The
Magnificent Failure of ObamaCare
By Gary North
From the point of view of a defender
of liberty, ObamaCare is the most magnificent welfare state program of our
generation.
Premium
expenses are going up for most people. Deductibles are going up for most
people. Cancellation letters are going out to millions of people. The
number of people signing up is less than the number of people who have received
policy-cancellation letters. In short, the costs are being front-loaded, and
the benefits are being back-loaded.
Always
before, welfare state politics has been based on a specific strategy:
"Benefits first. Costs later." This is called front-loading and
back-loading. The best examples of this process are Social Security and
Medicare. The costs are now coming due for these two programs. According
to Prof. Lawrence Kotlikoff, the back-loaded cost of the two programs is
now in the range of $200
trillion, present value. But no one really cares. Those costs will be
imposed in the future. Politicians care only about the immediate future,
namely, the next election.
The
politicians come to the general public, and they promise that the state will intervene
on the side of the middle class. The state will do so also to help the poor.
The costs will be borne exclusively by the rich. Politicians are careful never to
define how much money is going to be paid by the middle class, especially the
upper-middle-class. This is always kept secret. The assumption is that only the
wealthy will pay for the benefits that will be given to the middle
class and the poor.
Then, step-by-step, the
costs are imposed over years.
There is a kind of definition creep involved. More and more of the middle class
is defined
as being rich. This is never made public. But it does become
operational when the tax bills come due.
The way
around this has been to increase the amount of borrowing by the federal
government, and by other agencies of state and local governments. But,
primarily, it has been done through the federal government.
In order to
keep interest rates low, the Federal Reserve System intervenes in
order to create money out of nothing, in order to purchase the IOUs of
the United States Treasury Department. This conceals the extent of the cost of
the welfare state programs that have been passed into law by an enthusiastic
Congress, and supported by an enthusiastic electorate.
By front-loading the benefits, and by
back-loading the costs, the politicians have extended the welfare state to
encompass virtually every area of life.
ObamaCare is
the exception. ObamaCare is front-loading the costs, and it is back-loading the
benefits.
That is the
nature of all insurance. Insurance programs force you to pay for the
coverage now. You will receive the benefits later, if in fact you become
eligible by means of some disaster in your life. Whatever you have
insured against takes place, and you receive payment from the insurance
company.
In this case, however, the costs of
insuring the poor must be borne by people who buy the policies now. The poor cannot be excluded because
of prior conditions. So, this is not insurance; this is a welfare state
program, pure and simple. But it is being covered by the illusion that it is,
in fact, an insurance program.
People who
have pre-existing conditions that exclude them from getting insurance in the
free market are rushing to sign up for the welfare program. People who are
generally healthy, meaning younger people, are not rushing to sign up. They
don't want the program. They have been outvoted. They had not
understood that they are the targets of the program. They do not understand the
economics of health insurance, when coupled with the economics of ObamaCare,
have made
them the big losers. They are not rich. They are barely
middle class. But they are the ones who are going to pay the freight for the
poor people and the old people who are sick and cannot get insurance.
The front-loading is taking place today,
in a congressional election year.
The pain will be imposed on middle-class voters and younger voters prior to the
election. It will build all year long.
The subsidies come in
the form of tax credits, but half the voters do not pay income taxes. So, they will get no relief.
Supposedly, the government will pay for any increased costs of their insurance
policies. This will prove to be an illusion. It is a poorly timed
illusion from the point of view of the Democrats, and a magnificent illusion
from the point of view of the Republican Party. The Republican Party voted
across the board against the program. So, it took a position in 2010 that it
would front-load the cost and back-load the benefits.
In 2010, the
liberal media piled on the Republicans, calling them heartless opponents of the
poor and the weak. In 2012, this proved to be an ineffective attack on the
Republican Party. In 2014, the costs are being imposed directly, and the Republicans have
escaped the political liability. We now see Democrats running for cover. All of
a sudden, ObamaCare needs delays. All of a sudden, ObamaCare does not look like
such a good idea.
Because of
the timing of the increased premium costs, which are coming this year, the
traditional back loading strategy has hit the Democrats right between the eyes.
It took too long to get from the promise, which was made in 2010, and the
benefits, which are only appearing this year. But the benefits are being
extended only to people at the margin. They are people who almost
certainly would have voted for the Democrats anyway. Meanwhile, the costs are being imposed on voting groups, especially
young adults, who tend to vote for the Democrats, and who are now caught by the
details of the law that Nancy Pelosi said Congress would not be allowed to read
until Congress voted for the bill. Congress voted for the bill, and now the
targeted losers are finding out just how large the bill really is. They're
finding this out in an election year.
Because of
the unique situation in which all Republicans voted against the bill, it is now
possible to gain political acceptance by Republicans for the principle of the
repeal of ObamaCare. That will have to require the election of a Republican
president and Republican majorities in both houses of Congress in 2016. If,
as expected, Democrats lose ground in the Senate in 2014, the scene will be set
for a complete repeal in 2017. The ability of Republican moderates to
get a replacement program is minimal. There will be domestic opposition from
the Tea Party movement. But there will not be opposition by the Tea Party
movement to repeal. So, it will be much easier to repeal ObamaCare than it will
be to get a Republican substitute. This has not happened before. Always
before, some Republicans voted with the Democrats on particular welfare state
programs. Unified opposition across the board has not happened before. But
it happened this time. This makes ObamaCare unique.
Democrats
insist that once the program gets rolling, a majority of voters will support
it, and Democrats will be re-elected. This is Harry Reid's position. He has
stated clearly. This is the position of the mainstream media. They are hoping,
though of course not praying, that there will be enough beneficiaries on the
rolls to offset the losers who had their policies canceled, their premiums
increased, and their liabilities increased. So far, this hope is an illusion.
The horror stories are going to begin
very soon.
These horror
stories will be people who have had their deductibles increased, and who are hit
by a medical bill. They will find out that the deductible must be paid every
year. If they get hit by a multi-year disease, they will pay
these high deductibles every year from now on. The political pain will
be intense. While the mainstream media may not feature these stories, there
will be lots of them on the alternative media. Horror stories gain readership.
These are human interest stories. There are going to be thousands of them every
year.
Again, the Democrats
have made a mistake.
They have voted as a party in favor of a program that has front-loaded the
costs and back-loaded the benefits.
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