Robin SmithJonathan Gruber, architect of the Affordable Care Act, was recently featured in several videos offering remarks about an important aspect of passing Barack Obama's signature legislation in 2010.
"This bill was written in a tortured way to make sure CBO did not score the mandate as taxes. If CBO [Congressional Budget Office] scored the mandate as taxes, the bill dies," Gruber said. "Okay, so it's written to do that. In terms of risk-rated subsidies, if you had a law which said that healthy people are going to pay in -- you made explicit healthy people pay in and sick people get money, it would not have passed ... Lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical for the thing to pass."
The ACA earned its moniker, Obamacare, after becoming law without a single Republican vote in the U.S. House or Senate.
What were the promises of Obamacare, in the president's own words?
"If you like your plan/doctor, you can keep your plan/doctor."
"I will sign a universal health care bill into law by the end of my first term as president that will cover every American and cut the cost of a typical family's premium by up to $2,500 a year."
"Every single good idea to bend the cost curve and start actually reducing health care costs are in this bill."
This government takeover of about 20 percent of America's economy was going to accomplish its goals through two vehicles: mandating the expansion of state Medicaid (TennCare in Tennessee) for the poor (which was ruled unconstitutional by the Supreme Court) and creating state exchanges to offer insurance plans for individuals to purchase, most with taxpayer-funded subsidies.
Further, taxes would be applied to "Cadillac" plans made available through some governments, companies, and even unions on one end of the purchasing spectrum while catastrophic plans with high deductibles and low monthly premiums would be deemed insufficient and eliminated, along with some of the power of health savings accounts.
The results so far?
A November 2014 Gallup article opens with the statement, "One in three Americans say they have put off getting medical treatment that they or their family members need because of cost."
The piece asks the same question posed for 14 years, "Within the last 12 months, have you or a member of your family put off any sort of medical treatment because of the cost you would have to pay?"
The responses showed the highest rate of delayed care, at 33 percent, since the question has been surveyed.
Why? High deductibles characteristic of the "government-approved" plans have prompted patients to enter into a cash-paying health system that requires more out-of-pocket costs.
Paying the monthly premiums and the deductible have put health care out of reach for many people despite "coverage."
The only way to bend the cost curve downward for actual services provided in the health care arena will be through transparency of charges to allow consumers to compare prices, with health savings accounts placing the patient in charge of payment instead of a third-party that determines whether services are denied or approved, and with true competition that doesn't pick winners and losers through regulations that protect inefficient institutions and practices.
I'd submit, those who look stupid now are the ones who continue trying to solve a problem with the same failed principles.
Robin Smith, immediate past Tennessee Republican Party chairwoman, is owner of Rivers Edge Alliance.