Health

A Redistribution of Wealth Under Obamacare

James Oliphant contends that Obamacare technical glitches have revealed deeper, more structural problems: “The curtain has been yanked back to expose the ungainly reality that lies at the very heart of the program: Very simply, under the Affordable Care Act, there are winners and there are losers. And there were always going to be. That fact, even more than the star-crossed rollout, may be the more enduring political threat to Obamacare.”

“In the traditional entitlements, just about every taxpayer eventually becomes a “winner,” but under the ACA that may never happen. In that way, the law is more of a direct wealth transfer.”

Politically, the Obama administration can’t admit that the only way for the program to be successful is “that there would need to be a transfer of wealth—from the young to the old, from men to women, from the healthy to the sick. That to raise the floor, you had to lower the ceiling.”

Oliphant warns: “The simple truth is that the Affordable Care Act is, from a certain point of view, either a finely tuned machine whose parts have to work in an almost orchestral fashion for it to produce the wellspring of results that have been promised, or an infernal, jury-rigged contraption that could collapse from the smallest series of stresses.”

How the 'Nuclear Option' Impacts Obamacare

The Senate’s decision to invoke the ‘nuclear option’ has a number of healthcare related implications.

According to National Journal, “the Senate’s rules change will likely make it much easier for President Obama to fill the Independent Payment Advisory Board, or IPAB—a 15-member panel tasked with slowing the growth in Medicare spending.”

“GOP critics oppose the IPAB largely because it puts the power to set Medicare payments in the hands of unelected experts. Supporters say that’s exactly the point: Congress lacks the political will to actually make meaningful cuts …  Obama will likely be able to fill the board and move ahead with one of the most significant cost-control measures in his signature health care law—if he wants to.”

According to Ezra Klein, “one important effect of Thursday’s change in the Senate rules: … It makes it easier for the government to hire good people, and makes it easier for them to fire bad people.”

“That’s not to say any of them will be fired. But the constant use of the filibuster against political appointments made it extraordinarily difficult for the White House to fire anyone because they didn’t know whether they’d be able to appoint a replacement — or, if they could appoint a replacement, who Republicans would actually accept.”

Chart of the Day

— The Council of Economic Advisers has a new report finding that health care spending is growing at the slowest pace on record. This chart shows the average annual growth rate of health spending on private insurance, Medicare, and Medicaid from 2000-2007 (in blue), 2007-2010 (in red), and 2010-2013 (in green).

“The fact that the health cost slowdown has persisted so long even as the economy is recovering, the fact that it is reflected in health care prices – not just utilization or coverage, and the fact that it has also shown up in Medicare – which is more insulated from economic trends, all imply that the current slowdown is the result of more than just the recession and its aftermath.  Rather, the slowdown appears to reflect ‘structural’ changes in the United States health care system.”

What Americans Now Think About Obamacare

Digging into the results from a new Washington Post-ABC News poll about Americans’ reactions to the Obamacare rollout, Scott Clement outlines his top six findings:

  1. Obamacare opposition is rising. It’s now at a record high of 57 percent.
  2. Americans hate the individual insurance mandate. Almost two-thirds oppose this requirement with 53% ‘strongly’ opposing.
  3. Even more say the mandate should be delayed due to Web site problems. 71% say the government should delay health insurance requirements.
  4. But people like the employer insurance mandate. The employer mandate garners 85% from Democrats; 56% from Independents; 29% from Republicans
  5. Obama’s a bad manager, but not a liar. In general, most (56%) say Obama is not a good manager, don’t detect intentional deception (52%).
  6. Can the law be salvaged? Americans are split down the middle at 49% on whether the government can recover from early problems or whether it’s doomed to fail.