Storified by Brian Empric· Sun, Mar 17 2013 15:48:42
“That’s up six points from a month ago and the highest level of pessimism to date. Twenty-two percent (22%) think the system is more likely to get better, while 13% expect it to stay about the same.”
“Democrats remain much more upbeat about the direction of the health care system than Republicans and voters not affiliated with either party. Eighty-four percent (84%) of GOP voters and 53% of unaffiliateds think the health care system is likely to get worse over the next couple of years. At the same time, a plurality of Democrats (39%) expect it to get better.”
“Anyone can criticize. Where is the Republican alternative?”
“Think about the special interests Republican politicians are likely to talk to. Doctors, hospitals, insurance companies, drug companies, device manufacturers, employers, etc. Their interests are all different. I doubt if you can come up with any significant health reform that won’t be vigorously opposed by at least one of these. Since heath care is a $2.6 trillion industry, special interests are willing to spend megabucks to oppose reforms they don’t like.”
“Overall, think tanks on the right have a habit of ignoring each other. Often, they don’t even footnote each other. We proposed the idea of Health Savings Accounts (HSAs) in the early 1990s... Today, HSA plans are the fastest growing products in the health insurance marketplace and I think it’s safe to say that the idea is no longer even controversial…”
“The NCPA web site is about the only place on the Internet where you will find a continuing, ongoing interest in how we can create a genuine market for medical care in which providers compete for patients based on price, quality and convenience… In my ideal world, health insurance companies would have a shrinking role — eventually becoming no more active than a garden variety life insurance company.”
“The conservative think tank problem is not their belief in free markets. It is that each think tank seems to have a different idea about how markets can solve problems… Bottom line: there is no common health policy vision on the right.”
“Imminent elements of Obama's grandest policy move, the health-care overhaul known as ObamaCare, are calculated to screw his most passionate supporters (the youth) and to transfer wealth to his worst enemies (the elderly).”
“And while one of ObamaCare's earliest provisions was a boon to the young, allowing them to stay on their parents' insurance through the age of 26, what follows may come as an unpleasant surprise to many of the president's supporters. The provisions required to make any kind of health insurance plan work — not just ObamaCare, but really any plan of its sort — require healthy young people to pay more in health insurance than they consume in services, while the elderly… consume far more than they pay in…”
“In an interview, AARP legislative policy director David Certner (@DavidCertner) didn't contest the suggestion that young people would be forced to pay more, but argued that it was a matter of the common good, not simply the interest of his constituents.”
“It's about having a big insurance pool because everyone benefits from it,” Certner said. “If a younger, healthier person is spending a little more now, it's OK because at some point they're going to be a less healthy, older person too.”
“This is a reasonable policy argument, though it's worth noting that every interest group argues its interests are identical to the common good…”
“The near-total silence on this issue is a mark of a class that is either utterly selfless (hard to believe, honestly) or, as usual, singularly bad at seeing and defending its interests.”
The supporters of the law think that subsidies will keep premiums down, while the mandate keeps them in the market to avoid penalties, but the penalties are relatively weak and the subsidies will not be able to cover the premium increases.
“[A]s ObamaCare's official launch date approaches, even its backers are beginning to admit that the law could actually create powerful incentives for millions of people and thousands of businesses to drop their coverage, despite the mandate.”
“A February survey of major health insurance companies in five cities across the country found that they expect premiums for this (young & healthy) group to climb an average 169%.”
“We are very concerned,” California Insurance Commissioner Dave Jones told federal health officials at a December meeting, “if there is so much rate shock for young people that they're bound not to purchase (health insurance) at all.”
“The five-city survey, for example, found that while the law will jack up rates for the young, it will lower them an average 22% for older and sicker customers.
“At the same time, ObamaCare also forbids insurance companies from turning anyone down — a reform called ‘guaranteed issue’ — which also will provide an incentive for some to drop coverage, knowing they can get it back any time.”
“The problem is that if the young and healthy drop coverage, the result would be what the industry calls a ‘death spiral.’ Premiums will climb as the pool of insured gets sicker, causing still more to cancel their policies… This is just what happened in states that imposed strict community rating and guaranteed issue reforms in the past. In fact, of the eight states that did so, most ended up either dropping the reforms or loosening the rules after they saw enrollment decline and premiums climb.”
“[T]he annual penalty for not buying insurance will be as low as $95 in 2014, and even when the mandate penalty is fully phased in by 2016 it will be modest relative to the cost of buying insurance.”
“The same problem threatens to undermine ObamaCare on the business side, if companies decide that paying a penalty is cheaper than providing an increasingly expensive benefit to workers.
“The Congressional Budget Office now expects that employers will dump coverage for 7 million workers as a result of ObamaCare, nearly double its previous forecast. And it says the figure could be as high as 20 million.”
“Senator Jeff Sessions (R-Ala. and ranking member of the Senate Budget Committee, @budgetgop), who requested the report, revealed the findings... The report, he said, ‘confirms everything critics and Republicans were saying about the faults of this bill…’”
“The big-government crowd in Washington manipulated the numbers in order to get the financial score they wanted, in order to get their bill passed and to increase power and influence,” he said. “The goal was not truth or financial responsibility, but to pass the bill. This is how a country goes broke.”
“Obamacare was the one issue that most pegged Obama as a big government liberal in the eyes of the American citizenry. By refusing to emphasize it, Romney allowed Obama to move to the center in voters’ minds. Obamacare was the centerpiece of Obama’s first term. By not emphasizing it, Romney suggested to voters that it really wasn’t all that much of a concern — and hence neither was having Obama continue in office. Obamacare was the least popular aspect of Obama’s first term. By failing to hammer away at it, Romney handed Obama a pass. Obamacare is a horribly misguided and statist attempt to deal with genuine health care concerns that sorely need to be addressed. By failing to put forward (and to emphasize) a serious replacement, Romney prove to be the latest, and perhaps the most unfortunate, example in a long history of Republicans’ failure to make themselves heard on an issue that’s not only extremely important in its own right, but which (at least in the present day) probably has more bearing than any other issue on the size and scope of government.”
“In short, there is nothing attractive about Obamacare. One hopes that in 2016 the Republican party will nominate someone who understands this, and who will make Obamacare’s replacement a — perhaps the — centerpiece of his or her campaign. If Republicans are to be the party of limited government and liberty, they must do nothing less.”
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