Althouse: "Even if the Patient Protection and Affordable Care Act fails spectacularly, single payer is not going to happen in America anytime soon."

October 25, 2013

"Even if the Patient Protection and Affordable Care Act fails spectacularly, single payer is not going to happen in America anytime soon."

"Here’s why: Most Americans have insurance, and most Americans like that insurance. That’s why the administration designed such a complicated, kludgy system; they had to at least be able to claim that all the people who had insurance they liked would be able to keep it.... People are loss-averse; they worry more about losing what they have than they do about some unproven potential gain. If Obamacare’s insurance reforms break the market, that calculus still won’t change: Most people will still have insurance they like, and they will not be willing to give it up in order to solve problems in the individual market.... Even if the individual market functionally disappears, most people will still be covered.... Ironically, single payer seems much more plausible if the system succeeds...."

Megan McArdle rejects the conspiracy theory that Obamacare was meant to fail to get us to single payer.

93 comments:

Henry said...: Well, Megan McArdle has never shown much propensity for brightness, so I doubt one should weigh her comments very highly. The Obamanites are from the Chicago School of Politics, which means BOHICA to those they consider the opposition. McArdle fails to appreciate this reliable fact.; 10/25/13, 4:37 PM
Anonymous said...: It's not so much that you have insurance now, it's does that insurance meet the obligations of ACA. If not apparently it's say "bye" to your insurance... which seems to be what thousands of people are starting to experience now.; 10/25/13, 4:40 PM
I'm Full of Soup said...: On average, I find McArdle kinda pollyanish in her assessments but always expresses them with great confidence.

However, I get the impression she does not have too much real world experience [too much time spent in the Imperial City and NYC I assume] and is also a librul at heart.; 10/25/13, 4:43 PM
Almost Ali said...: Present company excluded, Megan McArdle is the smartest woman in the room. And a good reason to uphold the 19th Amendment.

Nevertheless, Obamacare is designed to break America's financial back, and it will.

(Hint: hard assets); 10/25/13, 4:45 PM
Smilin' Jack said...: People are loss-averse; they worry more about losing what they have than they do about some unproven potential gain.

I think the existence of Las Vegas refutes that statement.; 10/25/13, 4:45 PM
I'm Full of Soup said...: One solution to part of this mess is to grandfather in everyone's existing policy so no one gets cancelled. That is what Senator Johnson is proposing but Obama and libruls want to control everyone's healthcare so this could be an epic battle.; 10/25/13, 4:50 PM
I'm Full of Soup said...: I didn't suggest McArdle was not smart.; 10/25/13, 4:54 PM
Wince said...: Isn't McArdle's thesis predicated on private insurers being allow to walk away from the Obamacare exchanges if they enter the so-called death spiral?; 10/25/13, 4:59 PM
Larry J said...: In a rational country, government screw-ups would not be a reason for even more government intervention. But then, we don't live in a rational country. Liberalism - Our ideas are so good, we make them compulsory.; 10/25/13, 5:01 PM
chuck said...: On average, I find McArdle kinda pollyanish in her assessments but always expresses them with great confidence.

I believe she began as a very liberal young woman and has evolved to merely liberal. But she is still young, she has plenty of time to evolve further.; 10/25/13, 5:14 PM
SteveR said...: I don't think it was well designed to fail in order to bring on a single payer system, but that was the goal of the folks who put it together. I'm unable to come to a different conclusion, even with the not "anytime soon" escape hatch.; 10/25/13, 5:19 PM
dbp said...: McArdle is certainly right that it isn't a conspiracy. Obama and his gang are stupid enough to believe their plan would work,

"Never ascribe to malice that which is adequately explained by incompetence."

However, if the plan destroys the insurance industry, you can certainly bet that the left will pivot to single payer--it is what they have really wanted, but couldn't get, for ages.; 10/25/13, 5:21 PM
cubanbob said...: Megan McArdle has a problem connecting the dots. Most American's won't have the policy they want simply because of the ACA mandates. Employers will do the calculus and will decide whether or not its cheaper to pay the penalties or provide the plans.
The big jolt for employers, especially the large ones won't happen initially but they can see the trend line where the cost of providing the plans becomes unaffordable and its simply cheaper to dump the plans. Then where do those people go for their coverage? The subsidized system won't be able to absorb them.

Single payer is a bogeyman of the right and a wet dream for the left and on that she is right for various reasons it simply isn't going to pass in the US. 36 states decided to not participate in the exchanges that alone tells one those states aren't going to compel doctors in to some form of single payer scheme even if presuming the states actually have the power to do so.

