Obamacare

Universal Coverage? Sure, Whatever. That Sounds Good.

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Whitehouse.gov

Was President Obama's initial promise to pursue a major health care overhaul initially little more than an afterthought? In a lengthy reported piece on Obamacare's backstory, Politico traces Obamacare's inception to a pre-campaign speech in 2007, in which then-Senator Obama declared his intention to pursue universal coverage mainly because he thought it sounded good. 

Soon-to-be-candidate Obama, then an Illinois senator, was thinking about turning down an invitation to speak at a big health care conference sponsored by the progressive group Families USA, when two aides, Robert Gibbs and Jon Favreau, hit on an idea that would make him appear more prepared and committed than he actually was at the moment.

Why not just announce his intention to pass universal health care by the end of his first term?

Thus was born Obamacare, a check-the-box, news-cycle expedient that would ultimately define a president.

"We needed something to say," recalled one of the advisers involved in the discussion. "I can't tell you how little thought was given to that thought other than it sounded good. So they just kind of hatched it on their own. It just happened. It wasn't like a deep strategic conversation."

Even after Obama made the promise, the piece suggests, Obama still didn't put much energy into understanding the issue. 

Even after his pledge, though, it took months for Obama to buy in. In March 2007, he found himself on the same stage with a highly confident Clinton at another health care forum, this one sponsored by the Service Employees International Union in Las Vegas.

Obama staggered through a discussion that left policy wonks convinced that he was out of his league, particularly when compared to Clinton, arguably the nation's premier expert on health care after her unsuccessful attempt to enact reform in the 1990s.

While she dominated, he was confronted by an audience member who asked why he didn't have a health care plan yet. He responded that his campaign was only eight weeks old and promised to come up with one soon.

Another fun detail from the story: Obama's campaign trail opposition to the individual mandate was most political positioning. As a candidate in a tough primary, Obama was "simply looking for any way to differentiate himself from an opponent [Hillary Clinton] whose basic policy positions were indistinguishable from his own." But as soon as Clinton quit the race, Obama privately told advisers he'd likely end up proposing a law with a mandate. 

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  1. Wow – just like Syria! Obama throws out an idea, then gets backed into a corner, and must defend the idea and “do something” to protect his honor image.

    Hmm – almost seems like a pattern of NOT HAVING A FUCKING CLUE, MAKING SHIT UP AS YOU GO, AND BLUNDERING FROM ONE FUCKUP TO ANOTHER WHILE BEING RESCUED BY MORE POLTICALLY COMPETENT UNDERLINGS.

    What a fucking pinhead.

    1. He is a faculty lounge liberal and community organizer. He spent his whole career talking out of his ass to other liberals and having dumb white people think how smart he is. Until he was running for President, Obama had never been anywhere where people actually listened to him and actually thought and cared about what he said and assumed he meant it. That is not a good role for him.

      1. Also, I get the sense he’s never had to nail his flag to the mast to do something principled in the face of organizational push-back.

        He reminds me of some kids I went to school with: they were very non-controversial; they made sure they got good grades in everything; they stuck with the crowd for the most part; where they stood out was in socially approved ways, such as raising money for cancer research etc.

        They weren’t bad kids, but they weren’t really having their mettle tested.

        An executive of any organization, be it a three man tow-truck company, or a conglomerate with 17,000 employees must be able to lead an organization into doing things that the organization doesn’t want to do, to stop them from doing things that they want to do etc. A leader doesn’t merely preside. He must be able to bend people to his will. A good leader is one who bends people to his will to make an organization do good things rather than merely self serving things.

        Obama has shown none of these qualities: his ends are self serving ones, and he has shown no ability to bend people to work against what the organization wants.

        1. Exactly. And the prevelence of those types of kids once they are grown up in places like Wall Street, government, and the media goes along way to explain why so many of our institutions are failing. An organization full of people like that either runs aimlessly on its own inertia or runs off a cliff after it is taken over by someone with a charismatic and dominant personality but disastrous ideas.

          How did the banks manage to get so far in the hole with mortgage backed securities? Because they were staffed with people who were unable and unwilling to rock the boat and stand up to the organization.

