By Grace-Marie Turner
President Reagan gauged the success of a welfare program by how quickly people were able to move off government assistance and into remunerative work. Yet President Obama, the White House, and their allies are measuring the success of Obamacare by how many people can be enrolled in their new government entitlement programs.
The president celebrated the law’s “success” in getting seven million people enrolled in Medicaid and eight million (or so) people enrolled in exchange coverage, 87 percent of whom are receiving government subsidies for their insurance. And he hopes to lure another five million people onto Obamacare programs starting with the November 15 enrollment period. There is no expectation that participation in these government programs will be a temporary boost but rather that they will become a permanent fixture in people’s lives.
This is a fundamental, structural shift in the role of government in our lives. Under Obamacare, public assistance programs are no longer seen as a safety net but as a way of life — and not just for lower-income people but for middle income families as well.
Political leaders such as Nancy Pelosi brag that people no longer have to work at jobs they dislike just to get health insurance, and they can instead quit their jobs and become artists and poets. She celebrates this “freedom” as the president’s campaign depicted his vision of permanent dependency in the Life of Julia.
Private companies are also getting in on the game, responding predictably to the incentives the health overhaul law creates. Walmart is the latest corporation to announce that it is dropping health insurance for its part-time workers, taking advantage of the law’s built-in incentives for companies employing lower-wage workers to drop private health coverage and dump their workers into taxpayer-subsidized insurance. They are simply responding to the clear incentives the law sets out.
Certainly the last six years have been dreadful economically — from older workers whose factory and other blue-collar jobs have vanished to young people struggling to find that first job that will let them launch their career. But it would be a tragedy if we were to build an infrastructure that sees expansion of entitlement programs as the future. If we do, we will have an even more difficult time moving beyond our current economic troubles to once again envision a bright economic future with financial independence, not dependency, as the goal.
Abraham Lincoln celebrated the dignity of work as an avenue toward self-fulfillment. The purpose of work is to support ourselves and our families, of course. But he believed that in America people had the freedom to put their own unique gifts to work to provide a fulfilling and potentially prosperous life.
The main role of government, Lincoln said in an address to Congress in 1861, is “to lift artificial weights from all shoulders — to clear the paths of laudable pursuit for all — to afford all, an unfettered start, and a fair chance, in the race of life.”
Obamacare is the antithesis of this vision. The American people continue to oppose Obamacare. Few know the massive intricacies of this labyrinth of a law, but they viscerally understand that it is fundamentally at odds with the vision and spirit of America.
It encourages and even celebrates dependency. It penalizes small companies trying to become larger companies. It discourages companies from hiring entry-level workers so they can get started in their careers. It makes health insurance and health care more expensive by injecting huge government subsidies into the equation, then bills taxpayers for the ever-increasing costs.
It requires citizens to spend their personal money on an expensive private product that they may not want or need — and fines them if they don’t comply. It brags about the wonderful new benefits the government is providing in “better” health insurance while ignoring the costs to taxpayers and to those with private coverage who must pick up the bill. It burdens the economy with 20 new and higher taxes to pay for its massive new entitlement spending.
It harms seniors by robbing funds from the Medicare Advantage programs, which is producing better, more efficient care for seniors, and uses the Medicare money to finance new entitlement spending for middle-income working Americans. And it harms the most vulnerable citizens on Medicaid by throwing millions more people into the program — making it even more difficult for the truly poor with no other options to receive the care they need.
Make no mistake. Obamacare is at its heart a political, not a health care, program. Princeton professor and Obama advisor Paul Starr revealed the Left’s agenda decades ago in his Pulitzer Prize- winning book, The Social Transformation of American Medicine:
“Political leaders since Bismarck seeking to strengthen the state or to advance their own or their party’s interests have used insurance against the costs of sickness as a means of turning benevolence to power,” Starr wrote.
Are we becoming a dependency state? Many are deeply concerned that the answer is yes. But I have hope. Obamacare was thrust on the country with back-room deals, political maneuvering, and crony capitalism at its worst. The American people opposed passage of the law then and now tell pollsters they believe, by a two to one margin, that the law is harming them, their families, and friends.
The promises made to get Obamacare passed were outlandish and virtually impossible to fulfill: That health costs for the average family would be cut by $2,500 a year. The law would reduce the deficit while simultaneously creating a massive new entitlement program. If you like your health care plan, you can keep your health care plan. If you like your doctor, you can keep your doctor. And the Obamacare website would work as smoothly as Kayak.
Americans, including those who supported passage of the law, have been hit with a big dose of reality as these idealistic promises have morphed expensive mandates with hefty costs and fines. For many who thought Obamacare would bring a free-health-care utopia, they are facing a rude awakening about the mandates, restrictions, and costs of government-controlled health care. Government does not have the answers, especially to something as extraordinarily complex as the American health care system.
Let’s hope that the American people will be more skeptical in the future of promises that big government can capably administer massive economic reengineering undertakings. And that they recognize that those who are willing to trade liberty for security will wind up with neither.
Pollster Daniel Yankelovich takes a long view. He is a master at seeing megatrends in society. He says that public opinion progresses through predictable stages, from dawning awareness of a problem, to growing sense of urgency, then discovering that tough choices must be made, wishful thinking, and finally to weighing choices and making responsible judgments.
For all of its massive flaws, Obamacare has put the American people through a searing educational process. People are smarter now. They continue to be frightened about government power over their health care. They now realize that they aren’t going to get health care for free, and it likely will cost them more. They also see that government giving them choices can actually mean fewer of the choices they want.
This moment is an opportunity for conservatives to touch the core values of Americans with new solutions.
Backers of Obamacare want Americans to think they can get health care only if their deeply flawed law stays in place. In fact, people would get better health care at a lower cost with fewer strings attached if consumers, rather than politicians or government bureaucrats, were making their own decisions about the health care and insurance coverage that are right for them.
We are stuck in a 20th century industrial model of health care in a 21st century age of information and innovation. If consumers were empowered to make their own choices with better incentives, transparent prices, and flexibility with benefits, then genuine competition—not Obamacare’s fake competition—would flourish, giving people countless options we can’t even imagine today. We can have better health care that is more accessible to millions more people if we let the miracle of the free-market unleash creative solutions. The future is waiting.
It is worth remembering another Ronald Reagan quote about an alternative future if we are able to turn the corner from a dependency to an opportunity society. No one says it better:
I’ve spoken of the shining city all my political life, but I don’t know if I ever quite communicated what I saw when I said it. But in my mind it was a tall proud city built on rocks stronger than oceans, wind-swept, God-blessed, and teeming with people of all kinds living in harmony and peace, a city with free ports that hummed with commerce and creativity, and if there had to be city walls, the walls had doors and the doors were open to anyone with the will and the heart to get here. That’s how I saw it and see it still.
And how stands the city on this winter night? More prosperous, more secure, and happier than it was eight years ago. But more than that; after 200 years, two centuries, she still stands strong and true on the granite ridge, and her glow has held steady no matter what storm. And she’s still a beacon, still a magnet for all who must have freedom, for all the pilgrims from all the lost places who are hurtling through the darkness, toward home.
Reagan’s hope for America is still very much alive, with vast opportunities ahead.
Posted on The American Spectator, November 6, 2014