In the meantime in WI a recent study done by MacIver Institute shows that premiums will be doubling for 27 year old individuals that aren't qualified for subsidies. Isn't Obamacare wonderful?; 10/25/13, 5:29 PM
rhhardin said...: The right concern is who gets control of the narrative.

I say it continues with soap opera women.

They're the only ones who watch the MSM news, and that controls the narrative.; 10/25/13, 5:31 PM
eddie willers said...: The Obamanites are from the Chicago School of Politics

If only they were from the Chicago School of Economics.

Did you notice the economy went into the crapper the minute Milton Friedman died?; 10/25/13, 5:47 PM
Lem Vibe Bandit said...: If ObamaCare was not designed to fail from the get go, that could mean (imho) the incompetence with which the "signature achievement" has been handled is greater than anybody has been willing to admit.

The conspiracy, should it proved true, would be a convenient out. "We are NOT that incompetent, it was on purpose all along.

It not like Obama would suffer politically for it either. He could just say the republicans made him do it or whatever.

The Best and the Brightest.; 10/25/13, 5:49 PM
Big Mike said...: When Megan McArdle is analyzing hard numbers she goes where the mathematics takes her and writes honestly about what the numbers mean.

The trouble is that in this specific case she's applying logic in an inherently illogical situation. There never was any logic behind the ACA in the first place, so trying to find some now is an empty exercise.; 10/25/13, 5:57 PM
Lem Vibe Bandit said...: "... single payer is not going to happen in America anytime soon."

With "anytime soon", any prediction is bound to come true.

'What a bunch of malarkey'; 10/25/13, 6:14 PM
Anonymous said...: "Ironically, single payer seems much more plausible if the system succeeds...."

Nothing ironic about that, if the system succeeds, the single payer advocates will tout that as the best way to go, Americans will believe them. Frankly, if it succeeded, I'd believe them too until they decided I wasn't worth a govt's medical expense to get that newest life saving treatment.; 10/25/13, 6:19 PM
Tom said...: I don't think Obama wanted single-payer. That would mean he cared about how it turned out. He wanted a health-care law that put health-care under control of the federal government. He left it up a Democrat controlled Congress to get that done. When Scott Walker was elected to take the seat vacated by Ted Kennedy, the Congress passed the House version and we got what we got. My guess is everyone in DC knows this bill sucked. Because of how it was passed, Republican's will not lift a finger to improve it or make it tolerable (and I don't blame them -- further, I don't blame them for not "compromising" -- there was no compromise that squared with the GOP principles, anyway, Democrats had the votes).

But Obama got the bill he wanted because all he wanted was a health-care bill.

Now, what he probably regrets is that it was really effing hard to implement. My guess is there isn't a "single-payer" conspiracy. But I'm sure there is a plan that if the Obamacare fails, it fails in the direction on single-payer.; 10/25/13, 6:34 PM
Anonymous said...: Of course I am an enthusiastic supporter of fully socialized medicine, so long as it's coupled with outcome-based rationing.

Peter; 10/25/13, 6:37 PM
Clyde said...: "Most Americans have insurance..." Well, they do unless their insurance company sends them a notice telling them that their policy doesn't meet the minimum requirements of ObamaCare, which requires that everything be covered whether you want it or not, and that it is being cancelled. That's happening now to hundreds of thousands of people. And if the ObamaCare rollout tanks and only sick people sign up for it, then it will cause the insurance companies to turn around and raise everyone else's rates, legality be damned, or else they'll have to go out of business. If they go out of business, then all of us who have health insurance policies through them will be S.O.L. and we, too, would be forced into the exchanges. If their plan is to wreck the health insurance industry and implement single payer, I can't see a better plan.; 10/25/13, 6:41 PM
Mitch H. said...: As libertarian as McArdle is in principle, in temperament she's one of the best and brightest, one of the "smartest in the room" crowd. She has, and always will, suffer from knowing too much. She's got "policy derangement" - the persistent delusion that she can *understand*, and thus guide her lessers by that understanding. She suffers from an inability to experience her own radical, Hayekian ignorance on a visceral level. So take her pronouncements with a five-pound bag of salt - she will always present herself as knowing more than she can know.; 10/25/13, 6:55 PM
Anonymous said...: Megan McArdle is probably right, there was no conspiracy to have Obamacare fail in order to bring us Single Payer.

So what? In everything else, she is naive.

Do you really think the Democrats will sell Single Payer by saying, "We're going to take away your current insurance policy!"??

Of course not.

Obama lied, er, um, sorry, he misrepresented the law by continually promising, "If you like your current healthcare, your current doctor, nothing is going to change for you!"

Now we find out, now that it's too late, around 16 million people will be losing their insurance and their doctors.

I imagine Megan McArdle before Obamacare came out.....

