Conscripted Into Obamacare, I Conscientiously Object
I have been trying to work out why I am so upset about Obamacare.
We already live in a social democratic state that forcibly takes my money through taxes for things that I don't think anyone's money should be taken for. I may feel there is a better way to build the roads than have the government pay for them through massively redistributive taxation, collected essentially by force, but I don't get angry about using them every day.
So isn't there a prima facie case to be made that if we are stuck with a huge state, taxing and spending to the tune of about a third of the economy, then at least the attempt to save lives and maintain health through this questionable system is better than the funding of secret agencies to spy on us and otherwise eliminate our basic civil rights, the deployment of massive military capability that makes more enemies rather than eliminating any immediate threat, or the transfer of the hard earned wealth of working Americans to already privileged financiers?
How can Obamacare possibly be as bad as that litany, and why do I find myself angry about it, even as I find deeply hypocritical the objections of many Republicans whose party was actually responsible for designing the ACA that they now decry?
I am one of those whose healthcare coverage was cancelled. The nearest equivalent policy from the same insurer would have cost me 67% more than that the one I lost. A slightly worse policy (which I have purchased) costs me 20% more - presumably somewhat "subsidized" on account of my modest income. Ironically, the 67% increase would have been enough to price me out of health insurance, which has become for me much less affordable under the ironically named Affordable Care Act.
What could possibly justify cancelling my healthcare plan, and forcing me to replace it with a more expensive plan that covers drug addiction treatment that I shall never use because I do not take drugs, maternity care that I shall never use because I am male, and pediatric dental coverage that I shall never use because I don't have children and have no plans to have any?
The answer is, I suppose, the pragmatic and superficially humane notion, which most advanced societies have arrived at, that a wealthy, civilized society does not let its own suffer from bad health, and that since no one knowingly brings physical harm upon themselves, it would be wrong not to socialize resources to save lives and prevent suffering. After all, goes one argument, we accept taxation and the socialization of resources for much less necessary ends, so why would we not socialize for this? (There is also an implied (and much more tenuous) State and societal interest in reproduction, to justify my paying for the medical expenses incurred by someone else who chooses to have a child, even while I cannot afford to have my own child.)
You may agree or disagree with the above justification of Obamacare, but when it is used to justify a legal takeover one seventh of the American economy by the State, you end up with the greatest single move toward a communistic (used advisedly) society since the New Deal. Whether that is a step that America wants to make is for America to decide, but it is a step so large that it demands honest and extensive debate that can only legitimately end in informed consent (to borrow another idea from the field of healthcare that carries far too little respect among our political class) or dissent. And if the social democrats were successful in persuading the rest of us that we really wanted to change our culture and politics so massively as to socialize all healthcare, then we would have either to change the Constitution or to agree on some interpretation of it under which the socialization of healthcare is justified as the Constitutional protection of life, liberty and/or pursuit of happiness. (While many of my readers might find that latter notion incredible, just imagine how much more honest, comprehensive and principled a debate we would be having if anyone were to try even to make that case.)
America has not had that debate because Obamacare is not what we were told it was. The continued involvement of insurance companies in the healthcare industry provides the illusion of continuity, of the operation of a market, and of free contract and choice. The ultimate decision by social democrats not to advocate for the single-payer system that most directly and visibly realizes the changes they are trying to make gives the appearance that individuals will continue to be responsible for their poor health choices - not that they will be paid for by their fellow Americans. The ACA hurts some Americans very much more than others - something else no one told us to expect. (The worst case was that we could keep our coverage, remember, so there wasn't to be a downside. (Yes, I know it's laughable when you see it written down.))
There is at least something "honest" about the single-payer system: government as sole provider of, and payer for, universal healthcare is the most direct implementation of the socialistic purpose that drives it. Single-payer doesn't t pretend to individualism by having "individual mandates" (isn't all taxation for public welfare a mandate on the individuals who pay it?) or the involvement of insurance corporations as potential scapegoats for the State and/or the public - corporations who now received legally extorted (again used advisedly) business.
But even Hillary Clinton, who a decade ago did extensive work from the Left, as it were, on Healthcare reform, could see that Americans didn't want such a single-payer system: it was, in fact, rejected so comprehensively that even Obama, with all the political capital he won in a landslide swing against the Republicans in 2008, didn't try to push it. Rather, Obama's Democrats adopted a Republican plan that the GOP now hypocritically decries.
A single-payer system would be funded, presumably, out of our familiar progressive taxation system. While many conservatives and libertarians have no love for that idea or direct taxation, itself, even they would much rather be forced to pay for something that the country had honestly chosen after a proper national debate in which they had a chance to propose alternatives and lost. I know that because I polled the question among 14,000 liberty-curious and libertarian Americans, leaning from liberal to conservative, and an overwhelming majority said they'd take a single-payer system over the current Republicrat (I am not letting the Republicans off the hook for this) Affordable Care Act.
Obamacare is funded by doing disproportionate harm to a few - of which I am one. If I knew that the country had broadly and consciously consented to the deeply socialistic principles on which the system of healthcare that I was being forced to finance was based, I would swallow it and pay up, like I do with all my taxes. But clearly, it did not. The individual mandate, the involvement of the insurance industry, the use of taxation to compel me to enter contracts against my will, are all means by which the political class has hid its purpose from the people.
But there is something even worse: the ACA forces me into a new degree of supplication to the state. It essentially forces individuals like me to take hand-outs.
Although I have a modest income, I declare every penny I make and I pay my share of taxes. I have never taken a penny in welfare from this or any other country - and that is important to me. Of course, I use those things that I have to use to conduct a modern life, even if they are funded through taxation - such as roads, the air-traffic control system etc., and I accept the fact that I live in a nation where too many goods are deemed to be public goods and paid for accordingly.
But paying taxes and using public goods is rather different from what the ACA makes me do: it essentially blackmails me: it damages me financially by increasing the cost of something it tells me I must buy (but was buying anyway) and then forces me to accept a government subsidy as an individual to undo the damage. I resent that deeply. I resent it in the way I would resent a more blatant violation of my first amendment right to live by my own beliefs as long as I harm no one else.
It is all the more offensive because I am sure that if the nation had been honestly told this was to happen, the nation would not have allowed me or anyone else to be put in this position. In short, Obamacare feels like a massively personal and covert impingement.
Now some may say the ACA subsidy is ultimately no different from any other tax rebate - after all, all taxes and subsidies go into and out of the same pot - so my feeling is unwarranted. To which I ask, if that is the case, then why aren't we funding this whole thing from the tax system we already have in place without the need for any rebates at all: why don't we have the single-payer system? The answer, as we've seen, is that the nation rejected that system, so the ACA, which punts in decidedly the same direction, could only be (mis)sold to us with all this smoke and all these mirrors.
I am not a partisan. I am as sick of the Republican repetitions of the need to repeal the ACA that they mostly designed - without offering a principled alternative reform - as I am of the way the Democrats bounced us into this. As usual, a pox on both their houses.
But I have been conscripted into a rather covert attack on some simple American values and preferences. And as a conscript, I conscientiously object.