Obamacare

Obamacare Is at a Crossroads

And the liberal direction will lead to single payer

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Peter Suderman's excellent post this morning noted how Obamacare is turning into a spectacular failure. Insurance giant Aetna is pulling out from exchanges in 11 of 15 states, joining

Obamacare
bitzclet at Foter

the stampede by other underwriters. And some – though by no means all—liberals are grudgingly even beginning to acknowledge that the dreaded death spiral of adverse selection is setting in, I note in The Week.

So Obamacare, it is becoming clear, is unsustainable as it is and will soon be at a crossroads. It can either go in a more free market direction and give consumers more control over their own health care dollars and use market competition to curb escalating premiums.

Or it can become a full-blown single-payer government insurance monopoly with private underwriters completely driven out of the health care market.

But instead of fully coming clean on the fact that single-payer is the ineluctable logic of government intervention in the health insurance marketplace, liberals are pretending that a "public option" — creating a government plan to compete with the Aetnas of the world — will fix the death spiral, I note.

Go here to read why they are wrong.

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  1. Peter Suderman’s excellent post this morning

    Well, somebody doesn’t read the comments, that’s for sure.

    1. Not all of us are gifted with such critical minds as Shikha. She can truly vet all the excellent Reason posts better than we simple readers.

    2. The C- students of Reason have to stick together. Maybe grumble about all the attention the teacher’s pets, Walker and Root get.

      1. Are we talking the writers or the commenters?

        1. Writers, I think it’s fair to grade them on a curve. Commenters get a more general and individual grading structure because a curve would drive the trolls’ scores up too high.

          1. I’m not ashamed to maintain a Gentleman’s B around here.

            1. Him, I could have sworn I heard you say you would rather have the D.

                1. [Sulks in corner]

              1. I prefer the double D’s myself.

  2. I went down to the Crossroads,
    Feel down on my arthritic patello-femoral joints!

  3. I’m already getting screwed on my insurance thanks to the ACA. I better go stock up on KY because the pounding is about to start.

    1. You really have to wonder at what point the left becomes accountable for the damage they have caused. We got Obamacare, and it failed. We’re told that it’s because we didn’t go far enough and need single payer. Ok, we implement single payer, and it fails. What do they blame it on then? When do they just admit that they don’t know what they’re doing?

      1. Because now they are saying it was basically a Republican Mitt Romney plan. I kid you not.

  4. Good timing. Krugman just came out with the perfect solution. Accept free money.

    And the gaps have only grown wider since Obamacare went into effect, for two reasons. First, the Supreme Court made the federally-funded expansion of Medicaid, a crucial part of the reform, optional at the state level. This should be a no-brainer: If Washington is willing to provide health insurance to many of your state’s residents ? and in so doing pump dollars into your state’s economy ? why wouldn’t you say yes? But 19 states, Texas among them, are still refusing free money, denying health care to millions.

    1. That’s my Krugabe, droppin’ dollah bills from choppa’s

    2. why wouldn’t you say yes?

      Maybe you should ask them. Or dare to read one or two ‘conservative’ blogs that explain the objection.

    3. This should be a no-brainer: If Washington is willing to provide health insurance to many of your state’s residents ? and in so doing pump dollars into your state’s economy ? why wouldn’t you say yes?

      Because states have to pay @ 1/3 of Medicaid out of their own pockets, even pre-expansion Medicaid was wreaking havoc on state budgets, the 100% federal funding of the expansion was time-limited, and so signing on for expansion was guaranteeing a state-level fiscal catastrophe in the out years.

      Any other questions, Pauly?

      1. Now, now. In Krugabe’s defense, he is a mendacious piece of shit. And when you take that into account, you can almost forgive him for spouting such idiocy.

        1. “Free” money?
          Mendacious AND stoooopid.

      2. There’s also the fact that its *not* ‘the federal government’ paying for anything. That money came from the residents of the states, got a percentage skimmed off the top, and then it would have been fed back to the state.

        Best you can hope for there is that you’re living in one of the poor states that are net recipients of Federal redistributionist policies.

        1. I disagaree, A.

          Once those taxes have been paid to the federal government, its the federal government’s money, and not the taxpayers’ money in any way.

