Health Care changes

The Patient Protection and Affordable Care Act consists of a combination of measures to control healthcare costs, and an expansion of coverage through public and private insurance: broader Medicaid eligibility and Medicare coverage, and subsidized, regulated private insurance. An individual mandate coupled with subsidies for private insurance as a means for universal healthcare was considered the best way to win the support of the Senate because it had been included in prior bipartisan reform proposals. The concept goes back to at least 1989, when the conservative Heritage Foundation proposed an individual mandate as an alternative to single-payer health care. It was championed by many Republican politicians as a market-based approach to healthcare reform on the basis of individual responsibility and avoidance of free rider problems.

Marie Antoinette, informed that the peasantry could no longer afford bread, is alleged to have responded, “Let them eat cake.” There is no evidence these words ever passed her lips, but certainly no one ever accused her of saying, “If you like your cake, you can keep your cake,” and then having to walk it back with “What we’re also discovering is that cake is complicated to buy.” That contribution to the annals of monarchical unworldliness had to await the reign of Queen Barry Antoinette, whose powdered wig seems to have slipped over his eyes.

Still, as historian Michael Beschloss pronounced the day after his election, he’s “probably the smartest guy ever to become president.” Naturally, Obama shares this assessment. As he assured us five years ago, “I know more about policies on any particular issue than my policy directors.” Well, apart from his signature health-care policy. That’s a mystery to him. “I was not informed directly that the website would not be working,” he told us. The buck stops with something called “the executive branch,” which is apparently nothing to do with him.

The president promised to “fundamentally transform” America. Certainly, other men have succeeded in transforming settled, free societies: Pierre Trudeau did in Canada four decades ago, and so, in post-war Britain, did the less charismatic Clement Attlee. And, if you subscribe to their particular philosophy, their transformations were effected very efficiently. But Obama is an incompetent, so “fundamentally transformed” is a euphemism for “wrecked beyond repair.” As a socialist, he makes a good socialite.

But on he staggers, with a wave of his scepter, delaying this, staying that, exempting the other, according to his regal whim and internal polling. The omniscient beneficent Sovereign will now graciously “allow” us “folks” to keep all those junk plans from bad-apple insurers. Yet even the wisest King cannot reign forever, and what will happen decades down the road were someone less benign — perhaps even (shudder) a Republican — to ascend the throne and wield these mighty powers?

Hey, relax: If you like your constitution, you can keep your constitution. Period. And your existing amendments. Well, most of them — except for the junk ones . . .

“I wonder if he has the legal authority to do this,” mused former Vermont governor Howard Dean. But he’s obviously some kind of right-wing wacko. Later that day, anxious to help him out, Congress offered to “pass” a “law” allowing people to keep their health plans. The same president who had unilaterally commanded that people be allowed to keep their health plans indignantly threatened to veto any such law to that effect: It only counts if he does it — geddit? As his court eunuchs at the Associated Press obligingly put it: “Obama Will Allow Old Plans.” It’s Barry’s world; we just live in it.