President Obama’s press conference about the Affordable Care Act was one of the most remarkable statements I’ve ever seen a President make. Virtually every sentence of it was the opposite of the truth—and it was full of not just ordinary lies, but a particular brand of hoary old sunfaded tried-and-failed lies. They’re the kind of lie that political leaders utter when everything behind them is crumbling to the ground and everybody else knows it. They’re an Emperor’s New Clothes kind of lies. They’re a Bagdad Bob kind of lies. They’re a Five Year Plan kind of lies. They’re an I Am Not A Crook kind of lies. They’re the kind of lies that failures say when they feel the failure so deep in their bones that they can’t come up with really clever lies. Let’s take a closer look.
“Six months ago today, a big part of the Affordable Care Act kicked in, as Healthcare.gov and state insurance marketplaces went live.”
We all know what a fiasco that was. Long after refusing to come clean with actual numbers—and purposely issuing misleading statistics based on how many users had simply registered with the site, or had selected a plan, rather than how many had actually purchased insurance (that number was 0)—the Administration was basically forced to admit that not only was the website a complete failure, but that the most rudimentary background research and development checks had never been performed. Government officials had ignored warnings that the website would not work—because, of course, they have no incentive to get this issue right. Unlike a free market entity like Amazon (which effortlessly handles far, far more traffic than Healthcare.gov), the government gets paid even if it messes up. Secretary Sebelius, for example, when asked whether she would be resigning in light of her incompetence, told reporters that the people calling for her resignation—i.e., American voters—are “people she doesn’t work for.”
Also, Pres. Obama’s prevarications continue in his use of the term “marketplaces.” The actual word in the law is “Exchanges.” Exchanges are anything but marketplaces. In a marketplace, you get to decide what to buy and when to buy it. In an Obamacare Exchange, you’re forced to buy, the insurance companies are forced to sell, and the government dictates what it is that you’re forced to buy and sell. That is the exact opposite of a “marketplace.”
“Millions of Americans finally had the same chance to buy quality, affordable health care and the peace of mind that comes with it, as everybody else.”
Actually, they were able to buy health insurance. Insurance is not care. Insurance is only a place in the queue—it’s a coupon that promises you’ll get care at some future point. That’s a big difference. The government can give away coupons. It can’t give away care.
And, of course, it just isn’t true that everyone had the same chance to buy quality, affordable health insurance. Obamacare imposed requirements on health insurance plans that were so burdensome that they essentially canceled millions of insurance policies across the country—forcing people to instead buy policies covering items they would never need. By requiring people to buy Cadillac-quality insurance when Volkswagen insurance would have been good enough for them, Obamacare seeks to raise money to be spent subsidizing the insurance of those who, for whatever reason—often, bad planning on their part—do not have insurance coverage. This is essentially corporate welfare for insurance companies.
“Last night, the first open enrollment period under this law came to an end.”
Well, sort of. Not really, though. Thanks to the Administration’s liberal use of the delete key on the Obamacare keyboard, there have been so many delays, extensions, waivers, and rewrites of the law, that actually it’s quite easy to avoid compliance with the statute. In fact, the Administration has decided that one qualifies for a “hardship exception” to the law if one can say (without any need for actual evidence) that one couldn’t afford a policy, or that some other, unspecified burden came along. That is, Obamacare is itself the hardship that excuses one from Obamacare. Since the government isn’t requiring proof of any of this, and is granting extensions and waivers to employers, the uninsured, and insurance companies, it’s pretty hard to say that any “period” has “come to an end.”
“…Seven point one million Americans have now signed up for private insurance plans through these marketplaces.”
Well, kinda. One has to ignore the millions whose policies have been cancelled as a result of Obamacare, and one has to ignore the way the goal posts have been moved, over and over again, during this process. The 7 million figure is simply false, in fact—it counts people who have only selected a plan, not people who have actually paid for anything. The actual number, as the Washington Post reports, is probably at best about 4.8 million.
