奥巴马医改是一场灾难,正如预期的那样。
Obamacare Is A Disaster, Just As Expected

原始链接: https://www.zerohedge.com/political/obamacare-disaster-just-expected

## 奥巴马医改的预测与民主党的坚持 15多年前,共和党人团结起来反对《平价医疗法案》(ACA),准确地预测了它的失败:保费上涨、医疗资源配给以及私人保险市场的崩溃。巴赫曼、瑞安、麦康奈尔等政界人士,以及克劳特哈默等评论员和《国家评论》与传统基金会等机构,都警告了即将到来的灾难。 他们的预测被证明是正确的。ACA明显地增加了成本,减少了竞争,未能达到注册目标,并且最终未能“控制成本曲线”。尽管如此,民主党人却一再坚持,实施了临时的补贴增加来掩盖问题——而这些补贴的不可持续性也曾被反复警告。 与其承认这些失败,民主党人反而将系统的弊端归咎于共和党人,坚持认为进一步的制度“改革”最终会取得成功。这反映了进步思想的核心原则,根植于卢梭的信念,即社会制度腐蚀了天生善良的个人,从而为无休止的重组提供了理由,而不愿承认错误。作者认为,这种不愿承认错误的意愿是左派的 defining 特征,优先考虑乌托邦理想而非实际结果,并要求继续为明显存在缺陷的系统提供资金。

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原文

Authored by Stephen Soukup via American Greatness,

Just over 15 years ago, when the Democrat-controlled House and the Democrat-controlled Senate were debating the healthcare proposals offered by the Democrat president, nearly everyone on the political right was unified in opposition. It may well have been the last time the right was united on anything, but it was indeed unified and resolute.

Congresswoman Michelle Bachmann (MN) warned that “This monstrosity of a bill will not only destroy the private healthcare market, it will lead to massive increases in premiums and rationed care.” Congressman (and eventual vice-presidential nominee and Speaker of the House) Paul Ryan (WI) complained that “This bill is a fiscal Frankenstein. It’s a government takeover that will explode costs and kill jobs.” Senator (and Republican Leader) Mitch McConnell (KY) insisted that Americans “want reforms that lower costs, not a trillion-dollar government experiment.”

Right-leaning commentators like George Will and Charles Krauthammer agreed, not only with each other but with Republicans in Congress as well. Krauthammer, in particular, argued that President Obama’s promise to “bend the cost curve” down was pure, unadulterated, and extensively documented fantasy. National Review, much maligned among Trump supporters these days, dedicated most of an issue to exposing and forecasting Obamacare’s fiscal absurdities and the likelihood that it would result in lower quality of care, increased taxes, and exploding insurance premiums. Even the Heritage Foundation—in the news lately for purportedly exacerbating rifts in the conservative coalition—likewise agreed with everyone in the movement, insisting that Obamacare was a disaster waiting to happen and would keep none of the promises that it made, all while destroying what was good and valuable in the private insurance market.

More than a decade later, when it was clear that the system was in trouble and that only greater government intervention and spending could save it, Heritage (in the form of Robert Moffit, Edmund Haislmaier, and Nina Owcharenko Schaefer) took something of a victory lap, detailing Obamacare’s manifest failures and arguing that it was long past time to scrap the whole experiment.

“The facts,” the Heritage analysts noted, “are in.”

  • The ACA dramatically increased health insurance premiums and cost-sharing in the individual market….

  • The ACA collapsed insurer competition in the nation’s individual markets….

  • The ACA failed to meet official enrollment targets in the individual markets….

  • The ACA is pricing middle-class Americans out of individual market coverage….

  • The ACA expanded government coverage while wrecking the private individual health insurance market….

  • The ACA compromised access to care for persons—including those with preexisting medical conditions—enrolled in the nation’s individual markets….

  • The ACA failed—and failed miserably—to attract young people into the exchange insurance pools….

