Jan 132014

Current opinion of Obamacare perfectly embodies what I think is a primary cause of our seemingly chronically poisonous political discourse.

Obamacare is a hair’s width from a complete disaster. Let’s review the promises on which it was sold.

Keep your plan? Not necessarily. Keep your doctor? Maybe. Deficit-neutral? Absurdly not so. Lower health care costs for “a typical family”? Ridiculously untrue. Universal coverage? Not even close.

Did I miss any big ones? That looks like 2 Ds and 3 Fs to me (to be very charitable on the first two). The president’s signature accomplishment is a failure. It is awful. It harms many, many more than it helps. If there is a dogs-and-torches sort of moment for the American people, this seems like it.

Indeed, there are many saying just what I’ve said. But a significant minority still supports this travesty.


Well, those with preexisting conditions are in better shape than they ever have been. So there’s one diamond in the dump truck of manure. It didn’t take a disastrous omnibus law to help those people, despite the false dilemma bleatings of those who would claim otherwise.

I think the main reason some percentage of Americans continue to support this law is that its stated intentions are desirable. Its creators and backers say that it is designed to help, so it must be helping.

I do not question the motives of most Obamacare supporters. I question their assessments (if any) of its efficacy.

I would love to accomplish what Obamacare claims to accomplish. It is very clear that it doesn’t now, nor will it ever. So I want it stopped.

I want it stopped because it doesn’t work, not because I oppose its stated goals.

See the difference?

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 Posted by at 9:39 am

  6 Responses to “Questioning motives vs. efficacy in public policy”

  1. I’ve never been a “supporter” of the ACA. I was 100% confident that it wasn’t going to be the solution to all our problems. That confidence applied to anything that would’ve come from the healthcare reforms, before we even knew what they were.

    What I did support, and still do, is a change to how it all works. I still think there’s a lot of change to the healthcare system needed. I don’t claim to know exactly what would work best. I’m encouraged that we took a shot at it. I think that as we see what doesn’t work, we need to fix it. The fixes need to be targeted and surgical (for lack of a better term), not “welp that didn’t work, let’s nuke it from orbit”.

    I think the biggest ideological battle we face with it in the future as things change is the same battle we’re currently facing, which I think a lot of people are overlooking. That is, how much control over the whole system do we give private business. I think too much of the high costs and screwy coverage people are experience are disproportionally attributed to the law versus the businesses who are actually making the decisions.

    I know all too many people who have had their insurance plans drastically changed, and often attributed to Obamacare. Yet I know others who have had almost no change in their cost or coverage, retaining coverage nearly identical to what others lost. The only obvious variable between the various situations is the companies they work for, and to an extent what the insurance companies seem to be offering. I suspect many corporations saw the big headliner healthcare overhaul as a chance to suddenly change their employees coverage significantly, reduce the amount they contribute toward the premiums, and chalk it all up to “Obamacare”. Yes there are a number of parts of the law that motivate companies to do so, but said companies should be careful the public image they get for treating their employees so poorly, as it’s already been reported that some of those companies are taking a hit in customer base.

    I also keep putting “Obamacare” in quotes because I think it’s a misnomer. Obama originally came to the table with what pretty much amounted to “Welfare for Everyone”. The mandate, likely one of the most controversial parts, actually came from the republican side, with origins traced back to the Heritage Foundation and has been introduced into legislation a number of times by Republicans [source].

    What we ended up with is one of the last examples in the last few years (which I think is a shame) where both sides of the aisle compromised greatly on a significant piece of legislation. It’s also a shame that many of those who contributed to the law and voted for it have now disowned it. Now, President Obama has fully embraced the final result, as he probably should since it was a major part of his platform, so I guess it’s somewhat appropriate to call it Obamacare, but I still like to refer to it by it’s ACA name since it really does represent a compromise between both sides.

    I do think there are a number of things that should be cut out. I do think there are a few things that were left out. I don’t think we’ll ever get it 100% right, but I want us to keep trying. I want the bills that try to affect change to be stand-alone, single-topic bills, not tagged on to completely unrelated legislation, a problem our legislative process has had in general for DECADES, all for the pure purpose of politics and finger pointing.

    Also, for the record, I voted in the 2012 federal election, and I didn’t vote for a single incumbent.

    • Tahm, three quick points:

      We got this as a “nuke from orbit.” When you have better than 80% of people saying they’re satisfied with their current coverage, why didn’t we get those targeted initiatives you’re talking about to start with?

      There is no meaningful distinction between something being explicitly in the language of the law itself vs. said language reliably incentivizing insurance companies to take specific actions. This is a hair Obama tried to split when “if you like your plan, you can keep your plan” first started coming unraveled, and it’s a crock.

      This “compromise” garnered exactly zero Republican votes and is therefore nothing of the sort. “Obamacare” it shall forever be. He and the Democrats own it 100%.

      • I think the 0 Republican votes is a interesting, multi-variable equation of political science for the bill that ultimately passed. There were a few really screwy things at play, most of which are political and procedural tactics that I generally disagree with (stripping/reusing bills, filibusters, etc) that are used and abused all to often by both sides.

        I do still consider it a compromise though, because it’s not at all what Obama or Democratic leadership originally wanted. There was a well publicized meeting between Democratic and Republican leaders about their ideas, of the bill that passed was largely a result of.

        I wish our political climate was more welcoming to constructive debate and compromise. I think around the time of the ACA is when the notion of that being an option became a thing of the past. It’s a shame.

    • Two other thoughts:

      Note that I’ve been careful to say the “stated” purpose of the law. I think a substantial percentage of its proponents in Washington support that it controls American citizens at least as much as it (ostensibly) helps them. That’s why there’s been no serious slowing down and examining the myriad problems we’re having. Full speed ahead. Get them in the system. We’ll figure out what to do with them later.

      Also, getting back to the motive vs. efficacy point I’m making: I want to do something about the uninsured in this country. I do not think Obamacare is the way to do it. I oppose Obamacare. Too many then make the leap to I oppose doing something about the uninsured in this country.

      I think liberals are, by and large, good people who have bad ideas. I think liberals think many conservatives are bad people. That’s the difference.

      • Yea, I think most agree that we needed to do something about the uninsured. There are obviously many who don’t think we’ve handled it correctly with the ACA. I’m one of them.

        But the only other idea I’ve heard that might have a chance at solving the problem is one that isn’t as appealing to conservatives: fully socialized medicine (aka Welfare for Everyone). It’d be a bit more complex than just the title, but could address the healthcare cost and coverage issues but aggravate those who don’t care for social programs. I emphasize could, as I’ll rarely ever say will. We do have examples of it else where working relatively well, and perhaps where those systems have their downfalls we could build in our own fixes.

        But I’ve been listening for other ideas and I haven’t really heard one yet. If there’s one out there, I’m always open to what others think might work.

        • Tahm, I agree that we need to get costs under control.

          Do you really think an effective way to do that would be more government?

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