Being an in-principle laissez-fairist, I am of two minds about the new Speaker calling PPACA (“Obamacare”) a “monstrosity.” (Full disclosure: because of PPACA, my twenty year old son will have his private health insurance coverage, from which he was dropped, coverage paid for by me, restored in January.) First, the very sentence in which this word was used is at odds with itself: “I think it’s important for us to lay the groundwork before we begin to repeal this monstrosity.” In other words, we’re not going to repeal the monster, not right away, but we want to make it clear that we would like to. Now this is prudent because of course it is impossible for him to repeal it: such a bill would not get past a Democratic Senate and would certainly face presidential veto.

Our laws are already shot through with government-produced incentives and disincentives for participants in health care activity in countless ways. The principal effects of PPACA are to introduce a financial incentive to purchase health insurance from private parties, and to prohibit these same parties from dropping coverage. We already have things of a similar character. For example, your employer-provided health insurance has to be made available to you even after you get fired, or else the employer loses the tax break associated with having provided it in the first place. This has been true since 1985.

But what puzzles me is this: suppose that you deeply believed in freedom of contract. Suppose you passionately opposed government intervention in health care. Suppose you wanted to reduce taxes as much as possible, for liberty reasons and economic reasons. Suppose that you were especially concerned by government spending, and even moreso by deficit government spending. Your mission, should you decide to accept it, is to identify the single most important piece of legislation to repeal to accomplish as much as possible along as many of these dimensions as possible. What do you do?

That’s easy. Abolish Medicare. And if you know that it is politically impossible to do so, at least call it “monstrous.” In public, out loud.


3 comments on “Monstrous

  1. Pliny the Elder says:

    The reason is, of course, the weird sort of “baseline” that develops. Once a government program has been in place for a generation or so, it is no longer thought of a government, but as a near metaphysical necessity. This is why smart politicians do not even attack many of the things they despise. Reagan, for example, did not like minimum wage laws, so he ignored them and resisted increases. By the time he left office even the small amounyt of inflation duirng his eight years had rendered the minimum wage law almost irrelevant, i.e., almost no one was earning that little. Medicare now has become part of the furniture of the universe, and I have no trouble understanding what folks intend when they say ostensibly crazy things like “Keep the government out of my Medicare”. Ironically, this furniture problem will make a transition to, e.g., single payer that much more difficult. I am cautiously optimistic because 1995 and 1996 remain the only two years in modern US hisotyr when discretionary spending actually declined.

  2. poseidonian says:

    It would not surprise me if Boehner could be induced to say in private “in a perfect world, I’d abolish Medicare, but that’s just not feasible, and as a working politician in office, I must govern in the world as I find it.” My preference would be for such a man to say, in public, “we disagree with many of the provisions of PPACA, and look forward to working with the president to improve our health care laws” and if asked in public, to say “the abolition of Medicare is not seriously contemplated by anyone, and it is inflammatory rhetoric for the opposition to suggest that we are in favor of such a thing. However, costs are going to be a real problem in the future, and we will have to look at a range of possible responses.” Instead of calling a tweak on the Rube Goldberg “monstrous” and responding to the Rube Goldberg itself with a discreet silence. (I haven’t even started in on the cui bono question on PPACA, though the short answer is, the insurance companies, primarily.)

    But it is precisely such Republicans that are in the crosshairs today, and not from Democrats. I think Pliny and I would be happy to vote for such Republicans, but they are today an endangered species.

  3. Pliny the Elder says:

    Boehner’s choice of words does link up nicely with our earlier discussion about the comfort level with over-the-top language. Even if a law is a horrible idea it is probably not a “monstrosity.”

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