"Obamacare will never pass because 16 million people will lose what they currently have, insurance, insurance that they like."

She may be a smart economist, but she's a dumb politician.; 10/25/13, 7:01 PM
Anonymous said...: Megan McArdle is probably right, there was no conspiracy to have Obamacare fail in order to bring us Single Payer.

So what? In everything else, she is naive.

Do you really think the Democrats will sell Single Payer by saying, "We're going to take away your current insurance policy!"??

Of course not.

Obama lied, er, um, sorry, he misrepresented the law by continually promising, "If you like your current healthcare, your current doctor, nothing is going to change for you!"

Now we find out, now that it's too late, around 16 million people will be losing their insurance and their doctors.

I imagine Megan McArdle before Obamacare came out.....

"Obamacare will never pass because 16 million people will lose what they currently have, insurance, insurance that they like."

She may be a smart economist, but she's a dumb politician.; 10/25/13, 7:02 PM
Bob R said...: 1) I'm a pretty big fan of Mcardle. She is one of the most self aware urban liberal elitists I know. (Yes, this is a very low bar, but she's cleared it.)

2) If the conspiracy theorists are right - the people who designed Obamacare designed the conspiracy. Yes, I can think of one or two dumber things to try...Sorry, no I can't..

1) Destroy private insurance market
2) ???
3) They let us implement single payer!!!

The underpants gnomes would be ashamed to be associated with them.; 10/25/13, 7:05 PM
n.n said...: Obamacare permanently increases and normalizes dissociation of risk through redistributive change unbacked by productivity and will thereby preserve the status quo and sponsor corruption.

A single-payer alternative will be a monopoly or monopoly-like system, which through reducing competing interests will invite corruption and abuse. The consequence of a monopoly will be exacerbated when backed by an authority or an ability to coerce compliance or participation.; 10/25/13, 7:08 PM
Bob R said...: BTW, if the dems are allowed to implement single payer, put a lock on your underpants drawer, cause I have a new plan.; 10/25/13, 7:09 PM
Anonymous said...: Megan is 40, a reformed Liberal who considers herself a Libertarian who endorsed Bush in 2004.

I'm a really smart guy :) and Megan is smarter :); 10/25/13, 7:46 PM
Guildofcannonballs said...: "1) Destroy private insurance market
2) ???
3) They let us implement single payer!!!"

No I'm sorry you've missed the point completely.

1. Destroy.

2. Blame.

3. Pillage and Rape.

You don't need examples you've always known.

Just as Agnes Moorhead had her lil Orsons bags packed, she "had them packed for weeks now" the will know whom to blame, how, with flare.; 10/25/13, 8:09 PM
Hagar said...: This is interesting.
Since I first read McArdle I have considered her the very model of a proper conservative.; 10/25/13, 8:10 PM
Guildofcannonballs said...: Sometimes movies and songs and paintings and leaflets and leaves themselves ask, in not so many words, "if you had to all over, would you do it the same" and I always think 'yeah with more apostrophes.'; 10/25/13, 8:13 PM
Guildofcannonballs said...: "Legendary was the Xanadu where Kubla Kahn decreed his stately pleasure dome."

It would be easy, notable, and not-altogether-obtuse to note the reason I respect the writing of McArdle; other than the writing, which I respect enough to read and appreciate if not always understand, do to my limitations.

I found myself feeling homophobic when wondering "did J. M. Keynes wear make-up?" and have chosen not to engage in this conversation any further, for the moment.; 10/25/13, 8:25 PM
Guildofcannonballs said...: Dick Cheney was known as a pretty smart guy from WY for a long time before the year 2000 and the election that, won without question by Bush when considered by serious folks, but questioned by hate-leaders' hate-stoking hate better than this country has seen in some time.

Mitt wasn't so extreme, being from Boston right?

Bork.

Bork or be Borked.

Just don't get so used to Borking and getting Borked you forget the heartland Borkers, by God.; 10/25/13, 8:32 PM
somefeller said...: Megan McArdle rejects the conspiracy theory that Obamacare was meant to fail to get us to single payer.

How cruel of her. If one rejects conspiracy theory, contemporary conservatives have no remaining political theory. Irritable mental gestures, on the other hand, remain in ample supply.; 10/25/13, 8:35 PM
Michael K said...: I do not think Obamacare can be fixed. The problems are too great. For anyone who thinks this bunch can hatch a grand conspiracy, I suggest you look at Obama off TelePrompTer or Hagel's confirmation hearings. These are not bright bulbs.

My own theory is that the whole house of cards will collapse and we will have an opportunity, totally unexpected, to get a market based health care system. Getting there will be ugly but, after all, the voters elected this guy twice.

