The political battle against Obamacare failed. Twice, actually – in the ’08 and ’12 elections. And it’s going to fail again; the Senate and the President will likely succeed in blocking any effort to defund it, if by no other means than calling in markers from their praetorian guard in the media to make sure any shutdown is catastrophic to the GOP.
Which will blink.
Dan Henninger says the time has come to exploit Obamacare’s key weakness; Obamacare:
As its Oct. 1 implementation date arrives, ObamaCare is the biggest bet that American liberalism has made in 80 years on its foundational beliefs. This thing called “ObamaCare” carries on its back all the justifications, hopes and dreams of the entitlement state. The chance is at hand to let its political underpinnings collapse, perhaps permanently.
If ObamaCare fails, or seriously falters, the entitlement state will suffer a historic loss of credibility with the American people. It will finally be vulnerable to challenge and fundamental change. But no mere congressional vote can achieve that. Only the American people can kill ObamaCare.
I just finished watching Ken Burns’ Prohibition – which is all about how big social engineering goes terribly awry when it runs into contact with social reality.
I don’t like indulging in historical parallels – they’re seductive drugs that convey little real knowledge. But Obamacare is one of the greatest social engineering measures ever attempted – and “great social engineering” is almost invariably a synonym for “failure”.
Obamacare hasn’t even been fully inflicted, and it’s already a disaster.
Maybe the best thing that can happen is to have the American people look all of that Hope and Change in the face, and take it.
They asked for it, after all.
The thing is, if they wanted to “spread the wealth around” Obamacare isn’t very progressive, rally, plus it isn’t going to create ANY net value. Idiots.
The Fed can’t bail them out this time either. #bondmarketcollapse
“The people have spoken … and they must be punished.”
-Ed Koch
Just like it’s been undone in England, Canada, the Netherlands….?
What NW says. If the New Deal didn’t torpedo Keynesianism, I’m not sure the Health Insurance Deform Act will.
Problem is, WH is unconstitutionally exempting their voting block a piece at a time from participating in 0bumblerCare. This means all the rest of us will be forced into it and will end up paying double to support Soci@list leeches. Sigh…
Summary: “No major piece of social legislation has ever been undone”.
Response: “OK – so we do what? Roll over and die?”
Of course, the unavoidable corollary is that if Obamacare succeeds, the conservative ideology that the GOP has been preaching is a total failure. Healthcare systems in Canada, the UK, and the Netherlands have not been repealed because they provide far superior value to the US model.
RDFL,
How would we know? We haven’t tried it since Coolidge was president.
“they provide far superior value to the US model.”
Faith-based statement.
BTW, it’s your impression that none of those national systems have been repealed because they’re regarded as wonderful high quality systems?
Huh.
Healthcare in Canada is being “repealed”, our dimwitted, fact challenged Rick+/-DFL. Last I time checked, portions of it are being privatized. But why would you believe a Canadian, whose parents still live in Canada, on how wonderful Canadian healthcare system is? Nothing but libturd propaganda for +/-.
Mitch,
Conservative ideology predicts Obamacare will fail, as much, if not more than liberalism predicts it will succeed. If Obamacare does not fail, conservative ideology is wrong. Whether or not your ideal version of conservatism has ever been enacted does not matter. If it did, a liberal could claim the failure of Obamacare would not matter because, the U.S. has never fully implemented liberalism.
No healthcare system is free from problems, but no one wants to adopt the U.S. model. We are the Soviet agriculture of world health care.
Feel free to provide some evidence that the U.S. system cost significantly less per person or delivers significantly higher quality across the board.
JPA: No one in Canada proposes to eliminate universal health care paid for with a public social insurance program. Tinkering with private providers and and financing, does not mean adopting the U.S. model of employer based health insurance without a universal guarantee.
RickDFL once promised me that Obamacare would be like getting a raise of $2000/yr. That was just after he said that he couldn’t be called a defeatist regarding the Iraq War, because we had already lost.
He’s a clown.
Tinkering with private providers and and financing is proof positive single payer system was not working as intended. And never mind just about EVERYTHING we were told about 0bumblerCare had been a lie – lower premiums, you can keep your doctor, no death panels, not a tax, etc, etc… But I am sure you got your mindless talking points all ready to go to defend the indefensible, just like a good ‘ole apparatchik. Never mind the facts, just like you pretending to know anything about science while debating Global Warming. Howz that going for you, +/-, BTW? Any sightings of polar bears on ice floes lately?
