Friday, February 7, 2014

An ObamaCare Report Card

By Christopher  Conover, a research scholar in the Center for Health Policy & Inequalities Research at Duke University, an adjunct scholar at the American Enterprise Institute, and a Mercatus Center-affiliated senior scholar.

The Weekly Standard,  February 7, 2014

The woods are lovely, dark and deep,
But I have promises to keep, 
And miles to go before I sleep,
And miles to ge before I sleep.

Robert Frost, (1874-1963), Stopping ny Woods on Snowy Evening (1923) 

Is it not strange that desire should so many years outlive performance?

Shakespeare (1564-1616), King Henry IV
Listed below at the grades submitted by a senior scholar working for a conservative think tank (the American Enterprise Institute) and writing for a conservative magazine (The Weekly Standard). 
Conover  uses three standards in grading Obama ObamaCare – 1) Promises vs Performance 2) Performance compared to Predecessors 3) Outcomes,  A word of cautionary skepticism: When judging how well ObamaCare has performed, consider the source of the judgment.

One, Promises vs. Performance

1.      Universal coverage,  F

2.      No new taxes on middle class, F

3.      Annual savings for family, F

4.      Bends cost curve down,  Incomplete

5.      You can keep your health plan,  F

6.      You can keep your doctor, F

7.      No  increase in deficit, F

8.      I’m not going to touch Medicare, F

      Overall midterm grade, F

Two,  Peer Comparison to preceding Presidents

1.      Transparency, D

2.      Legitimacy of adherence to statuary law, D

3.      Legitmacy of implementation process, D-

4.      Quality of rules writing, C-

     Overall midterm grade, D

Three, Outcomes

1.      Increase in number of people insured, F

2.      Health spending, B-

3.      Quality,  C+

4.      Employment, C

5.      Federal budget deficit, A

I was particularly interested in his A rating for the deficit.  Here is Conoover explains the A rating.

Federal Budget Deficit. The adverse impact of Obamacare on the federal budget deficit is in the future. Because revenues were front-loaded and spending back-loaded, Obamacare had no adverse effect on the federal budget deficit through 2013. When all federal tax revenues are taken into account, Obamacare raised $58.3 billion in its first four years. Because much of the additional spending was exactly matched by spending reductions elsewhere (predominantly Medicare), the net effect was to reduce the federal budget deficit by $45 billion over this period. Thus, although its financing arguably is far more convoluted and less transparent than it should be, the law in its early years at least was honestly financed. Thus, the net cost to taxpayers was $13.3 billion or $43 per capita.”

Net Assessment and Outlook

And here is how Conover sums up his final grade:

Here’s the bottom line: ObamaCare has failed miserably on nearly every major promise made about it (Grade: F). The processes used to enact and implement the law have been tarnished by actions of questionable legality and a pervasive lack of transparency (Grade: D). On actual outcomes, Obamacare has fared better in the short term (Grade: C+), but there are worrisome signs that by most measures, the law’s performance will get significantly worse by the time final grades are handed out.”

“I’ll admit, I’m a pretty tough grader. In this era of grade inflation, some Americans may be inclined to be more generous. But after doing this for nearly four decades, I think I’m a fairly good judge of health policy work and its likelihood of success when put into practice. We’re only at midterm, but I’d have to say the long-term outlook for Obamacare is  very bad  indeed.”

Tweet:  Christopher Conover,  a Duke University scholar, gives ObamaCare  poor  grades overall at midterm – Promises vs. Performance F,  implementation, legality, and transparency, D,  and outcomes C+.

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