HL Mencken said, "democracy is a system where people deserve to get what they want and to get it good and hard."

Anyone who is interested could look here.

Anybody seen garage lately ? Maybe he's in DC helping fix the Big One.; 10/25/13, 8:37 PM
Unknown said...: As long as the House remains in Republican control, single payer will remain a pipe dream.; 10/25/13, 8:40 PM
Guildofcannonballs said...: I accused someone recently of probably being a pederast rapist.

I wrote very imprecise, or imprecisely it that's more better, as my comments could have been interpreted as giving this person credit for raping a known pederast. This is what I interpreted Todd Akin to mean.

That isn't what I meant at all.

I meant to say the person was a rapist probably.

And Pederast probably.

Probably.

Just like they feel one, the Black one, SCOTUS is.

These racists disgust me and should disgust (or worse) good, decent folks everywhere.

On-line lynchings work against the one Black SCOTUS, but not our healthcare website.; 10/25/13, 8:42 PM
Anonymous said...: These Docs are just waiting for the day the House is back in Democratic hands. 2014; 10/25/13, 8:44 PM
somefeller said...: Don't tell them about the super-secret conspiracy plan, Inga! They are easily frightened and now they may not be able to fall asleep tonight.; 10/25/13, 8:54 PM
Gahrie said...: As long as the House remains in Republican control, single payer will remain a pipe dream.

Which is why the only thing the White House is thinking about is how to win the House next year......; 10/25/13, 9:00 PM
Guildofcannonballs said...: The great Sarah Palin, when the high-tech systems meant to prompt her what to say, because she was speaking in front of thousands personally and millions nationally, failed, rose above.

Beautiful and unforgettable.

As long as Barack and family are around, I pray so are the Palins.; 10/25/13, 9:09 PM
Lem Vibe Bandit said...: That's a communist model Inga.; 10/25/13, 9:20 PM
Left Bank of the Charles said...: If Obamacare fails spectacularly, the Democrats will be finished on health care, and quite possibly finished as a political party.; 10/25/13, 9:39 PM
test said...: "somefeller said...
If one rejects conspiracy theory, contemporary conservatives have no remaining political theory."

I see the DU commenters are making their way to Althouse.; 10/25/13, 9:43 PM
30yearProf said...: Obamacare is already killing off many Employer-provided health insurance programs.

By 2018, there will be no employer provided plans, no pay raises in lieu of coverage, and insufficient doctors. The only option left will be to import the United Kingdom's failed model -- the NHS -- and ration care in favor of the young.

As a "grey hair," let me assure you that isn't going to happen without a massive inter-generational fight.; 10/25/13, 9:45 PM
mtrobertsattorney said...: Keep your eye on how many people are signing up for Medicaid instead of going to the Obama exchanges to buy insurance.

Medicaid, for all practical purposes, is free.

Obama Care, the law, transfered a whole bunch of money from Medicare and moved it to Medicaid.

It is the senior citizens on Medicare who will be among the first to get screwed under Obama Care.; 10/25/13, 9:47 PM
30yearProf said...: Obamacare is already killing off many Employer-provided health insurance programs.

By 2018, there will be no employer provided plans, no pay raises in lieu of coverage, and insufficient doctors. The only option left will be to import the United Kingdom's failed model -- the NHS -- and ration care in favor of the young.

As a "grey hair," let me assure you that isn't going to happen without a massive inter-generational fight.; 10/25/13, 9:47 PM
test said...: Hagar said...
This is interesting.
Since I first read McArdle I have considered her the very model of a proper conservative.

McArdle's only "conservative" characteristics are an understanding of economics and an unwillingness to pretend her preferred policies don't come with costs.

How revealing that these are so foreign to the left they qualify as conservative.; 10/25/13, 9:48 PM
Guildofcannonballs said...: Whom better to teach others how to rise above, if that be a goal (defined here as winning American-Style such as American-Winners have Won, with exceptions mostly non-American for the most part by-my-eye herewith) than the greatest riser yet Christ Excepted: SARAH PALIN.; 10/25/13, 9:53 PM
Guildofcannonballs said...: Just as BHO is the most powerful man in history given his status as POTUS, so is Sarah Palin the most Godly force other than mostly religious-forces amongst us.

In terms of religion Sarah or me or you aren't that powerful.

In terms of God.; 10/25/13, 10:00 PM
Lem Vibe Bandit said...: "Michelle Obama’s Princeton classmate is executive at company that built Obamacare website"

I Can See Chicago From My Window; 10/25/13, 10:02 PM
Revenant said...: I'm sorry, but the idea that Obamacare was designed to fail is idiotic.

