[Vision2020] The Many Ironies of Health Care Reform: Sad, Wicked, Amazing, Delicious, Socratic, Dramatic, and Cosmic

[Nicholas Gier]

Hail to the Vision!

This is my radio commentary/column for this week.  To read about Socratic,
dramatic, and cosmic irony you will have to consult the full version
attached.

May the Force Always be with Universal Health Care for All Americans,

Nick

*THE MANY IRONIES OF HEALTHCARE REFORM*


*Using tax penalties, as we did [in Massachusetts], encourages "free
riders" to take responsibility for themselves rather than pass their
medical costs on to others.** *

*
*

* Here is where the federal government can do something
we could not: Take steps to stop or slow medical inflation.
**—*Mitt Romney, *USA Today*, July 30, 2009


         There are many types of irony: sad, wicked, amazing, and
delicious. The tasty ones are those that make you smile and smack your lips
as you savor the incongruities of improbable events.

          Let us begin with the most scrumptious ones. The individual
mandate—the principle that all Americans should be required to buy health
insurance—was originally proposed by conservatives at the American
Enterprise Institute and Heritage Foundation.

          In the 1990s conservatives used at least two principles in their
argument for the individual mandate: (1) the obvious truth that the larger
the insurance pool the smaller the risk; and (2) the idea of personal
responsibility.  Following Republican principles (including states’
rights), no one will pay a penalty if everyone takes responsibility for
her/his own health care in the free-market state insurance exchanges.

          Critics of the Affordable Care Act confuse the tax for
noncompliance with the new taxes that are designed to pay for providing
about 30 million Americans with health insurance. The non-partisan
Congressional Budget Office (CBO) estimates that 4 million Americans will
refuse to buy insurance, and at $95 per individual the total would be $380
million in 2014. The non-partisan Joint Committee on Taxation estimates
that even with the new taxes Obamacare will provide a deficit reduction of
$437.8 billion by 2019.

Conservatives are now accusing Democrats of lying about the mandate and
taxes, but that makes Romney also a liar when he said that those who did
not comply with Romneycare would only pay a penalty, one which is actually
much higher than that in the Affordable Care Act.

The most delectable ironies abound in the history of Romneycare.  Bay State
Democrats, just as Obama was in his debates with Hillary Clinton, were
against the mandate, but Romney vigorously supported the idea and won in
the end. He now insists that he never raised taxes while he was governor,
but he did impose the mandate tax and added fees totalling $502 million in
lieu of taxes.

It is sad irony that the Mormon Romney, whose coreligionists are famous for
their honesty and probity, not only speaks falsehoods, but repeats them
even after they have been publicly corrected.

On healthcare Romney repeats a falsehood that many Republicans spout:
“Obamacare means that up to 20 million Americans* *will lose the insurance
they currently have, the insurance that they like and they want to keep.”

Also false are Romney’s claims that the Affordable Care Act “cuts Medicare
by $500,000 billion,” that “ending Obamacare saves $95 billion,” and that
“Obama is ending Medicare as we know it.” Romney supports the Ryan budget
that truly does end Medicare. The CBO has calculated that repealing the
Affordable Care Act will add $210 billion to the deficit over ten years,
and that it contains (not cuts) Medicare costs.
It is also ironic that many of those who oppose Obamacare want a much more
efficient single payer system instead.  In February of 2009 a *New York
Times/CBS* poll showed 59 percent agreed with the statement that “the
government should provide national health insurance.” Those who said that
Uncle Sam should cover all medical problems made up 49% of the
respondents. Except
for the mandate, nearly every other part of the Affordable Care Act has
overwhelming support, including the insurances exchanges.

In an op-ed in *USA Today* (7/30/09) Romney ironically conceded that only
the federal government was in a position to control our soaring medicals
costs.  This of course contradicts his current position that the states
should decide everything on their own.

After analyzing Romney’s column, Ryan Grimm (*Huffington Post *3/4/12)
concludes that the 2010 Democratic Congress did everything that Romney
asked for: sufficient time and reflection, a Senate bipartisan effort,
provisions for cost containment, deficit reduction (verified by the CBO),
and rejecting the public option.  That is yet another delicious irony.* *

Nick Gier taught philosophy at the University of Idaho for 31 years.
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