          1. How did the banks manage to get so far in the hole with mortgage backed securities?

            it was the purely rational choice. it’s better to have a possibly or even likely non-performing loan offset by a lien on real property than millions in CRA judgments and settlements offset by nothing at all, as Citimorgage learned in their settlement with Obama and ACORN in the 90’s.

            1. But that is not what they did. They bought into this insane idea that the entire housing market would rise forever. If the market rises forever, you will never lose provided your holdings are spread out enough to compensate for any individual loss.

              It wasn’t hard to figure out that the whole thing was going to crash if housing prices ever stopped rising. They had to have known that. But the organizational culture was such no one ever stood up and said “stop” or those that did were pushed aside.

              Also, it is the nature of any bubble that it makes money in the short term. That is why it is a bubble. People are making money and thus other investors are following that money. It takes a lot of intestinal fortitude to stand up and tell your organization to forgo immediate profits to avoid what you feel is going to be a long term disaster. The people tarran describes are not going to do that.

            2. How did the banks manage to get so far in the hole with mortgage backed securities?

              The Cause of the 2008 Mortgage Crash, Revised 4/21/2013

          2. How did the banks manage to get so far in the hole with mortgage backed securities?

            Because they knew most of them would be bailed out. It was musical chairs amongst the big banks. Only the first to fall had a chance at not being caught by the taxpayers. The odds looked very good from their perspective. Now, thanks to Docc-Frank, they know for a fact that all of them will be bailed out next time. There’s nothing to hold them back but regulations written by inferior/colluding bureaucrats.

            1. Now, I think they probably think that way. But before 08, I don’t think they did. Remember Lehman Brothers died. A lot of banks died in the S&L crisis. 2008 was not a pleasant experience for them. It was not something they dismissed. They didn’t want to go broke. But did anyway.

        2. They weren’t bad kids,

          They’re apparatchiks, so whether they are good or bad people is an open question, IMO.

          1. That is our entire country now, at least as it relates to big organizations. Big corporations are filled with the same sorts of people.

            And we wonder why so many institutions fail.

        3. and he has shown no ability to bend people to work against what the organization wants.

          Then again, if Obama were supremely capable at bending people to his will we would still be bashing him because his will is usually some combination of dumb and evil. I’ll take an evil incompetant over an evil mastermind any day.

          1. It goes back to where he is from. Obama is incapable of understanding the other side. So he is unable to co-opt their ideas or make any kind of reasonable compromise with Republicans. He is no different than Nancy Pelosi. They both think Republicans are evil and should have no say in the running of the Government. You can’t be that way as President. The country is too evenly divided. Well you can be that way, but you will never get anything passed outside of brute force or change public opinion on any issue.

    2. Almanian!|9.24.13 @ 10:13AM|#
      “Wow – just like Syria! Obama throws out an idea, then gets backed into a corner, and must defend the idea and “do something” to protect his honor image.”

      Where was Putin when you need him?

      1. I’m pretty sure he’s hacking the HHS databases to steal your identity — for the poor children.

    3. “What a Fucking Pinhead”

      The revealing new memoir from Barry Obama that discusses his turbulent stint as this nations chief executive.

    4. What was important was that he become President. You don’t have to actually stand for something, or desire to do something with the position. He wanted to sit in the chair.

  2. Obama staggered through a discussion that left policy wonks convinced that he was out of his league, particularly when compared to Clinton, arguably the nation’s premier expert on health care after her unsuccessful attempt to enact reform in the 1990s.

    So that’s the qualification for becoming an expert? If I taught myself veterinary medicine at home by performing surgeries on stray animals, does that make me the nation’s premier veterinarian?

    1. Well, remember that he’s a lame duck, so obviously a reporter decided that it was time to suck up to and flatter Clinton instead of Obama now. 🙂

      1. Clinton: ‘Suck it, bitches! Who else ya got? Biden?!’
        HA!

    2. Yes. Neither of them had medical degrees or had ever worked in the field. But they were “experts”. Just like Ezra Klein and Sad Beard are “experts” in economic policy even though neither one of them has ever so much as held a real job.

      It is not hard to figure out why things are so screwed up.

      1. In this bizarre culture, being an expert simply means having something to say. Clinton, Klein, Yglesias, Tom Friedman and David Brooks are all experts, because they have a lot to say about a lot of issues. It’s not like they’re all just talking out of their ass, right?

