More Health Care Follies

Republicans are banking on the failure of the evil Obamacare to restore their political fortunes in 2014 and 2016. But Ramesh Ponnuru warns them they must not be complacent. Oh, it’s going to be a disaster, he says, but perhaps not disastrous enough.

Opponents of Obamacare should plan instead for the likelihood that in its first years of full operation the law will fail in undramatic and unspectacular ways. Premium increases, cost overruns, and the like may keep the law from becoming popular, but they will not prompt the third of the public that supports it to switch sides, or even get its many soft opponents fired up about it. Meanwhile, the administration will spend millions of taxpayer dollars to advertise the law’s benefits. The law’s dogged defenders will explain away all the disappointing developments, and the polls, as the result of continuing opposition in red states. A few conservative lawmakers have speculated that the law will crash so badly that the Democrats will themselves demand repeal in the next couple of years. That is not the way to bet.

Republicans’ confidence that Obamacare will collapse has contributed to their lassitude in coming up with an alternative. It is a perverse complacency. If the program were going to collapse in the next three years, it would be all the more important for Republicans to build the case for a replacement for it. We can be sure that the Left would respond to any such collapse by making the case for a “single payer” program in which the federal government directly provides everyone insurance.

Ponnuru thinks a third of the country supports the health care reform law. A CNN/ORC Poll (they poll orcs?) taken May 17-18, 2013, found that 43 percent of Americans favor the law and 51 percent oppose it. However, only 35 percent oppose it because it is “too liberal.” The remainder of the opponents don’t think it is liberal enough. So it’s really just over a third who see it the way Ponnuru does. But let’s continue.

Jonathan Chait thinks that it’s politically smarter for the Republicans to not put forward an alternative plan, because that would expose what nitwits they are. Well, that’s not how Chait puts it, but that’s basically what he’s saying.

Republicans have wisely decided to attack Obamacare without committing themselves to an alternative because the alternative would be easy to attack. Ponnuru, for instance, suggests changing the tax code and stripping regulations to create “a market in which almost everyone would be able to purchase relatively cheap, renewable insurance policies that protected them from the risk of catastrophic health expenses.” Telling tens of millions of Americans they’ll lose their insurance that covers basic medical expenses and get bare-bones policies with thousands of dollars in deductibles is not a winning play.

Republicans are doing a good job scaring people with highly misleading claims about “rate shock.”

But the vast majority of the public is not going to see any changes under the new law. Even if the Obamacare exchanges collapse, they only bring in people who don’t have Medicare or employer coverage anyway and are already suffering through a dysfunctional individual insurance market. The “shock” is going to be felt by conservatives who are expecting their Randian fantasies of socialist dystopia to come true.

Timothy Egan writes,

The early indications are that most Americans will be pleasantly surprised. Millions of people, shopping and comparing prices on the exchanges set up by the states, are likely to get far better coverage for the same — or less — money than they pay now. The law, as honest conservatives predicted, before they orphaned their own idea, is injecting competition into a market dominated by a few big names. …

…“The surprise is that, for many in the individual market, the premiums will be lower and the benefits so much richer,” said Mike Kreidler, the state insurance commissioner in Washington. “Eventually, I can see the Affordable Care Act being embraced like Medicare, because once people get used to this kind of coverage, it’s going to be a pretty abhorrent thing to try and take it away.”

Egan compares today’s “ossified right” to conservatives who predicted dire things about Social Security and Medicare — before they went into effect. The question is, how long will the Right be able to keep the fear-mongering going once the law goes fully into effect? I expect that next spring we’ll be inundated with all kinds of stories hyping every little glitch. But if the sky does not fall, will the fear-mongering have an impact on the mid-terms in November? We’ll see.

Sorta kinda related — “How Do They Sleep at Night?