Saturday, June 30, 2012

3 Essential Takeaways From the Obamacare Decision: Gov't is Still Unlimited, Romney's Still Lame, & Health Costs Still Set to Rise.

3 Essential Takeaways From the Obamacare Decision: Gov't is Still Unlimited, Romney's Still Lame, & Health Costs Still Set to Rise.

So now that the sages of the Supreme Court have spoken about the constitutionality of The Patient Protection and Affordable Care Act, a.k.a. Obamacare, let's get straight to the takeaways:
1. There's no credible way to spin this as a "win" for limited government. Folks such as Wash Post columnist George Will and legal theorist Randy Barnett, to name two of many on the conservative and libertarian ends of things, are working hard to say the real silver lining in the SCOTUS decision is the clear language the court used in limited Congress' use of the Commerce Clause. As Will put it, "At least Roberts got the court to embrace emphatic language rejecting the Commerce Clause rationale for penalizing the inactivity of not buying insurance."

Yeah, well, when Chief Justice Roberts closed a window, he opened a door. Sure, I'd like to have some of what I assume Roberts and the rest of the Supes were smoking when they signed off on the it's-a-tax-not-a-penalty decision, but medical is illegal even in states where it's legal (wha?). That's due to the decision in a slightly older Supreme Court case, Raich v. Gonzalez, which showed the Commerce Clause to be infinitely stretchable when need be.
Will may be right that yesterday's decision may spark a backlash in favor of smaller government (or at least one that calls a tax a tax), but anybody who thinks government at any level will feel even the slightest bit limited by the ruling is flat-out wrong.
2. Hey Republicans: Mitt Romney is the worst possible candidate you could have right now. Before the ruling was even clearly reported, Republican and Democratic "strategists" (can't we call them something more accurate and less flattering?) were all claiming that yesterday's decision sealed the deal for their preferred party.
Let's leave aside the large and unchanged fact that Obamacare remains unpopular (most recent polls show majorities of Americans opposed to it and the number rises among those who say they are "well-informed"). The 2012 election will largely turn on the overall state of the economy, not whether the crux of Obamacare is recognized tax now rather than a mandate (though I must admit that now it's a tax, I kinda miss the broccoli mandate).
More to the point: Obamacare is essentially Romneycare on steroids (hmm, are those covered under the new law?), so having the architect of the latter blasting the former for doing what Romney crowed about doing in the Bay State is a tad confusing. It doesn't help that Romney, whose vagueness when it comes to spelling out anything about any of his policies is muy legendary, is vowing to "repeal and replace" Obamacare immediately upon taking office. The repeal part is self-explanatory (if not fully convincing) but what's he gonna replace it with? And if it's not a real market-driven plan that dismantles not only Obamacare but Medicare, why am I listening?
3. Health care will continue to cost more and more. One of the two major selling points of the new law was that it would "bend the cost curve down." Do Obamacare supporters seriously think that increasing government involvement in health care is going to keep costs low? Medicare, a single-payer system run by the federal government, is the single-biggest factor in rising entitlement costs; by design, the program's payroll taxes and premiums don't cover anything like the full cost of services (indeed, it's something like 50 percent, with the rest be covered by general tax revenue and borrowing). Medicaid is a classic case of Paying More for Less. That is, costs keep going up while outcomes are truly dismal for the folks trapped in the system: "A University of Pennsylvania study, for example, reported that colon cancer patients in Medicaid have a 2.8 percent mortality rate, compared with 2.2 percent for the uninsured. A study of Florida’s Medicaid patients found they were more likely to have late-stages of prostate cancer, breast cancer, and melanoma at diagnosis than the uninsured."
As CNN's Erin Burnett noted on OutFront last night, the "Affordable Care Act" has virtually no cost control mechanisms in place and a recent analysis by the firm Bradley Woods projects that insurance premiums will rise about 7.5 percent annually under the law.
Watch Burnett discuss the Supreme Court ruling with me, RedState's Erick Erickson, Buzzfeed's Ben Smith, and CNN's Roland Martin:

Nick Gillespie is co-author with Matt Welch of The Declaration of Independents: How Libertarian Politics Can Fix What's Wrong With America, now out in paperback with a new foreword. Follow him on Twitter.

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