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What’s wrong with ObamaCare?

Doctor Zero:

ObamaCare is the most powerful job-killing force unleashed against our economy in decades. It dramatically increases the cost of labor, and applies huge fines against companies that resist its mandates. Companies such as Caterpillar, John Deere, Prudential, and AT&T responded by announcing thousands of layoffs. This is a perfectly rational reaction to a bill that dramatically increases the cost of labor, especially when the legislation keeps mutating and producing expensive new horrors, such as the nationalization of student loans that wiped out thousands of jobs at Sallie Mae.

I sort of get much of that, although I would definitely have to follow the second link to see how ObamaCare is nationalising student loans, and to find out what on earth “Sallie Mae” might be. But, speaking more generally about this huge furore, I have a real problem with ObamaCare. Not in the sense that it is causing me to lay off hundreds of my employees, but in the sense that I am finding the arguments about it very hard to follow. Mountains of verbiage have already been written about ObamaCare and many more will follow. But I am afraid I missed the early bits, where the actual blow-by-blow damage that ObamaCare will unleash (is now unleashing) was itemised, briefly and punchily. Anti-ObamaCare writers tend now merely to allude to the assumed harm of it, rather than yet again itemising it. Much is made by critics of ObamaCare of the immense length and complexity of the relevant legislation, which it seems most US politicians have no more read right through than I have. But what, approximately speaking, does it all say?

I suspect I am not the only Brit who feels this way. Not that long ago, for instance, I heard those comedians on Mock The Week take it in turns to denounce Americans for not welcoming ObamaCare, and I knew they were talking out of their smug and self-satisfied arses (especially that little bald one who is smug self-satisfaction personified, if you don’t happen to agree with something he is saying). Death panels? No. It’s free healthcare for those who can’t now afford it, you obese God-frazzled morons. What could possibly be wrong with that?!? Do you all want to die prematurely of terrible diseases and accidents that the British health service cures immediately at no cost?

But had I been on the panel, trying to resist (in particular) the Smug Dwarf’s relentless leftery, I don’t think I would have done a very good job. Most Brits watching, if my reaction is anything to go by, either agreed that all American opponents of ObamaCare are indeed morons, or that they perhaps have their reasons for not wanting it, but that these reasons will for ever be a mystery, probably involving some Americanised version of God.

So, commenters, please fill me (us) in. Please help us Brits – this particular Brit especially – to wrap our brains around ObamaCare. What, briefly, are those “mandates” that Doctor Zero refers to? How are student loans involved? And what else is being inflicted?

I would like to be able to concoct a further posting entitled something like: “A brief but pretty much complete explanation for confused Brits of why ObamaCare is a really bad idea and why so many Americans are right to hate it”. And maybe, with your help, I will be able to do that.

One particular request. What concerns me is not to dig deeply into any particular harm that ObamaCare is doing. What I seek is completeness, combined with as much brevity as can be contrived. In the event that I do manage that follow-up posting that I can now only dream of, I want an American to be able to wizz through it, and say something like: “Yup, that about covers it. That’s why so many of us hate it. I actually don’t think number three is quite as bad as your short description of it implies, and I think number five is far worse even than you say. But, nothing major is missing from that list. Good job.”

Maybe such a posting already exists, and I need only read it, and link to it.

Or maybe (I’ve just been following the links in the quote above, just to check that they work), my question is wrong. Maybe what I really want is a brief guillotine-blow-by-guillotine-blow guide to the entire Obama legislative “achievement”, of which “ObamaCare” is only a part.

Anyway, whatever help anyone can offer along these approximate lines would be most welcome.

24 comments to What’s wrong with ObamaCare?

  • newrouter

    Mr. Obama traveled to a community college where the wife of his vice president teaches to draw attention to the student loan overhaul attached to the final piece of health care legislation that passed last week. In signing the bill, he put the final touches on his health care program but used the occasion to highlight the education provisions.


