The always thoughtful Michael Lind, author of the highly recommended Land of Promise: An Economic History of the United States, writes in Salon about how GOP Obamacare hypocrisy will backfire because the right wants to enact similar policies to replace Medicare and Social Security. Paul Ryan’s plans for Medicare look just like the exchanges in Obamacare.
Conservatives want all social insurance to look like Obamacare. The radical right would like to replace Social Security with an Obamacare-like system, in which mandates or incentives pressure Americans to steer money into tax-favored savings accounts like 401(k)s and to purchase annuities at retirement, with means-tested subsidies to help the poor make their private purchases. And most conservative and libertarian plans for healthcare for the elderly involve replacing Medicare with a totally new system designed along the lines of Obamacare, with similar mandates or incentives to compel the elderly to buy private health insurance from for-profit corporations.
If you don’t like Obamacare, you should really, really hate the proposed conservative alternatives to Social Security and Medicare.
Lind goes through Polislice favorite Mike Konczal’s exegesis of how the ACA rollout is a bigger problem for conservatives than liberals because the problems are because of the complexity forced on the system by its market based nature and means testing. Also, the failure of GOP governors to allow their states to participate contrasts nicely with those states that are participating and having no problems and falling premiums.
However, the smarter conservatives who are thinking several moves ahead (e.g. Ross Douthat) understand that this failed rollout is a significant problem for conservatives. Because if all the problems are driven by means-testing, state-level decisions and privatization of social insurance, the fact that the coreconservative plan for social insurance is focused like a laser beam on means-testing, block-granting and privatization is a rather large problem. As Ezra Klein notes, “Paul Ryan’s health-care plan — and his Medicare plan — would also require the government to run online insurance marketplaces.” Additionally, the Medicaid expansion is working well where it is being implemented, and the ACA is perhaps even bending the cost curve of Medicare, the two paths forward that conservatives don’t want to take.
But then Lind uses political jiu jitsu to show that liberal defense of the ACA could be used by conservatives to justify their plans to ACA everything. Mind blown, man! Mind blown!
I predict that it is only a matter of time before conservatives and Wall Street-backed “New Democrats” begin to argue that, with Obamacare in place, it makes no sense to have two separate healthcare systems for the middle class — Obamacare for working-age Americans, Medicare for retired Americans. They will suggest, in a great bipartisan chorus: Let’s get rid of Medicare, in favor of Lifelong Obamacare! Let’s require the elderly to keep purchasing private insurance until they die!
Once Medicare has been abolished in favor of Lifelong Obamacare, perhaps by a future neoliberal Democratic president like Clinton and Obama, Social Security won’t last very long.
I appreciate the forward thinking alarmism, I do. I just think that there’s really nobody on the left defending the ACA from the standpoint of this was the best idea and a great step forward. We’re all “holding our noses” and pulling for it because it was the best we could do and way overdue. I can’t find anybody anymore who doesn’t think that a single payer program wasn’t a better idea and the eventual goal.