Tag: ObamaCare

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folly general freedom ideological culture responsibility too much government U.S. Constitution

UN-​appealing

UN, U.N., United Nations, Obamacare, socialism, socialists

Like E.F. Hutton, when the United Nations’ Office of the High Commissioner for Human Rights “Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health” talks, people listen.

In disbelief, perhaps. Or amusement. But they listen. Well, at least Washington Post columnist Dana Milbank does, anyway.

Unfortunately, Milbank couldn’t get Dainius Puras — the Lithuanian doctor serving as the U.N.’s Special Rapporteur on the right of everyone to blah, blah, blah — to talk. Milbank did, however, uncover an “urgent appeal” sent by Puras to the U.S. State Department, with instructions to pass it along to congressional leaders.

Puras won’t discuss his confidential February letter until June, when “it becomes public at the next session of the Human Rights Council.” But the “leaked” letter announces the U.N. has launched an investigation to determine whether repealing the Affordable Care Act (Obamacare) violates international law.*

“The letter urges that ‘all necessary interim measures be taken to prevent the alleged violations’” Milbank further explains, “and asks that, if the ‘allegations’ proved correct, there be ‘adequate measure … to guarantee the accountability of any person responsible.’”

Should Congress repeal Obamacare, will U.N. troops occupy Washington, arresting congressmen for voting against its mandate?

The international body has no way “to impose its will,” Milbank acknowledges, seeming to wish it did and complaining that folks just “scoff at lectures from U.N. bureaucrats.”**

Taking solace, Milbank declares: “[T]he U.N. letter is at least a bit of moral support for those defending Obamacare.” 

Moral support? From the U.N.? Now, you’re pulling my leg.

This is Common Sense. I’m Paul Jacob.

 

* Along with other U.N. gobbledygook, the letter cites Article 25 of the Universal Declaration of Human Rights, which proclaims, “Everyone has the right to a standard of living adequate for the health and well-​being of himself and of his family” etc. etc. Standard U.N. speak: flowery, vague and unenforceable.

** People throughout the world and across the political spectrum — from the UK’s Daniel Hannan to Chelsea Clinton — scoff at the U.N. for being incompetent and corrupt. Not to mention thoroughly socialist.

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Accountability government transparency ideological culture moral hazard nannyism national politics & policies political challengers porkbarrel politics responsibility too much government

Legislating in the Real World

Steve Bannon, Trump, Freedom Caucus, big government, Ryancare, Trumpcare, Obamacare

Rolling back Big Government is not easy, especially when you are not that into it.

Robert Draper, profiling Steve Bannon in the New York Times, gives us a view into the mind of Trump’s right-​hand man, who appears to think GOP insiders are obsessed with principles. “[I]t’s all this theoretical Cato Institute, Austrian economics, limited government — which just doesn’t have any depth to it. They’re not living in the real world.”

At best, this only fits the Freedom Caucus members, who killed RyanCare. But who is avoiding reality, here?

“Bannon clearly is not as familiar with the mindset of congressional Republicans as he imagines,” counters Jeff Deist, head of the “Austrian” Mises Institute. “They are primarily concerned with how the whole ‘repeal and replace’ debacle plays back home.” 

Like Deist, I see the spectacular fizzle of RyanCare as evidence of the increasing irrelevance of Republican compromising. “The GOP is the party of trillion dollar military budgets,” Deist insists, noting that it “won’t even kill an openly cronyist program like the Export-​Import Bank.”

If keeping Big Government secure is all Republicans can do, what use are they?

“All around us are the almost unimaginable benefits of markets, cooperation, and technology,” Deist explains, “yet somehow we’re naïve if we don’t want to funnel human activity through government cattle chutes.”

Bannon will not secure solid GOP support if he keeps pushing the usual establishment compromises while pretending they are either realistic or revolutionary. Freedom Caucus Republicans seem bent on doing something Republicans usually avoid: change “the real world” for the better by practically limiting government.

Not just in theory.

Bannon seems to have other goals.

