Obamacare

Obamacare is Bad for Health Care Socialism

The federal health law makes it more difficult for states to pursue their own goals.

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Whitehouse.gov

Obamacare is bad for health care socialism. That's one takeaway from this big New York Times write-up of the ongoing problems and frustrations in Vermont, which set up its own exchange under the law, and initially viewed the Affordable Care Act as a bridge to the nation's first state-based single-payer system.

The state's residents and policymakers are both increasingly frustrated, however, because the single-payer plans have been scrapped, and serious technical and administrative problems remain with the exchange.

The state's single-payer plan was stopped in its tracks by cost estimates indicating that the taxes it would require would be far too high—the hikes would be "enormous" in the words of Gov. Pete Shumlin, who had backed the plan. But the exchange struggles, the article suggests, also helped kill public confidence in the plan. Meanwhile, Obamacare forced the state to build out the health care system that the federal government required it to have instead of the one that its residents and elected officials actually wanted. "This law, by preserving the private insurance system and treating health care as a commodity, made us do things that Vermont otherwise wouldn't have done," an official at group that advocates for single-payer health care told the Times.

Another way of thinking about this, then, is that Obamacare is not only bad for health care socialists, it's bad for all forms of local experimentation and control.

Yes, the law does allow for states to apply for waivers that would go into effect in 2017—that's how Vermont was planning to implement its single-payer plan—but in the meantime, it pushes states into building systems that meet federal criteria, and in the process makes it more difficult for them to pursue their own goals.

And the states that participated most fully, by building and running their own exchanges, are now struggling to maintain the systems that they built under Obamacare. As the Times points out, it's not just Vermont that's struggling: Hawaii looks increasingly likely to shut down its exchange due to its inability to raise operational funds. Massachusetts, Maryland, and Oregon created exchanges that essentially didn't work at all. California's exchange is already running an $80 million deficit. Some of the states are reportedly looking at ways to cut costs by integrating systems.

I think Vermont's single-payer plan was almost certainly doomed to failure no matter what. But it might have been an interesting experiment, and it would have been instructive to see how it compared with, say, the Massachusetts system—a system that was also derailed by Obamacare. And it would be even better if we could compare those more liberal, coverage-expansion-driven systems with other types of experiments in more conservative states like Indiana, Texas, or Florida.

But that sort of experimentation and comparison is extremely difficult, if not impossible, at this point, even with Obamacare's waiver system, which would only allow for liberal forms of experimentation, and then only under strict guidelines. Rather than allowing states to test their own ideas and succeed or fail on their own, Obamacare has encouraged failure across the board.

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  1. The state’s single-payer plan was stopped in its tracks by cost estimates indicating that the taxes it would require would be far too high?the hikes would be “enormous” in the words of Gov. Pete Shumlin

    Knock me down with a feather. You’re telling me free healthcare costs money?

    1. God damned socialism, getting in the way of….socialism.

      1. It’s fabianism getting in the way of stalinism.

        1. Once the Bolsheviks take care of the Mensheviks, it’ll all be fine.

    2. They could have solved the whole thing by just limiting doctors’ salaries to $25k/year in perpetuity. Sheesh!

  2. But the exchange struggles, the article suggests, also helped kill public confidence in the plan.

    I find this little tidbit interesting. I’m a fairly unalloyed pessimist when it comes to my government, but could we finally be seeing a reaction to the utter incompetence of government… that a little socialism failed so utterly that people are finally thinking that more won’t fix it?

  3. Pennsylvania has filed to create its own “exchange” in case the Supreme Court decides the law means what it says.

    Pennsylvanians would still use healthcare.gov, but PA will try to claim it’s running its exchange because it will operate a call center. This is how the Democrats will get around it, they’ll water down the definition of exchange, at least for Democratic governors.

    1. Worth saying twice, I guess. Actual news article:

      Under its application, Pennsylvania would still have the federal government perform some duties, such as eligibility determinations and enrollment through the healthcare.gov website. That could raise the question of whether the marketplace really is run by the state, if the Supreme Court outlaws subsidies to states where the federal government runs the marketplace.

      Sabrina Corlette, a senior research fellow at Georgetown University’s Center on Health Insurance Reforms, said Pennsylvania is approaching the concept pragmatically by having the federal government run the most expensive part of the operation, eligibility and enrollment.

    2. Yeah, have a 16 yr old build a website that redirects you to the federal exchange. There, we ‘exchanged’ our site with the federal one. Boom, subsidies inbound, bitches.

    3. The law doesn’t say “run by the state”: it says “established by the state”.

      The state could establish an exchange simply by passing legislation that says “The state shall establish a health care exchange described as follows” and simply describe healthcare.gov. The call center is needless fluff.

      1. What do you mean, “needless?” That fluff might be necessary to make it look like politicians are Doing Something!

        1. And hire idiot children of constituents!

          1. Okay, okay. Change “needless” to “expensive”.

  4. Pennsylvania has filed to create its own “exchange” in case the Supreme Court decides the law means what it says.

    Pennsylvanians would still use healthcare.gov, but PA will try to claim it’s running its exchange because it will operate a call center. This is how the Democrats will get around it, they’ll water down the definition of exchange, at least for Democratic governors.

  5. But that sort of experimentation and comparison is extremely difficult, if not impossible, at this point, even with Obamacare’s waiver system, which would only allow for liberal forms of experimentation, and then only under strict guidelines. Rather than allowing states to test their own ideas and succeed or fail on their own, Obamacare has encouraged failure across the board.

