Obamacare: The Reality And All The President's Spin
In the WSJ, Peggy Noonan suggests stepping back and viewing the thing -- Obamacare -- at a distance:
Support it or not, you cannot look at ObamaCare and call it anything but a huge, historic mess. It is also utterly unique in the annals of American lawmaking and government administration.Its biggest proponent in Congress, the Democratic speaker of the House, literally said--blithely, mindlessly, but in a way forthcomingly--that we have to pass the bill to find out what's in it. It is a cliché to note this. But really, Nancy Pelosi's statement was a historic admission that she was fighting hard for something she herself didn't understand, but she had every confidence regulators and bureaucratic interpreters would tell her in time what she'd done. This is how we make laws now.
Her comments alarmed congressional Republicans but inspired Democrats, who for the next three years would carry on like blithering idiots making believe they'd read the bill and understood its implications. They were later taken aback by complaints from their constituents. The White House, on the other hand, seems to have understood what the bill would do, and lied in a way so specific it showed they knew exactly what to spin and how. "If you like your health-care plan, you can keep your health-care plan, period." "If you like your doctor, you can keep your doctor, period." That of course was the president, misrepresenting the facts of his signature legislative effort. That was historic, too. If you liked your doctor, your plan, your network, your coverage, your deductible you could not keep it. Your existing policy had to pass muster with the administration, which would fight to the death to ensure that 60-year-old women have pediatric dental coverage.
...What the bill declared it would do--insure tens of millions of uninsured Americans--it has not done. There are still tens of millions uninsured Americans. On the other hand, it has terrorized millions who did have insurance and lost it, or who still have insurance and may lose it.
...Social Security was simple. You'd pay into the system quite honestly and up front, and you'd receive from the system once you were of retirement age. If you supported or opposed the program you knew exactly what you were supporting or opposing. The hidden, secretive nature of ObamaCare is a major reason for the opposition it has engendered.
The program is unique in that the bill that was signed four years ago, on March 23, 2010, is not the law, or rather program, that now exists. Parts of it have been changed or delayed 30 times. It is telling that the president rebuffed Congress when it asked to work with him on alterations, but had no qualms about doing them by executive fiat. The program today, which affects a sixth of the U.S. economy, is not what was passed by the U.S. Congress.
Related: In California, the poor are falling through the cracks as their applications for Medi-Cal are trapped in the state's computer system.
The question is, what will happen from here on. Your predictions?







The promise is still there.
Crid [CridComment at Gmail] at April 5, 2014 11:34 PM
Social security is simpler than ObamaCare, but it is just as much a lie. It is a giant Ponzi scheme (re Berny Madoff) which will lead a hundred million americans into an unfolding retirement disaster.
( politico dot com/news/stories/0412/75603.html )
Social Security trustees: We’re going broke
04/25/12 - Politico by John C. Goodman
What the current value of the unfunded liability means:
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The latest report of the Social Security and Medicare trustees shows an unfunded liability for both programs of $63 trillion, about 4.5 times the U.S. gross domestic product GDP. [$20.5 trillion of that is from Social Security.]
The unfunded liability is the amount we have promised in benefits, looking indefinitely into the future, minus the payroll taxes and premiums we expect to collect. It’s the amount we must have in the bank today, earning [3%] interest, for these entitlement programs to be solvent [fully funded].
=== ===
( cato dot org/publications/commentary/social-securitys-sham-guarantee )
Social Security's Sham Guarantee
05/29/05 - Cato by Michael D. Tanner [edited extract]
=== ===
Social Security benefits are not guaranteed legally because workers have no contractual or property rights to any benefits whatsoever. In two landmark cases, Flemming v. Nestor and Helvering v. Davis, the U.S. Supreme Court ruled that Social Security taxes are not contributions or savings, but simply taxes, and that Social Security benefits are simply a government spending program, no different than, say, farm price supports. Congress and the president may change, reduce, or even eliminate benefits at any time.
As a result, retirees must depend on the good will of 535 politicians to determine how much they will receive in retirement. And what could be less guaranteed than a politician's promise? In fact, Congress has voted to reduce Social Security benefits in the past. For example, in 1983, Congress raised the retirement age.
=== ===
( insureblog.blogspot dot com/2012/09/elephant-in-room.html )
Spocial Secrity funding: The elephant in the room
09/14/12 - InsureBlog by Bob Vineyard [edited]
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Well, there is a trust fund, but there isn't any money in it. Not real money. Only IOU's [a government promise to find the actual, consumable resources somewhere, somehow.] Those in denial say the federal government has never defaulted on their obligations so the IOU's are "secure".