This is Common Sense. I’m Paul Jacob.

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free trade & free markets moral hazard nannyism national politics & policies property rights responsibility subsidy too much government

TrumpCare Trumped

Trumpcare, Ryancare, healthcare, Obamacare, Freedom Caucus, socialism

It took awhile for the Obama Administration to accept the term “ObamaCare.” Nancy Pelosi was the initial driver of the massive scheme to permanently alter American medicine and insurance, and “PelosiCare” would have been a fit moniker for the wildly mis-​named “Affordable Care Act.” But the administration put the whole of the new president’s political capital behind it, and the ACA went into law popularly known as “ObamaCare.”

The Republicans pledged to repeal it, from Day One. And repeatedly passed repeal bills, certain to be vetoed by the president named Obama. They needed a Republican in the White House.

Donald Trump ran, in part, on the promise of getting rid of ObamaCare. But upon taking the reins, two things became obvious: Republicans in Congress lacked the guts to repeal the ACA, and even lacked a coherent scheme to alter it.

The new president could hardly be expected to possess the plan they lacked, though on the campaign trail he suggested* the best approach: repeal, then open up insurance markets across state lines. The GOP Congress, on the other hand, was all promise and no clue.

So Speaker of the House Paul Ryan hastily cooked up what was to be the new TrumpCare — a ridiculous reform package with nothing much to say for it.

He failed to gain support from Democrats (of course) and Freedom Caucus representatives.

TrumpCare, trumped, became RyanCare. A failure.

The Freedom Caucus representatives? They breathe freely.

Sure, they “betrayed” the new president, “robbing” him of glory. But they also saved the country from a “reform” in many ways worse than ObamaCare.

This is Common Sense. I’m Paul Jacob.

 

* It’s worth keeping in mind that Trump had been for socialized medicine before running for office. This is why there was no reason to expect policy leadership on his part.

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Accountability folly free trade & free markets general freedom moral hazard nannyism national politics & policies responsibility too much government

DumpCare

healthcare, Trumpcare, Obamacare, medicine, costs, regulations, Medicaid, single payer

Speaker of the House Paul Ryan insists that his “TrumpCare” plan to replace ObamaCare will decrease medical insurance rates. Others argue that his American Health Care Act will increase those rates. Likewise, he expects it to reduce strain on federal budgets; others deny this outright. The “coverage” issue is just as contentious.

TrumpCare is a mess because it is isn’t “DumpCare.” What’s needed is not yet another regulation-​plus-​subsidy system. We need repeal and then … more repeals.

Unfortunately, President Donald Trump has never really been on board with this. He has promised that no one would lose “coverage,” assuming that “coverage” is “health care.”

It is not. State charity programs like Medicaid (upon which ObamaCare relied way too much) are merely ways to pay for services. Dumping a gimcrack payment system is not the same as decreasing medical services. “DumpCare” wouldn’t dump care, only insane government.

For example, we know that health care outcomes for poor folks without Medicaid turn out to be better than poor folks with Medicaid.* Increasing the number of people on formalized subsidy programs is no panacea.

Besides, ObamaCare severely under-​delivered on “coverage.”

New programs, nevertheless, are traps, regardless of demerit: once you provide a benefit, folks come to rely on it and demand more — objecting when it’s taken away. Which is why few programs are ever repealed, despite failing to meet original expectations.

So far, the “small government party” hasn’t found the courage to actually limit government. Do Republicans really believe what they say, that fewer regulations and subsidies will lead to lower costs and better service?

It seems Republicans won’t take their own prescription.

This is Common Sense. I’m Paul Jacob.

 

* Oregon’s 2008 Medicaid “natural experiment” provides reasons to question the merits of the program. As the initial, randomized, controlled study found, “Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services.…”

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Accountability folly ideological culture moral hazard nannyism national politics & policies responsibility too much government U.S. Constitution

Tough Luck, Chumps

Obamacare, Affordable Care Act, Obama, Trump, Sanders, debate, CNN

Advertised as a big deal ahead of time, the debate didn’t get much play afterwards.

