What Else Is Wrong with Obamacare? It's not just the mandate...

November 22, 2011 - 12:27 am

With the Supreme Court’s decision to review the constitutionality of Obamacare’s individual mandate, that feature of Obamacare has been getting a lot of attention. The individual mandate is the requirement that essentially every American buy government-approved health insurance under penalty of law. The Obama administration claims that because Congress is empowered to regulate interstate commerce, it is also empowered to compel interstate (or, more often, intrastate) commerce — which is a rather novel interpretation of the Constitution.

Moreover, the news from the Court comes hot on the heels of the passage of an anti-individual-mandate measure in Ohio. The measure was approved by voters in all 88 counties of that crucial swing state — and by at least 20-point margins in 81 of those counties.

In light of these developments, it’s not surprising that the individual mandate has been getting plenty of attention of late. But is the mandate really the only thing that’s wrong with this 2,700-page de facto legal code that’s masquerading as a “law”? Hardly.

Here’s a partial list of the myriad other objectionable features of Obamacare:

It’s 2,700 pages long. Legislation of such unconscionable length is not only complicated to a degree that’s hard to fathom — this chart from Sen. Jim DeMint helps to some extent (you have to enlarge it to see it) — but it also severs the link between the law and the average citizen. It makes it essentially impossible for the law to be something that the citizenry can know and understand, even to a reasonable degree. A complicated monstrosity like Obamacare is a vehicle for government by bureaucratic and lawyerly “elites,” not for government by the people.

It would cause millions of Americans to lose their employer-sponsored health insurance and be dumped into Obamacare “exchanges.” These exchanges would be heavily subsidized, which means that much of the burden of health coverage would be shifted from employers to taxpayers. Already, 4.5 million Americans have lost their employer-sponsored health insurance since Obamacare was passed, as the overhaul offers plentiful financial incentives for employers to get out of the business of providing health care for their employees. The Congressional Budget Office (CBO) had estimated that from 2010 to 2011 six million people would gain employer-sponsored insurance — so the CBO’s estimates are already off by more than 10 million people. If Obamacare goes fully into effect (in 2014), far more Americans will lose their employer-sponsored health insurance.

It would loot Medicare. The CBO projects that during the overhaul’s real first decade (2014 to 2023), nearly $1 trillion would be siphoned out of Medicare and spent on Obamacare. The decision by President Obama and the then-Democratic Congress to fund much of Obamacare by pilfering from Medicare was an act of unusual political brazenness — one that voters in Florida aren’t likely to forget. (Most of the rest of Obamacare would be funded through tax increases.) The resulting lower reimbursement rates for Medicare providers — which the Medicare chief actuary says would soon fall below even the reimbursement rates for Medicaid providers — would mean that Medicare patients would either find themselves getting rushed through their medical visits, or else having fewer health-care providers be willing to see them at all.

It would cost twice as much as the deficit commission is trying to “save.” The CBO says that Obamacare would cost an estimated $2.5 trillion during its real first ten years, at a time when the deficit commission is trying to come up with $1.2 trillion in “savings” over ten years.

It would raise, rather than lower, health costs. The Medicare chief actuary says that Obamacare would increase health costs by hundreds of billions of dollars by the end of this decade.

It would massively expand Medicaid. At a time when our national debt is $15,000,000,000,000.00 and is about the size of our entire gross domestic product, Obamacare would provide a colossal expansion of Medicaid — expanding it to cover portions of the middle class. In fact, the CBO projects that fully half of the newly insured under Obamacare would be people dumped into Medicaid at taxpayer expense (see Table 4).

It would establish the grisly IPAB. The Independent Payment Advisory Board (IPAB) is a sort of poor man’s (because less powerful) British National Institute for Clinical Health and Excellence (NICE), the British rationing agency that so many of Obama’s nominees are rather enamored with. The IPAB would be charged with keeping future Medicare spending below a specified level. The dictates of its 15 unelected members would have the force of law and couldn’t be overruled even by a majority vote in both houses of Congress and the president’s signature.

It would politicize medicine and amass unprecedented power and money in Washington at the expense of Americans’ liberty. Alexis de Tocqueville warned democracies of the extraordinary dangers of the consolidation and centralization of power. He warned:

A democratic republic … in which … administrative centralization [was] accepted by custom and by law … would become more intolerable than in any of the absolute monarchies of Europe.

He presciently added:

It may easily be foreseen that almost all the able and ambitious members of a democratic community will labor unceasingly to extend the powers of government, because they all hope at some time or other to wield those powers themselves. It would be a waste of time to attempt to prove to them that extreme centralization may be injurious to the state, since they are centralizing it for their own benefit.

The individual mandate is only the tip of the iceberg. It’s time to repeal Obamacare.


Jeffrey H. Anderson, an independent writer, was the senior speechwriter for Secretary Mike Leavitt at the U.S. Department of Health and Human Services.