Here is the truth. The accumulated debt is $16 trillion, roughly 100% of GDP. As if that isn't bad enough, you need to factor in our unfunded liability, the amount we owe for future obligations. Things like federal pensions, Social Security promises, and Medicare promises. The unfunded liability exceeds $100 trillion.
=== ===
This must always be added to any discussion of any government "trust fund".
There is nothing of value in the Social Security "trust fund" (or in any US government trust fund). There is only a politician's promise to find the money [real resources] somewhere that was paid in at one time, but has already been spent. The trust fund bonds are only a paper record of what was collected in taxes "in excess" of the immediate cash needs of Social Security. That amount "in excess" was put into the general Treasury and spent, leaving a bond behind to note the borrowing.
( easyopinions.blogspot dot com/2009/01/ponzi-schemes-like-social-security.html )
Ponzy Schemes Like Social Security
Social Security is a direct-pay program. Amounts collected this year are all paid out, either to recipients or to government programs. The Ponzi scheme is ending. From this time on, more will be paid out than collected in cash. Only continued government borrowing can make up the shortfall. Or, the government will reduce benefits or inflate the currency. Seniors may get $100 in distributions, which may buy only what $50 buys today.
Andrew M Garland at April 6, 2014 12:31 AM
"That of course was the president, misrepresenting the facts of his signature legislative effort."
"That of course was the president, lying."
Fixed that for ya.
Radwaste at April 6, 2014 2:03 AM
. Or, the government will reduce benefits or inflate the currency. Seniors may get $100 in distributions, which may buy only what $50 buys today.
Posted by: Andrew M Garland at April 6, 2014 12:31 AM
This has already happened. A number of things that I buy are double the cost of what they were even in 2008.
Seniors will be lucky in twenty years for social security money to buy even 15 percent of what it bought 6 years ago.
Obamacare has already outlived its usefulness. It was a jobs program for Obama's big contributors, building the web sites etc, and it is a tax on people who don't have insurance,
The web sites will limp along for the next few years, then be quietly shut down, and all that will remain is the tax.
Isab at April 6, 2014 3:10 AM
I personally am thanking my company's management for the healthcare they provide for their employees, and the subsidies they pay for it.
And I am simply hoping (blindly) that it or some similar form of it, continues to be available.
(Even those of us that still have it, are scared poop-less of losing it.) My prediction is that, for those of us covered under an employer's plan, we will have a bit of a rocky road, we will be forced out of our currently-available plans due to the employer penalties, and will slowly sink into the same morass that everyone else is in. Hopefully the morass will be better then, than it is now. Timeline? Something like 5-10 years.
On another note, you might remember my friend who "successfully" navigated Obamacare (She was the one that got through, and got the insurance. And was then told by every doctor she called that they won't take it because it won't even cover their base costs - she would have to pay out of pocket. On top of paying the premiums. She cancelled.) That friend was notified last week by her former insurance company that a policy very similar to her old one was available again. She is now covered under that plan! Can't tell you what a relief that was, for them.
flbeachmom at April 6, 2014 4:43 AM
"The question is, what will happen from here on. Your predictions?"
The future holds another lie too:
If you like your country you can keep it. period.
Charles at April 6, 2014 5:18 AM
Mr. Garland:
+1
This is the reason I took SS as early as feasible, and am using it to pay down principle on my kids' home loans and student debt. When the system collapses, "my" part of it will have contributed to the net worth of the people from whom it is right now being extorted.
simon Kenton at April 6, 2014 6:53 AM
Andrew Garland is correct. Social Security started paying out more than it collected in taxes in 2010 and has been in the red ever since. This would have happened anyway, since the benefits have exceeded collections for just about everyone who ever received a payment. But having spent the "trust fund" (a misnomer, since there was no trust, nor was there ever a fund) in the meantime has only hastened its demise. I hope the country emerges from this disaster with a healthy distrust of government.
And Simon Kenton, your approach is a refreshing departure from the geezers driving around in RVs with bumper stickers bragging that they are "spending their kids' inheritance." It's not so funny these days. I'm tempted to take a permanent marker and add, "while they pay for our health care."
Pirate Jo at April 6, 2014 7:51 AM
Media continue to carry water for the Administration by ignoring problems with the ACA (24x7 coverage of missing airplanes apparently gets ratings.)
