Monday, November 23, 2015

ObamaCare As Deck of Cards

Patience, and shuffle the cards.

Cervantes (1547-1616), Don Quixote

Trust everybody, but cut the cards.

Mr. Dooley (1867-1936), Causal Observations

Picture ObamaCare as a deck of cards with two sets of dealers.

Dealers on the Right

Dealers on the Right are predicting ObamaCare will collapse like a house of cards before Congress has a chance to repeal it. These dealers point to UnitedHealthCare’s announcement it will cut back on its health exchange commitments in 2016 and probably withdraw altogether in 2017. United's CEO says United simply cannot afford to lose $425 million as it has so far on the exchanges. Its investors won’t stand for losses of this magnitude, unless of course the Obama administration steps in and bails out beleaguered insurers.

Dealers on the right also point to the collapse of 12 of 23 health exchange co-ops, with the remaining 11 teetering on the verge of bankruptcy. And finally, they observe that the Obama administration is forecasting that less than half of those originally expected to sign up for exchanges will do so. And those who do sign on are likely to be the chronically ill with high expenses that will drive costs and premiums even higher.

Next year more than half the states on the exchanges will experience double digit premium rises, and the accompanying deductibles and co-pays will be unaffordable.

Hence, an impending "death spiral", not enough of the young and healthy enrolling, higher premiums for the remaining folks, less of the latter signing on, and the House of ObamaCare Cards will come tumbling down. And all the King’s ( Obama’s) successors and all the King’s Horses ( future CMS, HHS, and other government agencies ) will be unable to put Humpty Dumpty (ObamaCare) together again (Rick Manning, “ObamaCare’s Predictable Collapse,” The Hill, November 22, and Editorial, “ ObamaCare Imploding Even Before Repeal, “ New York Post, November 23).

Paul Krugman, PhD, economist and New York Times contributor), A Dealer on the Left

The Right’s argument, asserts Paul Krugman, is a stacked, unshuffled deck. Somebody needs to cut the deck, and he's the man.

Everybody in liberal circles, Krugnab believes, knows that the federal government holds all the cards. Government sets the rules of the game. CMS is by far the single biggest payer of them all. Government has those all important trump cards, and two more - compassion and the conscience of humankind," in its hand. The end game, in his mind, universal coverage, is now in sight.

ObamaCare is, Krugman insists, a “huge success story,” with 17.6 million insured on Medicaid and the exchanges, with only 30 million uninsured to go. Krugman knows of what he speaks. Among his 10 books is The Conscience of a Liberal, and he has written 750 columns for Slate, the New York Times, and like-minded left-leaning publications. The critics may double down on ObamaCare, Krugman believes, but they will be in double trouble because the Health Law will double the number converted from the uninsured to insured.

ObamaCare, Krugman concedes, “is an imperfect system, but it’s workable - and it’s working ( Paul Krugman, “Health Reform Lives!” New York Times, November 23). And so it is and so it does, at least for the moment and for the rest of Obama's Presidecy, and for as long as the people believe the government can be trusted, a period which may be drawing to a close.

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