  • mdc

    From wikipedia:

    SLM Corporation (NYSE: SLM), commonly known as Sallie Mae, is a publicly-traded U.S.[2] corporation whose operations are originating, servicing and collecting on student loans.[3] Managing more than $180.4 billion in debt for more than 10 million borrowers, the company primarily provided federally guaranteed student loans originated under the Federal Family Education Loan Program (FFELP).[4] It now provides private student loans. Sallie Mae employs 8,000 individuals at offices nationwide.

    So it seems that he nationalised a part of the government, thereby ‘destroying’ the jobs of one set of civil servants while ‘creating’ new jobs for a presumably identical set.

  • Phil Mill

    This article is quite useful http://biggovernment.com/kdlee/2010/04/15/why-has-obamacare-become-a-tea-party-issue/

    In a nutshell it’s about taxation and big government. At the moment patients in America are treated like important customers (I know, I have have experienced U.S. health care pre-Obama). One of the comments in the thread below summed it up thusly:

    When those liberals find out what happens when you add thirty million more people in the waiting rooms of doctors offices and hospitals and they have to wait 10 months to get a 10minute doctor appointment, maybe then they will realize their mistake. Obama said it straight: Sit down, and shut up and get out of the way. Thats what will be the motto in doctors waiting rooms soon if the democrats prevail.

    Could have been talking about the NHS.

  • Surellin

    It’s hard to find a precis of the effects of Obamacare – they are still being discovered. There literally wasn’t time for the Congresscritters who voted on the legislation to actually read it (as many of them shamefacedly admitted), and Speaker of the House Pelosi, when braced on this fact, said that we would just have to pass the bill to see what was in it. Heh.
    The “mandate” is the requirement for everyone to buy health insurance. In short, this requires twenty-something people in good health, who might otherwise have no insurance or at best inexpensive coverage for catastrophic accident, to purchase the whole kit-and-kaboodle coverage mandated by Obamacare – and this is necessary because they need that cash flow from the young-and-poor to subsidize their older-and- sicker-and (generally) wealthier fellow-citizens.
    Incidentally, this mandate to purchase insurance is probably unconstitutional. There is no justification for the federal government to require citizens to purchase anything. The nearest equivalent is probably the requirement to purchase automobile liability insurance, but that is a matter of state law and, anyway, you only need to buy it if you intend to drive on public roads.

  • llamas

    The ‘mandate’ complained of is the provision that all persons in the US must procure health insurance by (whatever various mechanisms are provided) or pay a substantial annual fine, to be enforced via the Internal Revenue Service.

    There is no Constitutional mechanism which can empower the Federal government to compel citizens to buy anything, on pain of a hefty fine. This provision is being ramrodded through on the basis of an extremely – creative – reading of the Commerce clause – which is already the subject of a multi-state lawsuit against the Feds. Nor is there a Constitutional mechanism by which the power of the Internal Revenue Service can be used to lay and collect fines on citizens for activities not having any connection to the collection of tax revenues. It’s like using the IRS to collect parking fines.

    In practice, the mandate is nothing more than a tax on persons of middle- and upper-income levels for whom fairly-comprehensive health insurance (as defined in this program) makes no economic sense. The system is already a gigantic wealth-transfer mechanism, and the mandate is the means by which the system will extract wealth from those who choose not to participate.

    For young, healthy, single persons, the kind of ‘insurance’ that is mandated by this system is a very poor bargain – which only makes sense, since the system is heavily skewed to transfer healthcare resources disproportionately to lower-income citizens. The end-game is to create a reliable, perpetual voting bloc that is double-dipped – they will reliably vote for new taxes (since they don’t pay any) and more healthcare provisions (since they won’t be paying for them either.)

    The US already has extensive tax-funded healthcare for the truly-poor – the purpose of Obamacare is to shift much-greater numbers of people into tax-funded healthcare, for the purposes described, and the only way to do that is to get the rest of us to pay for it. It has nothing to do with providing healthcare per-se – that is merely a convenient hook on which to attach the wealth-redistribution and vote-buying goals. If the true purpose was to provide affordable healthcare for all, then Senator McCain’s simple proposal – a $5000 pa refunadable tax credit for all private health insurance purchasers – would have acheived that goal at a single stroke of the pen and at far lower cost.



