Most Read
    Image 01 Image 02 Image 03

    Did Obamacare Create the Expectation of Universal Health Coverage?

    Did Obamacare Create the Expectation of Universal Health Coverage?

    And did Obamacare solidify the belief that the federal government should provide it?

    Was the end goal of Obamacare to create the expectation of universal health coverage?

    Charles Krauthammer thinks so:

    On Friday’s edition of ‘Special Report’ on Fox News Channel, syndicated columnist Charles Krauthammer made the case that President Obama’s strategy for Obamacare was not to create a perfect health care system, but to create the expectation that health care is something the government is responsible for. He said Obama had been successful at “creating the expectation of universal care” and that as a result “the zeitgeist of the country has really changed.”…

    “That is the logic of Obamacare. It was a jerry-rigged system which would temporarily create an entitlement, but would not work because it is financially impossible… But they have succeeded at creating the expectation of universal care, and once you have that… What we’re going to get is Democrats going to a single payer,” he added.

    This is indeed what most of us have been hearing and thinking ever since Obamacare was passed—that the passage and then the implementation of Obamacare would constitute a point of psychological and systemic no-return because entitlements cannot ordinarily be turned back. Even if the GOP could agree on a way to roll back Obamacare (and so far, they haven’t been able to), the idea was that the public would not accept a more conservative approach anymore, because they have become wedded to the idea that health care must be a government-guaranteed right and not a privilege.

    But I’m also inclined to turn Krauthammer’s idea on its head. I reflect that Obamacare was preceded many decades ago by Medicare, and then in the early part of the 21st century by Part D (passed by the GOP, you may recall). In between (1986) we had EMTALA, the law that guaranteed emergency medical care at hospitals and didn’t really figure out how to pay for it—a law that was passed by a Republican Senate and Democratic House, and signed by Ronald Reagan, as part of a larger bill:

    That’s government racketeering explained in a nutshell: create the problem (strain on hospitals due to mandated free care) and use it as an excuse for wealth transfer, which is what universal healthcare amounts to in the end. And look how perfectly it works. The requirements under EMTALA are ostensibly what led to “Romneycare” and inspired the Heritage Foundation and Newt Gingrich to propose government- mandated health insurance coverage, giving liberals and libertarians a fair basis for pointing to “conservatives” as the ones who first proposed health insurance mandates.

    Our previous system of health insurance worked pretty well for most people, actually, but it was extremely complicated and some people fell through the cracks. Meanwhile, the growing entitlements (such as EMTALA) were at least part of the reason that health care was becoming more expensive and more often out of the reach of many of those without any insurance. Without going into the ins and outs and the details at the moment, I’ll just say that the expectation that the federal government do more to alleviate the burden was growing and growing and growing, and all the laws that I just mentioned were passed not just to expand those expectations but in response to expectations that had already expanded in a slow but seemingly inexorable progression.

    I use that word “progression” purposely. “Progressives” of the left call themselves that in order to promote the idea that their policies represent a natural, normal, and morally good example of human progress going forward in time. But those policies also create dependence, restrictions on liberty, rising costs, and bureaucratic messes that are hard to fix and resistant to change.

    Yes, as Krauthammer suggests, Obamacare has “create[d] the expectation that health care is something the government is responsible for.” But it’s also true that Obamacare reflected and was a response to the already-evident fact that the belief that “health care is something the government is responsible for” had been growing and growing for many decades. The details of Obamacare may not (and in fact were not) popular. The idea of it was. The whole thing was a system in which the expectation fed into the legislation, and then the legislation solidified the expectation that something similar would continue.

    The current impasse among Congressional Republicans represents a split between those moderates who don’t think we can or should go back very far—those who prefer tweaking Obamacare somewhat to keep the general idea in place but make it “better”—and those further to the right who think that turning it back entirely (and replacing it with one or another far more conservative solution) is not only possible but necessary for the good of the country and its people. This is a profound split rather than a minor one. It’s also an obvious split, and anyone who worked on a new bill to replace Obamacare had to be cognizant of it.

    [Neo-neocon is a writer with degrees in law and family therapy, who blogs at neo-neocon.]


    Donations tax deductible
    to the full extent allowed by law.


    Sonnys Mom | March 28, 2017 at 8:56 am

    Creating the “expectation” of universal health care as something the government is responsible for… a story line worthy of Ben Rhodes.

    Ragspierre | March 28, 2017 at 9:16 am

    According to Senator John Cornyn, the GOP will not try to repeal Obamacare via reconciliation again. Instead, they’ll work with Democrats.

    They hung conservatives out to dry, blamed the House Freedom Caucus, and are now giving away the game. They never intended to repeal Obamacare in the first place. If they did, they’d try again via reconciliation instead of surrendering altogether.

    They were not serious, but they had to set up conservatives to be the fall guys.

    I think that’s entirely plausible, and they’ll do it if we don’t stop them.

