Do you cause a train wreck to prevent a train wreck? That’s the logic behind Republican hard-liners’ threats to shut down the U.S. government if President Barack Obama and his Democratic allies won’t agree to dismantle Obamacare.
Any lucid soul will acknowledge that Obama won’t help sink the dagger into the chief accomplishment of his presidency. The Affordable Care Act – on the books since 2010 — isn’t going away. The new health insurance exchanges will open for business Tuesday, shutdown or no shutdown.
You have to wonder if Republicans really believe Obamacare will live up to the catastrophe they predict.
If they did, they’d be smart to skip the theatrics and simply let the massive new health system collapse on its own. The resulting public backlash could cost Democrats control of the White House and the Senate. The desperate-looking attempts to sabotage the ACA suggests that at least some Republicans are really afraid it will succeed.
In a better world, Democrats and Republicans would have collaborated four years ago on legislation to extend medical coverage to the uninsured, the core goal of the Affordable Care Act.
Both parties share blame for the scorched-earth politics that produced a law that would have benefited from more input from Republican lawmakers. Three years later, the country would be better off if enough Republicans collaborated on refining the law, which – like any legislation this complex – has flaws that need mending.
The ACA, for example, creates perverse incentives for some businesses to cut the hours of employees to evade the new mandate that they provide them with health insurance. (In some cases, employees actually get a better deal if their companies trim their hours and hand them checks to buy into Obamacare.) That’s a fixable glitch; it’s not a reason to tear down the entire system.
The complexity of the law has left Obama and fellow Democrats at a disadvantage, at least in the launch phase of the reforms. Defenders of the ACA have to explain its sometimes intricate provisions. Attackers merely have to cherry-pick and hype the negatives.
And Democrats, for the most part, have downplayed or denied the possibility that the nation’s overall health-care costs will go up, and many people will pay more under the reforms.
This needs a straightforward defense. When a medical risk pool is extended across an entire nation, the younger and healthier will inevitably tend to subsidize the older and sicker. Yet the younger and healthier will be older and probably sicker one day, and most of them will benefit from a broader safety net.
More fundamental, a humane society doesn’t shut sick people out of the doctor’s office because they can’t afford premiums. Expanding coverage costs money and requires government intervention, but sometimes it costs more to be a humane society.
Libertarians and many conservatives don’t accept this premise. They, too, should have to defend their position.