The ACA was a technocratic scheme which might have achieved many of its goals (insuring the uninsured, covering those with pre-existing conditions, making it easier to shop for insurance, lowering costs) had it been perfectly executed. In some dreamland where good programmers enjoy working for big government contractors, and politicians understand how to deliver performance and not rhetoric.
As Megan McArdle comments, penalizing the healthy lower middle class for not buying policies which now cost 50% more and cover less seems like political suicide. The penalties have already been waived for the foreseeable future by fiat, and that will likely continue.
The planned extension of ACA plans to many of those now covered by company policies won't happen. The ACA will limp along, and when the rates are published for 2015, it will be obvious that it's not sustainable in much of the country. In New York, the ACA actually *improved* the individual market, which had already been destroyed by do-gooder legislation, but in most places prices are up, costs are higher, and access to doctors, hospitals, and prescriptions has worsened. Some rural areas are reverting to cash-based care as options have disappeared.
What will happen? The ACA plans will limp along as a sad remnant of the original plan, heavily subsidized. The primary injustices of the plan -- much higher rates for the healthy middle class, subsidized coverage for the well-off with pre-conditions (often from polo injuries or other unwise lifestyle choices) will continue. The costs will be astronomical, enough to have covered most of the uninsured for free. And the uninsured will continue to not eat their dogfood, one of the primary misunderstandings of the technocrats being that the uninsured were clamoring for policies. The disorganized fraction of the population are barely able to plan to go to a medical appointment, much less jump through multistep hoops to get an insurance policy. And the provider availability situation will be so intolerable that catastrophic coverage will return to the norm.
Curtis Scott at April 6, 2014 10:12 AM
The reason that many doctors and hospitals won't take any of the ACA plans is that they can't afford the decrease in payment that comes with it. Just as happened with Medicaid and Medicare.
So there is going to be a growth of concierge medical practices and more older practitioners leaving patient medicine and either retiring or working for background medical stuff like insurance companies or software companies.
As the system fails it depends who is in Congress and the White House. If progressive Democrats are in place then there will be a push to a single payer, government controlled operation that only the rich will get good care and the plebes will face death panels and such.
The death panels are not named as such but will use actuarial tables to determine what services are paid for. So a 30 year old that shattered his knee will get a 100% coverage of the replacement. The 30 year old will be a tax payer for another 30+ years. The 60 year old will get 35% coverage because he is not going to be a tax payer for much longer. It's all described in the The Complete Lives System.
If it is a libertarian (not Republican) in Congress and the White House then there might be a chance to dig out. But we need to know which way it goes before giving a long term prediction.
Jim P. at April 6, 2014 11:04 AM
Obamacare was a poor compromise, but the best that could get through
the partisan sniping. Romneycare has been in effect a good deal
longer than Obamacare. The differences between the two are far
smaller than their similarities. I see very little rational basis
to think the long-term effects will differ much between the plans.
In other news, the sky is not actually falling.
Ron at April 6, 2014 5:26 PM
I predict they'll work out most the technical glitches, eventually, but then we'll be stuck with yet another huge unsustainable entitlement.
carol at April 6, 2014 6:00 PM
Obamacare was a poor compromise, but the best that could get through
the partisan sniping. Romneycare has been in effect a good deal
longer than Obamacare. The differences between the two are far
smaller than their similarities. I see very little rational basis
to think the long-term effects will differ much between the plans.
Posted by: Ron at April 6, 2014 5:26 PM
It takes a lot of chutzpah to reduce this argument to partisan sniping.
I see a lot of difference between what Massachusetts experimented with and the ACA, but I see you are very good at spouting the democratic party talking points.
People are not going to pay premiums for long when they find out, they can't find a doctor or a hospital that accepts the plan.
Isab at April 6, 2014 6:43 PM
Moar Curtis Scott.
Crid [CridComment at Gmail] at April 6, 2014 8:05 PM
Obamacare was a poor compromise, but the best that could get through
the partisan sniping.
Odd, I could have sworn it passed without a single republican vote. How exactly were the Dems forced to compromise?
lujlp at April 7, 2014 3:21 AM
Yes, it's the DMV-ization of health care. Which was the goal all along.
"This has already happened. A number of things that I buy are double the cost of what they were even in 2008."
I read a report last week, which I haven't been able to find again, that claimed that food prices rose by 20% in the first quarter of this year. If that's true, we don't have to speculate about hyperinflation any more. It's here.
Cousin Dave at April 7, 2014 7:26 AM
Obamacare was a poor compromise, but the best that could get through the partisan sniping.
That's a nice bit of historical revisionism. Care to name a single Republican who voted for it?
