Friday, September 27, 2013

I'll just say it: "ObamaCare will collapse" is wishful thinking

Here's a comment I posted on earlier this morning:
It's foolish to imagine that ObamaCare will just collapse under its own weight. Has Medicare collapsed? Has Medicaid? Or Food Stamps?

No -- ObamaCare may be many things (a thicket of regulations, a fraud- and identity theft-prone computer system, a set of mandates) but fundamentally it's an entitlement program. Once people have begun receiving subsidies, how is it any more likely that politicians will be able to cancel them than they can make even a small cut in food stamps?

And what would it mean for ObamaCare to "fail"? It's not like a car that'll just break down on the highway, or even a corporation that'll bleed cash until it declares bankruptcy. It's a government entity.

This wishful thinking has to be replaced by serious proposals (that Democrats would actually agree to) to fix the whole thing -- and not even by some columnist but by actual politicians. Irritated as hell that none of the so-called party leaders are doing this.
I am becoming increasingly frustrated by people who seem to live in a fantasy world in which ObamaCare will disintegrate on its own, or a Calvinist world in which, should it continue on, then it was meant to be and we should all just accept it and move on. Or a world in which staying true to principles holds not just for moral issues like abortion but principles around how to structure health care -- so that trying to get something done, even in this policy arena, that involves violating one's "Sacred Principles" is out of the question. Or in which resentment over the whole thing has just meant they'd rather suffer a lousy system than act to improve it.


  1. If true, then you are just proposing surrender since there is nothing the Democrats will agree to that isn't just increasing the entitlement nature of the PPACA. I agree, parts of Obamacare are likely here to stay- especially the Medicaid expansion, the various taxes, fees, and mandates of coverage. However, a key part of the program is vulnerable to collapse simply because its funding is dependent on voluntary compliance in overpaying for insurance. I don't think it a fantasy to believe this part will collapse. I can imagine that Democrats will respond by trying to increase the payments (or the mandate penalties, though unlikely now) the government makes into the system to keep the insurers from bolting, and the Republicans may well lose this battle for exactly the reasons you outline, but this is not a fait accompli.


    as i note in the above link, i think it will collapse in the same way many other financial disasters have collapsed (and faster than Detroit, because Detroit at least used to have a heyday)....but that will be extremely destructive, and would be better to annihilate the thing ASAP. But it seems career politicians are not interested in actually fixing anything (not that they've ever shown such a propensity for such)

    I feel sorry for all the people who work the call centers, are on the IT side, and, of course, the actuaries trying to price all this. They will be the first hit.

  3. The below is a used comment, recycled from where I put it up earlier this morning (Apt 11d) but it seems relevant. I think Yancey Ward is right that the kids will notice that they are being asked to grossly overpay to make it work for older people, and I would add that this flaw was put in to hide the cost away from the tax estimates. Is it going to go away? I doubt it, although not as much as you do. I think it was epic political malpractice to pass it as it was passed, and it may yet put the Reeps in power to be the ones to revise it. Anyway, here 'tis:

    on September 28, 2013 at 9:21 am said:
    I was tremendously impressed by a piece I read once, and have googled and cannot find. Maybe it is not on the intertubes: I know I read it on paper. I sort of thought it was from Caro’s book on Johnson. Maybe our Gracious Hostess, a genuine political scientist as she is, can help out. The discussion was about how Johnson, in the Senate and later as President, would keep looking for votes for something long after he had a majority. Anything big, he wanted to nail it down tight. He would offer significant concessions to get somebody on board. This was to get people to have an investment in something working, later. And once he got something passed, it stayed passed.

    I think the ObamaCare process was probably the most disastrous piece of legislative work of my lifetime: a huge change, with the barest majority. The Senate stolen by prosecutors in Alaska and the Secretary of State in Minn. The message of Massachusetts (Massachusetts!!!) electing a Reep was ignored by the Dems, and they jammed through the hugely flawed Senate version in the House because they could not go back to the well and fix things in the Senate. “You have to pass it, to find out what’s in it” in the deathless phrase of Nancy Pelosi. I expect that policy schools, for years to come, will be giving cases to their students about how foolish it is to try and do something like this on a thin majority. I guess a counter-example would be Bush 43 (yes!) and all the stuff he did with his pharmaceuticals benefit plan to get Dem backing, and it’s not under threat at all, now, it’s durable.

    Flaws including this crapdoodle we are talking about here of making a big incentive to force people part time, and making the pretense for tax scoring that it was low cost by the expedient of overcharging young people to subsidize old people through plan payments (you were always going to have to subsidize wrinklies, but you could do it honestly through taxes or you could do it by stealth on the backs of young premium payers).

    McMegan has a nice discussion of the Dems’ expection that the opponents would roll over on their backs with their legs in the air. Will people start to like it once it’s in place? Maybe, we’ll see. But the process has been disastrous for the Dems and for Obama.


Love comments! And the nice thing about this small blog is that I rarely get spam so don't need to moderate the comments.

I've set the comments up to allow anonymous users -- but I'd love it if you "signed" your comments (as some of my readers have done) just so you have an identity of sorts.