Economics

How I Learned to Stop Worrying and Love Obamacare

There is an ancient Arabic proverb: “The enemy of my enemy is my friend.” With this in mind, I can’t help but think that whatever Senator and leading Tea Party blowhard Ted Cruz opposes must be good. When Cruz decided to try to shut down America because he opposes Obamacare , well that sealed the deal for me. I say “Obamacare forever.”

Readers know that I think Obamacare has too many rules that create problems for payers and providers alike, and relies on some questionable practices for funding. I don’t like the rush to form ACOs or the lack of serious cost-effectiveness analysis (admittedly a concession to Republicans.) But Obamacare beats the hell (sorry Ted) out of Cruzcare, which, as far as I can tell, goes something like this: “Didn’t put aside enough money for that life-saving operation? Here is a prayer that might help.”

I used to sort of be a Republican. I voted for Bush (I won’t say which one in order to avoid embarrassment) and voted against Obama more than once (living in Illinois I had several opportunities.) And I hate that Obama is playing at President like someone playing poker with a winning hand.

This isn’t supposed to be about which politician claims the biggest pot for himself. But I will take a selfish and somewhat scornful Obama over Ted Cruz and the Tea Cozies any and every day of the week. And I will work to find the best Democratic leaders if all the Republicans can offer is Cruz and his TCs.

Shut down the government to finally fund Medicare and Social Security? Maybe. Shut down the government to achieve a rational tax code? Sure. Shut down the government to balance the budget? Now we are talking. But shut down the government to block the opening of the health insurance exchanges? How absurd!


This may be the most pro-market thing to emerge from this administration. Maybe the Tea Cozies think that if God had wanted exchanges He would have given CMS sufficient computer capacity to handle the opening rush of enrollees. More likely the TCs are afraid that the exchanges might work. (Speaking of computers, I can’t help but wonder if some savvy TC programmer – an oxymoron? – is sabotaging the open enrollment period.)

The shame of it is that there are plenty of ways to tweak Obamacare for the better. Changes to enhance market forces and promote alternative delivery systems would please everyone to the left of the TCs; i.e., most Americans. But thanks to Cruz and the TCs, any chance for debating how to improve Obamacare has been lost, at least for now.

Obamacare is not going away. I admit that I have gotten used to the idea and think it might not be such a bad thing after all. With luck, many of the TCs are going away; I am actually rooting for the Democrats to retake the House. When they do, I hope that Congress tries its hand at Obamacare 2.0 and takes this flawed but promising program to the next level.

David Dranove, PhD, is the Walter McNerney Distinguished Professor of Health Industry Management at Northwestern University’s Kellogg Graduate School of Management, where he is also Professor of Management and Strategy and Director of the Health Enterprise Management Program. He has published over 80 research articles and book chapters and written five books, including “The Economic Evolution of American Healthcare and Code Red.” This post first appeared at Code Red.

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Tina RochaKatLynn in SCAurthurJeff Goldsmith Recent comment authors
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Tina Rocha
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Tina Rocha

Nice deferring the biggest tech boondoggle in the history of the internet. This will need a complete platform rewrite then redevelopment of the applications. There is zero molecular whiff of scalability or interoperability. This frontend is technical baby food and you say Cruz is bad……ooookay then.

Lynn in SC
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Lynn in SC

I do have to admit that Obamacare is a perfect excuse for any and everything. It’s particularly useful for Principles of Economics students when they under perform on their test or the server provides bad service or the bartender brings you the wrong adult beverage…:”It’s Obamacare’s fault, repeal it and off with his head.” Says the Red Queen.

Aurthur
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Aurthur

…unless you have connections and can get yourself a waiver from The Act.

Bob Hertz
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As to the glitches in ObamaCare enrollment, here are three quick observations:

a. Part D has at least three momths of glitches in 2005;

b. The Federal government has never hired the best programmers for any of its functions;

c. No private insurance company or private exchange in history has ever had to factor in the family income of enrollees before confirming coverage.