The conspiracy theory depends not only on the notion that Congress had the votes for single payer but opted for some Rube Goldberg system of achieving it, not only on the notion that dozens or hundreds of Democrats were willing to put their re-elections in dire jeopardy, not only on the Democratic Party itself putting its very existence at risk if the conspiracy was ever uncovered -- but on the notion that hundreds of Democratic politicians and thousands of their staff managed to keep a secret. Back in reality we can't even keep top secret information out of the hands of mentally troubled crossdressing Marines.

Obama and the Democrats are just incompetent, you effin' retards. There is no evil conspiracy at work here.; 10/25/13, 10:05 PM
Henry said...: Nuts. Another Henry. There goes the neighborhood. Pay attention to the avatar.

What McArdle understands that the conspiracy theorists do not is that Washington is run by mandarins these days. The ACA was put together by legal mandarins and is intended to be implemented by policy mandarins. Technology, they took for granted. I didn't say these are smart mandarins.

Any conspiracy that requires hosts of complicit conspirators fails of its own permutations.

One could imagine a meta-conspiracy, a kind of reverse Marc Antony performance in which Obama raises up ACA for praise, hoping someone else will bury it.

But I don't believe that. Everything we know of how this White House works tell us that they really believe in mandarins. Every problem is solved by giving more power to mandarins. This is their idea of democracy. They are mandarins too.; 10/25/13, 10:10 PM
Lem Vibe Bandit said...: My top tweet thus far... down hill from here.

Lem ‏@Lemang01 52s
#Obamacare I can see Chicago from my @WhiteHouse. link; 10/25/13, 10:13 PM
Guildofcannonballs said...: I chose to use "that" as a verb.

Not with being in my nature as determined by my history, I chose to use "that" as opposed to "that that" deceiving none other than me.; 10/25/13, 10:36 PM
Seeing Red said...: Obama specifically stated he wants single payer even if it took 20 years.

Reid just said the same thing.

That is the goal.

Why won't people believe them?

McArdle spent 4 years in Hyde Park and she still voted for Obama. I read her, but after spending 4 years in Chicago she still wasn't capable of connecting the dots.; 10/25/13, 10:40 PM
Henry said...: Here's another way to put my point.

Macaulay, writing about 17th-century English royalists:

"The truth is that the theory of government which had long been taught by the clergy was so absurd that it could lead to nothing but absurdity."

Simple substitute in the word "academics" for "the clergy" and you have our current leftists.; 10/25/13, 10:47 PM
rcocean said...: This hasn't to be one of the dullest Althouse comment threads ever.

A serious discussion on Obamacare.

Damn that's boring.; 10/25/13, 10:52 PM
rcocean said...: Remember the Valarie Phlame affair? Or Scooter Libby?

Remember how people were really worked about it? And commented on it, endlessly?

Neither do I really, cause it was really, really, boring.; 10/25/13, 10:54 PM
rcocean said...: This reminds me of that.; 10/25/13, 10:54 PM
rcocean said...: Whenever I think boring Althouse comment sections, I think Valarie Phlame affair and Obamacare.

Well, and Simon. But he's long gone.; 10/25/13, 10:57 PM
Michael K said...: " Inga said...
These Docs are just waiting for the day the House is back in Democratic hands. 2014
"

Inga, these guys are waiting too. I just am not sure what they are waiting for.

"Try these recipes for vegan Halloween snacks, desserts, and candies that are spooky and delicious."

for example. There are goofy groups with web sites everywhere.

Do you have one ?; 10/25/13, 10:58 PM
Henry said...: @Seeing Red -- There are two ways to look at how Obama looks at this. One is evolutionary. Obama & Reid & Pelosi & their minions expect the ACA to be a success, leading to the political opportunity for much bigger successes. By this means they attain their stated goal.

The other approach is to believe that Obama & Reid & Pelosi & their minions set up ACA to fail, leading to the political opportunity for ... uh ... much bigger successes.

For the first approach, you have to believe that Obama & Reid & Pelosi & their minions are economic and technological naifs.

For the second, you have to believe they are secret Machiavellis hiding behind a pretense of being naifs. Furthermore you have to believe that these secret Machiavellis -- an identify for which there is no evidence -- are also political morons -- which is the one thing they don't seem to be. Your theory is that they have launched a Titanic hoping it will sink so they can build an even bigger boat.; 10/25/13, 11:09 PM
Guildofcannonballs said...: At some time and place, neither here nor soon, A. B. and A. A. will work out how good intentions do overcome silly differences in customs.

When Ann Althouse and Ann Barnhardt combine to query very, very elemental word issues then Jeff Goldstein will perhaps be relevant.