  • JohnK

    It occurs to me that, much as when you give a statement to the cops, legislators should at least me made to sit down and read each piece of legislation they vote for, initialling each page top and bottom. Not much to ask for is it?

  • John


    You’ve taken on a big task, but a very worthy one in my opinion. I’m no expert on the Obamacare law, I confess I only got through about a hundred pages of its 2000+. However, I do live right in the heart of middle America in a social environment which is to the tea party what Berkeley is to leftist thought processes, so here’s my take from what’s in the air:

    1. The details are blurry but the perception is that the law was passed in an underhanded and overly hurried way after a strawman debate which didn’t touch on the really relevant issues.

    2. There is NO constitutional basis for this thing. There is much resentment over this, and much feeling that we now have to put up with a long period of hassle and expense between now and the time the Supreme Court finally gets each of it’s provisions individually ruled unconstitutional. People are tired of this. They want the executive and legislative branches to share in defending the constitution, many refer to members of the Obama and Congress as felons and oath breakers since they are seen as intentionally breaking their oaths to defend the constitution by knowingly introducing unconstitutional legislation hoping they can get away with it “long enough”. A friend said, “If this is can be constitutional, anything can be constitutional and we no longer have limited government, we may as well have a king back.”

    3. It is expected to result in poor quality health care at a higher price with longer waits and worse service than we now see. Most people believe their current insurance will no longer be available, and for large numbers of people who self insure, insure through religious, family, or social communities, or carry only insurance against major events, it seems to be the end of their current insurance arrangements. They’ve been told “if you like your insurance you can keep it…” but they split pretty evenly between those who simply don’t believe that and those who believe it is true but includes the proviso, “… as long as you don’t mind paying for both.”

    4. It is seen as an attempt to dictate social outcomes and morality. People worry about being forced to pay for medical procedures they don’t approve of (abortion), being required to accept procedures they don’t want (circumcision, birth control without parental consultation, many other treatments of kids without parental approval or knowledge), or being denied procedures they do want on ideological grounds (abortion, circumcision, resusitation, care for the dying.) “Death Panels” is a kind of rubric or icon for this idea, based on the idea that whether someone should receive a particular treatment (in the extreme case be allowed to die) will be up to a government panel rather than the individual, the family, and the doctor. As far as I know, this panel is considered a fact by everyone involved in the debate, it merely goes by different names with different expectations and connotations.

    5. Many people believe that we just plain can’t afford it and are concerned by the idea that merely turning health care over to an organization which is a legend of irresponsible money managment, accounting tricks, and deficit spending is somehow all by itself going to make it more cost effective. Apart from some hand waving about administrative costs and advertising there’s not been much “connect the dots” on where those savings are going to come from. One member of my family said, “Let me get this straight, you’re going to add demand in the form of millions of people who can suddenly get all they want for free? And you’re going to do nothing to increase supply? And the price is going to go down? OK then…. ”

    6. I don’t know anyone who’s concerned about the student loan thing per se. Sally Mae or whatever is not on the radar and I don’t think they’d care if it was; it would look to them like the feds moving money and work from one pocket to the other. BUT, there is certainly a lot of resentment which predates this law by many years about legislators of both parties tacking stuff like that onto unrelated laws and on that basis there’s a lot of grumbling about it.

    7. I don’t know if you have this in the UK, but here we have lots signs dictating behaviour based on insurance, but mostly people ignore them. They are widely believed to be specious and merely a way of trying to make a rule look like it has more force.
    If you’re in the military there’s a long list of stuff you can’t do on your own time for risk reasons (sky diving I think, maybe motorcycles, mountain climbing, I’m not sure, a friend in the USAF showed me a list years ago). There’s concern about connecting law enforcement with risk management in this way. Some of us see this as a move to legitimize and expand the nanny state. It seems to give the gov a legitimate say in what risks you can take. Some believe motorcycles will be illegal in a decade, small planes, alcohol, smoking certainly, and others would soon follow. One (admittedly over excited) guy told me it was just a matter of time after this before they had big brother making us do our exercises on the telescreen.

