those driven by the government to force people to do something that they otherwise would not do are egregious.

          5. Jim

            make privately obtained health insurance tax deductible as well

            That only helps taxpayers who itemize deductions, so it leaves out most people.

            And even if individuals got the same tax break as employers, as a society we’d still be subsidizing health insurance, just as we subsidize home mortgages and charitable giving.

          6. Jim

            Government provided healthcare is a misnomer. A government has no means to provide healthcare.

            That’s funny, because my recollection is that until I was an adult all my healthcare was provided by the US government. My dad was an Army doctor; were he still alive, he would be surprised to learn that he was not in fact a government employee providing healthcare all those years. Most doctors in the UK work for the National Health Service; they too would be surprised to learn that they don’t provide healthcare.

            There are more ways to deliver healthcare than you seem to realize.

          7. Leland

            Your dad provided services at a deal he made with the government (see my comment about indentured servitude). Those doctors serving with the NHS perform at the level I described. NHS service is horrible compared to the US healthcare. Patients literally fear NHS nurses. You are making my point.

          8. Bart

            Jim
            February 18, 2013, 12:30 pm

            “That only helps taxpayers who itemize deductions, so it leaves out most people.”

            You seem to be assuming they would continue not to itemize, even when they would get a big break for doing so.

            Jim
            February 18, 2013, 12:56 pm

            “That’s funny, because my recollection is that until I was an adult all my healthcare was provided by the US government.”

            The fallacy of over-generalization, extrapolating from the small to the large. Just because a small pool of people, who provided valuable service to their country, can be granted an advantage doesn’t mean everyone else can be. Once you extend it to the population at large, it ceases to become an advantage.

    3. Gregg

      “Isn’t a move away from employer-tied insurance a good thing? ”

      Spoken like a true Lib-Dem……
      Solving world hunger is a good thing…..

      …but not if you do it by killing 3/4 of the world’s population.

      The means matter just as much as the ends – something Lib-Dems have long since forgotten about.

  5. Gregg

    “It has become very clear to everyone involved who is analytical and not ideological that the rational strategy, for both large and small firms, is to cease providing health care insurance to employees.”

    It was clear to me and a lot of other people that this was the OBJECTIVE right from the start. Cause employers to dump people off insurance by making it financially beneficial to do so…then scoop up all those people into a government system, institute death panels and now you have a whole new slave population with witless bureaucrats deciding who lives and who dies.

    1. BlueMoon

      You’ll have witless bureaucrats AND ego-centric, narcissistic, power- and money-hungry Congresscritters and Senators deciding who lives and who dies. The Congresscritters and Senators will love to be able to reward friends and punish enemies by interceding or not to obtain a waiver for treatment outside whatever the IPAB or other bureaucrats decree is allowable.

      1. Gregg

        Well that’s true. Effective medical treatment would then become a bartering commodity. As in Soylent Green only the insiders would get the good care.

        The rest of us poor slob outsiders get the blue pill.

        I really wish Lib-Dem-Soccie types would think hard about putting ANY kind of power into Federal hands….every single time you do that you give them the opportunity for graft.

        1. Jim

          I really wish Lib-Dem-Soccie types would think hard about putting ANY kind of power into Federal hands

          I really wish Libertarian types would think hard about putting so much power in the hands of employers and insurance companies. It isn’t as if state power is the only sort of power that can make one’s life miserable.

          1. Gregg

            “I really wish Libertarian types would think hard about putting so much power in the hands of employers and insurance companies. It isn’t as if state power is the only sort of power that can make one’s life miserable.”

            You have means to redress employers and/or insurance companies much more easily than a government who has the ultimate lever – force – to use on you.

            Don’t pay your insurance premium? You lose your insurance….

            Don’t pay your taxes? Your wages are garnered and/or you are thrown in jail.

            Why you think government is so noble and benign is beyond understanding.

          2. Leland

            I really wish Libertarian types would think hard about putting so much power in the hands of employers and insurance companies.

            Again with the limited options. Remove the incentives and employers can choose to provide insurance or not. If the employers provide insurance or pre-paid medical, why should anyone care? Also, individuals can decide if they truly want insurance, what most people call insurance but is really pre-paid medical, or pay as you use it healthcare. Some individuals can also choose not to take what their employers offering and obtain healthcare by some other means while demanding more pay.

