The American Spectator

Barack Obama’s promise to cure the ills of our health care system was obviously an important factor in his 2008 victory over John McCain as well as that year’s Democrat gains in the House and Senate. Most of the electorate favored some legislation that would slow rising medical costs and increase access to care. However, when Obamacare finally slogged out of the congressional slough, it was greeted with consternation and outrage. Instead of the reform they were promised, the voters got a grotesque government behemoth reeking of corruption. They were not amused. They appeared en masse at town hall meetings to harangue their representatives, organized a series of public protests and finally marched on Washington.

All for naught, of course. The President and his congressional accomplices ignored the voters, patronizing them with the assurance that they would learn to love “reform” once they understood it. But the electorate still regards the thing with fear and loathing. A recent Rasmussen survey showed that 54% of likely voters favor repeal, the precise percentage who opposed the law when it passed. Nonetheless, if the President is re-elected, ObamaCare will become a permanent feature of the entitlement landscape. The Supreme Court has demonstrated that it won’t protect us from the beast’s depredations, and a high priority of a second Obama term will be full implementation of his most important domestic “achievement.”

The only way to kill this monster is full repeal. And, for all intents and purposes, tomorrow offers the last chance to set that process in motion. The need to take advantage of this opportunity is made manifest by a review of what the President and the Democrat Congress wrought in the name of “reform.” It isn’t possible to cover all of Obamacare’s flaws in one column, but the point can be made by a brief summary of its worst provisions. Among these are mandates that restrict individual liberty and freedom of conscience, tax increases totaling more than $800 billion, the creation of perverse economic incentives that will kill millions of jobs, and the creation of a rationing board whose power will be virtually unchecked.

Obamacare contains a variety of arbitrary and harmful mandates, including one that requires insurance companies to provide health policies that meet federally defined “minimum standards.” This is a very bad idea with a long track record of driving insurance premiums up. But the law’s most egregious mandates are the “minimum coverage provision” that requires you to buy health coverage regardless of your desire or need to do so, and the HHS contraception mandate that requires all employers — including Catholic hospitals and universities — to provide employees coverage for abortion pills, contraceptives, and sterilization procedures. Combined, these mandates constitute a brazen assault on our most basic liberties.

The “minimum coverage provision,” more commonly known as the individual mandate, forces you to buy a service from a private company approved by the government. This is the first time in the history of the republic that such a law has been passed by Congress. And, contrary to the claims of its supporters, it isn’t comparable to state laws requiring drivers to buy auto insurance. Such requirements are imposed as a condition of owning and operating a large and dangerous machine. You can avoid those mandates by utilizing public transportation. The individual insurance mandate, on the other hand, is imposed on you merely because you exist. Thus, you can only avoid it by dying or paying a fine to the government.

The HHS contraception mandate is arguably worse than the insurance mandate. It is an outright attack on the religious liberty of Catholics and countless other people of faith. As it is phrased on the website launched by the Archdiocese of Washington in conjunction with a series of lawsuits filed against the government over this issue, the contraception mandate is “an unprecedented attack by the federal government on one of America’s most cherished freedoms: the freedom to practice one’s religion without government interference.” And Obama’s token accommodation is a cheap charade. It provides a very limited set of exemptions for a tiny group of religious employers that does not include Catholic hospitals and universities.

In addition to its attacks on individual and religious liberty, Obamacare contains a gigantic tax increase. The Heritage Foundation identifies 18 new taxes in the law, totaling $836.3 billion. Some have already been implemented, including a tax on drug manufacturers that will total $34.2 billion. Its largest tax increase will fall on individuals. Couples earning more than $250,000 (and single filers making more than $200,000) will pay additional taxes totaling $317.7 billion over the next 10 years. Beginning in 2014, individuals who decline to buy health insurance will begin paying taxes that will total $55 billion. Also lurking in the law is a new tax that will siphon $29.1 billion from the pockets of medical device manufacturers.

This medical device tax is a good example of the perverse incentives that will kill so many jobs. It obviously raises the cost of doing business for the affected companies, and businesses respond to such increases in ways that bode ill for employees. Sometimes employers abandon expansion plans that would create new jobs. Last July, an Indiana-based medical equipment manufacturer did just that: “Cook Medical… said it’s nixing plans to open five new plants in the next five years — claiming the [Obamacare] tax will cost between $15 million and $30 million a year.” Other companies respond with layoffs. Boston Scientific, which manufactures defibrillators and pacemakers, announced last year that it plans to eliminate 1,200 jobs.

Another job killing feature of Obamacare is the exemption of companies employing fewer than 50 full time workers from the tax that larger companies must pay if they fail to provide health insurance. This provision is behind the huge number of part-time jobs that were included in the October 6th report from the Bureau of Labor Statistics (BLS) and it explains why the November 2nd BLS report shows double-digit percentages of underemployed workers in many states. For purposes of Obamacare, the IRS defines a part-time employee as someone working less than 30 hours per week. As Robert Samuelson succinctly explains, “Employers have a huge incentive to hold workers under the 30-hour weekly threshold.”

Incentives to avoid creating full-time jobs, combined with huge tax increases and mandates that threaten our basic liberties, are certainly enough to put Obamacare on what the President would no doubt call a “kill list.” But no catalogue of this law’s many outrages would be complete without a word or two about the Independent Payment Advisory Board (IPAB). IPAB is the committee of unelected officials whose ostensible purpose is to control costs. In reality, it will supervise the rationing of care to seniors. The board’s fifteen unelected members will decide what procedures and services are “appropriate” for Medicare patients and how hospitals, doctors, and other health care providers will be paid for those services.

This power to ration care is such an integral part of Obamacare that the Democrats tried to inoculate IPAB against repeal. David Hogberg reports in Investor’s Business Daily, “Congress is only able to repeal IPAB during a roughly seven-month window in 2017. First, both the House and Senate must in 2017 introduce a joint resolution for the purpose of repealing IPAB. However, they have to introduce the resolution no later than Feb. 1, 2017.”This, according to legal scholars, is unconstitutional because no Congress possesses the power to impose such limits on future Congresses. Sadly, we have recent evidence that the Supreme Court is not always willing to uphold constitutional limits on congressional power.

IPAB, to borrow a phrase from the immortal P.G. Wodehouse, puts the tin hat on it. ObamaCare has got to go. The monster must be slain — now. And the only way that will happen is if Mitt Romney is sworn in as President in January and the Republicans have majorities in the Senate and the House. Romney has his flaws, but he will probably keep his pledge to repeal and replace Obamacare. If Barack Obama is re-elected, his unnatural and corrupt creation will have four more years to intertwine its tentacles throughout the U.S. health care system. By the end of a second Obama term, it will be virtually impossible to disentangle them. If we want to get rid of Obamacare, tomorrow is our last chance.