One of the things that mainstream media tends to overlook in the current debate over the roll-out of the Affordable Care Act (aka “Obamacare”) is that it employs the very market solutions that business-centric Republicans love to tout as the panacea for all that ails, but either don’t really seem to understand, or only apply topically when needed — like zinc ointment for a skin rash.
One reason the media keep missing it is because the White House Office of Communications (WHOC) repeatedly fails to point it out.
We need to remember that Obamacare is not socialized medicine, or anything remotely like it, no matter what those reality-challenged moonblind sub-normals in sloth cloth say on the buzzbox.
The foundation of Obamacare is state-based insurance exchanges. The idea is not to socialize medicine, but to socialize risk across a broader population base and thereby to reduce costs for everybody. In fact, that’s all insurance companies of any stripe do — socialize risk by spreading loss across a large subscriber base. The ACA state-based insurance exchanges just make it more efficient.
Here’s where market principles apply: as health insurance companies compete for customers within a huge pool of potential customers, over time there will be winners and losers, as there are in any competitive marketplace. Those who survive and prosper will be those who figure out ways to: 1) Provide better services at lower cost; 2) Create more efficiencies in providing those services; 3) Find innovative ways to create those efficiencies; 4) Increase productivity while decreasing overhead.
What’s for a free market capitalist and Austrian School Tool not to like? Maybe the regulations?
Ah, regulations. Admittedly, insurance exchanges do require government to set some minimal standards for the products being offered. But that’s just to prevent customers from getting screwdiddified by spivs and scammers, who are as common as dandelions in the insurance racket. Best to think of exchange regulations as a kind of gated community for the rest of us: it’s designed to keep out the riff-raff. We want only the real Tiffany in our community. And then there are some minimum quality requirements for the four tiers of product being offered. Best to think of those as “community standards” for our gated conclave. No pink flamingoes on the front lawn or urban chicken farms in the backyards. Nothing so distasteful and raw …
No, Obamacare is not socialized medicine and its power plant as an engine of change relies primarily on market principles to work, so again, what’s not to like?
This is where things get a little untamed for RW truthiness hucksters when formulating arguments against its implementation. So far, they’ve been scoring extra games at pocket pinball because it’s also an area that mass media has largely failed to explore. Or simply ignore. So they can flog any late-nite cable swag they like without hindrance from Fifth Estate bridge trolls. Hey, free stuff! And again, it’s mostly due to a WHOC failure to exploit the myriad opportunities that sparkle like water-white diamonds strewn along the path.
One very important thing that Obamacare does is to provide individuals with a raft of new freedoms. They have the freedom to choose between different levels of care based on their income, budget and personal needs. They have the freedom to choose between different offerings by different providers. They even have the freedom to choose not to participate (although that freedom becomes increasingly expensive over time).
But — and here’s the rub — they also have the freedom to leave an employer without having to worry about losing access to affordable health care and taking on an unacceptable risk of economic catastrophe for their families.
To be fair, the New Yorker magazine (bless them) weighed in on this recently:
‘Meanwhile, the likely benefits of Obamacare for small businesses are enormous. To begin with, it’ll make it easier for people to start their own companies—which has always been a risky proposition in the U.S., because you couldn’t be sure of finding affordable health insurance. As John Arensmeyer, who heads the advocacy group Small Business Majority, and is himself a former small-business owner, told me, “In the U.S., we pride ourselves on our entrepreneurial spirit, but we’ve had this bizarre disincentive in the system that’s kept people from starting new businesses.” Purely for the sake of health insurance, people stay in jobs they aren’t suited to—a phenomenon that economists call “job lock.” “With the new law, job lock goes away,” Arensmeyer said. “Anyone who wants to start a business can do so independent of the health-care costs.” Studies show that people who are freed from job lock (for instance, when they start qualifying for Medicare) are more likely to undertake something entrepreneurial, and one recent study projects that Obamacare could enable 1.5 million people to become self-employed.’
