As noted here last week, Obamacare is seen by some as an elitist system of health care, rather than the equalizing force it purports to be. This week, the news is that the nation’s unions aren’t happy with how Obamacare is shaping up for them, and the Obama administration is scrambling to find new ways to entice them to publicly support the Affordable Health Care Act.
Richard Trumpka, president of the AFL-CIO (the nation’s largest labor union), is saying that the Obamacare plan wasn’t thought through well enough, and is stepping back from fully backing the plan. He wants to see the 30 hour work week endorsed as full-time under the plan, mainly to help workers in industries like fast food. According to The Washington Times:
Critics of the law say the 30-hour cutoff has forced fast-food chains and other employers to trim employees’ hours to keep them at part-time status and avoid penalties tied to the law’s employer mandate, which requires companies with 50 or more full-time workers to provide health coverage or pay fines.
“That is obviously something that no one intended,” he [Trumka] said during a wide-ranging interview hosted by the Christian Science Monitor in Washington.
In addition to internal logical inconsistencies which raise serious concerns of long term economic sustainability regarding the Affordable Care Act (ACA), recently analyzed by John MacDhubhain, Robert Pear reports in the New York Times over the weekend how confusion over certain ambiguities in the law (ironically over the meaning of the word “affordable”) would end up hurting some of the people it is precisely designed to help: working class families.
The new health care law is known as the Affordable Care Act. But Democrats in Congress and advocates for low-income people say coverage may be unaffordable for millions of Americans because of a cramped reading of the law by the administration and by the Internal Revenue Service in particular.
Under rules proposed by the service, some working-class families would be unable to afford family coverage offered by their employers, and yet they would not qualify for subsidies provided by the law.
Medicare beneficiaries will be “assigned” to 5,000 patient-minimum organizations to coordinate their care. While HHS Secretary Kathleen Sebelius talks about improvement in care, the politically poisonous truth is that Medicare is going broke and ACOs are designed to save money.
The words “rationing” or “treatment denial” or “withholding care” are not part of her press release, but reading the regulations reveals intentions to “share savings” with those who fulfill, or “penalize” others who fall short of, the administration’s objectives. The administration’s talking points include politically palatable words that emphasize quality improvement and care enhancement when the real objective is cost control by a utilitarian calculus.
Physicians and other health care providers will find themselves in conflict with the traditional ethos of duty to patient within ACOs. Doctors will face agency conflicts between the time honored primary duty to patient. Medical care providers will receive incentives for controlling spending, and penalties if they do not. “No one can serve two masters” (Matthew 6:24); not even physicians.
Another election has come and gone, and once again the balance of power has significantly shifted in Washington, D.C. and statehouses across America. Tuesday’s results are, I suppose, a win for fans of limited government, in that a Republican House of Representatives will make it more difficult for President Obama and his Democrat colleagues in the Congress to enact more of what has been a very statist agenda. But even with the prospect of divided government on the horizon, we who believe in individual liberty and the principles of classical liberalism still have much to be concerned with. Perhaps the primary concern is whether or not those Republicans who were swept into office—not due to any real love of the electorate for the Republican Party, but rather due to anxiety over the direction the Democrats have taken the country—will be able to hold to the principles of limited government and individual liberty that so many of them claimed to espouse during the campaign, or whether those principles will be abandoned in a mad pursuit of power. Forefront in the mind of every lover of liberty should be Lord Acton’s famous maxim: “Power tends to corrupt, and absolute power corrupts absolutely.”
My sincere hope is that with Americans deeply dissatisfied with both major political parties and finding that the government is either unable or unwilling to solve the major fiscal and social problems that we face, people will begin to re-think their basic assumptions about the role of government in American life. For decades, the default assumption has been that the government is a force for good and can be a driver of positive social change. Witness Social Security, Medicare, the Great Society, the War on Poverty, etc. All of these programs were designed by experts to alleviate some pressing social need, and were assumed to be the right thing to do. After all, who wouldn’t want to help the poor and elderly to live a fuller, better life? And yet, as the years went by, all of these programs—though well-intentioned by their creators—have failed to achieve their lofty goals. The Social Security “trust fund” is devoid of funds and packed with IOUs left by politicians who, over the years, have spent the money promised to seniors on other programs. Medicare, Medicaid, and other government health care programs have warped the economics of health care, paying doctors less and less and therefore driving up the cost of private insurance in order to make up the difference. Obamacare is little more than an attempt by the government to solve a cost crisis—created in large part by government intervention—with even more extensive government intervention into the market. We already know how that story ends. And as for the Great Society and the War on Poverty, trillions of dollars over the years simply failed to alleviate poverty in America, and in many cases only created deeper, more entrenched social problems.
It is clear by now to anyone who cares to look that massive government intervention into society tends to do more harm than good, no matter how well intentioned the interventionists are. Government has its place—no arguments for anarchy are to be found here—but the government must be limited to its proper place. The genius of the American founding came in the limitation of the national government to certain enumerated functions, leaving the people at liberty to take care of the rest of life as they saw fit. The respect for individual liberty and the acknowledgement that the rights of citizens were not granted by the state but were granted to individuals by God himself provided a firm foundation for the vibrant growth and strength of the United States in the coming centuries. As a people, we need to realize that the further we move away from those founding principles and the more we cede our liberty to governmental agents in return for a promise of security, the less likely it is that we will remain strong, vibrant, and free.
At the Acton Institute 20th Anniversary Celebration, Acton President Rev. Robert A. Sirico reminded us of the roots of human dignity and the importance of individual liberty during his keynote address: