Friday, December 4, 2015

ObamaCare: Everything That Rises Must Converge, by the Numbers

Everything That Rises Must Converge.

Title of 1965 book by Flannery O’Conner (1925-1964)

Sooner or later, whatever rises politically must converge. It is a law of political gravity in democracies. There are invariably cycles of ups and downs, but inevitably in governments guided by consent of the governed, the will of the people, a consensus must be reached.

Yesterday the Senate passed a bill to repeal ObamaCare, even though the bill faces a certain presidential veto, and the Senate and the House lack the numbers to override a veto.

The Senate bill calls for ending individual and employer mandates and penalties that accompany those mandates, for no longer expanding Medicaid, for repealing the taxes on “Cadillac” health plans, and for defunding Planned Parenthood, which now receives $450 million in government support.

The Senate bill is symbolic. It faces a certain Obama veto. But as Republicans see it, it puts the President and Democrats on record for favoring what the people oppose.

Why is passing a bill certain to be overturned by a Presidential veto important?

Convergence and the Numbers

Consider these current converging numbers.

•0NE Americans oppose health law compared to those who favor the law, 50% vs. 43%.

•TWO, Americans disapprove of President Obama’s job performance vs. those approve it, 51% vs. 44%

• THREE, Composition of Senate, 54% percent Republicans vs. 46% Democrats.

• FOUR, Composition of House of Representatives, 57% Republicans , 43% Democrats.

Add these numbers up and divide by four, and they average 53% to 44%, almost precisely that of the 53% to 47% Senate vote to repeal.

There is nothing scientific about this analysis, but it indicates that the majority of Americans, as reflected by the their attitudes in national polls and their votes as to who should represent them, are skeptical about Obama and ObamaCare – broken promises, allowing choice of doctors and health plans, failure to contain costs, effects on slowing the economy, increases in premiums, deductibles, and out-of pocket costs; disruptions generated among the middle class, who must pay the Piper for its good intentions but ill-effects, not the least of which, is the uncertainty of it all.

The government is the principal contributor to health care spending, the biggest payer by far. Overall spending increased in 2014 to 5.3%, 17.5% of GDP. Federal expenditures in 2014 grew by 11.7%, and Medicaid enrollment went up 7.7%. Overall spending in U.S. is now $3 trillion, roughly $11,000 for every man, woman, and child in U.S.

The Obama administration says factors behind increased federal spending are the rebounding economy (What rebound? Say critics), aging baby boomers ( But wasn’t that to be expected? Say critics), spikes in specialty drug costs for hepatitis C, cancer, and multiple sclerosis ( up 12.2% due to pharmaceutical company greed, Say Obamanites), and anyway, all the federal government needs is time for its cost-lowering policies to take effect ( How much time is enough? 7 years? 8 years? Another Democratic administration? Ask critics).

Give us time, say ObamaCare advocates , for the systemic changes we endorse, paying physicians and hospitals for quality outcomes and coordinated teamwork based on data ( accountable care organizations and bundled payments for the continuum of care from the beginning to end for episodes of care, related to a specific illness or procedures).

At what disruptive costs to a market-driven system and to personal freedoms, say critics.

Whatever position you advocate – government health system control and free-market reform, or what combination of the two you endorse – these positions are about to converge in the 2016 elections.

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