January 16, 2015

WHICH IS WHY OBAMACARE AND THE REFORMS HAVE NOTHING TO DO WITH HEALTH CARE:

Why Republicans can't come up with an Obamacare replacement (Ezra Klein, January 16, 2015, Vox)

In Philip Klein's new book Overcoming Obamacare, Cato's Michael Cannon scolds the right for getting outplayed, again and again, on health care.

"Conservatives are falling into the same trap now that they fell into with fighting the Clinton health plan ... they're conceding the left's premises that the government should be trying to provide everybody with health insurance, or the government should be trying to expand access to health insurance, or the government should be subsidizing health insurance, because some people need help and therefore the federal government should be the one to help them. The problem [comes] because once you accept those premises, all of your solutions look like the left's solutions. They look like Obamacare. And so a lot of conservatives, as much as they want to repeal it and say they want to repeal Obamacare, they're still pushing replace plans that amount to 'Obamacare Lite.'"

Cannon is right. The basic project of health reform, at least as it's been understood in American politics in recent decades, involves the government giving money to poor people so they can buy health-care insurance. That money needs to come from somewhere. The government usually gets it from politically unsympathetic constituencies like the rich and corporations, both of which lean Republican. In the case of Obamacare, Medicare cuts were added to the package, meaning another Republican-tilting constituency -- the elderly -- absorbed the pain.

The problem for conservatives is that making sure poor people have health insurance is politically popular, at least in the abstract. But the plans that achieve it tend to be in tension with both broad tenets of conservatism -- it raises taxes, it redistributes wealth, and it grows the government -- and with key factions of the conservative coalition.

The result is that conservatives have rarely made health reform a priority.


Of course conservative reforms build off of Obamacare, which was the Heritage health plan.  But now that we have the individual mandate we'll use it to force everyone into HSAs, which are permanent personal accounts, just like the ones we'll replace Social Security with.  It's a surreptitious means of making everyone build wealth over the course of their lives in order to reduce their claims on the welfare state in their old age.

Posted by at January 16, 2015 2:10 PM
  

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