But that doesn’t matter, anyway. As John Sununu pointed out yesterday, a specific target amount was never what this was about. It was supposed to be about insuring the uninsured and reducing costs. But since a hefty percentage of those who have “signed up” will end up not paying—and another large chunk are people who have moved over from other forms of insurance, or who have newly signed up for Medicaid—this 7 million figure is very misleading. In the main, Obamacare has not signed up the previously uninsured, but has only shifted insured folks to different lists. As health insurance expert Robert Laszewski observes, “[even if] all of the one million people who signed up in the last week were previously uninsured, that would mean that only three million previously uninsured people have purchased coverage in the government-run exchanges.” And the actual out of pocket costs for everybody have gone way up.
“Truth is, even more folks want to sign up…”
Actually, polls show that Americans despise Obamacare. This law has never been popular with voters—the majority have always disapproved it, and perhaps in part because they voted for the presidential candidate who said he was opposed to the Individual Mandate.
“…anybody who was stuck in line because of the huge surge in demand in the past few days…”
But there’s a huge surge of demand or Amazon.com during the Christmas holidays, and for Priceline.com during the weeks leading up to Summer Vacation, and they never seem to have the kind of “website problems” that Healthcare.gov had. Again, the reason is that things are more efficient when the people who make the decisions get rewarded for getting things right and get punished for getting things wrong. That happens in the free market. It doesn’t happen in the realm of government.
“Seven point one million. That’s on top of the more than 3 million of young adults who gained insurance under this law by staying on their family’s plan.”
Throughout discussions over the ACA, President Obama has touted the importance of being “responsible”—by which he means, being forced to pay for other people’s health insurance. The penalty (tax) for not buying insurance is referred to in the law as a “personal responsibility payment.” How odd it is, therefore, that the President continues to boast of a provision in the law that allows young adults, who could very well get a job and buy their own insurance, to remain in the nest well into their 20s, paid for by their parents. Is that responsibility?
“Making affordable coverage available for all Americans, including those with preexisting conditions, is now an important goal of this law…”
But insurance companies were already legally required to insure people with preexisting conditions, even before Obamacare. And Obamacare does not necessarily insure people with preexisting conditions. For example, we noted a while back that the ACA allows bureaucrats to impose a “tobacco surcharge” on people who smoke. If the point of prohibiting “discrimination against those with preexisting conditions” was the premise that everyone should get insurance, no matter what, then this surcharge qualifies as the type of discrimination that President Obama is falsely professing to have eliminated.
“In these first six months, we’ve taken a big step forward.”
Given the numbers of delays, extensions, exemptions, and waivers that you’ve issued, Mr. President, isn’t it really more of a small step, or a shuffle, or a tippy toe? And, of course, it’s actually a step backward when you consider the millions of people who have had their insurance policies cancelled, or their premiums go up, as a result of Obamacare. You remember that, right? Because you had to backtrack your repeated promises that “If you like your plan, you can keep your plan”? And then your fellow Democrats had to tell people why it was actually a good thing to lose their insurance, or even their jobs, as a result of Obamacare?
“This law is bringing greater security to people who already have coverage.”
What he means is that insurance plans that once only covered things you needed are now forced to cover things you don’t need—and to charge you accordingly. So now men are required to pay for maternity care they don’t need. That way, they’ve got “greater security”...in case they ever get pregnant.
“Millions of Americans remain uncovered, in part because governors in some states, for political reasons, have deliberately refused to expand coverage under this law.”
Then why did the ACA allow states the option of whether to participate or not? Under the Administration’s expansive interpretation of the Commerce Clause, presumably the federal government could have essentially taken over the entirety of the process. And, in fact, the ACA provides that if states decline to fund exchanges, the federal government will take over that power and fund the exchanges itself. The states “deliberately” (i.e., after deliberation) exercised the option they have—an option that is actually fiscally sound, given that state-funded exchanges gain nothing for the state, but cost them a lot of money—and the federal government has fallen down on the job of setting up alternatives. Now, if I tell you “You can do X, but if you choose not to, I’ll do X for you,” and you choose not to do X, and I provide a lousy, failed excuse for an X, who’s really to blame? Governors who declined to fund exchanges from state coffers acted responsibly—it’s the Obama administration that has failed. He is just saying, “Oh yeah? Well, you should not have trusted me.”
“That’s what the Affordable Care Act…is all about. Making sure that all of us, and all our fellow citizens, can count on the security of health care when we get sick.”
