Saturday, November 28, 2015

ObamaCare: Not an All-or-Nothing Proposition

Thou has seen nothing yet.

Cervantes (1547-1616)

Six years in, it is clear ObamaCare is not an all-or-nothing proposition.

As is, the health law is not accepted by the majority of Americans , Republicans, or Independents, or even Democrats. But they do not totally reject it either.

Certain aspects of the health law will remain - no exclusion by health plans for those with re-existing disease, coverage of young adults under their parents plans, coverage and subsidies for low-income Americans.

Other aspects of the health law are likely to go away or to be severely modified – individual, employer, and religious mandates, the raft of regulations that hamper small businesses and dampen innovative and entrepreneurship, and the compulsory use of electronic health records by physicians or Big Data as the final solution to almost everything, , to name a precious (and expensive) few.

Total repeal or total acceptance is not in the political cards.

Why the mixed picture? Well, in its present form, the Patient Protection and Affordable Care Act is neither protective nor affordable for many in the middle class.

Both political parties have dug in their heels and are unlikely to budge unless the American electorate says otherwise.

The sweeping GOP midterm victories in 2012 and 2014 assure this gridlock, as do two liberal rulings in the Supreme Court declaring the law as constitutional.

The health law has had its failures as outlined in a Human Events article in 2011 (“Too Ten Failures of ObamaCare after One Year.” The article listed these “failures”.

1. Explodes federal deficit

2. Kills jobs

3. Lose your doctor and health plan

4. State budget deficits to grow

5. Higher premiums

6. Crushes business

7. Fewer Americans to have access to care

8. Senior citizens to lose healthcare coverage

9. Overburdens small business

11. Tax hikes

Some of these things have come to pass, but not all and not all to the extent forecast.

The unemployment rate is 5.0%; 17.6 million uninsured are now covered thanks to the health exchanges and Medicaid expansion; overall government health care spending has ebbed; medical bankruptcies are fewer, and the government has initiated changes that it says promise to increase quality and integration, and save money, given time and good intentions.

Government oversight and failures have become more evident, and corrective market and political forces have kicked in.

I am optimistic, while the health reform law may not be all-or-nothing, something useful will turn up. Something is better than all or nothing.

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