  • The ACA Medicaid expansion prioritizes able-bodied adults, many of whom are working, over the elderly, the disabled, and poor women and children….

  • The ACA did not, as predicted, “bend the curve” of America’s healthcare spending….

  • The ACA’s vaunted delivery reforms did not yield the anticipated savings.

Everything Republicans warned would happen did happen. And the Democrats’ response was to offer a massive “temporary” increase in subsidies to help paper over the failures. Again, every sentient person in the country insisted that doing so would be a disaster, that the subsidies would only increase costs, and that they would not be temporary.

The Democrats didn’t listen, however. They didn’t listen in 2009 and 2010 when Congress initially debated and then passed Obamacare—without a single Republican vote in either house. They didn’t listen in 2020, when they insisted they needed expanded subsidies to address the financial hardships created by COVID-19. They didn’t listen in 2023, when they extended the COVID-era subsidies as part of the inaptly named Inflation Reduction Act, at a cost of $64 billion. And they’re still not listening now. Indeed, they just engineered the longest shutdown in American government history because they have no intention of ever listening or ever admitting that perhaps the right was absolutely spot-on in its predictions about Obamacare.

Worse still, in addition to sticking their fingers in their ears and ignoring the experiences of the last decade and a half, the Democrats are actually blaming the Republicans for all of the healthcare system’s problems, insisting that the GOP is somehow responsible for their delusions. As Senator Bernie Sanders, the ideological spirit animal of today’s Democrats, put it, “This government shutdown is all about whether Republicans will get away with raising healthcare premiums by 75% for 20 million Americans and throwing 15 million people off their healthcare.”

Over the years, countless conservative commentators have played upon the famous line in the movie “Love Story,” arguing that “being a liberal means never having to say you’re sorry.” More accurately, they would note that being a liberal/leftist/statist means never having to say you were wrong or admit that your utopian dreams were, in reality, nightmares. This is a feature, not a bug, of leftism. Just as today’s young leftists insist that communism can work, despite its many high-profile and bloody failures, because “real communism has never been tried,” so the Democrats insist that Obamacare can work if it’s tweaked and adjusted in just the right ways.

Although Jean-Jacques Rousseau shares the title “father of the modern left” with many of his Enlightenment contemporaries, he clearly did more than most to undermine and destroy the existing social and political orders and to discombobulate the West. As Nietzsche argued, Rousseau was “the greatest revolutionizing force of the modern era.”

Rousseau did not believe in the concept of Original Sin and insisted that the very idea was invented to keep man oppressed, silenced, and miserable under the thumb of society’s imperfect institutions. “Everything is good as it comes from the hands of the creator,” he wrote in the opening pages of Emile, but “everything degenerates in the hands of man.”

As a result, Rousseau and his followers saw society’s institutions as the foremost threat to man’s freedom and happiness. If man is good by nature, yet he behaves poorly under the direction and guidance of specific institutions, then the institutions, by definition, must be corrupt. They are clearly the cause of the aberrant behavior and must, therefore, be reformed—as thoroughly and as frequently as necessary to enable man to live as he should in a collective society. As the historian Paul Johnson noted in his Intellectuals, to Rousseau, society or “culture” was an “evolving, artificial construct….” But it nevertheless “dictated man’s behavior,” meaning that “you could improve, indeed totally transform, his behavior by changing the culture and the competitive forces, which produced it…” In short, according to Rousseau, one can change the world by successfully changing its institutions—over and over and over again, until you get it right, without ever having to say you’re sorry for getting it wrong.

Normal people, of course, think that the institutions created by Obamacare are destructive, costly, and ultimately ineffective. And we know they believe this because so many of them said so before the system was ever put in place. The Democrats disagree, and they will not be dissuaded from their course by any appeals to theory or experience. They want to keep the institutions and keep reforming them until they inevitably find the right formula.

They’ll get it right next time. Trust them. Oh, and in the meantime, pony up.

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