    So… Healthcare Neutrality kind of fucked up innovations in the marketplace of healthcare?

    1. Someday, socialism,neutrality, etc. are going to work. No,really. I have been told by my government, so it must be true.

  6. Socialism costs money. Your money. Duh.

    You DO want to join rest of the civilized world, right?

    Right?

  7. I’m not too broken up about Obamacare being bad for even more hare-brained socialized medicine experiments. Maybe we could try a few free-market experiments.

    1. ^^^This. The Stupid Party didn’t bring up the notion of laboratories of democracy enough during the health care debates. They should have just made it a state by state issue – you want single payer or gov’t managed care – fine, do what Mass. did. There’s nothing stopping you…except your citizens will have to pay for it, and when they see the bill, the socialized medicine idiots will be thrown out of office.

      1. But that was the argument and was, pretty much the status quo, at the time.
        Each state fucked up their own medical insurance by demanding required coverages and limiting which companies could offer it. Even in Republican states, this led to higher-than-necessary costs – though 80% of Americans were happy with their coverage – and didn’t seem to cost any legislators their jobs.
        One of the things the Stupid party was, and continues to, advocate is, aside from scrapping federal controls and mandates, allowing medical insurance companies to sell across state lines, injecting the alien concept of competition to the marketplace.
        I think states placing restrictions on what people from other states can purchase is exactly why the founders included the interstate commerce clause.

        1. Insurance lobbyists are the driving force behind no cross border policies, it cut’s into their profit margin too much.

          The only lever to negate the power of lobbyists is term limits.

  8. Well, this just proves that single-payer must be imposed nationwide! /progderp

  9. American Socialist

    “Hi, Peter, did you notice that uninsurance rate has gone way down and some polls show that people like ACA now?”

    It’s like almost like there’s no net gain if you spend someone else’s money to pay for someone else’s need.

    1. Hi, Peter, did you notice that uninsurance rate has gone way down

      Um, no? From where I’m sitting they’re still 100% higher than they were in 2013.

  10. Obamacare is Bad for Health Care Socialism

    Oh, crap. First, the complete failure of the communes, then the 120 million murdered, and now this!

    I tell you, Socialism can’t seem to catch a break!

  11. In California, the numbers show 50% of the last years signup, didn’t resign.. for anything- Zero coverage whatsoever. Some estimates are that without Fed bailouts, policy rates should be as much 80% higher for next year.
    Pelosi isn’t talking about it though.

    1. And that is before the probable passing of legislation to include Illegals…………
      Which Pelosi isn’t talking about.

    2. Cali will maintain its subsidies, regardless of the SCOTUS decision.
      It will only be applied to the states that didn’t set up exchanges – California did it, I think, even before the law said they had to.
      Statism is strong in that one.

  12. I have a great idea

  13. So. . . Obama’s ACA doesn’t work? No kidding. How could it? Insure more people with greater coverage for less money. On the face of it it cannot work. ACA Fail. It will go down with a history like communism, ” real communism was never really tried”. That is only because it (and ACA) are both flawed idealogical utopian money pits.

  14. My best friend’s mother-in-law makes $85 hour on the internet . She has been out of work for 5 months but last month her pay was $16453 just working on the internet for a few hours.
    Visit this website ????????? http://www.workweb40.com

  15. Fear not, Vermonters, the goal of the ACA was the destruction of the private medical insurance industry – how dare they make money off sick people – and King v Burwell may have been part of the plan.
    Insurance companies will not be able to go back to their old policies, since the coverage mandate won’t go away and the lack of subsidies will drive so many out of the marketplace that the chaos created will demand government emergency action – voila the need for full-on government run medical insurance – AKA single payer.
    If it wasn’t the goal, all along, why did so many, who wanted socialized medicine, jump on the Oblamocare bandwagon?

  16. The definition of insanity is doing the same thing over and over, expecting different results.
    Socialism has failed everywhere it is tried, the completeness of that failure corresponding to the degree in which it is implemented. (Spain vs Greece).
    Taking small doses of poison is still poisoning yourself.

    Taking money from Peter to pay Paul is still theft, a disincentive for Peter to work and an incentive for Paul to not work.

    There is no such thing as “free stuff”, it is the ill-gotten-booty of someone elses’ labor.

    1. Name one thing the government does efficiently, without waste, fraud and abuse every step of the way?

  17. Vermont’s exchange was created with single payer in mind – but its failure was not what doomed single payer. If Shumlin had had his way, in 2017 all health insurance would be abolished, and the State would pocket the total of all Obamacare credits payable under the Exchange to finance single payer. That’s why Vermont’s law prohibited anyone from obtaining health insurance outside of the Exchange – the only state to impose such a monopoly requirement.
    The failure of the Exchange made the point that the state of Vermont could not get anything right, even with $198 million Federal dollars to play with. How could these geniuses make the far more complicated single payer scheme work?
    But what really finished off single payer was Shumlin’s discovery – after three years of denial – that he would have to extract an impossible $2 billion in new taxes from hard-pressed Vermonters to finance his single payer dream. Even if the Exchange had worked perfectly from Day One, single payer was politically and economically impossible.
    There’s nothing in the “big NY Times writeup” worth reading. The reporter interviewed only Shumlin appointees, SEIU-funded activists, and a Progressive Party legislator. She ignored the people who had explained that this thing wouldn’t work since 2011 (in my case, since 1992). This is like interviewing the last three finishers in the Indianapolis 500.

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