Monday, July 2, 2012

Courting Disaster

Speaking of distractions...

During the seemingly endless months leading up to the Supreme Court ruling on Obamacare, the focus was primarily on the individual mandate. Now that we finally have the ruling, the focus continues to be on the mandate, I mean, the tax.

Now, I am as amused as anybody about the way the pundits’ predictions on the outcome were totally wrong for months and how politicians on both sides have shown their hypocrisy by reversing their supposed principles on what the Supreme Court should and shouldn’t do. Conservatives, who usually rail against courts that overturn duly passed laws, were fiercely disappointed that the court didn’t overturn this law. Liberals, who can frequently be heard bemoaning 5-4 decisions as proving the justices’ partisan motives, were this time praising the court’s integrity. And the president, who swore up and down that the mandate did not constitute a tax on the middle class and who ridiculed George Stephanopoulos for looking up the word “tax” in a dictionary, gratefully accepted (without acknowledging) the court’s definition of what a tax is.

But to my mind, this has all been and continues to be a distraction from what is really important. The question of whether Congress can order citizens to buy a product is certainly a very interesting one, as is the way it all finally got interpreted by the court. But personally, I have never particularly agreed with those who see the individual mandate as some sort of enslavement. Our personal liberty is limited in all kinds of ways by the government. What makes it okay is that the government has to answer to the voters, so these limits on our liberty are enacted indirectly by ourselves. If we don’t like what the government is doing, we can vote it out of office. That is what elections are for. No, the problem with the ironically named Affordable Care Act was never the mandate. It was the fact that, as it finally emerged from Congress, it pretty much guarantees that health care will continue to get even more expensive and out of reach for more, rather than fewer, people.

It attempts to “help” people get healthcare coverage. And it does it in the same sort of way that Fannie Mae and Freddie Mac were meant to “help” people to buy houses and government-subsidized student loan programs were meant to “help” people get a higher education. And the result of all that help has been to contribute to a vicious circle of those things becoming ever more expensive and people needing ever more “help” from the government. Think about it this way. Creating a healthcare mandate (of, if you prefer, tax penalty) to get more people to have health care is sort of like trying to end poverty by passing a law to require people to have money.

Yes, I understand that the idea is for those who can afford health insurance (including the young and the healthy who otherwise might not buy it) to pay into the system to provide more and better care for those who do need the health insurance and for those who cannot afford it. Requiring people to have insurance is not unreasonable, but it will only work if marketplace forces are allowed to keep costs down so that people can actually afford it. And the law, in all its volumes of text, never dealt with the factors that actually drive up health care costs. As a study cited in Time back in March (for example) notes, Obamacare makes no difference to the projection that health care costs will eventually exceed a typical family’s income. And with Obamacare in place, it will only be rational behavior for more and more people to give up and let the government subsidize their care rather than to keep working.

The president’s chief of staff, Jack Lew, made the Sunday talk show rounds in the wake of the court’s ruling, and I never saw anyone more anxious to change the subject from what was ostensibly a victory for his side. It just reminds people of all the laughable claims that were made about the Affordable Care Act while it was being fought over: that it was a “jobs bill,” that it would reduce the deficit, that it would bring costs down. Other Democrats in various panels (Donna Brazile on ABC’s This Week was one), when pressed about the illogic of how the whole thing was supposed to work, ultimately conceded that their preference was never really Obamacare but single-payer.

And that seems to be the president’s plan. If he can just get through the election, then when the healthcare situation worsens, he can put it forward that single-payer is the only solution. He’d be right insofar as it would be better than what is in place now. But it’s hard to see how, even if he is reelected, he would have enough support in Congress to put that through.

Unless the public collectively takes a firm stand, one way or the other, on the healthcare issue by giving the White House and a sizeable majority in Congress to one party or the other, we are liable to see two or four or more years of things getting worse and the two parties doing their best to attach the blame to each other, since there won’t be anything else they can do.

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