    That’s kind of long winded so you’ll probably be grateful that it’s all I can think of for now. I hope it is some help in a social anthropology kind of way. (BTW, other than the concerns mentioned in #4, I haven’t heard anything about God or religion in any of these discussions. )

  • Dom

    “The US already has extensive tax-funded healthcare for the truly-poor …”

    It’s odd that so many people do not know this. My brother was unemployed for most of his life, and when he worked it was a low-paying jobs — sport’s director at a boys home, and so on. Triple-bypass surgery, kidney replacement, liver problems, years on BP medication, cataract surgery — all of it tax-funded.

    The real problem is America is middle-class people, many of them on not-very-good insurance policies, who suffer a catastrophic illness.

  • john


    I think you’ve got something there. My grandmother was the same way (my aunt too…). What I’ve seen is lower to middle middle-class folks who have had “free” health insurance (parent/university/employer funded) all their lives who lose their jobs and then are indignant that suddenly they have to pay for health insurance… and it costs as much as their cable bill and their cell phone… combined!

  • Dom

    We may have strayed from what the poster requested. Here’s why I am not looking forward to any variant of ObamaCare.

    I work in IT, and I am old enough to remember when a computer filled a room and used only 800 BPI tapes. Then there were PDP’s, and 6400 BPI tapes, then desktops, Lisa’s, Mac’s, PC’s, Windows, laptops, IPads, Internet shopping, email, blogs. Everything changed in a very short time. I have to wonder what things would look like today if someone back then had said that information should be free (in the Progressive sense of the word, meaning everyone pays).

    And I have to wonder what health-care would look like if the government just freed-up the marketplace. I bet we’d have nurses making housecalls, doing simple diagnoses, and dispensing medication. We’d have easier drug trials, too. Healthcare might look like the one example of healthcare that I really admire, the kind given to my pets — it’s cheap, excellent, and the doctor always says “good boy” when he’s done.

    Since ObamaCare, like most nationalized junk, won’t end, we will never find out.

  • Tedd

    It has just struck me how much this U.S. health care bill (PPACA, aka ObamaCare) is like the Charlottetown Accord we had here in Canada twenty or so years ago.

    The Charlottetown Accord was an attempt by then Prime Minister Mulroney to rectify a problem of legitimacy that Canada’s constitution has, as a result of it not being ratified by Quebec. Mulroney made several attempts to patch that bug, culminating in the Charlottetown Accord, which was put to a referendum in the early 90s. As with the PPACA, the Charlottetown Accord was very complex, containing many, many provisions designed to ostensibly attract support from various factions. Few voters knew or understood what was in it. Its failure in the referendum has been attributed to many causes, but it has always been my belief that the very complexity of the Accord was its main weakness. Designed to have something in it to please everyone, it instead seemed to have something in it to annoy or offend anyone. (I strongly suspect that an overwhelming majority of Canadians who voted in favour of it never read it.)

    It seems to me that there’s a direct parallel to the U.S. PPACA. I suspect there is quite strong support in the U.S. for some kind of health care reform, possibly even strong support for some kind of universal, government-funded program. But, rather than containing “something for everyone,” the PPACA probably contains at least one provision that’s perceived to be a major problem by each of a majority of U.S. citizens.

    Incidentally, this quote from the Wikipedia article on the Charlottetown Accord has interesting implications for U.S. politics, if my thesis is correct:

    Probably the biggest result of the referendum, however, was the effect of most of Canada’s population voting against an agreement endorsed by every first minister and most other political groups. This stinging rebuke against the “political class” in Canada was a preview of things to come — in the federal election on October 25, 1993, a year less a day after the Charlottetown referendum, the Progressive Conservatives under new leader Kim Campbell were reduced to two seats. They were replaced in most Western ridings by the Reform Party and in Quebec by the Bloc Québécois, the parties who had opposed the Accord.