Especially from the Left blogosphere.

Why?

Billed as about the “future of ObamaCare,” it was really about what should replace ObamaCare.

The CNN debate pitted Sen. Ted Cruz, well-​known Republican opponent of the Affordable Care Act*, against Sen. Bernie Sanders, well-​known “independent” proponent of what he likes to call the “Medicare for All single-​payer program.”

Upshot? While either Bernie or Ted may possibly be construed to have won, there was indeed one certain loser, ObamaCare itself.

Sen. Sanders conceded nearly every charge Sen. Cruz lobbed at the program. He merely countered with his support for treating health care “as a right, not a privilege” (a leftist farrago from days of yore) and moving on to single-​payer medicine.

That’s how bad ObamaCare really is. Its chosen champion refused to champion it.

The basic tension was best summed up between “town hall” questioners Carol, suffering from multiple sclerosis, who asked Cruz to promise continued coverage for cases like hers, and LaRonda, a woman with a chain of hair care shops who cannot afford insurance for herself or her employees and also cannot expand her company because at 50 employees the ACA would force her to provide insurance.

Cruz expressed his sympathy for Carol, but seemed to meander around her request for a guarantee. He also evaded** a straightforward answer re: “healthcare as a right.”

Sanders was a tad more honest, in effect giving the “tough luck” answer that the entrepreneur just “should” pay*** for her employees’ medical insurance.

Well, we sure are all “paying” for ObamaCare, one way or another.

This is Common Sense. I’m Paul Jacob.

 

* Which is the same thing as ObamaCare. Some folks purportedly hate ObamaCare but love the ACA. No reader of Common Sense, of course.

** Cruz concluded the debate better, alluding to an old SNL skit about a recording session wherein the cowbell ringer always wanted “more cowbell” in every take. “It was government control that messed this all up. And Bernie and the Democrats’ solution is more cow bell, more cow bell.”

*** “[I]f you have more than 50 people, you know what, I think — I’m afraid to tell you — I think you will have to provide health insurance.”

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Accountability responsibility too much government

Out of Our Misery

Obamacare, ACA, Trump, Chickens home to roost

Obamacare may be on the way out.

According to The Atlantic, “the powers of the incoming Health and Human Services secretary are broad enough to cripple the [Affordable Care Act] so it has to be replaced.” Which is significant since the new President has just “signed an executive order empowering his administration’s agencies to do all they can — within the bounds of the Affordable Care Act — to undercut that law.”

The Atlantic’s Vann R. Newkirk II suggests this is … “ironic.” The executive leeway Trump is taking is not without precedent. “The irony of that component,” he writes, “is that it rests on precedent set by the Obama administration, which used executive and regulatory power liberally to make the law work in the face of Republican opposition.”

Irony? How about chickens returning to the home roost?

Obamacare itself undermined Obamacare. The plan, from the beginning, was so gimcrack with hidden redistribution that, to both opponents and proponents, it was designed to fail … to usher in the Glorious Era of socialized medicine.

Since Obamacare increased “insurance” costs for hundreds of thousands of previous insurance policy holders, and increased medical costs generally, too, it actually discouraged participation from the healthiest, many of whom would rather pay the exorbitant fines, er, “taxes.” Throwing the insurance industry into a death spiral.

So, putting the system out of our misery sooner seems sensible.

But Congress and Trump cannot stop there. Either they repeal more federal regulation and subsidy*, or keep parts of Obamacare, despite a lack of financial stability. A new bill in the Senate promises to do the latter.

We haven’t seen much hint of the former.

But can hope. Audaciously.

This is Common Sense. I’m Paul Jacob.

 

* To let markets work. Note that The Atlantic tends to miss the point of Obamacare critics. In describing more market-​based options, the magazine characterizes the Medical Health Savings Account approach as “For people sick of high deductibles, Republicans offer high-​deductible plans as replacements for Obamacare.” The idea is to incentivize people to pay for their own care, which would bring costs down generally.

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