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Obamacare a train wreck? On the contrary, it’s going to work

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Nobel laureate Paul Krugman indulges a bit of SPITEFUL ANTICIPATION:

Recent political reporting suggests that Republican leaders are in a state of high anxiety, trapped between an angry base that still views Obamacare as the moral equivalent of slavery and the reality that health reform is the law of the land and is going to happen.

But those leaders don’t deserve any sympathy. For one thing, that irrational base is a Frankenstein monster of their own creation. Beyond that, everything I’ve seen indicates that members of the Republican elite still don’t get the basics of health reform — and that this lack of understanding is in the process of turning into a major political liability.

On the unstoppability of Obamacare: We have this system in which Congress passes laws, the president signs them, and then they go into effect. The Affordable Care Act went through this process, and there is no legitimate way for Republicans to stop it.

(Snip)

I guess that after all the years of vilification it was predictable that Republican leaders would still fail to understand the principles behind health reform and that this would hamper their ability to craft an effective political response as the reform’s implementation draws near. But their rudest shock is yet to come. You see, this thing isn’t going to be the often-predicted “train wreck.” On the contrary, it’s going to work.

Oh, there will be problems, especially in states where Republican governors and legislators are doing all they can to sabotage the implementation. But the basic thrust of Obamacare is, as I’ve just explained, coherent and even fairly simple. Moreover, all the early indications are that the law will, in fact, give millions of Americans who currently lack access to health insurance the coverage they need, while giving millions more a big break in their health care costs. And because so many people will see clear benefits, health reform will prove irreversible.

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2 Comments

  1. “On the unstoppability of Obamacare: We have this system in which Congress passes laws, the president signs them, and then they go into effect. The Affordable Care Act went through this process, and there is no legitimate way for Republicans to stop it.”

    Actually, it would seem based on recent behavior the best way to “stop it” would be to put a Republican in the White House. Then the new President can decide to do whatever they want with the ACA. They don’t even need Congressional approval to do it.

    Krugman is right though, in general the train has left the station and it is not coming back.

    Health care has already been irrevocably altered in this country, some for the good, some for the bad. I am less optimistic about the success of the ACA, but I think that is an intentional design flaw to move us into a single payer system. Politicians of all stripes will be happy to gain total control of such a large segment of the economy.

  2. Here is another opinion from the Chicago Tribune.

    http://www.chicagotribune.com/news/opinion/editorials/ct-edit-obamacare-0818-jm-20130818,0,5666959.story

    The Affordable Care Act, aka Obamacare, is a hugely complex law that sets up online health insurance marketplaces, requires people to have coverage or pay penalties, and doles out subsidies and incentives to nearly everyone in health care. Doctors, hospitals and insurers have spent large sums to gear up for its requirements. Employers are mulling: Hire? Fire? Cut workers’ hours?

    Millions of Americans, that is, stand to gain or lose from how this law is enforced — with the Obama administration bending that enforcement in ways that test, and arguably exceed, the boundaries of lawful conduct.

    Every time the White House undercuts one provision of Obamacare, there is a massive ripple effect on other provisions. It’s generally a zero-sum game: When someone gains, someone else loses. Example: When employers are relieved of their mandate to provide insurance, taxpayers risk having to subsidize more of those companies’ employees.

    The administration asserts that it can make these changes under the president’s broad executive authority. Yet critics make a compelling argument that the president is stretching the limits. Former federal appellate Judge Michael McConnell, director of the Constitutional Law Center at Stanford Law School, writes in The Wall Street Journal about a different sort of mandate: the mandate in Article II of the Constitution that the president “‘shall take Care that the Laws be faithfully executed.’ This is a duty, not a discretionary power. … As the Supreme Court wrote long ago (Kendall v. United States, 1838), allowing the president to refuse to enforce statutes ‘would be clothing the president with a power to control the legislation of Congress, and paralyze the administration of justice.'”

    Like most issues of presidential authority, this isn’t cut and dried. Presidents do have broad discretion on how laws are enforced. But they’re on shaky ground when they decide whether to enforce a law. It’s not hard to understand why: Imagine the outcry if President Mitt Romney refused to enforce, say, Obamacare.

    Granted, any president may decline to enforce statutes he believes are unconstitutional. But Obama is making no such claim here. Basically, he is admitting that parts of law are impossible to enforce on the deadlines imposed by Congress — deadlines he signed into law. He’s also admitting he doesn’t want to have Congress make these changes, for fear that if lawmakers get their mitts on this unpopular program, they would at least debate far more extensive changes than he’d like.

    Congressional Democrats, and some Republicans, may agree with the numerous delays, changes and special favors. But the president invites chaos when he picks which parts of Obamacare to enforce, and which, in retrospect, he has decided are unworkable or unwise

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