- If there is a problem, the federal government should attack it.
- Government can compel people to act against economic self-interest by passing laws.
- There is no downside to big government.
- The welfare state is the best mechanism to help the poor.
- Those opposed to big government hate the poor.
- Government is capable of running highly complex systems effectively.
- When addressing big problems it is best to centralize and standardize.
- Unintended consequences of government programs are a small price to pay.
- People will trust the government with private decisions and personal information.
- Spending more and taxing more are evidence of concern for the poor.
All of these precepts have been challenged by conservatives, but there is nothing like a real example and personal experience to drive home a message. We don’t have just a few “glitches” or even a time crunch for putting up the exchanges, we have in Obamacare a fundamental misunderstanding of the limits of the government and citizens’ aversion to big, complicated entities. The effort to construct one big system with a highly regulated product (Obamacare-standard insurance) may in fact be the entire effort’s undoing.
CMDA CEO David Stevens, MD, MA (Ethics):
“Our healthcare system is broken and badly in need of a fix. The root problem is that healthcare costs too much, so individuals and businesses can’t afford insurance. The Affordable Care Act, unfortunately, is built on the premise that most people’s health insurance programs are not adequate and all perceived inequities must be solved. So the law says preventative services and contraceptives must be free. It doesn’t allow surcharges for age or preexisting conditions. Children can stay on their parents’ plans until age 26. There are no lifetime cost ceilings. Plans must contain psychiatric, eye and other coverages that most insurance plans have not provided.
“I like all those things, just like I like all the bells and whistles on a Mercedes Benz 500 with its great ride and exquisite comfort. But I’ve never owned a Mercedes because I can’t afford one, just like most people in our country. I drive a Honda Civic and, you know what, it gets me there. We can’t afford the Affordable Care Act either. It will add a whopping $2.8 trillion to our healthcare costs over the next 10 years. Already, self-insured individuals are experiencing the reality of that sticker shock but they are no longer in a market-driven healthcare economy. They can’t buy a well-used insurance vehicle at an economical price. Only a Mercedes is adequate.
“We very well may be headed for a debacle. The ‘cure’ may be worse than the disease. If so, everyone may be so traumatized that they refuse to even give a hearing to a real solution.”