It would be nice if we could “count on” anything we need when we need it. But that doesn’t mean I have the right to force other people to pay for it. It would be nice if I could “count on” a house, or a nice meal, or someone to make me a nice suit, whenever I want it. But these are all things that must be provided by other people’s labor. They don’t just drop from the sky like manna, and the government doesn’t just manufacture such things for free. Health care, too, is a service provided by other people. It must be paid for by money taken from other people. Yet the President ignores these people. In fact, he says that Obamacare ensures
“that the worth and dignity of every person is acknowledged and affirmed. The newly insured…deserve that dignity. Working Americans…deserve that economic security.”
But what about the people whose earnings are taken from them by force to pay other peoples’ bills? What about their dignity? What about their security? To “secure” surely means that what I earn is protected against expropriation, doesn’t it? And yet the ACA takes away my earnings—forces me, against my will, to pay—for other people, when I never did anything wrong. I never hurt those people. To seize my earnings to subsidize them is to commit an injustice against me. Why does my worth and dignity not count in this equation?
“Women, the sick, the survivors—they deserve fair treatment in our health care system.”
That’s true. They deserve to get what they pay for through their own money, and they deserve to respect my right to do the same. They certainly don’t deserve more than that, or to take my wealth from me, or to force other people to provide them with health care services which they haven’t paid for. If I don’t have money to buy a sandwich, it’s not “fair treatment” to force the guy at Subway to give me a sandwich anyway. On the contrary, that’s unfair treatment.
“All of which makes the constant politics around this law so troubling.”
Troubling it may be, but please recall that it was the President who, early on in the process, decided not to seek Republican support for the ACA because, in his words, “I won.” It was his party that chose to ram the ACA through Congress in the middle of the night at Christmas eve, rather than try to negotiate with Republicans and seek some kind of support or buy-in. It was the President who forced the nation into a so-called “government shut down” rather than to delay the implementation of the ACA…only to turn around within a few weeks and issue his own series of delays.
“…at times this reform has been contentious and confusing, and obviously it’s had its share of critics. That’s part of what change looks like in a democracy. Change is hard.”
One reason change is hard is because one typically must negotiate with one’s opponents—with those who think your ideas aren’t really as good as you think they are. But the President chose not to proceed that way. He chose to use the bare majority of Democrats in Congress to rush through a piece of legislation which members of Congress had not even read.
“Overcoming skepticism and fear is hard.”
Admitting you were wrong is hard, too, sometimes, Mr. President. Admitting that the law that got passed wasn’t even what you wanted, might be hard. Vanity sometimes stands in one’s way. I mean this quite sincerely. Sometimes, when I’ve done or said something that I secretly regret, I actually get more outwardly stubborn and insistent that what I did was right all along, or that my critics are just evil people, just because I’ve bought in so much to whatever it was that I did or said, that I can’t really believe I could have screwed up. But isn’t it part of respecting other people’s dignity and worth to admit to our fellow citizens when we’ve messed up, and when perhaps their criticisms might have some validity after all? Part of what change looks like in a democracy is listening in good faith to what your fellow citizens have to say—not just talking, but listening. Overcoming skepticism is hard. But overcoming one’s confidence in oneself is often much harder.
“This law is…working…. All of which makes the lengths to which critics have gone to scare people, or undermine the law, or try to repeal the law without offering any plausible alternative, so hard to understand. I’ve got to admit—I don’t get it.”
But critics of the ACA have provided numerous alternatives—alternatives that would focus attention on the consumer of health care services, and open up the paths for innovation and new ideas, rather than creating more bureaucracy. Market-based alternatives have worked for every other industry, and they would work for health care, also. If I want a burrito this minute, I could go to any one of a dozen restaurants within five minutes of here and get a nice, tasty, safe meal for about three bucks—five if I want a Coke. Why? Because the consumer is in charge—I know what I’m spending, and I know what I’m getting, and I can shop elsewhere if I don’t like what I get. Yet the ACA does not follow this model when it comes to health care. Instead, it forces people to buy insurance they don’t want, forces insurance companies to insure people who are already sick, and reinforces a system where the consumer doesn’t pay, and doesn’t have much choice to go elsewhere. The President, of course, knows that consumer-oriented alternatives exist. But he has always dismissed them out of hand without any serious consideration—thereby rendering them “implausible.” Why? Is that what change looks like in a democracy? Is that respecting his fellow citizens’ worth and dignity?