          Its not even as if the Medicaid match is tied in any way to the taxes received from any given state. Its straight up redistribution – if a state comes out anywhere close to even, its pure happenstance.

          1. Once those taxes have been paid to the federal government, its the federal government’s money, and not the taxpayers’ money in any way.

            While true in some legal/accounting sense, this is beside the point. They didn’t earn that money, and they sell themselves as stewards of it on our behalf. Calling them out as e.g. “wasting taxpayer money” is not wrong in a general sense.

          2. Once those taxes have been paid to stolen by the federal government, its the federal government’s money, and not the taxpayers’ money in any way.

            FTFY

    4. That’s the difference between children like Krugman and mature adults. Mature adults know that there is no such thing as “free money”.

      1. Ooops.
        Scooped again…

      2. Krugman, the Nobel prize winning economist, really needs to have a talk with Krugman, the mendacious political pundit. He’s given them both a terrible name.

    5. First, the Supreme Court made the federally-funded expansion of Medicaid, a crucial part of the reform, optional at the state level.

      The court didn’t make anything. The court recognized the impingement on states rights by this terribly written bill. This was almost stunning, given the court’s usual deference.

    6. Nice to see Krugabe cloaking himself in the question-marked coat of Matthew Lesko.

  5. Crossroads? You mean dead-end in the wrong part of town.

  6. God damn it!

    This would be tantamount to creating a single-payer system ? a government-run monopoly. And the only thing worse than a private monopoly is a state monopoly. Indeed, single-payer systems in countries like Canada and Denmark only stay afloat by dipping deeply into public coffers and/or rationing care ? defeating their whole purpose. Even if the left tried, it’ll be nigh impossible to pull this off in a debt-ridden country already careening toward a massive entitlement spending crisis.

    This is the everything about single payer in the article. There’s no explanation of why it’s not going to work, why it won’t fix the death spiral or why a leftist should be reluctant to embrace it. And the link to ‘rationing care’ goes to exact opposite situation – doctors make patients make one appointment per complaint, because they are paid per appointment.
    Why? It’s supposed to be an easy argument to prove.

  7. turning into a spectacular failure

    HAHA no. This thing was such a flaming dumpster fire that the Dems had to pass it under the most underhanded means a bill has ever been put in to law. It was doomed from day one and even its own supporters agreed that the money wasn’t there.

    It was never ever going to be anything other than a complete and utter failure.

    1. Exactly, Tman.

      As soon as I read those words, I was hoping that somebody else took notice.

    2. At no point has it been anything other than a failure. Remember the rollout of the exchanges? Colossal failure. Remember the projections on exchange enrollment? Colossal failure. Remember the promise that your outlay for healthcare would go down? Colossal failure.

      At no point has this law delivered anything but failure. The administration has to move the goalposts to its own ten yard line to claim any successes at all.

  8. so they had to lie to pass this law, Roberts had to invent crap to uphold it, and entirely predictable consequences happened. Remember, when we brought up all these issues when they passed this bill, we were called conspiracy theorists and racists….

  9. Fuck that cutesy euphemism “single payer”. The healthcare the progs are shoving us into will be government-run healthcare. Don’t call it anything else, especially not the misleading moniker the progs picked.

    1. Single payer may sound nice, but it also points to one the major flaws of government run healthcare. Monopsony pricing power drives down prices, decreasing supply. This is called rationing.

    2. Speaking as one of the token Canucks here, yeah, government-run healthcare is about as appetizing as a “government-run restaurant.”

      It’s government food. What could possibly go wrong?

    3. Which suggests my alternative solution. If the progressives are so adamant that they need to have the government provide healthcare, I’ll meet them halfway. Let’s allow them to sign up for the VA with the stipulation that that’s the only healthcare they can use from now on.

  10. What the healthcare system needs is more illegal immigrants.

  11. So the feds under Hillary are so concerned about losing some coal jobs they’re going to throw money at retraining the miners, but they’re going to effectively lay off every person employed in health insurance in the entire nation by implementing single payer.

    1. No, they will be hired (at 1.5 times their previous salary) to be the ones implementing single payer. No net loss of jobs at all!

    2. That WOULD be cool though.

  12. “That will be President Obama’s legacy. He should be worried. Very worried.”

