It's the Stupidity, Stupid

It's that time of the season again for Democrats to defend the kludgey Affordable Care Act against the predations of the corrupt Supreme Court and the nefarious Republicans, who'd rather see one rich plutocrat thrive than have millions of regular folks enter for a chance to barely survive in the for-profit health insurance sweepstakes.

The latest round in Good Cop-Bad Cop kabuki involves the Supremes gratuitously deciding to take up a case involving the confusing state exchanges. One lower federal court recently decided that resident-consumers of states embracing the federal exchange should get the tax subsidies, while another lower court has decided the opposite. The highest court in The Homeland will now decide what the crafters of the law actually "intended."

So, just when I thought I'd seen the last of them, emails are again arriving, urging me to "click here" and "have the president's back" on his signature legislative achievement(s). These petitions obviously come attached to an appeal for money in order for the Democrats to "fight back" against the GOP Death Panel for the rights of a couple million people to both like their Obamacare and keep their Obamacare. This whole Supreme Court brouhaha is all over a stupid "typo,"* they shrill.

Of course, the ginned up hysteria is just more much ado about nothing. The Supreme Court "spared" the law once before, punishing only the poor re state Medicaid expansion, so they will likely do so again. After all, the law gifts the predatory insurance and pharmaceutical industries with profits beyond their wildest imaginings. No way will this money spigot be turned off to satisfy a cadre of phony libertarian Obama-haters.  

It's the latest manufactured crisis, designed to keep us on one side or the other instead of noticing that the two teams are both part of the same corrupt league, and that the game is fixed. It's also a very lucrative manufactured crisis, acting as a magnet for partisan fundraising and armies of K Street lobbyists bearing gifts of cash they don't even bother to hide any more. Bribery is legal now.

Luckily, a few intrepid truth-seekers have dug up a year-old video in which one of the original architects of the law is caught admitting that it was deliberately designed to be a complete confusing mess. Its opacity was built right in. Otherwise, it never could have passed.

Jonathan Gruber, an MIT economist, was paid $400,000 to help the Obama administration rely on "the stupidity of the American voter" by writing the bill in such a "tortured way" as to deliberately disguise the fact that there was a tax involved in the individual mandate. (Psst... the dummies in the Heartland can't be told that the healthy will pay for the sick, because socialism.) The White House, according to this expert, was more interested in Congressional Budget Office scoring being politically beneficial to them, rather than the law itself being beneficial to the health of the lucky few recipients of insurance.

As constitutional lawyer Jonathan Turley writes,

What is fascinating is that Gruber is open about what has long been hidden in this Administration: the lack of transparency as a tactical political vehicle. The ACA was pushed through by a muscle vote on a handful of votes while the Administration made claims that he later had to admit were misleading at best, such as the President’s repeated assurance that citizens could keep your current insurance policy if you liked it. Gruber also admits that the Administration crafted the law to avoid it being supported by a tax despite Chief Justice John Roberts’ later decision that it was a tax. Gruber says that, while he would have preferred to be honest and open, such considerations had to be set aside in the interests of passing the law — even by less than honest means.

Meanwhile, the Obama administration is now (whoever could have predicted?) predicting fewer new enrollees than previously estimated. Their best case scenario is that by the end of 2015, a grand total of 9-10 million people will have been signed up. From the Washington Post:

HHS officials also said Monday that of the 8 million people who bought health plans by this past spring for the first year of coverage under the law, 7.1 million remained in them as of mid-October. Of those who left, some had stopped paying their monthly insurance premiums, and 112,000 were immigrants dropped by the government because they had not proved that they were eligible.The administration’s enrollment expectations appeared five days before the start of the second sign-up period through the federal insurance exchange being used in about three dozen states and through separate state-run exchanges. The figures also emerged as the health-care law — enacted in 2010 as a crowning domestic achievement of Obama’s presidency — is facing new political and legal peril.

As much as I despise the Republicans and the five reactionary justices of the Supreme Court, the Obama administration has to be considered equally culpable in this manufactured mess. As much as I would hate for the millions of people now benefiting under expanded Medicaid to be kicked off, or even for those partially subsidized enrollees to be deprived of their Bronze Plans (stories abound of $10,000 deductibles charged to workers who barely make ends meet as it is)  it's hard to defend the indefensible.

 Will these continued failures and challenges to the torture that is Obamacare nudge us closer to Single Payer health coverage? After all, despite the GOP's hollow "victory," most voters do favor progressive initiatives, including health care. Any improvements will likely come at the local level, because Big Money has full control in Washington.

Here is one ray of hope: student members of the notoriously arch-conservative  American Medical Association have just passed a resolution in support of state legislation supporting true universal health care:

Although the resolution applies only to the student section of the AMA, supporters say it sends a signal to the larger organization that many physicians-in-training think the most recent round of national health reform didn’t go far enough.

“Last Friday’s vote is yet further evidence that physicians – and in this case physicians-in-training – are increasingly angry about private insurance companies that meddle in doctor-patient relationship, deny access to care, balk at payment, and afflict providers and patients alike with costly and unnecessary red tape,” said Bradley Zehr, a second-year medical student at Boston University School of Medicine who helped write the resolution.“Med students want to practice medicine and to help people get better, not to be part of a corporate enterprise that puts financial gain over our patients’ well-being,” Zehr said. “They see the millions of people who will remain uninsured or underinsured under the Affordable Care Act. That’s why physician opinion is shifting toward a nonprofit, publicly financed, Medicare-for-All-type system that would cover everyone while also controlling costs.”

The Obama administration may have relied on the alleged stupidity of the American voter when it rammed through its corporation-friendly kludge. What they very stupidly haven't relied upon is the basic humanity and unacknowledged intelligence of the American voter, and the political power of the health care community  Americans are discovering that "voting" for representatives instead of policies is neither sufficient nor particularly effective in the runaway oligarchy that masquerades as a democracy.

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* Contributor Pearl Volkov's comment on the Paul Krugman column (linked above) really zings it:


The complications of Obamacare go beyond a so called typo which could have
been deliberate in case someone is cleaning up as a result. The huge
thousands of pages of the original health care bill was never completely
read by voting Congresspeople by their own admission and left lots of
loopholes for misunderstanding, misstatements, misrepresentation,
misinformation and misconduct. Reports of the financial activities of the
numerous insurance companies handling medical claims are not only impossible to make sense out of but I firmly believe deliberately made complicated andconfusing to cover up the allocations of great sums of money to them from patients who have no choices and have no information how their coverage is allocated.

By covering some comparatively minor loopholes for people, you are so happyand busy rejoicing for these coverages that the miserly help which gives spotty coverage or none to many citizens is never mentioned.
If you are going to write columns of anger about the attempt to destroy
Obamacare whether for the right or wrong reasons, at least do your homework.

There are several progressive/liberal websites which keep accurate reports
on this issue and prove how the financial set up of Obamacare provides belowstandard quality of actual medical care for subscribers in comparison to the fees collected.