November 24, 2013


(JOHN HARWOOD, 11/24/13, NY Times)

These days the word is particularly toxic at the White House, where it has been hidden away to make the Affordable Care Act more palatable to the public and less a target for Republicans, who have long accused Democrats of seeking "socialized medicine." But the redistribution of wealth has always been a central feature of the law and lies at the heart of the insurance market disruptions driving political attacks this fall.

"Americans want a fair and fixed insurance market," said Jonathan Gruber, a health economist at the Massachusetts Institute of Technology who advised Mr. Obama's team as it designed the law. "You cannot have that without some redistribution away from a small number of people."

Mr. Obama's advisers set out to pass the law in 2009 fully aware that fears among middle-class voters sank President Bill Clinton's health initiative 16 years earlier. So they designed the legislation to minimize the number of people likely to be hurt.

Instead of a sweeping change to a government-run "single-payer" system favored by Democratic liberals, members of the administration sought to preserve the existing system of employer-provided health insurance while covering the uninsured through the expansion of Medicaid and changes to the individual insurance market.

They also added benefits available to any family, such as the ability of children up to age 26 to remain on their parents' health plans.

But throughout the process, they knew that some level of redistributing wealth -- creating losers as well as winners -- was inescapable.

They were nonetheless acutely aware of how explosive the word could be.

...maybe they could accept a plan that really transfers wealth, one with publicly-funded HSAs, instead of the one that only redistributes wealth to insurance companies and medical providers.  Sadly, the UR is too Republican for our own good.

Posted by at November 24, 2013 5:17 PM

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