Hint: you can't because they didn't because the Democrat party had a supermajority in the Senate and a majority in the House and all of the Republicans held firm, including John "Bipartisan" McCain and Lindsey Grahamnesty.
If it is a "poor compromise" it is because the White House showed zero - nada, zilch, none - leadership and let Harry Reid and Nancy Pelosi pork it up.
I R A Darth Aggie at April 7, 2014 7:37 AM
I read a report last week, which I haven't been able to find again, that claimed that food prices rose by 20% in the first quarter of this year. If that's true, we don't have to speculate about hyperinflation any more. It's here.
Well, we don't include fuel and food costs when calculating inflation, so don't worry about such things.
On the other hand, I haven't seen such a jump in prices, either in the store or when I eat out.
I R A Darth Aggie at April 7, 2014 7:42 AM
On the other hand, I haven't seen such a jump in prices, either in the store or when I eat out.
Posted by: I R A Darth Aggie at April 7, 2014 7:42 AM
I havent seen as much of it in restaurant prices as I have in the grocery store. The resurant business operates on a pretty thin profit margin, and can raise the price of drinks easier than menu items. I always go with water, which generally saves me three or four bucks right away.
At my age, the thought of spending half the price of a real meal on a glass filled with carbs, and chemicals makes me cringe.
When I shop at the grocery store, I shop for base ingredient items not prepared foods, and the costs have jumped enough in the last few years, that someone with a reasonable memory for prices would notice. Good bacon has almost doubled in price. Real yougurt, not the processed crap, is up 60 percent. Nuts, vegtables, and fruits, the same.
On what little prepaged stuff I buy, the net weight has gone down, while the price has increased twenty percent or more.
The government bets that most people are so poor at math, they wont notice, and most of the time they win that bet.
I wish I had bought about fifty k worth of ammo, and reloading components back in 2008. That stuff holds its value well against inflation.
A case of CCI SV rimfire ammo was selling for $230 in 2008.
If you can even find it now, it is double that.
Isab at April 7, 2014 12:47 PM
"On the other hand, I haven't seen such a jump in prices, either in the store or when I eat out."
I'm seeing some in the stores. What's happening more right now, though, is that quantities are decreasing while per-package prices hold steady. A lot of it's subtle and you have to look closely: something that used to be 12 ounces is now 11.5 ounces, that kind of thing. Consumers haven't really noticed yet, but producers can't go much further before it starts to become obvious.
The other thing that's happening is that energy prices are rebounding despite the increase in domestic oil and gas production thanks to fracking. One explanation I've heard is that the EPA is starting to make the remaining coal-fired power plants shut down, so all that the new gas-fired plants are accomplishing is to replace existing production, at a higher cost. We have really got to start getting next-gen nuclear on line.
Cousin Dave at April 7, 2014 1:47 PM
Have to agree with Cousin Dave -- the backups for all the floundering wind farms and solar systems are natural gas.
The biggest mistake we made regarding nuclear power was conflating nuclear power with nuclear weapons, and pushing to have light water reactors instead of breeder reactors.
So now we get more waste and less safety and everyone thinks that the countryside around Chernobyl and Three Mile Island are glowing.
They're not. You get more radiation in a frickin' airliner. We need 21st century breeder reactors online, worldwide, or we're going to be a planet of poverty and despair and coal pollution.
Gog_Magog_Carpet_Reclaimers at April 7, 2014 3:51 PM
Absolutely, Gog. The anti-nuke crowd also created the public perception of "any radiation exposure is bad", aided by public ignorance of what radiation is or where it comes from (e.g., the natural background). And yeah, the combination of NRC regs and industry culture trapped us in the first-generation light-water designs. I was just reading the other day about the Molten Salt Reactor Experiment, which was already a more advanced reactor design in the early 1960s. I remember in grade school, circa 1970, reading about self-regulating molten-salt and gas-cooled reactors, and that they expected the first ones to be on line by 1975. There is technology out there that's far better than what we're currently using.
IMO it's madness to be burning oil and gas for baseline electricity generation. Gas should be mostly used as a fuel that's consumed at the point of use, and as a chemistry feedstock. Baseline electricity should mostly be nuclear, with coal where it makes sense, and some gas for peaking loads. Solar might make a certain amount of sense in parts of the country (mostly the desert Southwest) where the weather is advantageous, and the good thing about solar is that its capacity profile over the course of a day is pretty easy to project. Until the storage problem is solved, wind is just too damned unpredictable.
Cousin Dave at April 8, 2014 7:32 AM
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