Rick, there’s a lot more that needs to be dealt with here, but when Obamacare is causing costs here to skyrocket, appealing to Canada and such is just a diversionary tactic. So is appeal to outcomes–there are any number of reasons that U.S. outcomes lag, starting with the fact that our government pays people to overeat and smoke.
But since you want to know what is better about our system, we’re paying more or less for a higher survival rate for a lot of diseases, including heart disease and cancer. http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-027766.pdf
Oh, and by the way,one of the chief researchers in these areas, the Cleveland Clinic, just announced a plan to cut 3000 jobs due to the Health Insurance Deform Act. Stryker, Medtronic, and Boston Scientific are laying off thousands due to this debacle, and good luck paying for your insurance with that part time job courtesy of HIDA.
Oh, and guess what will happen if HIDA’s provision for 25% compensation for Medicare comes through? Good luck finding a doctor for your parents or grandparents at that compensation rate. Mayo has been telling new doctors not to accept Medicare patients in Arizona since 2009.
PM: I doubt I ever said “Obamacare” would save the average American $2000. I said a system like any other major industrial country (i.e. universal access financed mainly by a social insurance program) would save $2000. That is (very roughly) the difference between U.S, per capita HC spending and them. Obamacare is not such a system.
JPA:
It seems some polar bears are having trouble finding any ice at all.
http://www.theguardian.com/environment/picture/2013/aug/06/polar-bear-climate-change-sea-ice
RickDFL said:
“No healthcare system is free from problems, but no one wants to adopt the U.S. model. We are the Soviet agriculture of world health care.”
Powhatan Mingo said:
“He’s a clown.”
Who apparently enjoys making retarded analogies.
RickDFL:
#1 Single payor is better than Obamacare. The comparison is not appropriate.
#2 On way or another, the plan has to make actuarial sense. This can be done in lots of unnecessarily negative ways backed up by government force. If you have a sociologically homogenous society–which we don’t have here–it is much easier. Particularly if you started it decades ago. We have better options. This is ONE http://www.thepurplehealthplan.org The Swiss system, effectively. The big thing is the government contribution is LIMITED BY GDP, which is the ONLY way ANYTHING like this is paid for. Notice GDP is REALLY LOW AND GOING NO WHERE. (Clearly, we need more NEO-Keynesian SPENDING and DEBT. LOL) Plus making the young and healthy pay more just destroys society’s and individual’s human and financial capital.
#3 I highly doubt that countries that have genuine resource currieries like Canada ought to be included. It is EASY for them to just wave a wand and make it happen. Plus Canada had their fiscal crisis a long time ago. The UK pound is getting killed by QE and the North Sea oil fields running out. What’s happening to global markets is not pretty.
Fundamentally, what had to happen was pre-existing conditions had to be partly or fully socialized and treated in clusters and the rest of it had to make actuarial sense mostly from the bottom up instead of in Obama’s top down government force nightmare of waste, graft, and suffering.
Obama is just another whore-parasite that gives nice speeches.
Ultimately, LBJ and Nixon have created an Inflationist-Collectivist Doomsday Machine.
No monetary soundness and no actuarial sense. It ripples through EVERYTHING.
FS: I agree with #1. At least, single payer systems provide equal care at lower cost. Single payer would be better than the ACA.
For #2, any universal/socialized health insurance system essentially sets a GDP cap on an annual basis, so I am not against some sort of annual public spending cap (supplemented by private spending). I don’t know if the cap needs to be fixed beyond the normal budget process. Suppose, due to tech advances, for an extra 5% of GDP, we could all live to be 200. Seems like voters should have a choice to spend their money on that, instead of say submarines, NSA surveillance, cotton subsidies, or SNAP.
But, on the whole, the Purple plan, seems interesting, and certainly more constructive than anything suggested in SITD. It is universal and socialized. The tough question would be how prices were negotiated between consumers, insurance companies, and HC providers.
As for #3 “resource currieries”??? Resource currency? Reserve currency? Not sure what currency has to do with health care economics?
The issue is, they need to set a GDP cap and ration it form the bottom up almost totally, free market, except for pre-existing conditions, which are socialized. The Purple Plan progressive -izes it, which is what they want. Obamacare is REGRESSIVE, mostly.
All government actuarial activities end in disaster. LOOK AROUND. Politicians are whores, not actuaries and leaders.
