Among those that still support the Affordable Care Act, a.k.a. Obamacare, the talking point has become, “What if it all just works out?”
And thus we arrive at the pass at which the entire rationale for annexing one-sixth of the U.S. economy is reduced to wishful thinking.
There is not a shred of real-world evidence to support the thesis that Obamacare is going to work out. Every single national poll points to the inescapable conclusion that the American people have figured this grim fact out. The measure was not popular to begin with, having never enjoyed majority support. But now that abstract political argument is turning into real-world consequence, what support Obamacare had is rapidly eroding.
Even reliable Obama constituencies such as labor unions have turned against the Affordable Care Act. Labor bosses such as the Teamsters’ Jim Hoffa and the AFL-CIO’s Richard Trumka, both of whom poured money and support into the Obama machine, have figured out that Obamacare is going to cost their members more money while reducing the quality of their benefits. The union bosses are now busy demanding that President Obama carve them out some specific relief.
The impact on small business is particularly acute. For the first time in our history, small businesses are hoping to become smaller rather than larger – something hitherto antithetical to the American ethic.
This is happening because growing a business to the point that it needs 50 or more fulltime employees can be the kiss of death. Examples of small businesses seeking to shrink rather than grow include restaurant franchisees and service providers such as car washes and dry cleaners. At no time did the financial models of enterprises such as these support providing their employees with health insurance. The delayed-but-not-gone Obamacare “employer mandate” will impose costs on these employers that cannot be passed on to customers, rendering the businesses unable to remain financially viable. Philosophical arguments about the “right” to quality health care are one thing. But math is math. These businesses have reacted by either shrinking their fulltime payrolls or by carefully avoiding the hiring of the 50th fulltime employee.
It is no mere coincidence, then, that since the first of the year, more than three quarters of all jobs created in the United States have been part-time jobs – an unprecedented statistic.
Small business owners that have historically provided health insurance find themselves in a terrible squeeze. This observation is acutely personal because I am a small business owner and I do provide my employees with health insurance.
I am now in the position of being forced to pay more in premiums to meet the Obamacare-mandated “minimum value standards.” The meeting of those standards comes at the price of sharply increased premiums. In the interest of my employees I will swallow as much of that increase as I can, resulting in less profit available for expansion and capital investment. What I cannot absorb I will pass along to my employees, resulting in a de facto pay cut.
(I can’t wait for that employee meeting in the conference room. Perhaps I’ll buy everyone lunch.)
And then there are the doctors. Obamacare is accelerating their retirement. The American Academy of Family Physicians reports that more than a third of family doctors say they plan to quit practice in the next five years. Family doctors constitute the keystone of medical services delivery and their absence will be keenly felt. Medical schools are saying flat out that they will not be producing graduates in anywhere near the numbers adequate to take up the slack.
Many – some say most – of these looming retirements are the result of Obamacare. The paperwork burden, the compliance costs, the chance of violating Obamacare regulations that could produce severe fines and penalties and the coming decreases in Medicare and Medicaid reimbursements are conspiring to convince doctors that now is a good time to wind down their practices.
The right to “affordable health care” isn’t worth much if there is no doctor to provide the care.
“If you like your doctor you can keep your doctor,” may well go down as one of the biggest con jobs ever perpetrated by a U.S. president.
Finally, there’s history. What massive federal program has ever just “worked out?” Social Security and Medicare – massive in scale yet small when compared to a cabinet department takeover of one sixth of the U.S. economy – are right now so dysfunctional and so broke as to threaten the very solvency of the nation.
There is nothing to suggest that Obamacare is going to work out. There is everything to suggest that it is going to continue to cause economic dislocation and unintended consequences on a massive scale.
Wishful thinking will not redeem one of the worst pieces of legislation in U.S. history.