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Can you hear us now?

November 12, 2013

If the Obama administration was truly concerned with providing government controlled insurance to the uninsured, why didn’t they simply design a Medicaid-style government basic healthcare plan, and raise the FICA payroll tax 1% or so  to pay for it?

The primary reason is that the goal of Obamacare was never to simply provide healthcare to those that didn’t have it. Universal healthcare schemes aren’t exactly new, Before there was Obamacare, there was Hillary-care. There are already laws, such as EMTALA (42 USC § 1395DD, et seq, 42 CFR 489.24) that require hospitals to provide emergency  basic care.

Once you get past the basic constitutional duties of government, everything that comes after that has a political shading. That doesn’t mean that all government programs turn out badly, but it does mean that an awful lot of them come into being to push a political agenda either on a personal or national scale. In this case the goal seems to have been to pave the way to a omnipotent government system.

Even as the law was being steamrolled through a one-party Congress, thoughtful analysts were sounding the alarm that it was poorly crafted, relied on shaky financial models, and wouldn’t actually cover all of the 30-40 million people that were lumped into the uninsured category.

This law was designed to make sure that people who were happy with their current insurance plans couldn’t keep them. The only way the money end of this law works is to compel participation, and that meant it was necessary to create a captive population. What better way to do that than outlaw all existing plans for that segment of the population that (a) has money to pay for insurance and (b) wants insurance? To create that population the law had to actually grow the uninsured population, at least temporarily.

You could make the case that if (and that’s big if) the healthcare.gov website is actually functioning 100% properly on December 1, there will be a flood of people signing up to beat the deadline when their previous plans quit paying the bills. What happens when they can’t pay the higher premiums, or  when they realize that they will never meet the deductible so that the insurance kicks in? Well, arguably they may lose the coverage, either voluntarily or inadvertently through cancellation for nonpayment. Then what?

At some point, probably sooner rather than later, you are right back to the same scenario we have now. Insurance has always been expensive because the healthy and wealthy supported the sick and poor. That isn’t changing, because it can’t. It’s almost like the biological process of natural selection.

The already more expensive premiums for those on the unsubsidized plans will continue to go up, simply because they must. The people that can’t afford insurance at any price or don’t want it still won’t have traditional insurance. They will wind up on Medicaid, or simply fade into the shadows again. Since many of those people don’t or can’t work they can’t be fined or taxed into submission, and everyone else will still pay for their coverage. It’s hard to see how that creates a better or even a different healthcare environment.

It remains to be seen how this law will fare in the future, If there is any common sense left among politicians, this law at least in its current form will go away. It may not be repealed, but it will morph into something else. It remains to be seen what that will be, but it is all too likely that it will be too little, and way too late.

No one wants to keep people from receiving healthcare. There were a lot of folks out there that had better ideas to provide health insurance to the poor  than Obamacare. The question is, can our tone deaf politicians hear them now?

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