HR3200, America’s Affordable Health Choices Act of 2009

Why is much of the public suddenly and so vehemently opposed to this Bill? Aside from its length (1,018 pages) and aside from the ongoing political circus around it, (examples, here and here) I think there are fundamental reasons that the public is alarmed by, and therefore opposed to the Bill. Overall, my take is that opposition is fueled by an Administration that cannot seem to give simple, straight answers to good questions the public is asking. And strategically the Administration is caught in traps largely of its own making.

It fell into the first trap by biting off more than it can chew. The problem that has been aching for a solution is access to adequate health care for the uninsured. There are long-term possible cures for this problem, but until then the immediate aspirin tablet is to insure them. In a strategic blunder, the Administration determined that nothing short of radical surgery on 100% of the health insurance in the U.S. would suffice to fix the problem of the uninsured 15%. In so doing, it got way ahead of the problem. The Administration also got way ahead of the American people who (I believe) would have supported reasonable proposals to insure the uninsured but are correct to resist this enormous, top-down, governmental intrusion into their own private insurance. Besides, in some respects, the uninsured represent failure of government in the first place.

Second, the Administration walked into a logical trap. The Administration claims that radical change to American health insurance is essential to America’s future economic well-being. But at the same time, the Administration assures the public that the change it has in mind will allow anyone who likes their current insurance, to keep it. A large majority of Americans are insured, and like their current insurance enough that they resent a mandate to change it. Change without change will save the economy? Yeah, that’s gonna happen.

The Administration also created a financial trap for itself. After persuading Congress to pass a $700 billion economic “stimulus” that greatly increased the deficit, Obama promised that he will not sign any health insurance bill that increases the deficit. OK, fine. But now CBO has determined that the health insurance bill requires significant additional federal spending, that it will increase the deficit, and the farther out the analysis goes, the worse the financial picture gets. So at this point, regardless of the street-level protests that are taking place, the bill appears DOA. As a result, the Administration is scrambling to find reasons to justify going ahead anyhow. But their reasons are making the situation worse, because they aren’t addressing what has the public worried. Example: the notion that the bill can be financed by additional taxes on high income taxpayers. But CBO already said it can’t. So all taxpayers have even more reason to worry their taxes will be raised. Example: the notion that the bill can be financed by insurance “savings” from elsewhere. But where will most savings come from if not from the elderly population that uses the majority of medical resources? So Medicare participants and their families worry even more that this bill tosses grandma under the next bus. Example: the Administration has done an absolutely wretched job of explaining Section 1233, Advance Care Planning Consultation, to Medicare participants. In fact, I’d like to know what Section 1233 means, too - and I won’t be eligible for Medicare for years (0.75 years, to be precise).