Commentary Magazine


The Cruelty of ObamaCare

When ObamaCare’s individual mandate went before the Supreme Court, both sides argued over whether it was severable from the rest of the law–could one stand without the other? Severability also weighs on the law, in a more figurative sense, in its defense: now that we know the law isn’t working and won’t do what was promised, can the moral arguments used to bludgeon its opponents still be employed with any credibility?

That is, since ObamaCare’s defenders can no longer argue in favor of the law’s technical merits, can they still argue in favor of the law’s moral merits? The answer is no: as Frank Sinatra sang, you can’t have one without the other. The moral imperative of passing ObamaCare was always specious, since the administration wasn’t telling the truth when selling the law–and they knew it, having briefly debated whether or not the president should start telling the truth about the law and deciding to keep on misleading the public.

But ObamaCare’s defenders don’t have much left at this point, so they’re going to try loud, self-righteous hectoring to drown out the truth. The latest example is from the Washington Post’s Colbert King, who visited a church in Washington D.C. that seemed to spend its weekend politicking for the president’s agenda. King writes that this is because the people of this church are good people, and their attitude toward ObamaCare was in stark contrast with ObamaCare’s opponents, who are bad people. Yes, it’s really that simple according to King:

The talk-show criticism and the pulpit defense crystallized the Obamacare debate. Drawn into sharp relief is the struggle taking place in this country between doing what is right and good and an unashamed indulgence in the immorality of indifference.

The issue couldn’t be put more simply.

Because ObamaCare is broadly unpopular, King is basically telling his readers they are bad people. Some of them may be “right and good,” but given the poll numbers, it’s clear King thinks a great many of them are indulging in “immorality.” This is a variation on a column by King’s Post colleague Matt Miller, who had earlier used the deaths of thousands in Typhoon Haiyan to tell his readers that they are bad people:

Disasters like Haiyan bring into sharp relief our moral instincts when faced with the paramount role that luck plays in life. When human beings are left vulnerable and desperate by events beyond their control, we want to help. Empathy for human frailty and powerlessness in such a tragedy evokes compassion. We say such victims “deserve” help because they are suffering through no fault of their own.

So of course we’re sending money and Marines to Manila.

A typhoon is obviously beyond anyone’s control. But so is a preexisting condition.

Now, Post readers could easily point out that King and Miller are arguing in favor of getting insurance to those who don’t have it, and since ObamaCare is kicking millions off their insurance plans while also preventing them from finding new (more expensive, of course) plans, perhaps it is King and Miller practicing “an unashamed indulgence in the immorality of indifference.”

But it should also be noted that a key element of greatly expanding coverage for poor and older Americans under ObamaCare is Medicaid, a program studies show serves people no better–and sometimes worse–than those without any insurance at all. This is when ObamaCare’s defenders finally get somewhat honest and admit that ObamaCare is not a health program but a wealth transfer. Medicaid, they say, is about preventing unaffordable health-care bills from piling up on those who can’t pay them.

ObamaCare opponents, who understand the health-care issue significantly better than big-government leftists, have tried to warn that expanding Medicaid will exacerbate the lack of doctors available to see Medicaid patients. Now that the media is playing catch-up, they can read the same analysis in the New York Times:

Medicaid for years has struggled with a shortage of doctors willing to accept its low reimbursement rates and red tape, forcing many patients to wait for care, particularly from specialists like Dr. Mazer.

Yet in just five weeks, millions of additional Americans will be covered by the program, many of them older people with an array of health problems. The Congressional Budget Office predicts that nine million people will gain coverage through Medicaid next year alone. In many of the 26 states expanding the program, the newly eligible have been flocking to sign up. …

In California, with the nation’s largest Medicaid population, many doctors say they are already overwhelmed and are unable to take on more low-income patients. Dr. Hector Flores, a primary care doctor in East Los Angeles whose practice has 26,000 patients, more than a third of whom are on Medicaid, said he could accommodate an additional 1,000 Medicaid patients at most.

“There could easily be 10,000 patients looking for us, and we’re just not going to be able to serve them,” said Dr. Flores, who is also the chairman of the family medicine department at White Memorial Medical Center in Los Angeles.

What happens if you give people coverage but they can’t be seen by a doctor? Or they have to wait so long to get an appointment, if they can get one at all, that what should have been an easily treatable condition worsens significantly? The health outcomes will often be terrible, and the bills will pile up anyway. Their other choice is, of course, to pay out of pocket for a doctor who doesn’t take Medicaid. Which they could have done anyway, before waiting months for an appointment and now living in agony.

All this aggravation would come as the government promised them those days were over and they could now get health coverage. This process, which underpins ObamaCare’s major expansion of coverage, is cruel. And the moralizers in the liberal commentariat passing judgment on those who oppose this malicious process might want to take that into consideration.

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