Then throw in the fraud. http://www.cbsnews.com/8301-18560_162-5414390.html
Resource currencies create demand for government bonds (low interest rates) and organic GDP, effortlessly. Canada has a low population and a HUGE level of all kinds of stuff the planet needs. This is rare. Mongolia is another one.
The rest of the non – developing world has WAY TOO LOW OF A GDP
The issue is, they need to set a GDP cap and ration it form the bottom up almost totally, free market, except for pre-existing conditions, which are socialized. The Purple Plan progressive -izes it, which is what they want. Obamacare is REGRESSIVE, mostly.
All government actuarial activities end in disaster. LOOK AROUND. Politicians are whores, not actuaries and leaders.
Then throw in the fraud. http://www.cbsnews.com/8301-18560_162-5414390.html
Resource currencies create demand for government bonds (low interest rates) and organic GDP, effortlessly. Canada has a low population and a HUGE level of all kinds of stuff the planet needs. This is rare. Mongolia is another one.
The rest of the non – developing world has WAY TOO LOW OF A GDP for all of this clever bullshit. Just wait.
They just want to destroy everything and then force single payor.
More Fed easing, more laws, and more taxes. Fuck that.
You don’t need 20,000 pages of bullshit to get everyone taken care of and get the economy going.
After the cold war was won, we should have gone with a pure Ayn Rand / Ron Paul society. It would be WAY better than what is going on now or what Obama and his lemmings imagine.
Rick- I see from your link that one polar bear died, allegedly from lack of ice. How would one know that? And that’s supposed to prove ….what? That GW is real? So that would mean if I could find an instance where one lived because of increased ice, it would that cancel out your global warming bear, correct? Actually, the number of polar bears has been increasing: http://dailycaller.com/2013/06/13/polar-bear-population-reaches-its-limits/
Also the West’s demographics. 2/3 of GDP growth is population growth. This is serious shit unless we let in a ton of poor people that aren’t that fired up about E pluribus unum.
Soylent Green anyone?
We are inured to it, but fundamentally you can’t allocate this many resources via politics. It’s impossible. Look at ALL of the debt. Look at the unemployment and the lack of opportunity.
Everyone is rightly worried and scared and they will keep trading in freedom for security until it collapses.
FS: I agree with #1. At least, single payer systems provide equal care at lower cost. Single payer would be better than the ACA.
Wrong., RickDFL. And we now know that whatever single payer system you are talking about is purely imaginary — like the $2 grand you said Obamacare would stuff into my pocketbook. More socialism has failed to deliver, so we need even more socialism! Yeah!
For #2, any universal/socialized health insurance system essentially sets a GDP cap on an annual basis, so I am not against some sort of annual public spending cap (supplemented by private spending).
Before Obamacare, the market essentially set a GDP cap on health care spending.
First of all, what is on offer with Obamacare, and what is given to Medicare and Medicaid recipients, is not simply health insurance. Health insurance would cover costs that exceeded a certain deductible. What is on offer, and is legislated in detail, is a full health care plan. People are, in fact, required to invest in a health care plan, just as seniors get full coverage with Medicare, not simply insurance for catastrophic medical charges.
Second, Obamacare is a good deal (as is Medicare) if you were planning to buy the coverage mandated by the law. If so, then the law will make it cheaper for you. It is cheaper because those people who did not plan to buy coverage will now have to, subsidizing those who were going to buy a health care plan anyway. Because Obamacare does little or nothing to actually reduce health care costs, it is a zero sum game. Subsidies for one group must be coming from another group. In this case, one of the groups doing the subsidizing is young people who would have chosen not to buy health insurance, living with the risk instead.
We would do ourselves a tremendous favor if we separated medical services into those whose impact on life expectancy is high, which should be fully funded by the government, and those whose impact is low, where government funding should be partial, means-tested, and judged relative to other quality-of-life services that the government would like to provide. Among the side benefits would be that we would spend a larger fraction of our tax dollars on children and adults in their productive years, investments that pay society back in greater wealth and productivity, rather than on elders in their final years, which offers society only a bottomless pit of costs. Old people live longer when they eat well, exercise their minds and bodies, and do useful things. The quality and quantity of their contact with the medical profession has little impact on how much time they have left.
Emery, at least you are not as much of a fantasist as RickDFL.