        1. That and having the right credentials and somehow getting the right soap box. It is a totally bizarre culture.

  3. “I can’t tell you how little thought was given to that thought other than it sounded good. So they just kind of hatched it on their own. It just happened. It wasn’t like a deep strategic conversation.”

    Some people might find this difficult to believe.

    Not me.

    Also, can somebody please explain to me what in the name of Cthulu “defund Obamacare” means? The nodders on my teevee make it sound as if Obamacare is an already fully functional single payer universal unlimited health care program, but those evil Rethuglitards want to end it. You know, if I fall off the roof and break my leg, Obamacare would swoop down and make me well again, but Ted Cruz and rand Paul won’t let it.

    What, specifically, is being “cut”?

    1. the CR includes “Sec. 137. (a) In General- Notwithstanding any other provision of law, no Federal funds shall be made available to carry out any provisions of the Patient Protection and Affordable Care Act (Public Law 111-148) or title I and subtitle B of title II of the Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), or of the amendments made by either such Act.”

      it goes on from there, but it basically doesn’t allow the government to continue implementation.

      1. Yep. It cuts off all funds to those agencies responsible for implementation. So no one would be able to run the databases. No one would be able to run the Federal exchanges. No one would be able to investigate whether you met the mandate and no subsidies would go out to States or individuals. Basically, the executive branch would not have the resources it needs to execute the law as written. Of course, they currently have all the funding they want and they still have done a piss-poor job of executing the law as written.

    2. the CR includes “Sec. 137. (a) In General- Notwithstanding any other provision of law, no Federal funds shall be made available to carry out any provisions of the Patient Protection and Affordable Care Act (Public Law 111-148) or title I and subtitle B of title II of the Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), or of the amendments made by either such Act.”

      it goes on from there, but it basically doesn’t allow the government to continue implementation.

    3. If Obamacare was the cost saving law it was advertised as, wouldn’t defunding it be impossible?

  4. Even after Obama made the promise, the piece suggests, Obama still didn’t put much energy into understanding the issue.

    A statement that helps support my thought that when Obama’s handler’s entered him into the 2008 Presidential election cycle they had no thoughts on Obama actually winning the primary, let alone the general election. I still believe that the plan was to gain Obama national campaign experience, perhaps even get him on the ticket as a VP candidate, and then to run Obama as presidential candidate in 2012 and/or 2016 after Obama actually gained some experience as a US senator.

  5. Clinton, arguably the nation’s premier expert on health care after her unsuccessful attempt to enact reform in the 1990s.

    So, there’s nobody who really comprehends the health care market. I can believe that.

  6. I found a good pre-2008 election run-down on the healthcare reform proposals at “thehealthcareblog.com/blog/2008/03/21/ a-detailed-analysis-of-barack-
    obamas-health-care-reform-plan/” (I won’t link it because the site tried running an unsigned app so fuck ’em) that says basically that Obamacare is a Trojan horse, step one on the way to universal healthcare.

    Would the Obama/Clinton health care system work?

    It would clearly get almost everyone covered sooner rather than later.

    The real question is how would it be sustained. Are their cost containment strategies going to support a system that is affordable in the long run?

    No.

    These Democratic proposals are about access ? getting just about everyone covered. Getting everyone into this unsustainable system will then make things even more unsustainable creating an imperative for a second wave of real cost containment when the feel good list of cost containment proposals now in their plans falls short. My sense is that most Democratic health policy experts already know this but see no other political alternative.

    I don’t think Obama was really talking out his ass with regards to healthcare reform, it’s just that the long and the short, the alpha and the omega of his proposal – like so many other proposals – is “Free shit for everybody”. The rest is just details.

    1. The problem is that bringing all of these new people into the system is going to necessarily reduce the well being of those in the system. That quote admits that. The progs assume that once people see their well being get worse, they will demand single payer.

      Maybe. But it also seems possible that people are at heart pretty selfish. Everyone loves to talk about the need to cover the uninsured and the poor, provided doing so doesn’t cost them personally anything. I think it is just as likely that the 75% of the country that was happy with their health care and their insurance before Obamacare demand their old insurance back and want the new entrants kicked out.

