Tuesday, December 10, 2013

THE PRAIRIE EDITOR: A Curious Unintended Consequence?

When the new administration pushed through its healthcare
reform in 2009-10, I did not agree with it, but I did understand
that from the president down to the leadership of the U.S.
house and senate, they believed they were bringing important
and necessary change to the American healthcare system.

The 2010 national midterm elections were, in part, a plebiscite
on this reform (usually referred to as Obamacare). I knew my
own opposition was shared by many Americans, and I openly
predicted in late 2009 that here would be a political wave
against the Democrats, primarily driven by voter unhappiness
with Obamacare.

The electoral wave did happen in 2010, and with Obamacare
implementation ahead, Republicans looked forward to the
presidential election in 2012, and Democrats viewed their
prospects with some trepidation.

The Democrats then took two actions, one very smart and
effective, and the other very risky. The former was to
organize President Obama’s re-election brilliantly, and
with focus on getting out their voter base to support the
president. The latter was to leave the Obamacare legislation
untouched, and set to go into effect in 2013. In that case,
they made, in my opinion, a very vital error.

With the real-life consequences of the Obamacare legislation
not yet realized by most Americans, and with their own
presidential candidate seemingly compromised by his own
healthcare reform in Massachusetts when he was governor,
Republicans  and many observers (myself included) deluded
themselves to think that 2012 would be a repeat of 2010
without a presentation of an alternative vision of government
beyond the usual conservative slogans.

When Mr. Obama won re-election, albeit by a relatively
narrow margin, he and his congressional colleague interpreted
it as their reform being somehow accepted by the public, polls
indicating the opposite notwithstanding, and furthermore,
they were tempted to believe they had created an historical
legacy, thus concluding they were right after all.

The current circumstances of a disastrous “roll-out” of
Obamacare are being likewise interpreted by them as only a
temporary glitch, and that when the system is properly “up and
running,” the nation will embrace it while their opponents will
be proven wrong.

As I have repeatedly stated, along with my criticisms,
Obamacare has some positive features and necessary changes.
But I have also stated that the overall system is inherently
flawed and unsustainable over time. There is no question that
some Americans will clearly benefit from Obamacare, and these
examples are now being trotted out and publicized to gain
support for the legislation. The basic flaw, however, is that the
system requires all Americans, young and old (until they reach
the age for Medicare) to participate. To pay for the benefits
of the few, the rest must subsidize them with dramatically
higher healthcare costs and reduced benefits. That means no
waivers, no exceptions, and no pay-a-penalty to opt out. Even
with “total” participation, there is no cap on costs over time,
with the likely result that healthcare insurance (while
“universal”) can and likely will go up to unacceptable rates
and diminished benefits in relatively quick order.

Furthermore, in order to try to control increasing costs,
Obamacare would inevitably lead to coercion  that would
either virtually "outlaw" the U.S. medical profession or have
healthcare in America conducted without sufficient physicians
and other trained medical personnel.

It is not the first time that politicians have buried their heads
in the political sand. Leaders of both parties have done this
with some regularity throughout the nation’s history.

In desperation, the Obama administration has tried to bring
about some unilateral (i.e., outside the provisions of their
authority in the legislation) delays and exceptions, including
putting off some of the most troublesome provisions until
2015 or later. Even if they could legally do this (the U.S.
supreme court will soon decide if they can), it only moves
the problems to just before the 2016 presidential election.
This, it would seem, is taking “political deja vu all over
again” to an ultimate form of electoral self-destruction.

The proponents of Obamacare did pass their legislation,
and the president signed it. Unlike almost any other major
U.S. legislation, not a single member of the opposition
party voted for it. Now that it is dramatically failing,
vulnerable Democrats are abandoning their once-solid
support for Obamacare. Others are holding on, hoping that
“computer glitches” were the only problem, and that the
system will not only work, but be redeemed.

There is a way out of the impending policy and political
disaster, but that would require the Democrats to reverse
field and abandon the legislation as it is now constituted.
They were not wrong to want to reform healthcare, and I
don’t buy the notion by some on the right that proponents
on the left did not intend to do what they felt was best for
the country. But the president and his congressional
colleagues decided to enact their legislation without
compromise and without any support from their
opposition. Republicans are not entirely blameless on
this, but Obamacare ultimately is not their responsibility.

If it seems unrealstic for me to suggest that the Democrats
reverse field on Obamacare, I point out that the
equivalent of this is what President Bill Clinton did after
his re-election in 1996. I also recall that his second term
ended more successfully than most second terms.

Mr. Obama, Mrs. Pelosi and Mr. Reid apparently are
determined to see Obamacare through more or less as
it stands. They feel they have fulfilled an historical

There is an obstacle to their legacy, however. It is the
electorate in 2014.

If Mr. Romney had been elected in 2012, it would have
obviously made Republicans feel better in the short term,
but there is no certainty, partisan appointments, cabinet
policies, and regulations aside, that he would have solved
the fundamental problems of the nation subsequently,
nor that he and his congressional colleagues could have
repealed Obamacare. Nor was Mr. Obama’s re-election
in itself a prescription for political disaster. As every
second-term president, Mr. Obama had choices to make
and actions to take, especially at the beginning of his
new term, that could have a positive result.

George W. Bush ran into a political brick wall with his
priorities and choices after 2005, particularly in the
economy. In different circumstances and very different
choices, Mr. Obama appears to be going down a path
that will, unintended, likewise result in frustration,
disappointment and the eventual defeat of his party
at the polls.

Copyright (c) 2013 by Barry Casselman. All rights reserved.

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