The Business End of Obamacare
by James Surowiecki
In a country that cherishes its personal freedoms and myths of upward mobility, it’s damn hard to argue in favor of restricting those freedoms so poor people can stay poor. Unless, of course, the loyal opposition fails to make any kind of counter-argument in reply; then it’s an easy argument to make. It’s even harder to argue for restricting other peoples’ personal freedoms when the ultimate purpose is to strip them of significant income every year through bandit profiteering. That is, unless all you hear in reply is crickets — then it’s a real easy argument to make. And it’s even still that much harder beyond all previous hardness to argue that Obamacare restricts our personal freedoms by imposing fines on non-participants when the atlernative is even more restrictions on personal freedoms. That is, of course, unless no one points out that all non-participants’ personal freedoms remain unrestricted. However, just like meth-frenzied gearheads who blow through red lights screaming profanities and flipping birds with both hands, we impose sanctions. It’s the behavior that is sanctioned — not the choice. It’s the potential for resultant injury to the rest of us that we want to prevent. But no one in the WHOC seems too inclined to want to make that argument.
Starting in 2014, millions of Americans will have much more freedom to seek better jobs at higher pay with better benefits. They’ll have the freedom to start their own businesses, perhaps even to compete with a former employer to provide better service and higher quality at lower cost. They’ll have the freedom to work as a contract employee at fewer hours for higher wages; the freedom to work a part time job while getting a degree or pursuing a career dream; the freedom to become an independent website developer or personal care aide or a masseuse. They’ll have the freedom to retire from a factory job a few years early and make a little money doing seasonal work, or as a hired hand, while spending the rest of the time making handcrafted furniture in a backyard woodworking shop, or growing cutting flowers in a backyard hothouse.
They’ll have the economic freedom to take on entrepreneurial risk. They’ll have the freedom to try, to fail, and to try again. They’ll have the freedom to dream and to turn their dreams into reality.
That, in turn, will put upward pressure on wages and benefits, which means that those of us who work for a living will get a bigger piece of the pie. While those of us who make money from money will get less.
Personally, I can see a day when the whole trend toward franchised mass-marketing of everything from haircuts to paperclips at big box retailers will start to be reversed. You’ll get your hair cut by Gina, in the little nook she leases at that renovated strip mall, because you like Gina and she knows how to make your hair look nice and you want her and her family to prosper. You’ll buy your paper clips and printer paper at the stationery store next door to Gina where Bill, your former high-school AmLit teacher, sells magazines and home office supplies and printer cartridges to keep him in beans and bacon while he edits a monthly small press journal of poetry. You know Gina and you know Bill and you like spending your money with them. That’s one element that makes a community. What you spend, and where you spend it, and who you spend it with, will again become in part about the relationships you have with your neighbors.
The RW pundits at least have that part right. Obamacare is about to transform the American economy as we know it, but not in the form of some monstrous government takeover. It will come in the form of free market principles intelligently applied for the benefit of the many, as opposed to the few. Obamacare will liberate millions who are currently tied to jobs they hate, tied to circumstances they detest, tied to health insurance premium extortion they can’t afford but feel they can’t avoid through “job lock.” Those captains of industry who spend their days with an unblinking, inhuman eye on the economic Tarot know it … and they don’t like it.
That’s what’s really driving all the Sturm und Drang from the right. For too long, they’ve had it all their own way, all the profits now flow to the top — very little flows horizontally anymore — and the cost of health insurance and the unacceptable risk of economic catastrophe for a family was one short leg of a tilted table that kept the wheel of fortune rigged in their favor.
Now that game is gone bust.
Soon begins a new stage in the economic history of our country, what macro-economists call an efflorescence, or “flowering”. Soon begins a more community- and relationship-based, localized exchange of goods and services with social media as a primary tool for personalized, highly targeted marketing communications. Together, these changes should have the same degree of impact on the growth of small businesses as globalization has had on manufacturing and the internet has had on mass retailing.
But first we need to do a little housekeeping to clear out the Couch Surfers who are freeloading on the rest of us. They need to find something useful to do.