By Ramesh Ponnuru
Monday, December 09, 2013
Obama lied, insurance plans died.
Okay, it’s not as catchy as the equivalent Bush-era
slogan. The thought — that there are parallels between the signature initiative
of the George W. Bush administration and that of the Obama administration — has
nonetheless occurred to a lot of people, especially in recent weeks, as
Obamacare’s exchanges have failed to launch.
In both cases, presidents undertook ambitious projects:
to remake part of the world, or a huge portion of the economy, along the lines
that our government wanted. Redesigning Iraq proved to be impossible, and
reorganizing health care may prove impossible as well. It is at least proving
to be very difficult.
The Iraq War contributed to Republicans’ losing control
of Congress in 2006. Obamacare contributed to Democrats’ losing control of one
of its chambers in 2010. But the political trajectory of these projects was
different. The Iraq War started with a level of bipartisan and popular support
that Obamacare never had. Most Senate Democrats voted for the authorization of
force in Iraq, while Republicans were nearly unanimous in opposition to
Obamacare. But if the Iraq venture reached greater heights of support than
Obamacare, eventually it also hit lower depths than Obamacare so far has.
In both cases, as well, the president governed
differently than he had campaigned. George W. Bush said he would advance a “humble”
foreign policy when he was running. The attacks of September 11, 2001, changed
his agenda. Obama made clear he wanted to reshape health care. But he opposed
what would become the least popular part of his health-care law, the
requirement that all people buy insurance. His opposition to it was one of the
few differences of policy he had in the Democratic primaries with the
second-place finisher, Hillary Clinton. During the fall campaign he
relentlessly attacked the Republican candidate, John McCain, for proposing to
tax employee health benefits. The law Obama eventually signed included such a
tax.
Once the Iraq conflict became unpopular, Bush’s critics
said he had “lied us into war.” The administration had rested its case on the
claim that Iraq was developing weapons of mass destruction. That’s the main
reason it went to war, and the reason the public agreed to it. And the claim
turned out to be false. But it was believed by the administration, as by the
world’s intelligence services, and thus not a knowing falsehood.
The untruths involved in selling Obamacare were smaller
but more deliberate. The president continually said that the law would cause
insurance premiums to drop by $2,500 per family. He surely hoped that it would
restrain the growth of costs so that families would be spared a $2,500 increase
that would take place in the law’s absence. But that’s not what he said.
Whether his hope has come true is a matter of fierce debate among experts, with
the balance of evidence on the negative side. His actual statements were
clearly false.
Obama also repeatedly promised that people who liked
their health insurance would be able to keep it under his plan. On at least one
occasion he added a verbal “period” to the promise, meant to convey that no
lawyerly dodge was being executed. The administration knew better. The law’s
requirement that all health-insurance plans cover certain “essential benefits”
made some insurance plans illegal whether or not customers liked them. The law
also will create incentives for some employers to drop their health plans even
if some or many employees would prefer to keep them.
The administration reportedly considered weakening its
statements in light of these features of its bill. It decided instead to keep
making them. The bill ended up barely passing the House, and its chances of
passage probably could not have borne much more truth.
Some liberals react angrily to any comparison of
Obamacare to the Iraq War, saying that their project is not getting anyone
killed. The point should be conceded to them, but not too hastily. They have
maintained, with more vehemence than evidence, that Obamacare will save lives
by extending health insurance to people who lack it. If their premise is right
but their plan ends up reducing the number of people with insurance, then they
will indeed have caused deaths. Anyway, an analogy is not an identity.
There is a final parallel between the troubles that beset
the Iraq and Obamacare projects that has not received much attention in the
partisan debate. Both sets of troubles were not really predicted by the
opponents who later claimed vindication because of them. The anti-war movement
warned that fighting in Iraq would produce blowback terrorism against American
civilians and chemical-weapons deaths among American troops. What actually
happened — the disintegration of the Iraqi state followed by America’s
desperate attempt to pick up the pieces — did not feature heavily in the
opposition’s arguments.
The foes of Obamacare argued that it would increase
rather than decrease costs, reduce access to doctors, and so forth. Very few of
them, however, foresaw that the federal government (and many state governments)
would be incapable of developing the websites the program required in the
requisite time. They thought that the “markets” that Obamacare created would be
misshapen and irrational. They did not doubt that the administration would be
able to create them at all.
Thanks to the law and its implementation, many Americans
are finding themselves without the old insurance plans they were told they
would have, unable to buy replacement plans, and liable to pay the fines for
not getting them that Obama opposed in 2008. That is not a scenario even the
most committed enemies of Obamacare expected.
The websites may be fixed eventually, but even if they
are, the program may be lastingly handicapped by their early difficulties.
Those difficulties may very well mean that the initial pool of people in the
exchanges is much sicker and older than the administration hoped, and that
premiums and subsidies will therefore have to be much higher. And that in turn
will affect for the worse how those risk pools develop in the future.
Supporters of the Iraq War, many of them, could hardly
believe what they read and saw from 2004 through 2007. Surely there were smart
people in our government who knew what they were doing. Surely they had plans
for all contingencies. The Obama administration, judging from some of the
recent reporting, had a similar faith that the smart tech experts within its
orbit would be on top of implementation.
If there is a wider lesson here, it is that the grand
designs of governments, left or right, can go wrong in many more ways than they
can go right, than anyone can foresee, and than even the “best and the
brightest” — as Obama recently, and without irony, called his Web designers —
can fix.
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