    This could be the decisive battle for conservatives this century. So much else hangs on the outcome of this crisis, and make no mistake; crisis this is.

      Mac45 in reply to Ragspierre. | March 28, 2017 at 11:04 am

      Correct. The HFC, for whatever reason, has done the rest of the country a service. By killing this terrible bill, they keep the cross hairs of Obamacare correction squarely on the Congress. And, the rest of the Republicans in office are going totry to blame them for the continuing death spiral of Obamacare, even though the AHCA would have done nothing to stop, or even slow, it.

      What will likely happen is that nothing meaningful will be done about Obamacare and it will collapse within the next 5 years. When it does, the natural inclination of our elected officials will be to “save” people’s insurance by imposing a single payer healthcare insurance entity. It will naturally be controlled by the government. That is when the real battle will have to be fought.

      mariner in reply to Ragspierre. | March 28, 2017 at 2:05 pm

      Well written, Rags.

    AmandaFitz | March 28, 2017 at 9:42 am

    Mo Brooks has filed a clean repeal bill, but it’s EXISTENCE is getting no reporting.

    John Cornyn is basically a RINO- he’s only pretended to be more conservative since Ted Cruz was elected.

    There’s a good article by Dr. Tom Coburn on the web today and yesterday there was an excellent article on Patterico- both worth reading.

    The GOP needs to have some backbone to change the system- and so far, I have seen little spine from the Paul Ryan contingent.

    Krauthammer gets it. The majority of Americans now feel that health insurance is an entitlement. This means that it is unlikely that Republicans will repeal the ACA. I have repeatedly stated that any repeal or replacement of Obamacare, which reduces government participation in healthcare or healthcare insurance, will mean the loss of healthcare insurance by soe portion of the population. There is simply no way to reduce costs to the consumer without socializing [nationalizing] healthcare and healthcare insurance. And, as the main complaint of the populous is that the premiums and deductibles on their current healthcare insurance are too high [even with government subsidies], doing anything which may cause them the loss of that insurance is political suicide.

    This is the reason why the Dems are not concerned that the Republicans will repeal, or replace, Obamacare. They know the score. And, when Obamacare collapses, they know that the Republicans will do the politically expedient thing and pass legislation to advance a government supported, single payer healthcare insurance system.

    Government third party healthcare insurance programs [Medicare and Medicaid] created the current crisis. But, the elected representatives will not make the sacrifices necessary to remove the cause of the problem and allow the market to adjust to allow for affordable healthcare.

    Was the end goal of Obamacare to create the expectation of universal health coverage?


    Anyone who tells you otherwise is either deluding themselves or is purposefully obfuscating the issue in order to try to set up the framework to argue that health care IS a right and SHOULD be universally “free” (to the end recipient).

    I argued this point extensively WAAAAYYY back in 2009 (unfortunately on Aberrant Templar, a blog that no longer exists) when the Patient Protection and Affordable Care Act (PPACA, aka Obamacare) was in the drafting stages, that it was:

    1.) designed to make the populace believe that health care was a “right” that they were entitled to;

    2.) designed to drive the health care insurance companies into the ground after 3 years (and that they would move to abandon the state insurance exchange “marketplaces” as soon as the guarantees regarding losses were removed);

    3.) that the federal government would then make it a requirement to participate in the state insurance exchanges as a prerequisite to offering coverage at all;

    4.) set the process for “single payer” by creating a pathway for “medicaid” to accept all applicants as soon as a critical mass of insurers had abandoned the state insurance exchanges; and

    5.) once a critical mass of “sick” individuals had joined medicaid and the medicaid funds were depleted so as to make medicaid “bankrupt” due to the abnormal ratio of sick-to-healthy, the federal government would make it illegal for any company to offer health insurance except FOR medicaid, and would require doctors to only accept payments THROUGH medicaid (no direct payments allowed). They would do this on the idea that “the expense is too high, and we have to distribute the cost of paying for the sick to the rich, who can afford to pay ‘just a little bit more’ by taking them out of their ‘platinum’ plated plans, and making them ‘share the burden.'”

    1 and 2 came to pass, but the populace rebelled before 3 could be imposed by the Democrat controlled Congress. Once the Tea Partiers held a portion of the Republican Party, and the Republicans were in control of the House, 4 became impossible to pass, which now leaves us where we are: with a completely broken system where the big players have extracted their profits from the early “guaranteed” years, and abandoned ship, ne’er to return, because they know that if they do, they will HAVE to accept pre-existing conditions AND they WON’T be able to extract the payment for those pre-existing conditions from the individuals, but will have to distribute the cost over the entire purchase population, which will make the insurance excessively priced to all, which will cause government to attempt to re-regulate pricing.

    Leave a Comment

    Leave a Reply

    You must be logged in to post a comment.

    Notify me of followup comments via e-mail (or subscribe without commenting.)

    Font Resize
    Contrast Mode
    Send this to a friend