The single biggest blunder of Obama’s presidency was his decision to prioritize a makeover of America’s health-care system over an immigration overhaul. Obama’s health-care plan had zero bipartisan support, while reworking immigration had considerable enthusiasm on both sides of the aisle. By choosing health care, Obama rendered both programs politically vulnerable.
As the historian Nancy Tomes outlines in a seamless and utterly fascinating narrative, the good old days never really existed. (Read an excerpt). For more than a century now, American health care has been a fraught marketplace, hosting a power struggle among consumers, providers and regulators that may have escalated over the decades but is otherwise remarkably unchanged.
Steven Brill’s latest book, America’s Bitter Pill, is a frustrating mix of excellent history and muddled health policy analysis. The book is a very good addition to the literature on the history of the Affordable Care Act and by far the best reporting I’ve read on the bungled implementation of the federal health insurance exchange. But Brill’s analysis of why the ACA cannot reduce health care costs is naïve and confusing. Brill claims a few smart men on the White House “economic team,” including Peter Orszag and Ezekiel Emanuel, fought hard to push “game-changing” cost-containment into the ACA but were defeated by others who were less interested in cost containment.
That explanation is wrong on two counts:(1)There was little evidence in 2009, and little today, to support the claims by Orszag et al. that the methods they promoted would cut costs;(2) The ACA in fact contains most of what Orszag et al. fought for.What Brill unquestionably gets right is his conclusion that the ACA cannot cut costs.
Nothing shows the progressive dependence on subterfuge more starkly than Obamacare, which, by imposing a personal mandate to buy insurance in an effort to bring health care to all, will restructure one-sixth of the American economy. Single-payer government health insurance has been a dream on the left for decades, but it was never a politically realistic option. This was true even while Democrats controlled both houses of Congress, as they did during the first two years of Obama’s first term. The American public wouldn’t tolerate the level of government funding that a single-payer system would require, so the best that the administration could do was to impose a regulatory structure, while accepting a private-insurance model. In crafting the Affordable Care Act, the administration intentionally avoided describing the individual mandate as a tax—a tacit admission that doing so could have sunk the bill. After the bill became law, however, the administration turned around and argued before the Supreme Court that the mandate was, in fact, a tax. The Court upheld the mandate as an exercise of an enumerated government power to levy taxes. Even then, the administration concealed Obamacare’s taxes on the wealthy, which were not added to the income-tax tables. The recently publicized comments of MIT professor Jonathan Gruber about the deception involved in promoting the Affordable Care Act demonstrate that such chicanery has become intrinsic to modern progressivism.
President Obama is in the middle of his fight to pass the Affordable Care Act. This is the book’s most politically compelling chapter, though the word “ObamaCare” is entirely absent. Some in the White House, such as chief of staff Rahm Emanuel, worry that the stumbling, unpopular effort to pass the ACA will damage Democrats in the 2010 midterm elections. “Rahm recommended scaling back to a plan that would cover fewer people, but garner more votes,” Mr. Axelrod writes.
When President Obama asks what the odds are of passing the most ambitious bill possible, his congressional liaison, Phil Schiliro, replies, “Depends how lucky you feel, Mr. President.”
Mr. Obama smiles and says: “Can I say this? I always feel lucky. Let’s go all in. When your name is Barack Obama and you’re the president of the United States, how can you not feel lucky?”
60 Minutes Video – With the passage of the Affordable Care Act, everyone with a stake in the $3-trillion-a-year health industry came out ahead — except the taxpayers, says author Steven Brill – CBS.comJanuary 12, 2015
What Obamacare doesn’t do S (13:19)
via 60 Minutes Video – With the passage of the Affordable Care Act, everyone with a stake in the $3-trillion-a-year health industry came out ahead — except the taxpayers, says author Steven Brill – CBS.com.
Democrats made a mistake by passing President Barack Obama’s health-care law in 2010 instead of first focusing more directly on helping the middle class, third-ranking U.S. Senate Democrat Charles Schumer said today.“Unfortunately, Democrats blew the opportunity the American people gave them” in electing Obama and a Democratic Congress in 2008 amid a recession, Schumer of New York said in a speech in Washington. “We took their mandate and put all our focus on the wrong problem — health care reform.”