    Au contraire. President Obama will be proud. Very proud. When ObamaCare fails forward into single-payer as it was designed to do.

    1. Sorry, I do not see the expertise 9D chess to presume he had any idea it would do anything other than wobble along as has S/S, with ‘fixes’ propping it up for another 5 years.

      1. It didn’t take 9D chess skills to figure out that ObamaCare would crash and burn, and that the idiot American public would clamor for government to fix it. It doesn’t even take checkers skills. It barely takes tic-tac-toe skills to figure this out. I’m definitely not saying that Obama is a real-life Frank Underwood, but merely that he is not a retard.

        Obama is on record saying that he sought a step change on the way to achieve single-payer. His advisors are on record saying that their strategy was to intentionally deceive the stupid voters and their stupid representatives.

  13. Obamacare sucks. But remember, this is only the individual market. A lot of people still have health insurance they are more or less satisfied with. Single payer requires everyone giving up their health care in return for the government running everything. I don’t think we are anywhere close to the kind of crisis that would get people to do that. I think the Progs are delusional.

    1. But remember, this is only the individual market.

      Yes, the self employed were not screwed enough by the old system. We really had to give it to them fast and hard.

      How I hate people who refuse to collectivize for their own good.

      1. It sucks. Don’t think I meant otherwise. I just meant it doesn’t’ suck badly enough to get people to go for single payer, Prog dreams aside. If anything, it makes single payer less likely because people now know that if they have healthcare, they can’t trust any promises they can keep it in the event of “reform”.

    2. I had insurance, and still do. O-care has undoubtedly increased my cost, since my insurer is now paying for the deadbeats along with those of use who did pay.
      Pretty sure I’m in the majority, and after the stench of the O-care ram-through, I also doubt the hag can push though anything like ‘tax-payer’ medical care.
      Given the way the emails keep wrapping around her neck, I’m seeing her election as not the disaster it might have been; she’s trusted by fucking ignoramuses like Tony and commie-kid, and not many others. It’s beginning to look like she’d have a hard time getting a holiday resolution pushed through congress; most all would be looking at it carefully to see who got the political payoff.

      1. I still don’t think she is going to win. If she does, outside of the Republicans rolling over and giving her every judge she wants, I don’t think she will get anything accomplished beyond stealing. Also, I don’t think her health will hold up for four years. I don’t think she will win but would not be shocked if she did. I am absolutely certain that if she does win, she will never so much as seek re-election much less win it.

        1. I still don’t think she is going to win.

          The polls are tightening again, and its still August. Way too early, still, to throw dirt on Trump’s coffin.

          1. Especially with debates and a high probability of a big October surprise looming.

    3. But remember, this is only the individual market. A lot of people still have health insurance they are more or less satisfied with.

      Most to all of those employer plans shift more costs to the employee than they did pre-OCare. If people are satisfied with them, its not because they are better, or even unchanged. Its because they know they can’t do better elsewhere.

  14. Too bad that “crossroads” doesn’t encompass a set of railroads tracks, with Obamacare playing the role of Nell Fenwick.

    1. Poor, poor Nell!

    2. But Nell always gets rescued, right? Shouldn’t it instead be Robert DeGuerin (James Caan’s character in Eraser)?

      /sighs that I can’t do youtube links from work/

  15. Proposition:

    Drug companies are preparing for single payer healthcare by exploiting the Orphan Drugs Act and the Unapproved Drugs Initiative to control the market for particular old drugs (injectable ephedrine, colchicine, etc.) in order to raise prices so they can demand higher government payments once single payer arrives.

    Thoughts?

  16. OT: Gene Wilder has passed away.

    1. Gene Wilder has passed away.

      **HEAVY SIGH**

      That sucks.

  17. Well, the good news is Gene Wilder won’t have to worry about Obamacare any more.

    1. Not a reply to Crusty – just a failure to refresh after my nephew just told me he heard it on the radio.

      1. I’m not good enough to reply to? I see…

  18. Fuck that cutesy euphemism “single payer”. The healthcare the progs are shoving us into will be government-run healthcare.

    How about SantaCare?

  19. Exactly as the liberals intended.

  20. That’s really cool. I would be interested in seeing more graphs of different information you pull from these logs. suicide squad online

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