Self-Analysis of ObamaCare

All writing is communication…It is the Self escaping into the Open.

E.B. White (1899-1985), The Elements of Style

Q: Hello, Self. What do think about ObamaCare and the State of Union?

A: Both are in trouble.

Q: Why?

A: With ObamaCare, costs and premiums continue to rise, promises to keep your doctor and health plan are in shambles, and average of public polls indicate only 38% approve while 51% disapprove.

The State of the Union is equally bad. The economy shrank 2.9% in the last quarter, Obama's job approval as dropped to as low as 40% (CBS/WSJ), 54% disapprove of Obama's handling of the economy, 55% think economy is getting worse, 63% of the people say the country is headed in the wrong direction, effective unemployment is around 13%, only 27% approve of Obama’s handling of foreign affairs, and news of the so-called scandals at the IRS and the VA, defeats in Iraq, and the Benghazi affair dominate the headlines. It will be difficult for the Obama administration to turn all of these negatives into a positive.

Q: Why do think ObamaCare is in such turmoil?

A: Seven reasons, especially when placed in context of the negatives above.

• Its partisan passage without a single GOP vote.

• Its broken promises.

• Its failure to contain premiums.

• Its one-size-fits-all philosophy.

• Its negative effect on the middle class.

• Its negative impact on doctors.

• Its coercive mandates infringing upon American’s freedoms of choice and individual liberties.

Q: Explain.

A: Its partisan passage was arrogant, poisoned the political environment, and rendered compromise nearly impossible.

Its broken promises – you can keep your doctor and health plan are self-evident- are politically toxic because the administration knew about them beforehand.

It has not contained premiums which are rising faster than before ObamaCare, at unpredictable rates, but fastest in the individual and small group markets.

Its one-size-fits-all philosophy, namely that all federally-sanctioned plans must contain 10 essential benefits, whether you need them or not, makes no sense to those who do not need these benefits, and raises premiums for everybody, especially the young who see themselves paying to support others.

Its negative effect on the white middle class who view themselves as financing Obama’s dream of equal outcomes for all based on economic class, rather than equal opportunities for all based on skills, talents, entrepreneurship, and economic growth. ObamaCare has slowed economic growth. The U.S. 43% corporate tax harms economic growth and undermines the idea that a rising tide lifts all boats.

Doctors are disillusioned with ObamaCare. It cuts their reimbursement and burdens them with bureaucratic paperwork. It blames them for rising costs, and in effect, drives them out of private practice into hospital employment or retirement or into direct pay/concierge medicine, all of which aggravates the doctor shortage.

The coercive impact is largely ideological and stems from the individual and employer mandates which say you must knuckle under to the government or pay economic penalties. This impact has created a partisan divide among Democrats and Republicans over ObamaCare. The latest Kaiser tracking poll, dated June 19, indicates the following. Among Democrats, 20% say ObamaCare helped their healthcare, 65% said it had no impact, and a mere 8% said it harmed their care; among Republicans, 5% said it helped, 54% said it had no impact, and a whopping 37% said it harmed their ability to get or to pay for care.

Q: So what do you conclude?

A: I conclude ObamaCare is unworkable or harmful for many, particularly the white middle class who tend to turn out for midtwerm elections. Among the 8 million who signed up on the exchanges, most were in poor health or were uninsured. That is good. Its future is uncertain. I believe its fate hangs in the hands of voters in November. Perhaps, as Mark Twain (1835-1910) said of Richard Wagner's music, " It's not as bad as it sounds."