Jeff Goldsmith
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Jeff Goldsmith

On the political substance of David’s post, I’m with him. This episode has been an embarrassing nihilist freakout on the part of the Republicans that could not only damage the economy, but accelerate international search for a substitute for the dollars as the world’s reserve currency.Bobby Jindal’s comment about “We’ve got to stop being the stupid party” was prescient, as was Bob Dole’s post 2012 election comment about the need to put out a “closed for repairs” sign. Obama was eminently beatable in 2012, and the Repubs managed to blow it. It wasn’t just nominating Richie RIch, but the message… Read more »

Aurthur
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Aurthur

“the message of intolerance and indifference to human suffering”…as in my way or the highway, I not only won’t compromise or negotiate; I won’t even talk to you or provide you answers or any information. I will, however, “inflict maximum pain”

Aurthur
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Aurthur

Item C…Check that, it’s the household income, so it includes anybody residing in the house, like crazy uncle Billy or Grand Moocher Marian Gail Robinson. Also, just because you publicly portray yourself as a single mom does not allow you to exclude the earnings of your shiftless, lazy, radical husband, even if he is the potus.

Sigrid
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There is a great deal to work out, and I’m afraid it will take many years to have a definitive answer on what types of unintended consequences occur despite everyone’s best intentions.

Chiropractor in Schaumburg
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Well, certainly I agree with what are you feeling about Obamacare, we are sailing in the same boat. For now i just hope to see Obamacare 2.0 to rich at next level for the mutual benefits.

Jardinero1
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Jardinero1

I accept your feelings about the ACA, Ted Cruz and the ACA but the exchanges are not “the most pro-market thing to emerge from this administration.” They do not fit the definition of markets. Markets are where willing sellers and willing buyers meet without coercion. In the absence of coercion, willing sellers and willing buyers agree on the quality of the good and the price or they agree to walk away from one another. The ACA’s health Insurance exchanges have none of those features. Health insurance exchanges are a state created medium where coerced buyers are forced to buy a… Read more »

Bobby Gladd
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Boy, and people crack on ME for assertedly being pedantic.

“I refer to the threat of violence, loss of freedom (incarceration), or involuntary loss of property(extortion, taxes, fines) under pain of violence or the loss of freedom.”

None of which characterizes the Health Insurance Exchange as set forth in the PPACA.

“pain of violence” — oh,PULEEZE, hand me the Kleenex.

You’re one of those Ayn Randians, ‘eh?

Jardinero1
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Jardinero1

I think Randians are despicable. I don’t know where you find Ayn Rand in my comment. I deliberately define coercion to avoid the usual comments on how advertising, or cultural norms or whatever are coercive.

Bobby Gladd
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You clearly find a LOT of stuff “despicable.” Your comment was hyperbolic. Yahoo board stuff. e.g., Shall I cite for you the verbatim section of the ACA setting forth the IRS’s narrowly circumscribed authority with respect to people failing to obtain coverage under the individual mandate? Page 131? (g) ADMINISTRATION AND PROCEDURE.— ‘‘(1) IN GENERAL.—The penalty provided by this section shall be paid upon notice and demand by the Secretary, and except as provided in paragraph (2), shall be assessed and collected in the same manner as an assessable penalty under subchapter B of chapter 68. ‘‘(2) SPECIAL RULES.—Notwithstanding any… Read more »

Kat
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Kat

Just dont pay for it and find out whats going to happen, yes they can take away property, etc…. if you dont .

Bobby Gladd
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CHIEF JUSTICE ROBERTS concluded in Part III–B that the individual mandate must be construed as imposing a tax on those who do not have health insurance, if such a construction is reasonable. The most straightforward reading of the individual mandate is that it commands individuals to purchase insurance. But, for the reasons explained, the Commerce Clause does not give Congress that power. It is therefore necessary to turn to the Government’s alternative argument: that the mandate may be upheld as within Congress’s power to “lay and collect Taxes.” Art. I, §8, cl. 1. In pressing its taxing power argument, the… Read more »