  • Richard Thomas

    Imagine everything that’s good and bad about English healthcare.

    Now subtract all the good things and double all the bad things. Now throw in a bunch of expensive and irrelevant stuff on top of that.

    For all that I’m against the NHS, I have to admit that there are a lot of aspects of it that are nice-to-have. The most pressing example is not having to worry about where healthcare is going to come from should one experience a period of involuntary unemployment. (Note: Please don’t lecture me on the evils of the NHS, you’re preaching to the choir). The point is that the aspects that make the NHS worthwhile were deemed unacceptable to Americans and were taken out, leaving only a hodgepodge of the worst ideas possible, increasing costs for everyone and improving health-care for almost no one. Let’s not forget too that even the supposed improvements are held off for 4 years while revenue is, of course, due for collection immediately.

    The pork goes without saying of course.

    All in all, this bill has as much to do with honest health-care reform as the words “hope” and “change” have any actual substance. None.

  • Jay

    I’m sorry there is no list yet. Like everyone else, I have not read the law.

    All I need to know is that the federal government is trying to force me to buy health insurance. Whether the reasons are good or bad doesn’t matter. This is unconstitutional.

    As you well know, tyranny will follow. Once I am forced to buy health insurance, I will be told what it will have to include, and what I will have to pay for it. Then I will be told how to behave, in order to control costs. I will be told what I can eat and what I cannot eat. Restaurants will be told what they can serve, and what they cannot serve. I will be punished for “unhealthy” lifestyle choices. I will be told what medical service is covered and what is not covered. Then I will be forbidden to pay for what is not covered, as that would be unfair to the “have nots”.

    We are already seeing the impacts on new drug development. The previous standard was “safe and effective”. Now, cost is a consideration for FDA drug approval. The new drug may be safe and it may work better, but if the federal government thinks that the benefit does not justify the increased cost, they will not approve the new drug. The same is true for medical procedures. Now, for a pharmaceutical company, the question is not “Are people willing to pay for this new drug under development?” but rather, “Will the government be willing to pay for this drug, or would it rather save money with the older, cheaper drug?” Anyone that has seen how long it takes for the feds to update their computer systems knows the answer to that question. Therefore, new drug development will slow. What is the benefit of extending human life 5 more years when that will cost 5 more years of social security pay outs, and 5 more years of Obamacare pay outs? The incentives all go the other way!

    Obamacare is bad, and hopefully will be strangled in its crib.

  • Just to say: although there is no list (see Jay above) as yet, I for one am still learning a lot. Thanks to all.

    If the comments keep coming, maybe a list will soon become possible.

    The fact that nobody has yet volunteered a list is itself quite interesting, I think, even though none of the commenters so far seems either ignorant or stupid. It reminds me of the bit at the beginning of PJ O’Rourke’s Parliament of Whores, where he points out that absolutely nobody knows what the entire Federal Government consists of.

  • Phil Mill

    I’ve now read the article you linked to. Very enlightening.

  • newrouter

    here’s how obamacare maps out bureaucratically


  • Completeness and brevity?

    Good luck with that.

  • Aspen

    A brief list of what the bill does is not possible to generate. The specific provisions of this bill (and every other piece of legislation crafted by statists or oligarchs) are all about which bureaucrat will exercise what powers at whose behest. The actual interactions of ObamaCare with the existing health care system will work themselves out over the next decade or two through thousands of rulings and judgments made by the government officials so empowered. Our Congress is full of leaders who think that passing meta-laws to empower the administrative state isn’t a sign of their own incompetence and a dereliction of duty.

  • razorbacker

    Student loans and ObamaCare (Democrats don’t want you to call it that anymore) are two separate issues. You have been mislead by a perhaps poorly written article.

    The primary problem with ‘free health care’ is that a large percentage of the U.S. population believes that universal single payer health care will lead to reduced quality of care, rationed by government employees.

    I’ve been around this vale of tears long enough to recognize that once something is both ‘free’ and ‘guaranteed to all’ the price rises exponentially.