Also, as I've mentioned more than once, Sarah Palin will be the star she was, has been, and always will be.; 10/25/13, 11:11 PM
NotWhoIUsedtoBe said...: There's a problem with the reasoning. Most people didn't want Obamacare, but it happened.; 10/25/13, 11:33 PM
Guildofcannonballs said...: Those whom I thought wouldn't did.

Left here am I, ulta-right.; 10/25/13, 11:43 PM
Lem Vibe Bandit said...: Sebelius blames republican global warming for the website failure.

Fault her all you want, she will make an excellent spin doctor. I can see her as George Stephanopoulos sidekick.

Her spin talents are being completely wasted as HHS secretary.; 10/25/13, 11:49 PM
Lem Vibe Bandit said...: This comment has been removed by the author.; 10/25/13, 11:59 PM
Lem Vibe Bandit said...: As for the GOP, shutting down the government and ObamaCare on the same day?

Didn't they said the GOP was dead?
I wish they make up their minds.

Should I condemn the GOP for shutting down the ObamaCare website or praise them for finally accepting that Obama would not give in on defunding nor delaying ObamaCare?

The dear leader is sending me mixed messages.; 10/26/13, 12:01 AM
Lem Vibe Bandit said...: Idea for a movie...

GOP vs NSA
Whoever wins We loose; 10/26/13, 12:05 AM
Revenant said...: Obama specifically stated he wants single payer even if it took 20 years. Reid just said the same thing. That is the goal. Why won't people believe them?

I want to fuck Scarlett Johanssen.

It doesn't follow that (a) I have a prayer of making that happen or (b) my every action is part of an insidious plot to bring that about.; 10/26/13, 12:10 AM
Kirk Parker said...: NotquiteunBuckley,

I think you need to have the (analog) hardware folks look into you--it appears one of your analog inputs is inputting a lot of noise (broken ground lead, perhaps) and you're outputting quite a maze of babble.; 10/26/13, 12:47 AM
Kirk Parker said...: As far as the designed-to-fail bit goes:

NO, there was no overt conspiracy. But clearly the ACA was " ' designed ' " by folks with a variety of motives. (Not sure I have enough levels of scare-quotes around designed, but let that go for now, ok?) In particular there are three major strands:

1. The looney idealists, who thought that you really could "bend the cost curve" by fiat w/o affecting anything beneficial.

2. Rent-seekers like the big insurance companies who had visions of the government nudging, channeling, forcing new customers their way.

3. Those who thought single-payer was really the way to go; divided into (a) some who saw the ACA as a fallback/provisional/as-good-as-we-can-get-for-now system, and (b) those--smarter but more evil--who knew it was an unworkable Rube Goldberg device and were expecting to be able to ride in and rescue use with single-payer.

No, don't ask me to assign particular percentages here...; 10/26/13, 12:54 AM
Mitch H. said...: The conspiracy theory depends not only on the notion that Congress had the votes for single payer but opted for some Rube Goldberg system of achieving it

But Congress didn't "write" the ACA, people did. And those people wrote it in fragments, and palimpsests, - manifestos and think-tank papers and a dozen different model bills created over the quarter-century between their first failure in 1993 and second, catastrophic success in 2009. This frankensteinian monstrous chimera was fathered by a schizophrenic host of think-tankers, activists, and idiot journalists, mothered by determined Hill staffers, and birthed by ignorant ham-handed politicians. At least forty-five percent of that legion of fools were single-payer fanatics, who pushed to the very end for different fragments of the bill, and were out-voted, and yet their input and votes were necessary to bring the final form to the floor and to the President's pen.

"Conspiracy" is too strong a word, and it is the mockers' word, not the theorists'. Strawman exaggeration, to be tied to the stake and burned. But there were definitely a vast tribe of single-payers arrayed in alliance with the corporatists, who often pushed not for the wise thing, but the half-wise thing in the composition of the drafts. Not intent, but motivation, or to get Marxist, interests.; 10/26/13, 4:27 AM
Mitch H. said...: What McArdle understands that the conspiracy theorists do not is that Washington is run by mandarins these days

What McArdle *doesn't* understand, because she's got biases like everyone else, is that the ACA wasn't substantively intended by the *current* batch of mandarins, but rather stitched together from written-over half-effaced bits and pieces by two generations of wonks. The sheer volume of the bill, and its ferocious, intricate complexity, meant that the intent of the ten thousand drafters included some twenty-five years old, some younger, some even older. By the time it came to the floor, it wasn't a bill, but a Jungian world-dream of two generations of the collective liberal unconsciousness. And the supposed single-payer plot was not a scheme of the head - which fervently wanted the bill to succeed - but an intrigue of the heart, which was not in this business of shuffling about with damnable businessmen.; 10/26/13, 4:38 AM
rhhardin said...: Whom better to teach others how to rise above, if that be a goal (defined here as winning American-Style such as American-Winners have Won, with exceptions mostly non-American for the most part by-my-eye herewith) than the greatest riser yet Christ Excepted: SARAH PALIN.

