The Purpose of This Bl;og

By and large, liberals are very decent, kind, and compassionate people who genuinely want what is best. This should be kept in mind as we explore the Law of Unintended Negative Consequences near invariably resulting from Leftist big-hearted solutions to societal problems.

Wednesday, November 20, 2013

Obamacare - Expansion of Government and Executive Powers

Several liberal pundits and self-serving "fact checkers" have been quick to point out that Obamacare isn't a massive federal take-over of the health care system and a significant portion of the U.S, economy. (See HERE and HERE and HERE and HERE and HERE)

Indeed, in 2010, Politifact.com dubbed the "take over" claim the "lie of the year." (See HERE, see also HERE and HERE)  Others consider it to be an unwarranted scare tactic. (See HERE)

Good folks on the Left rightly point out that unlike with socialized medicine in Britain, Obamacare doesn't own the medical system, nor does it administer health care products and services. Rather, it plays a minor role in regulating and providing some health insurance, and it relies heavily on private insurance. (See the links above)

Liberals also point out that Obamacare isn't "the biggest entitlement program the American taxpayers have ever seen," (See HERE and HERE)

Whew....that's a relief, isn't it?

Ironically, these dismissals and charges of lying are, themselves, misleading. They obscure and unwarrantably minimize legitimate concerns about the dangerous expansion of the federal government, and this at a time when the federal government seriously lacks the revenue to meet its current obligations, and has been plummeting deeper into debt.

They also ignore the constitutionally debatable power grab by the Executive Branch.

For example, Obamacare was set to expand the number of people enrolled in Medicare by 21.6 million (see HERE)--from 66.5 million (see HERE) to 88.1 million. This represent about a 33 percent increase in federal expenditures. In 2010, the non-partisan Congressional Budget Office (CBO) estimated the 10-year cost of just the insurance portion of Obamacare: "Gross additional costs of $1.5 trillion for Medicaid, the Children's Health Insurance Program (CHIP), tax credits and other subsidies for the purchase of health insurance through the newly established exchanges and related costs, and tax credits for small employers." (See HERE) This was revised upwards in 2013 to $1.79 trillion. (See HERE)

The Congressional Budget Office (CBO) estimates don't include state funding of Medicaid. And, "ObamaCare will exert pressure on state Medicaid spending (although the pressure will be delayed for a few years by federal subsidies). This pressure on state budgets means less money on education and transportation, and higher state taxes." (See HERE)

As originally written, the expansion of the federal government and encroachment on state rights by Obamacare was so extreme and unprecedented as to raise serious constitutional questions. (See HERE) The Supreme Court heard some of the cases and partially upheld Obamacare and partially struck it down. (See HERE) There are an number of constitutional challenges still working their way through the courts and pending review by the Supreme Court. (See HERE and HERE and HERE and HERE and HERE)

Putting this into perspective, the nearly $2 trillion federal expansion over the next ten years entails an enormous shift from private funded health care to government funded. "So what really happens with the Affordable Care Act?  The 'government' currently pays about 43% to 46% of all healthcare costs, mainly through Medicare, Medicaid, and the armed services. When Obamacare is fully implemented, it is expected this amount will increase to 49.2%. (See HERE)

Said another way, in part because of Obamcare, tax payers will end up paying for nearly half of all health care expenditures in the U.S..

Granted, the shift from private to public funding of health care began years before Obamacare. (See HERE)

Nevertheless, Obamacare spurs things along in the wrong direction.

Even more alarming, in addition to all the new personnel and offices and resources needed to administer Obamacare, and beyond the expansion of power inherent in the shift from private to public funding of health care--i.e. the golden rule (he who has the gold, rules), there is the dangerous expansion of executive powers that heightens the risk of seriously tipping the constitutional checks and balances between the different branches of government, a totalitarian-ish shift of legislative powers from the Legislative Branch, where it rightly belongs, to the Executive Branch. (See HERE)

This shift takes at least two forms. First, there is the shift of power that Congress willingly gave up to the Executive Branch. I am not talking here about the Senate "nuclear option" eliminating the filibuster that effectively leaves the Democrat president free to do as he wishes with the Democrat-controlled Senate (see HERE), though the "nuclear option" may adversely apply to Obamacare. (See HERE)

Rather, I have in mind where Congress included a provision in the misnamed Affordable Care Act which gave a small, unelected group of people, called the Independent Payment Advisory Board (IPAB--see HERE), or "death panel" as some Conservatives and Liberals have come to call it (see HERE and HERE and HERE), legislative power over the purse in relation to Medicare.

Aside from the questionable constitutionality of the panel (see HERE), not only will it be difficult for the Congress to stop or over-turn the IPAB financial recommendations (ibid, see also HERE and HERE), but citizens wont be able to challenge the recommendations in court. (see HERE) And, according to Dave Camp, Chairman of the House Ways and Means Committee, "Buried in Section 3403 of ObamaCare is a powerful board of unelected bureaucrats, the so-called 'Independent Payment Advisory Board' (IPAB), whose sole job will be to save money by restricting access to health care for Medicare beneficiaries.  IPAB is required to achieve specified savings in years where Medicare spending is deemed 'too high,' according to the Democrats’ health care overhaul." (See HERE) (See also HERE

Because of the rationing and "life and death" decision-making powers granted to the IPAB, it has become increasingly more controversial and opposed by members of both major political parties. (See HERE and HERE and HERE and HERE and HERE and HERE and HERE and HERE and HERE)

Second, their is the shift in legislative power that the President capriciously usurped to himself, which has yet to be judicially countered by Congress. This questionable power grab consists of the President's arbitrary and presumptuous and seemingly unconstitutional waiver of various Obamacare requirements--such as the employer and individual mandates, cap on out-of-pocket expenses, as well as the President's so-called "fix" that is supposed to enable people to keep the plans they like. (See HERE and HERE and HERE and HERE and HERE and HERE and HERE and HERE and HERE and HERE and HERE)

Evidently, Obama suffers under the false impression that since Obamacare is his health care plan, and bears his name, that he is entitled to do with it whatever he wishes.

[Update 3/27/2014: the President recently extended the deadline for individual health care insurance enrollment until April 15th  (See HERE and HERE and HERE) As expected, a number of face-saving rationalization have been put forward, but the real reason is that Obamacare has failed miserably to meet its necessary and most charitable projections.]

Perhaps, though, the area of greatest governmental expansion is in the crushing proliferation of government  regulation. (See HERE and HERE and HERE and HERE and HERE)

Summary

 The unintended negative consequences (Leftist LUNCS) here are, as Steven Horwitz describes them: "Obamacare’s approach to fixing the very real problems of U.S. medical care is exactly backward. It undermines the market-driven parts that are working, and expands government control that is not." (See HERE) And, the way in which the President is going about administering Obamacare, it has concentrated power to unelected bureaucrats in the Executive Branch and away from the elected Congress, in ways that are constitutionaly very questionable.

[Update 12/4/2015: Health Care Spending Grows at Fastest Rate in 7 Years]


For an explanation as to why these Leftist LUNCs occur, please see: Gov: Wrong Tool for the Right Job - Introduction and Cold Nanny as well as The Politics of Compassion, Emotions, Ignorance, Denial, Blame-Shifting, and Victimization

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