Needless to say, I’m not happy with Obama’s healthcare proposal. Before I get into this, I want to make something clear: my opposition is due to experience, not ideology. If it appeared (or better, if there were evidence) that putting on a pink mumu, whirling a rubber chicken around our heads, and singing the Star Spangled Banner would make a good healthcare system, then rubber chickens, mumus, and singing lessons all around.
But what Obama proposed is what we’re living through in Massachusetts. And it’s, at best, a modest improvement–it’s more ‘chang-iness’ than significant change.
Having a limited public option that only applies to the most desperate (most people won’t be able to join if they wanted to) screws over lower-middle class and middle class. Depending on where you live, aren’t these either the Democrats’ strongest supporters, or, in red states, the people we’re trying to reach out to? And from what I’m hearing, you will have to pay around thirteen percent of total income out of pocket if you’re not near the poverty line (or very well to do). That is before you also pay FICA taxes to support Medicare. While Obama made a big deal about the $900 billion dollar cost (which seems to be more about saying it doesn’t cost a trillion dollars than anything else), most analysts are saying that means that subsidies for lower-middle class and middle class people will be very limited or non-existent.
Because Democrats wouldn’t want to play into the stereotype of enacting legislation that helps the poor at the expense of the middle class or anything.
Based on the MA experience, what will probably happen is a one-time premium decrease: insurance companies will be flush with money, and they’re not stupid–to avoid something worse, they’ll lower rates. But because the cost control mechanisms are limited (or non-existent), cost increases will rocket upward. If you think I’m crazy, not only did this happen, I predicted it before Romneycare was enacted. Absent single payer, they are two ways to control costs: competition from a government plan, or direct regulation. This has neither.
What worries me most is the initial reaction by what passes for the left. Look, Obama gave a great speech (and the cranky white guy shouting “Get off my damn lawn” probably helped). Jonathan Cohn thinks this is a strong defense of a liberal/progressive view of government. Yes, the rhetoric was nice if you heard the dog whistle. But regarding the middle, contrast this approach to that of FDR or LBJ who didn’t just talk the talk, they enacted legislation. That’s how you convince people: by creating something that works well. Yet, I have no doubt that the More Serious Pundits among the left-of-center crowd will now dutifully line up behind Obama-Romneycare, and explain to the rest of us, prior experience be damned, how we’re being unrealistic.
And who said there were no elected Republican African-American officials at the national level?