      I am not sure what will happen. The progs are making a reasonable bet that they can fight off any reform short of single payer by arguing “we can’t kick anyone out”. But I think it is just as reasonable to think that dog won’t hunt when people are faced with real reductions in their standard of living that are directly attributable to Obamacare.

      Every other Prog program has been cleverly designed to deliver apparent benefits while hiding the costs. Never before has there been a prog program that benefited a few people at the undeniable expense of the majority of the country. It is hardly a sure thing that the majority, after seeing their health care get worse and more expensive thanks to Obamacare will demand a total government takeover as a result.

    2. Getting everyone into this unsustainable system will then make things even more unsustainable creating an imperative for a second wave of real cost containment when the feel good list of cost containment proposals now in their plans falls short.

      IOW, a Cloward-Piven tactic, like trying to get as many people on food stamps as possible.

  7. I can’t tell you how little thought was given to that thought other than it sounded good.

    “It sounded good at the time” pretty much sums up his entire presidency.

    Universal healthcare? It sounded good at the time…

    Close Gitmo? It sounded good at the time…

    Most transparant administration EVAR? It sounded good at the time…

    Red line? It sounded good at the time…

    I could go on, but you get the idea.

    1. ^^THIS^^

      Take any area of government and Obama and his people had no idea what they were doing. All they had was platitudes.

  8. Blame the late PA senator John Heinz for all of this. If he hadn’t died in a plane crash in the early 90s, Harris Wofford wouldn’t have run to replace him, he wouldn’t have hired James Carville, who wouldn’t have suggested using health care against heavily favored opponent Dick Thornburgh (remember, the early 90s were the age of HMOs which people hated), he wouldn’t have won on the issue, Carville wouldn’t have taken that issue to the Clintons, who wouldn’t have started this whole universal health care ball rolling.

    1. albo = James Burke.

    2. Also, if he hadn’t died in that plane crash, his widow wouldn’t have inherited his money and let John Kerry use it to run for president and position himself to become secretary of state.

  9. it basically doesn’t allow the government to continue implementation.

    Thanks, I guess. So the vast teeming hordes of government employees will have to pretend to be doing something else in order to collect their pay?

    1. You can only do things that Congress says you can. If Congress says “you can spend no money doing x”, then you can’t do that. Whatever law you are talking about becomes a dead letter.

      For example, Congress could end the federal drug war the same way. They would just pass a budget that said “no federal agency can expend funds enforcing the following titles of the US Code” and then list out the statues that make possessing or selling or importing drugs a federal crime. That would be it. The DEA would have to sit around and train all day I guess. The FBI and CBP and ICE would have to immediately suspend work on all of their drug investigations and work on other crimes.

      1. The FBI and CBP and ICE would have to immediately suspend work on all of their drug investigations and work on other crimes.

        I interpret this to mean work on committing other crimes. Is it possible I’m becoming too cynical?

        1. No. I recently passed a traffic stop where two police vehicles were sitting behind a car with no plates, and my first reaction was “The bastards stole his plates!”. A few minutes later I realized that they’d just take the whole car instead of bothering to remove the plates and probably pulled him over for lack of plates.

      2. the fun begins when agencies get creating in their interpretation of what they are authorized to do.

        and then, suddenly, when there’s something they don’t want to do, it “oh, we don’t have the authorization for that.”

        1. That is what they pay people like me for. And honestly, I have told clients no when they wanted yes much more often than I have told them yes when they were hoping for no.

          They are hard chargers. They all want to do something to put on their evaluations. And that often involves doing shit they have no authority or any business doing.

        2. They will continue chasing drug busts, only they won’t charge the drugs, but all the ancillary charges (guns, money laundering, etc.).

          1. That would be harder than you think. It is the drugs that gives them the knowledge of the stuff you mention. They could probably re-classify a lot of their on going investigations as something different, but they couldn’t charge drug crimes and the sentences available would be much smaller.

            Moreover, without the underlying drug charge, there are very few federal gun charges. Unless the guy has a machine gun, just having a gun is not a violation of federal law. It would be if you have a gun and are selling drugs. But without charging the drugs, you can’t charge the using the gun in a federal crime charge.

