The Real Beneficiaries and Victims of Obamacare
Obamacare was promoted as a program that would not only right those wrongs, but that would create no losers at all. This was always an absurdity, as anyone with a modicum of math knowledge would know. But those were the promises explicitly made by Obama and the Democrats: everyone would save money, no one would lose doctors or hospitals or health plans, the sick and unemployed would be covered, and it would save us all money -- except for the very, very, very rich, whose taxes would be raised.
Well, it hasn't quite turned out that way. The old system had winners and losers, and so does the new one. But they are a very different set of winners and losers. You might say that Obamacare turns the old system on its head, and it's not just the very rich who are penalized, it's the solidly middle class and upper middle class. Not only did those groups not bargain for this, they were explicitly promised it would not happen.
But even without the broken promises, there's another problem with the inequities of Obamacare: they do not flow from anything we recognize as natural consequences, because they are imposed by a government that has made the decision as to who will be the winners and who will be the losers. The dirty little secret of Obamacare (that was never really a secret) is out: it is the most redistributive entitlement program in U.S. history, although it was pitched as something quite different. Edsall quotes Edward Carmines, a political scientist at Indiana University, who writes:
Most of the benefits of the new program will go to the poor and less-well-off and most of the costs will be born[e] by the well off. Neither is true of Medicare or Social Security. When the new law was passed it was hailed by the New York Times as the most redistributive policy in a generation, and they were right. It was not sold as being markedly redistributive, of course, but that is how it was designed and will operate.
Long before Obamacare was passed, the conservative economist and author Thomas Sowell wrote an entire book on the impulse behind redistributive programs, and their consequences. It was entitled The Quest for Cosmic Justice (1999), and in it Sowell contrasted the desire for cosmic justice with traditional justice:
Not only does cosmic justice differ from traditional justice, and conflict with it, more momentously cosmic justice is irreconcilable with personal freedom based on the rule of law. Traditional justice can be mass-produced by impersonal prospective rules governing the interactions of flesh-and-blood human beings, but cosmic justice must be hand-made by holders of power who impose their own decisions on how those flesh-and-blood individuals should be categorized into abstractions and how those abstractions should then be forcibly configured to fit the vision of the power-holders. Merely the power to select beneficiaries is an enormous power, for it is also the power to select victims---and to reduce both to the role of supplicants of those who hold this power.
Obamacare does exactly that: it empowers the government to select beneficiaries and victims according to its own idea of cosmic justice, as though government were an all-seeing, all-knowing judge and jury combined. The result may feel as though there are winners and losers. But when all become supplicants, we are all losers.