  • razorbacker

    I guess that I should mention a fact of political life here in the U.S. of A.

    When a politician wants to pass a real stinker of a law, one that the pol knows has fuckall chance of passing, he or she will attach the stinker to a law that has public approval. Then when the popular law is passed it is only later that anyone notices the stinker law.

    This would be avoided by the pols reading bills before voting, but that is too much to ask. Hell, it’s too much to ask for the pols even to write the bills themselves. That menial task is left to staffers, paid and nonpaid lobbyists, and special interest groupies.

    That is why you see such magnificent mash-ups of bills.

    I’m coming around to the idea that no law shall be enforceable that is written in language that is unable to be understood by a high-functioning mental defective. We’ll negotiate that definition later.

    Heh. See what I did right there? I should run for office.

  • Midwesterner

    These are a couple handfuls from the 450+ bookmarks I have on the whole health care rodeo. I just grabbed some of the more recent ones that looked like they might be interesting.

    My apologies in advance for ones that are off topic. I don’t have the time to evaluate them. Here they are in no order whatsoever.

    *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link) *(Link)

    Brian, if this comment is just a big ugly mess in the middle of the thread, please delete it. I just thought some of the links may help explain the more immediate concerns. On balance though, I think Aspen nails it.

  • Laura

    Here’s my little list:

    1) Obamacare will give every destitute person in the world with a major health problem, like AIDS or cancer, to scrape together enough money for a plane ticket to the USA so that they can get their free healthcare. Even though foreigners won’t be covered under Obamacare, it would be racist and xenophobic to exclude them from the system once they are here. The free rider problem will worse than anyone can imagine, and I can imagine plenty. We should have eliminated birthright citizenship, deported millions of people, and made it clear that there will be no amnesty, and THEN tackled the problem of the uninsured.

    2) Most Canadians see the American healthcare system as a safety net for Canadians, who have socialized medicine. Once Obamacare kicks in, what sort of safety net will there be for Canadians OR Americans who are displeased with what they are offered under socialized medicine?

    3) Most of the pharmaceutical companies of the world are in America. They charge top dollar for their newfangled drugs when they sell them to Americans, but cut deals with the governments of countries in Europe with socialized medicine. For many decades, American consumers have been subsidizing the true cost of medical innovation for those who have socialized medicine. Once America has socialized medicine, will medical innovation and development of new drugs slow down? Lots of Americans are scared of this.

    4) Les Miserables is NOT an American story. Many middle-class and working-class people live from paycheck to paycheck. For many people, this is their own bad management, but nevertheless, a lot of people are going to fail to purchase a policy, get hit with the fines, have the IRS come after them, and then get caught up in a system of penalties. Currently, if you run afoul of “Sallie Mae” by defaulting on your student loans, you can end up losing your professional license. Just yesterday, I saw a web posting by a physician who defaulted on his student loans, had them balloon up to $400,000, and as a result lost his license to practice medicine. He now drives a truck. Similar things happen to people who fail to pay child support, alimony, and taxes on time. In most cases, the people who get caught in these situations bear a great deal of responsibility for their own plight, but America is supposed to the be the land of the second/third/fourth chance, and a lot of people are truly disturbed to see people being hounded to Hell and back by the government. There is no statute of limitations for the acts that lead to these situations, and no relief in bankruptcy court. Nearly every extended family in America at this point has a family member who has fallen into one of these interminable, unsolvable situations, and people would like to see a reduction in this sort of enforcement activity, not an increase.

  • Laird

    Here’s a fairly short editorial which lists some of the major problems with Obamacare.

  • Sam

    It’s an illusion that all poor people have access to government funded medical care. Single men are excluded for coverage in most states no matter how poor, that’s missions of people right there. Check our the Montana’s gov’t page on medicade eligibility http://www.dphhs.mt.gov/hcsd/medicaid.shtml#basic

    For the first time millions of sick people will have access to medical covers most of us take for granted. If a few thousand people are laid off by greedy corporations that don’t want to NOT make millions in profit this year, I’m okay with the trade off.