Wednesday, February 27, 2013

Why the big push against Obama care?

A dear friend and colleague of mine, an independent computer consultant, writes “So, why the big push against Obama care? It is far from perfect but anything that begins to dissociate healthcare with employers is a step in the right direction in my opinion.”
Dear D,
We agree that the current system of privileges for employer-sponsored plans is flawed.  Individuals who shop for health coverage independently of their employer should not be handicapped by a 70 year-old wage-control evasion scheme. See page 67 of Pull the Plug on Obamacare: ‘Level the Playing Field Because World War II is Over and We Thought We Won’.
So then isn’t Obamacare a step in the right direction? It would be if it were expanding the choices people have and resulting in lower costs. But it’s doing the opposite. Corporations, small businesses, universities and even unions are already finding that the cost of compliance with the law’s mandates (like guessing whether their plan will qualify for approval of the department of Health and Human Services – HHS – according to rules that have been announced but are yet to be written; and collecting information on how much their employees’ spouses earn) are making it difficult or impossible to continue to offer health coverage to their members. At the margin, they are shutting down more than expanding.
Employers’ incentives under Obamacare are increasingly to cut back on hiring (especially if they are near the 50-employee threshold), cut back hours to part-time status or substitute offshore contracts or machines that don’t talk back or take sick days. This is not ludditism; there is a place for automation and free trade in a capitalist economy. But making employing American workers more expensive than it needs to be by force is not a free-market virtue.
Moreover physicians, traditionally self-employed, are being herded into large hospital corporations as employees. By 2014, the majority of those that haven’t taken early retirement (80% are contemplating it) will be employees of increasingly large health maintenance organizations (HMOs) or accountable care organizations (ACOs). This trend should be alarming to an independent  businessman like yourself who is one of the admirable few computer consultants who has managed to keep out of captivity in spite of the overregulation that discourages corporations from contracting with entrepreneurs on pain of IRS wrath.
To the rescue: the state-run health insurance exchanges, the free-lunch bazaars. These are not markets; if they were then the only role for government would be as referee to enforce contracts, support private property rights and prevent and punish murder, robbery, theft, fraud, rape, persecution and conspiracy. Rather, the exchanges are regulatory sandboxes for the czars of the HHS and IPAB (Independent Payment Advisory Board) to play in, making decisions for patients, families and caregivers, spending taxpayer money and taking control over our lives.
A ‘step’ in the right direction? Obamacare is not a ‘step’.  It is the most ambitious social program ever attempted in the USA, bigger than Medicare and Social Security combined, and those are already on track to Greek-style bankruptcy, having blown all original cost estimates by orders of magnitude (see ‘A History of Cost Overruns’ on pages 48-50). There is nothing to lend confidence to the idea that the most massive program of all will be immune to a similar fate.
The ACA is far more than ‘far from perfect’. Unfortunately it is fraudulently conceived, destructive and doomed to failure. If you don’t believe me, please read Sally Pipes’ The Truth About Obamare or Betsy McCaughey’s Beating Obamacare.


More Health care reform resources on the Obamacare page.