Obama care is not socialized medicine. Quite the opposite. It is a very complex effort to use the power of the federal government to create a system of privately run health insurance for everyone. And that is its Achilles heel.
Not only does the health care law create millions of new customers for America’s very profitable health insurance companies, it requires everyone without health insurance from their employer, their spouse or some other outside source to buy a policy or pay a fine. Paradoxically, because the law puts private businesses at the wheel and gives them a gold-plated guarantee of profits, it also will keep U.S. health care costs the highest in the world.
David Leonhardt, a student of U.S. social and political history who writes for the New York Times, made this analysis Tuesday:
“ … We’ve lived through a version of this story before … Nearly every time this country has expanded its social safety net or tried to guarantee civil rights, passionate opposition has followed.
“The opposition stems from the tension between two competing traditions in the American economy. One is the laissez-faire tradition that celebrates individuality and risk-taking. The other is the progressive tradition that says people have a right to a minimum standard of living — time off from work, education and the like.
“Both traditions have been crucial to creating the most prosperous economy and the largest middle class the world has ever known. Laissez-faire conservatism has helped make the United States a nation of entrepreneurs, while progressivism has helped make prosperity a mass-market phenomenon.”
Leonhardt then turned to the current dispute in the courts:
“Two federal judges upheld the individual mandate — to buy health insurance or pay a fine — this year, saying that it fell under Congress’s power to regulate commerce. But Judge Henry Hudson, of a Federal District Court in Virginia, ruled on Monday that Congress had overstepped by prohibiting a form of inactivity — that is, not buying insurance. And as Reagan did with Medicare, Judge Hudson argued that the mandate had a larger meaning: he said it ‘would invite unbridled exercise of federal police powers.’
“In truth, the law is quite moderate. It is more conservative than President Bill Clinton’s 1993 plan or President Richard Nixon’s 1974 plan (in which the federal government would have covered anyone who wasn’t insured through an employer). It’s much more conservative than expanding Medicare to cover everyone. It is clearly one of the least radical ways for the United States to end its status as the only rich country with millions and millions of uninsured.
“But the law depends to a significant degree on the mandate. Without it, some healthy people will wait to buy coverage until they get sick — which, of course, is not an insurance system at all. It’s free-riding.
“Without the mandate, the cost of insurance in the individual market would rise, perhaps sharply, because some healthy people would not be paying their share. Just look at Massachusetts. In 1996, it barred insurers from setting rates based on a person’s health but did not mandate that individuals sign up for insurance. Premiums then spiked. Since the state added a mandate in 2006, more people have signed up, and premiums have dropped an average of 40 percent.
“It’s easy to look at the current debate and see an unavoidable trade-off between this country’s two economic traditions — risk-taking and security. But I don’t think that’s quite right. I think it is ultimately as misplaced as those worries about Social Security and Medicare equaling Bolshevism.
“Guaranteeing people a decent retirement and decent health care does more than smooth out the rough edges of capitalism. Those guarantees give people the freedom to take risks. If you know that professional failure won’t leave you penniless and won’t prevent your child from receiving needed medical care, you can leave the comfort of a large corporation and take a chance on your own idea. You can take a shot at becoming the next great American entrepreneur.
“With every previous major expansion of the safety net, history has had a chance to prove the naysayers wrong. It may yet in the case of universal health coverage. But the decision now seems to rest with the nine members of the Supreme Court.”
What Obamacare does and doesn’t do for our nation