What he means by “undermine the law,” by the way, is presumably the effort by Republicans to delay implementation of the individual and employer mandates—which, of course, the President himself did only months after castigating Republicans on the grounds that Obamacare was “law of the land” and must be followed to the letter.
“Why are folks working so hard for people not to have health insurance? Why are they so mad about the idea of folks having health insurance?”
This is a really astonishingly cruel and unfair thing to say of one’s fellow citizens. Surely the President doesn’t really believe that opponents of Obamacare somehow want people to suffer, or want them to go without health care when they need it. Surely he knows that critics of Obamacare think there are better, more efficient—not to mention, more Constitution-friendly—means of providing care for people who need it. I’ve been involved in opposing Obamacare for a few years now, and I can honestly say I have never once heard a single person in the opposition express, even in their most private conversations, any desire to see people go without health insurance.
Yet rather than acknowledge the loyalty of the opposition, President Obama chooses to accuse them of “working hard” to make certain that “people don’t have health insurance.” Part of what change means in a democracy, of course, is acknowledging that people have good-faith differences. But instead of doing so, he resorts to a particularly bland and unimaginative attack on the motives of opponents—an attack he and his audience both know isn’t true. Is this respecting the dignity of one’s fellow citizens? No, it’s simply childish. It’s desperation. It’s proof of the old adage that the demagogue demeans himself in order to attack others.
“Many of the tall tales that have been told about this law have been debunked. There are still no ‘death panels.’”
There may not be “death panels,” but there’s still the Independent Payment Advisory Board—an agency of unelected bureaucrats, free of any responsibility to the legislative, executive, or judicial branches, which has unlimited power to take whatever steps it believes are “related” to Medicare expenses. True, IPAB is legally prohibited from “rationing care,” but since it’s immune from any judicial oversight, there’s nothing you could do about it if IPAB did ration care. I understand it’s silly to use the phrase “death panel,” but this agency does, in fact, have the power to reduce Medicare reimbursement rates to zero for procedures it deems unworthy, and it could do so without any accountability to the democratic branches or to any judge. Blithely assuring one’s audience that there’s nothing to see here is, well, not exactly dignified or democratic.
“Armageddon has not arrived.”
Nobody said it would. They said that Obamacare would raise premiums and lead to insurance cancellations; would fail to sign up enough people; would be ineptly handled and poorly implemented; would violate the Constitution; would perform worse than a free market for health care, and would hurt the economy. All of these have happened, with the possible exception of the latter, which has been mitigated only by the President’s own waivers, extensions, and after-the-fact changes in the law. And, honestly, “Armageddon has not arrived” is not exactly one’s strongest argument for the success of a policy, is it, Mr. President?
“I will always work with anyone who’s willing to make this law work even better. But the debate over repealing this law is over. The Affordable Care Act is here to stay.”
If that were true, of course, such a desperate speech, so full of lies, distortions, and shoddy ad hominem would not be necessary. On the contrary, just as with everything else in this speech, the reverse is true. The debate over repealing this law has switched into high gear. If the Affordable Care Act were here to stay, then there wouldn’t have been some 30 or so modifications to the law—all of dubious legality—and we would not be here, in April of 2014, some four years after the law was enacted, still talking about whether it was a good idea in the first place. Successful policy just doesn’t have that kind of can tied to its tail.
But most of all, it just is not the role of the President to declare any kind of policy debate “over.” That just is not how change works in a democracy. Nor does the President himself believe it. This is the President of Red Lines. He draws Red Lines all the time, only to draw a new one the next day, and a new one the next day, sometimes even crossing over them himself, as with his delays and waivers. The result is not just to destroy his credibility on Red Lines, but to invert it. Now, when he draws a Red Line, you know it is exactly the next line that will be crossed. He would not draw it, if he did not know in his heart that it is going to be crossed.
Obamacare is an object lesson in failure. Failed politics, failed policy, failed bureaucratic thinking. The President’s press conference today is all too typical of Beginning of the End statements that we’ve seen from so many collapsing leaders. It’s time for the grownups in the room to find some way of cleaning up this mess.
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