Any discussion of national health care costs needs to begin with the acknowledgment that health care is scarce good. There is not enough to go around.
If health care is to be rationed –and it is rationed and it will have to be rationed in the future — you can do it a number of ways, but the worst way is to let politicians and bureaucrats decide what care will be provided and who it will be provided to. Without a cost structure that reflects the values of the people who pay for health care, the wrong priorities will be made and resources will be squandered on treatments that the people who pay for health care do not value. The support of the net payers for the system will weaken. You will, at best, end up with a two-tier system where, for example, the children of the wealthy get braces and eye correction surgery, and the children of everyone else get crooked teeth and eyeglasses.
There are not many no-cost gains to be squeezed out of the existing system (as RickDFL fantasizes).
This is a great discussion.
@RickDFL
The Purple Plan is universal but there is NO MORE GOVERNMENT “ACTUARIAL SCIENCE” and no more government insurance employees and system. No more SEIU or whatever they use. The private insurers become utilities, which is probably the humane, sensible thing. Customers can pick which health insurance utility they want vs. just forcing them into the beneficent collectivist monolith of force, graft, and stupidity.
Except for the giant tax rebate that progressive-izes it and cordoning off preexisting conditions, it’s free market bottom up rationing instead of IPAB death panels and other assorted statist foolishness.
Look at the VA system. Does ANYONE think that more voting and politics and OUTRAGE is going to fix it? Come on. The government can’t do healthcare.
WAKE THE HELL UP! Look around. Is more easy money and statist force going to make the world a better place? or does a pure Ayn Rand / Ron Paul world have more “social justice” and opportunity than this crap or what’s in Obama’s narcissistic dreams?
These are the best books –ever–for anyone to figure out the answers to these questions.
http://www.amazon.com/The-End-Near-Going-Awesome/dp/0062220683/ref=sr_1_1?ie=UTF8&qid=1380367320&sr=8-1&keywords=kevin+williamson * http://www.amazon.com/Home-Economics-Consequences-Structure-Capitalism/dp/0844772607/ref=sr_1_2?ie=UTF8&qid=1380367345&sr=8-2&keywords=home+economics
Does anyone think we can keep paying for more government with more government and easy money, especial given the age demographics? http://upload.wikimedia.org/wikipedia/en/0/05/Us_gov_spending_histry_by_function_1902_2010.png
The main things that pay the bills and provide what people need and want is entrepreneurship and cheap energy.
Health care costs are always plotted against life expectancy as though this showed some sort of efficiency. In reality, a relatively small fraction (probably 10-20%) of healthcare costs have a large impact on life expectancy. Most of the huge gains in life expectancy were due to public health infrastructure (sewers and clean water, mostly), better diet, vaccines and antibiotics, a dose of which can be bought for pocket change (well, most of them). The impact on life expectancy of each of those 4 is measured in years if not decades. The other big hitters on life expectancy are genetics and lifestyle choices. The impact of a cancer treatment costing hundreds of thousands of dollars is measured in weeks. An organ transplant costing a half million in total will only yield a few years at best. Most surgery for people over 65 hastens death, even when the immediate medical issue is resolved. No, most of our health care dollars are spent increasing the quality of life, not lengthening it.
When we consider the question of what we should spend on healthcare as a nation (individuals are free to spend what they want), we should regard most of healthcare as a way to improve the quality of life of our citizenry, not a way to lengthen their lives. Education also improves the quality of life, as does superior infrastructure, unemployment benefits, child and elder care, help for the poor, the arts, or advances in basic science. But medical care trumps them all as a priority, because we fear death more than we do poverty or ignorance, and we associate all of medicine with saving lives, when in fact little of medicine is about that.
@Emery That’s all well and good, but using politics, Cass Sunstein’s narcissistic brain and government force to enforce all of that is a socially unworkable idea.
The ACA, also known as Obamacare, is a disaster for American workers. RickDFL is in favor of it only because it is yet another way to skim a few dollars out of a worker’s pocket and spend it on the things RickDFL would like to spend it on.
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@Powhatan Mingo I don’t know about rick in particular, but in general there is A LOT to that. Easy Money –> statism –> “graftism ” –> screws up the economy –> people vote Left because they lack stability and opportunity –> repeat –> bond market collapse
TFS-
You can ignore pretty much anything RickDFL says about healthcare. He’s a fool. He seems to believe that having the government run the health care industry will result in greater efficiency, e.g., better health care at less cost. This supposedly accomplished by reducing wasteful competition and pixie dust. In reality, the reason single payer health care countries spend less per capital is by the government controlling prices. That is, the government will ignore the pricing information that makes an economy or an industry more efficient.
