Kevin D. Williamson:
Regardless of whether there is a President Cruz or a President Rubio in January 2017, regardless of the existence or size of a Republican majority in Congress, the so-called Patient Protection and Affordable Care Act (ACA) has failed. The grand vision of an efficient pseudo-market in health insurance under enlightened federal management — the heart of Obamacare — is not coming to pass. Obamacare, meaning the operating model that undergirded the law that Congress passed and President Barack Obama signed with great fanfare — is dead, and it will not be revived. What remains is fitful chaos.
A brief refresher:
The fundamental problem with ACA is that under it, insurance ceases to be insurance. Insurance is a prospective financial product, one that exploits the mathematical predictability of certain life events among very large groups of people — out of 1 million 40-to-60-year-old Americans, x percent will get in car wrecks every year, and y percent will be diagnosed with chronic renal failure — which allows actuaries and the insurance companies that employ them to calculate premiums based on risk, thus funding the reimbursement of certain expenses incurred by the insurance pool’s members. Insurance is, by its very nature, always forward-looking, considering events that have yet to come to pass but that may be expected and, to a reasonable extent, predicted with some level of specificity. Under ACA, insurance is retrospective. ACA mandates that insurance companies cover pre-existing conditions, meaning events that already have happened, which renders the basic mathematical architecture of insurance — the calculation of risk among large pools of people — pointless. Insurance ceases to be insurance and instead becomes something else, namely a very badly constructed cost-sharing program.
Not all cost-sharing programs are bad ideas. Medi-Share, for example, is precisely the sort of voluntary, privately administered mutual-aid program that could — and, I believe, will — end up displacing government-run health-care programs entirely. But Obamacare is a very different kind of beast: It creates a deeply perverse incentive structure by combining compulsory coverage of pre-existing conditions with a mandate that is enforced in theory more than in fact. The mandate is necessary to prevent the ruthless exploitation of the preexisting-coverage rules: If insurers have to cover you no matter what, then there’s no point in buying insurance — thereby sharing in the costs — until you are sick enough to need it.
As James Freeman reports in the Wall Street Journal, the ACA’s plethora of exemptions — there are at least 30 of them — ensure that a great many people — 12 million last year — will simply opt out. “It is easy to avoid or limit exposure to the penalty with some simple tax planning,” he writes. In 2016, there were supposed to be 21 million people enrolled in ACA programs; the Obama administration currently predicts that the actual number will be somewhat less than half of that. This was entirely predictable; in fact, it was predicted in the pages of National Review, in my book The End Is Near (and It’s Going to Be Awesome), and elsewhere.
Many of Obamacare’s failures came fast and early. Strike one: “If you like your doctor, you can keep your doctor.” Strike two: Obamacare will save “the average family $2,500 a year on their premiums.” Strike three: Obamacare will add “not one dime” to the deficit. We all knew that was coming, just as we knew that people would respond to the very strong incentives not to buy insurance by not buying insurance.
#share#Other failures took longer to become manifest. The architects of Obamacare are deeply distrustful of the role of for-profit companies in the health-care business because, in their nearly pristine ignorance, they falsely believe profits to be net deductions from the sum of the public good rather than measures of the creation of real social value. So they created incentives to set up co-ops, nonprofit enterprises that would administer Obamacare plans in particular states and jurisdictions. It was obvious from the beginning that if Obamacare’s perverse incentives created insurance pools that were older and sicker rather than younger and healthier, these co-ops wouldn’t be economically viable: You need lots of young, healthy insurance subscribers to offset the costs associated with your older, sicker subscribers. Many of us — myself included — assumed that the federal government under President Obama would simply write these co-ops huge checks to keep them afloat. We were half right: The government is writing them huge checks, but they are failing anyway, so fundamental is their economic unsustainability. Half of the co-ops have gone belly-up already, including large, prominent, splendidly subsidized ones in Kentucky, New York, Louisiana, and South Carolina. Hundreds of thousands of customers have lost their coverage as a result. Hundreds of millions of dollars in taxpayers’ money has been poured into these enterprises, to no avail.
In Colorado, the non-profit corporation that lived off Obamacare subsidies went out of business 2-3 weeks ago. So, those that bought plans from them are scrambling to find a new carrier – they represent around 50% of the Obamacare market. Instead of finding a better solution, a Dem legislator wants a single-payer alternative. Single-payer would mean raising $26B in new taxes, the size of the current state budget. So much for being an Obamacare success story.
Working exactly as designed
Poor Barry didn’t think it would happen while he still was in office. Maybe a year or two later so the republicans could be blamed.
Thus far 11 of the 23 obama are co-ops have closed…gone bankrupt. Just as was predicted by anyone with an iota of economic sense, the left is calling for doubling down on government failure via single payer socialist government takeover of healthcare.
Think about this insanity for a second. Despite clear evidence of government failure in running a healthcare system, these far left ideologues insist the fix for government failure….is more government control.
Leftism is a mental disorder.
The cry for a gov’t run single payer system will start to get louder. Which means we end up with the VA health care system for everyone.
Don’t worry, the GOP will continue to fun and bailout Commie care like it always does.
Anyone who thought you could add thirty million to the rolls of health care, eliminate pre-existing conditions and make providers offer “free” treatments and lower costs was INSANE. You heard me say it here long ago.
There was no “purity of heart” (hopefully, that is sarcasm). Obamacare follows a tried and true left wing formula; put something in place that is so huge and cumbersome that it, in their argument, is impossible to replace. So, we simply have to keep financing it… otherwise, innocent people will suffer.
See the arguments for illegal immigrants elsewhere; the reason we can’t address it (with anything but amnesty) is because there are too damned many illegal immigrants here (ignoring the fact of who created that mess). Obamacare is no different.
It IS probably cratering sooner than imagined (by the left) making it necessary to concentrate more on global warming than addressing this disaster. But, fail it will and unless we can extricate ourselves from this liberal trap, we will wind up with NIH, dumping old people out of valuable hospital beds and Soylent Green.
I guess its time to demand from our representatives all of the ideas that were demonized by the left. No government socialist programs( I say hiding my purse) we have failed programs already on life support of printing money to cover.
there won’t be a president cruz or rubio. They are NOT eligible to run for office. I am tired of people interpreting the Constitution of the United States the way they want to. rubio was born in Miami, Florida but to TWO CUBAN (illegal) citizens. Just because you were born in the USA, does NOT mean you are eligible. cruz was born in Canada to a US born mother and a Cuban father (BTW was a soldier of castro). He is not eligible either. Both these men know yet continue to stomp on the the Constitution and would not defend or uphold it, as they are not now.
Just because you were born in the USA, does NOT mean you are eligible. If just being born in the USA was the prerequisite to run for the office of president and or vice president then terrorist Omar Hammami born in Alabama could run; and terrorist Anwar al-Awlaki born in New Mexico; and terrorist Adam Gadahn born in CA. – and there are more. You get the picture.
The requirement is to be 35 years old, and be a natural born US citizen. If Cruz was an American citizen by birth, which only requires one parent to be an American citizen regardless of the location of the actual birth, that infant is considered a US citizen, a criterion Cruz meets. Infants born to US soldiers married to foreign nationals and delivered in other countries are considered US citizens. Unless you have some other information regarding Cruz’s birth that disqualifies him, he qualifies to be president.