            All of those options could be available and don’t require federal manipulation. They are sure better than government servitude. And best of all, they don’t require personal health information to be uploaded to a central database that is sure to be hacked.

    2. Jim

      scoop up all those people into a government system

      There is no “government system” — the public option was killed in the Senate.

      institute death panels

      Sigh. There are no death panels. You’ve been terribly misled.

      1. McGehee

        the public option was killed in the Senate.

        Because when the whole thing failed — as they (unlike you) knew it would — the public option would be seen as a failure too, poisoning the political well for the actual goal: single payer.

        1. Jim

          No, the people who killed the public option (e.g. Joe Lieberman) were the people most opposed to single payer. The people pushing the public option (e.g. Nancy Pelosi) were the ones most open to single payer.

          The public option was killed as a gift to insurance companies.

          1. Leland

            The public option was killed as a gift to insurance companies.

            You speak of the Cornhusker Kickback. I’m glad you are recognizing it properly as graft. Its one more reason the GOP should repeal the PPACA.

          2. Jim

            No, the death of the public option has nothing to do with the Cornhusker Kickback. The Cornhusker Kickback was about reimbursement rates for Medicaid providers (i.e. doctors and hospitals) in Nebraska — it had nothing to do with private insurance companies, or the public option (a proposed government-run insurance option for people not on Medicaid or Medicare).

            Its one more reason the GOP should repeal the PPACA.

            Because it was passed with legislative horse-trading? By that standard the GOP should repeal the 13th amendment.

      2. Michael Kent

        They may not call them that, preferring to go by the innocent-sounding name of IPAB panels (or NICE panels), but death panels they are.

        When a government panel can decide who gets or who forgoes medical treatment, it’s a death panel.

        1. Jim

          IPAB doesn’t do that.

          On the other hand, before Obamacare your private insurance company could decide to cancel your policy altogether when you get too sick. That’s a sort of death panel that Obamacare eliminates.

          1. Michael Kent

            “On the other hand, before Obamacare your private insurance company could decide to cancel your policy altogether when you get too sick.”

            If by “too sick” you mean exceed $2 million in lifetime benefits, then yes. Otherwise, no they couldn’t. It seems you don’t know much about my health insurance policy before ObamaCare.

            But if my private insurance company did have such a clause in its contract, I would be free to buy insurance from someone else. Not so when I have to buy health insurance from the government.

            And under single payer, if the government denies my health care, I die.

            I can’t tell if you’re genuinely surprised that large numbers people would object to that or knew it all along and just enjoy the thought of it.

      3. Leland

        There are no death panels. You’ve been terribly misled.

        Indeed, it is misleadingly called the Independent Payment Advisory Board.

        1. Jim

          You, too, have been terribly misled. IPAB identifies Medicare savings, which Congress can override. If IPAB is a death panel, then Congress, which has controlled Medicare spending since 1965, and continues to today, has been a death panel all along. The difference is that when Paul Ryan proposes steep Medicare cuts, he’s a GOP hero.

          IPAB, like “death panel”, is just the target of a fact-free five-minute hate.

          1. Leland

            Congress can override by repealing the law. Otherwise, IPAB increases the power of how the current Medicare board functions. Why increase the power? Because the current board could only make recommendations that Congress could ignore. The increased power allows IPAB to implement its recommendations. What type of recommendations can they implement? They can decide what procedures they rule to be inefficient or ineffective. Your doctor can no longer make that decision. And Jim, we know if you had your way, the IPAB decision would be the Single Payer thus the only decision maker. You’re not fooling us.

            The fixes your want were cooked in the original bill. You got the bill you claimed we wanted. Public opinion disagreed then and now. The solution is to repeal the bill and get government out of the examination room. My health is none of the federal government’s business. IPAB wants to make it their business. It’s a death panel.

      4. Gregg

        “The public option was killed as a gift to insurance companies.”

        You better tell your own party..cuz your fellow commies don’t agree with you

        “And we’re also going to have to make decisions about health care, doc pay for health care that has no demonstrated medical benefits.

        So the snarky version… which I shouldn’t even say because it will get me in trouble is death panels and sales taxes is how we do this.”

        Paul Krugman
        Krugman

  6. Gregg

    “I think the Democrats will be reaping a whirlwind in the next two election cycles.”

    That would be nice but then I thought the lib-Dems were going to lose big this last election cycle.

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