An enduring moment in the health care saga occurred when House Speaker Nancy Pelosi ascended the steps of the Capitol before the final vote on the Senate bill, wielding the same oversized gavel that was used to enact Medicare, with thousands of ambient protesters calling for her ouster.
It is appropriate that this event took place outside the house of Congress, where the superb arrogance of power could finally be seen by the people, rather than heard of by them, which was their fate for most of the past year.
We can attribute the public’s delayed recognition of this boondoggle to two phenomena: (1) the effectiveness of the campaign to disseminate the virtues of Obamacare; and (2) the furtiveness of the process itself.
As to the first point, let us feel free to correct the misinformation our politicians have spread about the president’s health care plan, the new law of the land, even if doing so lands us in the ranks of people accused of being “sore losers.”
The overarching claim made by proponents of the new plan is that, when implemented, it will have a shrinking effect on the nation’s budget, which has grown to such proportions that experts now deem it unsustainable.
The evidence rallied to support this is a recent report by the Congressional Budget Office, the body that everyone cites until it is no longer beneficial to do so. The report puts the total cost of the new proposal for its first 10 years at $940 billion, a curious number since it is just below $1 trillion, a price tag that politicians would be hard-pressed to harmonize with in the reality of “the worst crisis since the Great Depression.”
Of course, this was no accident. While the CBO is highly respected as an economic prognosticator, its predictions are based entirely on information it receives from Congress, which is often colored by politicians’ ideology. Consequently, their results rarely turn out badly for the ruling party, which gains legitimacy from having its position affirmed by the impartial body.
The situation has been no different with Obamacare. Desiring to appear fiscally responsible while receiving credit for a historic social policy victory, the Democrats in Congress chose to stagger the benefits people receive such that most of the cost is lodged in the latter part of this decade and the next decade. This, plus two last-minute accretions ““ an additional $50 billion in taxes and $66 billion in Medicare cuts ““ paved the way for the lower-than-expected CBO score, which the Democrats then used to vindicate themselves.
However, there is also a downside to this method of accounting. While the hard-to-swallow pills of the new legislation ““ including new taxes and cuts to Medicare and Medicare Advantage ““ will be felt immediately by a large percentage of the population, only a small fraction will reap the benefits.
Here’s why: The two mandates that supposedly make up the law’s crowning achievements ““ insisting that insurers open their doors to all petitioners (“guaranteed issue”) and forbidding them from varying their prices with different groups of individuals (“community rating”) ““ will not commence until 2014. In the meantime, there is very little to nibble on.
This delayed gratification will not sit well with Obamacare supporters, who were repeatedly told that their sorrows were urgent problems. As the long-spoken-of benefits of the bill continue to go uncollected, these individuals are bound to grow restless.
They will not be alone either. People who criticized the bill from its conception, who do not consider the war to be lost, have recast their opposition into a new repeal movement, which could potentially add other members to the long line of Obamacare adversaries. Recently, companies such as AT&T and Caterpillar Inc. have announced that the new system will raise their expenses, an outcome we think would lead to another contretemps: higher unemployment.
Putting out these flames will prove difficult for Obamacare’s supporters. While they expect the mandates to work salvific effects on the cost of premiums, the number of uninsured, and all the other areas of weakness in the health care system, these plans may just as easily cause a deepening of the crisis. The latter concern is exacerbated by the individual mandate, which stipulates that everyone must acquire insurance or pay a fine.
Regardless of doubts about the constitutionality of such a fine, as fines go, this one is not very punitive, which raises the prospect that people will simply pay it to stave off higher premiums. If they do this en masse, insurers, to adjust for the loss of customers, will be compelled to raise premiums, creating an opening for more governmental largesse (e.g., a single-payer system).
Ultimately, then, while Obamacare contains the seeds of its own destruction, it also establishes a way for Democrats to reach their ultimate ends. Suddenly, all their desperation and sacrifice ““ jeopardizing their majority, compromising on abortion ““ achieves a more plausible explanation than simply, “We wanted to contain the cost of health care.” It also becomes clear why the proffered ideas of Republicans, organized around more consumer control over health decisions, did not progress very far.
The goal with health care reform this time around was, and will continue to be, a government-based system in which the individual is forced to serve the “collective good,” which means forfeiting his individualism.
So we must brace ourselves for the continued onslaught against our freedom.
E-mail at apherson@media.ucla.edu. Send general comments to viewpoint@media.ucla.edu.