It was the kind of spectacle that policy wonks savor — three
days of dry and complex argument before the U.S. Supreme Court on
the constitutionality of the Affordable Care Act, commonly known as
Obamacare.
To cite a question that occupied a whole day of questioning: If
the federal government can compel you to buy health insurance, can
it also compel you to buy broccoli — or anything else
that it deems to be in your best interests?
Should the Supreme Court uphold the law, it will signify that
the act has met the minimal standard of constitutionality. Nothing
more. The debate over constitutionality, however it is resolved,
should not obscure the fact that the health care reform act is
simply a bad law. Let us count the ways that it violates basic
principles of sound policy.
1. It exemplifies a legislate-in-haste-repent-at-leisure
mentality. Few Senators and Congressmen had time to read the
2,700-page bill before it was brought to a vote. Then-House Speaker
Nancy Pelosi famously stated, “We have to pass the bill so that you
can find out what’s in it.”
2. It violates the principle of impartiality. “When a bill is
2,700 pages,” as columnist/author Mark Steyn noted, “there is no
equality: Instead, there’s a hierarchy of privilege micro-regulated
by unelected, unaccountable, unconstrained, unknown and unnumbered
bureaucracy.” Already the administration has granted a long list of
exemptions to various companies and unions.
3. Recently, the Department of Health and Human Services
dictated that employers, including religious organizations, must
cover contraception and abortion-causing drugs in their health
plans. Apart from any moral objections to such provisions, why
should the federal government tell employers and employees what
their health insurance has to cover?
4. Good public policy would encourage health care consumers to
shop around and purchase insurance policies that are best suited to
their own needs and spending priorities. The health care reform
bill does the opposite. Decision-making power is turned over to
bureaucrats, who pay no price for decisions that are costly or
wrong-headed.
5, 6, and 7. Good public policy does not raise false
expectations. Backers of the health reform bill violated this
principle three times over. They promised a) anyone can “keep their
plan if they like it’; b) the plan would mandate many new benefits
and still reduce the average family premium by $2,500; and c) that
it wouldn’t add “a single dime” to the federal deficit. To review
each of those points in turn:
According to a McKinsey & Co. study, a third to a half of
employers plan to stop offering health insurance beginning in 2014.
Faced with expensive mandates and less expensive fines, many
employers will choose the fines and cause their employees to move
to government-sponsored plans.
Another study concludes that a typical family health insurance
plan costing $12,300 today will cost more than twice that by 2019.
There are no “free” mandates or other benefits — to paraphrase
Milton Friedman.
And finally, the administration has grudgingly acknowledged
spiraling costs under its plan. Last October, the administration
dropped the long-term care program known as the Class Program from
implementation of the new law as financially unworkable. It also
added $111 billion premium subsidies to its proposed fiscal 2013
budget.
8. Good public policy avoids ticking time bombs. The health-care
law is filled with them.
The legislation will increase Medicaid enrollment by an
estimated 24 million new beneficiaries by 2015. Missouri and other
states struggling to balance their budgets will pick up a
significant share of the cost.
The law includes a massive new health entitlement/income
redistribution program for families earning more than three times
the poverty level. In 2014, it will channel up to $3,000 in
taxpayers funds to families making up to $95,000.
It also discriminates against young people, forcing them to
purchase health insurance at inflated prices in order to subsidize
older beneficiaries. Simultaneously, the law imposes severe
penalties on young people who use Health Savings Accounts to secure
health benefits for themselves in later years.
9. The law is fiscally irresponsible. It includes a raft of new
taxes. But these appear to be wholly inadequate to the task of
paying the bill for over-promising and extending new entitlements
to tens of millions of people. That leaves rationing as a last
resort, and the government’s own reports contemplate major cutbacks
in Medicare spending down the road.
10. The Affordable Care Act is truly unaffordable… and
unsustainable. Perhaps the Supreme Court will strike it down. But
whatever the Court decides, that does not excuse our elected
representatives from their responsibilities. Our government should
not erode our freedoms, degrade our quality of life, or bankrupt
our future. The health care reform bill does all those things. If
it is not struck down, it should be repealed.