            Money laundering is more stand alone. So they could pursue those cases. But that would quickly run dry. If the feds were no longer enforcing the drug laws, dealers could be more open and honest with their cash and thus avoid such charges.

            1. So they just spend their money enforcing the gun charges, and the drugs just come along with them. The drugs are still a federal crime, so you can still charge using the gun in a federal crime.

    2. I have never thought about it, but I would also think that Congress could effectively commute the sentence of every drug offender in federal prison by putting a rider in the Bureau of Prison’s budget that prohibited them from expending funds for the imprisonment of anyone convicted of a drug crime. The BOP would then have to release every drug offender since they couldn’t spend money to guard or feed them anymore.

  10. But as soon as Clinton quit the race, Obama privately told advisers he’d likely end up proposing a law with a mandate.

    He didn’t even do that. Under the ACA not having health insurance was only subject to a penalty. It was not a mandate like contributing to FICA is. Then Justice Roberts takes a look at this and says it’s not even a penalty, it’s a tax. Roberts ignored the Obamacare propaganda and called it what it was.

    So, why can’t a simple majority in congress repeal it?

    1. you can. use the reconciliation process.
      see http://www.nationaljournal.com…..e-20130327

    2. Yeah, that will be interesting when the Repubs cite Roberts opinion that it is a tax to ram through a repeal over a Dem filibuster.

  11. Obamacare is a Trojan horse, step one on the way to universal healthcare.

    No kidding.

    I haven’t seen it recently, but there was an infuriating “See how much Obamacare has helped me?” ad which pretty much made it clear the intent of Obamacare is to bankrupt the insurance companies. Payment caps are evil, children, mmmmkay?

  12. America – where a spectacularly unqualified clown gets elected president on a massive wave of white liberal guilt. What a country!

    1. Once, OK. But re-elected, after his incompetences and narcissism had been on display for 4 years?

      That’s what scares me.

      1. Using the IRS to harass t he other side and keep them from organizing didn’t hurt that effort. There was a huge dropoff in Republican turnout in both 08 and 12. The 08 drop is pretty easily explained by the fact that Republicans were demoralized after 8 years of Bush and by the passage of TARP. But 2012 is a lot harder to explain. Romney wasn’t Ronald Reagan. But it shouldn’t have mattered. He wasn’t John McCain either.

        If it was because people were mad over him not being conservative enough, I would think Johnson would have done better. It sure seems like more people should have showed up to vote against Obama and voted Johnson as a fuck you if for no other reason. But they didn’t.

        Perhaps the failure of Republican get out the vote efforts had something to do with that. We will never know. But Obama is the first President ever to use the IRS to help his re-election efforts and to harass the other side. Unless that is the new SOP, which it might be, it is hard to judge what happened in 2012.

  13. But re-elected, after his incompetences and narcissism had been on display for 4 years?

    America, where any idiot can grow up to be President. Twice!

    1. Brooks, it would be racist to hold Obama to the same standard we hole any other President too.

    2. George W. Bush put the ball on the tee for Barack Obama.

  14. I’ve worked with guys like Obama. They talk without thinking, then believe once they say something – it’s as good as done. We used to call it “traveling light”.

    I feel no remorse at torpedoing their careers since I know I’ll have to clean up the messes they make.

  15. I can’t tell you how little thought was given to that thought other than it sounded good.

    The affectation of good intentions, every goddamned problem proglodytes have unleashed on society starts with that motivation.

    Clinton, arguably the nation’s premier expert on health care after her unsuccessful attempt to enact reform in the 1990s.

    THAT IS WHAT THEY REALLY BELIEVE

    An economic illiterate, professed believer in technocracy, is the nation’s greatest authority on an industry she has never been a member of, contributed to the knowledge base of, or studied with any degree of rigor.

    THAT IS WHAT THEY REALLY BELIEVE

    1. Worse still, since they are all idiots and are terrified of being seen as such, they ruthlessly eliminate and marginalize anyone who actually knows anything.

  16. George W. Bush put the ball on the tee for Barack Obama.

    Yes. Yes, he did.

    1. And then John McCain gives him a mulligan.

      1. All true. Him winning in 08 is understandable. Winning in 12 however..

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