That must be a world distance record whom-force hypercorrection.; 10/26/13, 5:48 AM
Jaq said...: I would be for single payer if there was another country that we could free ride off the way the rest of the world free rides off of our system.; 10/26/13, 6:08 AM
Bruce Hayden said...: How cruel of her. If one rejects conspiracy theory, contemporary conservatives have no remaining political theory. Irritable mental gestures, on the other hand, remain in ample supply.

Simplistic, and exactly wrong - though we are seeing more and more with Obama that some of the conspiracies may be right. How did we get someone we still know so little about, with so little experience, aptitude, personality, and training for the job as President?

But deep within the cocoon of liberal and progressive orthodoxy, you fail to see that the counter to their ever growing dreams and demands for bigger and bigger government is libertarianism and the Tea Party. They want government down sized, not up sized. Big government is bad because it is grossly inefficient, inept, corrupt, and corrupting. It increases disparity while trumpeting the opposite. It provides the wrong incentives to people: don't work hard, because the govt will support you by taking from those who do; don't compete in industry because bribing politicians and govt officials is cheaper and more efficient; that trading security for liberty brings you neither; etc.

The biggest problem with big government is that it cannot work well, or even decently well. That is because belief in such is based on the false conceits that man is perfectible, that he can with central planning plan and manage better than the free market and individuals can, even if the best and brightest were the ones doing the central planning, which they aren't because they can make much more money exploiting the government. The progressives share the same naive Utopian views as do their fellow socialists, communists, and fascists. And they inevitably fail in their attempts at governing for the same basic reason - because man is by nature selfish and self-interested.; 10/26/13, 6:26 AM
MayBee said...: What do people imagine when they say they wan single payer? In the UK, I am still inundated with ads for health insurance and companies offering protection against medical bankruptcy. The NHS runs in deficit, and which emergency rooms should be closed is a perennial political football. Hospitals are literally incentivized to let people die of dehydration. There is no way to collect money from visitors and illegal immigrants who pay no taxes but receive care. Private clinics thrive.

What do people imagine when they imagine a single payer US system?; 10/26/13, 6:27 AM
Bruce Hayden said...: I agree with many above - ObamaCare is too big to be much of a conspiracy. Too many cooks, many of whom were too young or dumb to know better, and too many parties pursuing their own self-interest. It is a mish mash, much too large and complicated to have been designed rationally or well. You know it was badly designed when they missed the obvious - what happens if states opt out of expanding Medicaid or their own exchanges? What happens to the states that did take the federal Medicaid bribes when they run out? Many of these Blue states already are in dire shape financially, so I expect that they thought they could just print more money to cover these state costs. Won't happen unless the Dems can get back to their 2009 levels of political control in DC. What happens if the web site isn't up in time so people can avoid then individual mandate by signing up for insurgence in time? What happens to the mix of part time and full time workers when the former are exempted from the employer mandate? (Ditto for employee counts)

The reality, I think, is that this legislation is a monument to progressive arrogance and stupidity. They overreached because they could, with little seeming regard to what they could realistically expect to accomplish. All the pigs at the trough got fed well, while the rest of us are left paying the price. And, for too many of them, that was enough, getting their piece of the action.; 10/26/13, 6:50 AM
Rusty said...: For our resident non - sequitur.

. A quote in today’s New York Times illustrates that point beautifully. It seems that in the days immediately before HealthCare.gov’s disastrous launch, “top White House officials were excitedly briefing lawmakers, reporters, Capitol Hill staff members and Washington pundits” about the “shiny new Web site that was elegantly designed, simple to use and ready.”

It’s Potemkin villages all the way down.

H/T Instapundit.; 10/26/13, 7:46 AM
jr565 said...: Inga wrote:

These Docs are just waiting for the day the House is back in Democratic hands. 2014

not going to happen. And if it did, it would be the last major democratic achievement for 50 years.; 10/26/13, 8:05 AM
pm317 said...: The website failure gives credence to those who warn that government can’t be trusted to get big things right, and that the market, not bureaucrats, should fix health care.