FYI, the biggest health insurer in America is United Health Group. Its market cap has doubled since January, 2009. Obamacare obviously ain’t costing the big insurers any money.
It don’t matter anyhow. Having a single supplier doesn’t make for a cheaper, higher quality product.
The real efficiency gains can only come from triaging, to denying care to those who contribute the least amount, economically, to the payer.
You want efficient health care? Deny care to the old and encourage women with problematic pregnancies and abnormal fetuses to have an abortion.
If I was a for profit health insurer I would be raising my rates every year and yelling “Obama Care!” because apparently people will blame the president and not the company that’s actually profiting from the increased premiums.
However, the main problem with mandated insurance is that insurance sucks. Nobody likes to buy insurance. It’s a high-stakes bet where you are hoping to lose your money.
Emery, I think the solution to the profiteering of insurance companies is to buy stock in profiteering insurance companies. Ditto profiteering oil companies. What is a profiteering insurance company’s ROI? 3%? 5%?
One of the things that tells me that leftists are dumber than conservatives is that many leftists, even leftists who have graduated from Harvard Law and are elected to high public office, believe that health care is expensive because of insurance company profits and doctors enriching themselves by performing unnecessary surgery.
Emery-
Earlier you wrote that a heck of a lot of advances in health care amount to improvements in health infrastructure, clean water, sanitation, and so on. No doubt you are right.
There’s a lesson here. Back in the 1950’s, the internationalists looked at economic development in the first world, and the poverty of third world countries (mostly recently decolonized), and thought that the best thing to do was to build hydroelectric damns, highways, and other infrastructure. The money would come from a world bank.
Didn’t quite work out like they thought it would. I think that the most politically neutral way to describe what happened is to say that the money was not spent as intended, and when it was spent as intended it didn’t produce customers eager to buy electricity, or cars and drivers to drive on the new, paved highways.
As Westerners, there is a strong desire to believe that the advantage of a deep well or a desalinization plant is so great, compared to a girl or woman walking a mile or more to get a few buckets of dirty water, that the locals will appreciate the new technology and treat it as a valued public resource, worth sacrificing or at least changing local customs to maintain.
This is not always true.
And when it is not true, it is difficult not to think of the lines of Kipling’s “The White Man’s Burden”, ironically or non-ironically. If you offer a village clean water, and the price is that the women of the village will be less burdened by work, and the village refuses it, on what basis can you say that they are wrong? If you over rule the village, how is this not colonization?
This is absolutely must read from Kevin Williamson
“… the Obama administration has responded to scarcity in the general health-care market: by naming a committee.”
“Obamacare will be no less arbitrary than those of the Seattle God Committee, though they may be a good deal less honest about the underlying calculations of social value.” http://www.nationalreview.com/article/359791/gold-plated-ambulance-kevin-d-williamson/page/0/1
As much rationing from the bottom up as possible is the only humane, civil, and non-wasteful way to do it. P.S. there is no such thing as innovation by government force, either
From the Williamson piece:
” . . . the Obama administration’s record for picking promising technological investments is exceedingly poor.”
What do Obamacare supporters think that this will look like?
As far as I can tell, the insurance companies will be happy, the government will be happy, but doctors and patients will be unhappy.
American liberals since FDR have been trying to sell the message that government services, which we should all want because they are equally for all, can be expanded while only taxing the rich. This doesn’t work of course, and the middle class ends up paying money to the government in hopes of seeing some of it come back in the form of services that the middle class could have bought for itself, had it not been taxed. To a large degree, the success of the American right in keeping tax rates low has been because of the dissatisfaction of the American middle class with the inefficient system of progressive taxes and universal benefits, which repeatedly makes American Liberals seem economically incompetent. Only in those countries where there are flat taxes and progressive benefits has the scope of government services been able to expand to the level desired by American Liberals.
I have looked at this over and over. There is only one place you can get the money for this crap: Incomes between $70,000 and 120,000.
But then look at the GDP, and even THAT is OVERSTATED. Then throw in the demographics.
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QUOTE Emery: “flat taxes”
The collection and compliance costs for the income tax are 25%.
25%
Then throw in Lois Lerner.