American Elephants


It’s Over. It Didn’t Work. by The Elephant's Child

ARFBYK_2942681bYou have probably noticed that Democrats generally believe that most things are better done by the government than by the private sector. The federal government is not just a bureaucracy, but a bureaucracy of bureaucracies, thousands of agencies, departments. offices, all with their own cultures, rules, traditions, and all striving to grow in importance, size, and share of the federal budget. Service, not so much.

Whereas, the private sector strives to make a profit, clearly a dirty word. They haven’t been elected or appointed. They make too much money, they fire people —sometimes in massive numbers. The federal government tries to make them more responsible and keep corporations from doing bad things. Obviously the important things should all be done by a wise government who can help the common folk out there, who need all the help they can get.

So when the cost of health care seemed to be climbing, and there were people who didn’t have health insurance, of course the Democrats planned to take it over by showing just how good a health insurance plan could be and all the good things that they would include — as quickly as possible while they controlled Congress. Promises, big promises — more affordable, if you like your doctor you can keep your doctor, all sorts of good things — and it just doesn’t work.

The co-ops that were going to save so much in costs are going belly-up at a tremendous rate, more every few days. A New York State audit finds that ObamaCare exchanges have enrolled hundreds of dead people and paid out benefits. Some of the dead people were enrolled after they died. A cover-up is in the works. ObamaCare premiums are projected to soar by 20.3 percent on average in 2016 instead of the 7.5 percent claimed by federal officials.

Supporters credit ObamaCare with helping nine million uninsured Americans find coverage in 2014, but a new paper from the Heritage Foundation suggests that the increase came from adding nearly nine million people to the Medicaid rolls. The wealthy can have health insurance, but at a higher price, but they can afford it. Many middle-class Americans are paying higher premiums that they can barely afford. Millions of other Americans  have found themselves forced out of affordable plans with their new premiums rising rapidly.

Regardless of whether there is a President Cruz or a President Rubio in January 2017, regardless of the existence or size of a Republican majority in Congress, the so-called Patient Protection and Affordable Care Act (ACA) has failed. The grand vision of an efficient pseudo-market in health insurance under enlightened federal management — the heart of Obamacare — is not coming to pass. Obamacare, meaning the operating model that undergirded the law that Congress passed and President Barack Obama signed with great fanfare — is dead, and it will not be revived. What remains is fitful chaos.

That’s Kevin Williamson at National Review.  His careful explanation for why it doesn’t work is very worth reading. Obama’s ‘promises’ of course have proved as improbable as all of his others. You can’t keep your doctor, It’s going to cost way more, not $2,500 less, and ObamaCare is adding a bundle to the deficit.

The architects of Obamacare are deeply distrustful of the role of for-profit companies in the health-care business because, in their nearly pristine ignorance, they falsely believe profits to be net deductions from the sum of the public good rather than measures of the creation of real social value.

Add in a complete lack of understanding of the role of incentives, some major innumeracy,  unbridled confidence in cost-saving gimmicks that were mostly wishful thinking. Republicans are a lot better at this sort of stuff, and they do mostly understand incentives. But they may want to rewrite it, in an attempt to repair the unrepairable.

What I am most concerned about is getting the federal government out of the health care business. They are totally incompetent at it and should never be allowed to have any responsibility for it. The Indian Health Service is a disgrace. The Veterans Administration is embroiled in scandal. Medicaid is a mess, and Medicare is rapidly going broke, along with Social Security. Even more, it is a political debacle as well.

Since it was first enacted, conservative think-tanks have been studying what works and what doesn’t. There are dozens of them, and top scholars have been working on better answers. Let’s get them all on the table. Ask the medical profession for their best ideas. Consult with the Health Insurance Companies instead of regarding them as the enemy to be punished and controlled.

The biggest mistake was to assume that you could take the health care system, layer on a vast bureaucracy of many agencies on top, each striving to increase their budgets, wrap it all up in a package of glitter with fancy logos and music and Life of Julia,  pajama boy, and unneeded gifts and expect it to be more efficient and cost less.


4 Comments so far
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Not that the Dems will stop trying to use it as a cudgel, though.

On Tuesday, Mark Bevin won the Governorship of Kentucky, and a good portion of the comments I’ve seen from our more left-leaning countrymen is that now 400,000 Kentuckians will lose their insurance (through the state co-op, KyNect) because Bevin promised to get rid of it. The problem they won’t admit is that KyNect has been on life support for the past year, and the only reason that it’s going to make to the end of this year is the outgoing governor, Breshear, propped it up with state and federal funds through an executive order (gee, wonder where he may have gotten the idea for doing that…). As it stands, Democrats will try to blame the collapse of KyNect on Bevin, mainly because the inevitable bankruptcy will happen under his new administration.

Comment by Lon Mead

The British National Health Service is continuing to fall apart, not in people leaving the system, but in outcomes. People are not surviving NHS treatment, and every category is headed down, rather than up. As you say, the Dems will try to frighten people that Republicans are trying to take away their care. I’ve been reading the work of lots of think tanks. Hoover has just released a pre-publication copy of Dr. Scott Atlas’s new book. I fear that each of these candidates will try to come up with their own solution, and Congress will try to re-write ObamaCare — the worst possible solution. The think tanks need to come up with a conference on health care, and invite Congress to get ther good ideas in and headed in the right direction.

Comment by The Elephant's Child

I’ve been urging my local representative, Phil Roe, who is a doctor, along these same lines.

Comment by Lon Mead

My problem is that my only Republican representative is a State senator. Not much help.

Comment by The Elephant's Child




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