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October 03, 2012 8:43 AM In What Sense is Obamacare “Conservative”?

By Mark Kleiman

J.D. Kleineke of AEI states an important half-truth: the architecture of Obamacare is consistent with conservative principles of competition, transparency, and personal responsibilty, and conservatives who denounce it are mostly incoherent and self-contradictory in doing so.

But it is only half the truth. The other half is that the subsidies built in to the plan constitute one of the largest downward redistribution programs ever created: about $200B/yr., forever.

Obama doesn’t want to say this because he fears losing upper-middle-class votes if Republicans charge him with “class warfare.” Republicans don’t want to say it because they want to conceal the actual class war they have been waging so successfully. Yes, Obamacare is consistent with conservative principles, but the GOP and its tame pundits are more than ready to rise above principle and do what the plutocrats want. Obama’s critics from the left have less of an excuse.

[Cross-posted at The Reality-based Community]

Mark Kleiman is a professor of public policy at the University of California Los Angeles.

Comments

  • smartalek on October 05, 2012 5:10 PM:

    "the subsidies built in to the plan constitute one of the largest downward redistribution programs ever created: about $200B/yr., forever."

    So the forced transfer of taxpayer dollars from the middle class to the corporate coffers of the insurance companies that wind up with the loot constitutes a "downward" movement?
    I see you're using the latest Newspeak dictionary; mine must already be outdated.

  • fsteele on October 09, 2012 2:20 AM:

    "So the forced transfer of taxpayer dollars from the middle class to the corporate coffers of the insurance companies that wind up with the loot constitutes a "downward" movement?"

    Well put.

  • Patrick on October 09, 2012 3:04 PM:

    If you give a poor person a $200 Visa card and they use it to buy a microwave, you are still giving them something, despite the fact that Sears has $200 more in their account. The fact that money you give to the needy goes on to be spent on things is not a sign that it is not a downward redistribution. Do you want money to go to the poor and then have them not spend it? Because if they spend it they have to spend it on goods, and most of the people who are selling goods are not themselves needy.

  • CRA on October 12, 2012 5:39 PM:

    Patrick is right, of course. Another variant would be if we simply gave poor people money to spend on health care directly, without recourse to insurance. Doctors would enrich themselves at taxpayer expense by providing medical services to the poor. I'm not suggesting we do that, but it'd be a mostly downward transfer, followed by a choice of providers, most of whom would be higher up on the socioeconomic ladder.

  • paul on October 15, 2012 1:21 PM:

    And this is why couching everything in terms of transfer payments doesn't always make sense. Insofar as the law results in poorer people actually getting medical care they wouldn't otherwise have gotten, it's a transfer to them. At the same time, it's a transfer to the insurors and the medical sector in general, because the money transferred to the poorer people is legally bound to end up in their pockets. (This is very much akin to certain kinds of feign-aid deals, where a recipient country gets $X million, just as long as it spends the cash on products and services from donor-country companies.)

    Meanwhile, the money is coming from general tax revenues (skewed somewhat toward the upper brackets) but also from existing medicare funding (skewed toward wage-earners), so a lot of what's going on is a transfer out of one pocket and into another.

    The real transfer, I believe, isn't so much in the flow of funds; it's in the change of service agreements. By mandating the 85% payout ratio, outlawing rescission and bogus pre-existing-condition exclusions, and by pushing guidelines for more-effective care, the government is ensuring that people actually get what they thought they paid for. And that's a huge transfer of, well, something, from the providers and shareholders to the consumers of the health industry