Obamacare Is 'Bro'-ken Beyond Repair
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Morning Jolt October 23, 2013 Obamacare Is 'Bro'-ken Beyond Repair Most Americans don't like thinking about health insurance. If you're thinking about it, usually it means something's gone wrong. The best-case scenario is that you've gotten sick or injured, and the health insurance pays for the treatment. The worse scenario is that you're fighting with them to get them to cover the costs of your treatment. There's a reason most Americans were comfortable, if not thrilled, getting health insurance through their employer: The choices are limited, and it's easier to pick among three plans offered through your employer than the multitude of plans offered on the market. There's a school of thought that while we like a lot of choices in theory, in practice we find too many options confusing and get paralyzed by indecision. If I offer you a choice of two movies to watch tonight, you can pick pretty quickly. Yet if we start looking at the On Demand options, we will scroll and scroll and scroll and "how about that one? No?" and scroll and scroll and FOR GOD'S SAKE, HONEY, JUST PICK A MOVIE ALREADY I DON'T EVEN CARE ANYMORE. -- Er, sorry, just lapsed into old habit there. The point is that many people find making a decision more difficult when they have a lot of choices. I just plugged information into ehealthinsurance.com and found 18 plans priced from about $500 to $1,500 per month. Picking a plan requires evaluating trade-offs (Do I want a higher monthly premium in exchange for a lower deductible?) and weighing a lot of unknowns (Am I going to need a lot of coverage in the future? What if I pay a lot and never need it? What if I don't reach my deductibles most years?). A while back, liberal blogger Kevin Drum acknowledged the emotions that drove much of the health-care debate in this country for the past decades:
Thus, to build the political momentum to pass the bill, Obama and his allies had to promise something close to the ideal of all upside and no downside. Charlie Cooke remembers:
That is why Obamacare is truly destined to fail. It's not just the website; it's a series of ultimately contradictory promises. And its most nominal form of success -- avoiding the death spiral -- hinges on two extremely big gambles. The first is that most Americans will warmly embrace the process of comparison-shopping for health insurance. The second is persuading young invincibles to buy insurance. Behold, a new web ad from Colorado Consumer Health Initiative and ProgressNow Colorado Education:
Oh, and if I were setting up a system that absolutely, positively depended upon getting young people to buy insurance . . . I would not have included a provision that requires plans to cover children until they're 26. Medicaid Is a Very Nice Program that Is Very Expensive to Expand. It didn't take long before this post generated responses that I was A) a jerk because I suggested I could be open to expanding Medicaid if the federal government and states were flush with cash and B) a jerk for suggesting neither the federal or state governments were in the kind of financial shape to expand Medicaid coverage. As one of the first commenters put it, "we are the richest nation in the history of the civilized world." He asserted that suggesting that the United States couldn't afford to expand Medicaid is a "false choice." Actually, it's quite debatable as to whether we're the richest nation in the world today. Our GDP is less than that of the European Union by most measurements. Per capita, we're somewhere between tenth and 18th. And if you've got $17 trillion in debt and have run deficits of about a billion a year for the past four years, and you're celebrating a $670 billion deficit . . . to sound a bit like Mark Steyn, you're not as rich as you think you are. So, let's step back and ask ourselves how we want the very poor -- we're talking $958 in income per month for one person, or $1,963 gross income per month for a family of four before taking out taxes -- to pay for their medical care? The Obamacare Medicaid expansion raises it to individuals making $1,275 per month or families of four making $2,611 per month. Most Americans get their health insurance through their employer, but if you're making $900 to $1,900 per month, there's a good chance your employer doesn't offer health insurance. Obviously, you don't have much money lying around you can use to purchase insurance individually. Medicaid is a good program -- we don't want pregnant women, individuals with disabilities, children of low-income households, some of the poorest elderly, and low-income parents suffering unnecessary health problems -- but it comes with the same problems the rest of our entitlement programs have -- too much money going out, not enough coming in (no FICA taxes go to Medicaid) and the costs are exploding because poor people can require expensive health care as much as everyone else. And now, under Obamacare, we're expanding Medicaid a lot. With Ohio signing off on the expansion, it's now 25 states. The governments -- federal and state -- are going to be paying for the health care of millions of more people now. While that's good news for them, that's bad news for the fiscal bottom lines of those states. (Why yes, many of the states expanding Medicaid or leaning towards it are the same ones with giant state-worker-pension liabilities -- Illinois, California, New Jersey, Hawaii, Kentucky, Massachusetts, Colorado, Maryland, Rhode Island.) Expect a lot more intense budgetary fights in these states as the Medicaid funding requirement starts to take a bigger and bigger bite of those state governments. Bloomberg Prepares to Spin a McAuliffe Win as a Mandate for Gun Control Mike Bloomberg loves to really throw around the big money once his guy is safely ahead:
One of my Virginia regulars writes in:
Clairvoyance can be a real pain sometimes. ADDENDUM: Kathleen Sebelius told CNN's Sanjay Gupta last night:
Translation: I blindsided the president on the single most important task of his presidency. She still has a job. He's kind of a wimp, isn't he? To read more, visit www.nationalreview.com
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