This is a standard line, standard sentiment you see liberals and their lapdog media repeat as if it is the fault of the people who mistrust the government. But what they don't acknowledge is why the mistrust. If Amazon or another nameless startup put up a 'product' like Obamacare, do you think the CEO or others will get another job or hold their current one? But here we have Sibelius and Obama enjoying their perks for another 3+ years. That is what people complain about, accountability. Where there is no accountability, there is mistrust.; 10/26/13, 8:27 AM
pm317 said...: One more thing.. any company, any contractor worth his salt would want to associate with this debacle now.. well they should not unless they get carte blanche in terms of time and money. So who is this savior who is going to save this in six weeks, Zients?; 10/26/13, 8:36 AM
Hagar said...: The PPAHCA is not the result of a conspiracy; if it was, it would have a unifying plan to it. As it it is, Obama turned the project over to Harry Reid to move through Congress, which Reid did in his fashion as a lawyer/lobbyist with no particular convictions of his own, so the result is a crazy-quilt where anybody and everybody willing to contribute a million dollars or more to any Democratic campaign coffer got his/her/its patch sewn on.
If it can't be made to work in practice, it is not Harry Reid's problem. They asked him to get it through Congress, and he did. So there!; 10/26/13, 9:12 AM
ALP said...: Bruce Hayden:
"...The biggest problem with big government is that it cannot work well, or even decently well. That is because belief in such is based on the false conceits that man is perfectible...."
*****************
This. This. This. Every debate I have about politics can be boiled down to what you believe about human nature. I can't tell you how many times I've been reduced to yelling: "We are mammals with large brains and are NOT perfectible!"

The left's belief in this strikes me as another flavor of New Age/"Oprah Winfrey" thinking, in addition to an offshoot of helicopter parenting. We citizens are like children, you know, we need endless rules and structure in order for us to be molded into properly-thinking adults.; 10/26/13, 10:02 AM
Mrs. X said...: Many on the left who voted twice for their king-wannabe may believe (mistakenly) that the law won't apply to them. I use as an example my father, a reflexive democrat voter, who is old and wealthy. He can afford to pay extravagantly for health care out of pocket, so he thinks of the ACA as a theoretical problem, with no real world effects on him. I've tried to tell him that A) if the policy destroys the system, there will be no healthcare available to buy and B) others (me and my husband and kids, for instance) don't have the financial wherewithal to pay for what our "insurance" doesn't cover. But Dad just votes for the NY Times approved candidates and backs whatever policies they put forth.; 10/26/13, 10:30 AM
Hagar said...: And that is as far as the ideological and political leadership of the Democratic Party have thought about it; get it through Congress, and then some other people somewhere will make it work somehow. That is for the little people to do.; 10/26/13, 10:45 AM
Ken Mitchell said...: "There is no path to single payer from even a spectacular Obamacare implosion — for the same reason that there was no path to single payer before Obamacare was passed."

There's no "path" to Obamacare, either, but that doesn't mean that the Dems aren't trying to achieve it, even though it's a chimera and a fantasy. Ditto "Single-payer"; it won't work, but that isn't going to stop the Dems from destroying the American health care system in the attempt.; 10/26/13, 8:37 PM
Ken Mitchell said...: Blogger Tom said...
"I don't think Obama wanted single-payer. "

Funny; Obama was pretty straightforward about SAYING, back in 2008, that he wanted "single payer" national health care. He wasn't speaking in code, nor speaking cryptically, or anything; he came right out and SAID IT.

Of course, if you wanted to make the argument that everything he says is a lie; therefore, SAYING he wanted single payer is proof that he did NOT want single payer, I'd have accept that this would be a valid argument.

But just as even a stopped clock is right twice a day, it's possible that Obama actually spoke the truth, just that once.....; 10/26/13, 8:43 PM
Rusty said...: A short lesson for our ACA boosters.

A market. Any market, is when two or more knowledgable people get together for the purposes of trade. Without any restrictions or coercion. The deal is made only when both parties walk away satisfied.
Now add a third party to regulate the seller. The seller is no longer interested in satisfying the buyer. They only have to satisfy the regulator. Prices and conditions will be altered to suit the regulator. Not the buyer.
When regulations are imposed to regulate the buyer two things happen. The buyer will seek to find an alternative source or simply not participate. Black markets ensue.
See where this is going?
The current healthcare fiasco is a rather imposing example of the above. Both buyer and seller are being regulated. Prices for insurance have increased. Since the healthcare industry only has to satisfy the government and the market is essentially closed to new players, the buyer it at the mercy of the regulators. No amount of buyers participating in the system will drive down the prices since they have no choice but to pay the price asked or risk a penalty. The price of premiums will only go up.Buyers will begin-if they haven't already- to devise ways to opt out of the system to avoid any penalties.

Honestly.
What the hell did you think was going to happen?; 10/27/13, 9:06 AM
Anonymous said...: Yes he did say it and he capitulated to advisors who steered him wrong. He was influenced into making deals with insurance companies instead, something over which he lost part of his base over.; 10/27/13, 12:19 PM