David Frum

10.31.13

Getting It Right on Obamacare

I hate to say ‘I told you so,’ but extremist Republicans still don’t understand that their obstruction on health-care reform isn’t helping. Here’s what I have to say to the critics.

I’m only human, and I’ve slipped once or twice. Yet on the whole, I think I’ve done a decent job biting back the “I told you so”s to my fellow Republicans on the subject of Obamacare. I don’t expect any kind of parade of recognition for having predicted the outcome accurately. On the other hand, it is annoying—after having predicted everything accurately—to hear “Ha ha yah boo!” from people who got everything wrong.

For more than four years, I’ve argued the following about Obamacare and health reform:

1) The Affordable Care Act is a bad law. Among other problems: It doesn’t do enough to control costs. It over-regulates the insurance industry—the people who should have the mission of cost control. It expands Medicaid too much, burdening states with future financial obligations. And it is financed with taxes that will slow economic growth.

I’ve made those points literally hundreds of times since 2009: in writing, on radio, and on TV. Here’s one typical example from 2010, chosen simply because it came up first in a Google search.

2) That said, the Affordable Care Act contains good elements, including a continued reliance on private insurance as the coverage vehicle for most middle-income Americans. I also have often said that the goal of the ACA—universal coverage—should be welcomed by all as a highly desirable goal. Universal health coverage may not be a human right, but the lack of coverage is surely a severe human wrong.

3) Through 2009, I again and again argued that the Republican decision to refuse all negotiation on the ACA was bad strategy. Democrats had the votes to pass their law in 2009-2010. Betting everything on a “Waterloo” campaign to smash the Obama presidency was simply reckless. The smart play was to test whether it was possible to improve the law before it passed, so as to minimize the problems in point 1. All-out obstruction only achieved the worst possible law. A better way was to seek changes that would be attractive to Republicans and moderate Democrats alikes, such as those I outlined here.

I recognize it’s tedious to reference myself at such length. But I want to set the stage accurately for a reply to some criticisms of my column earlier this week about my personal Obamacare experiences. I am one of the Carefirst customers in the District of Columbia whose coverage has been canceled. Carefirst directed me to the D.C. health exchange. On the exchange, the policy most directly comparable to mine cost $200 per month more and carried a higher deductible.

On the Mediaite site, Tommy Christopher has this to say about my column:

Now, it is tempting to greet the best-selling author of eight books, writer for The Daily Beast, and well-compensated public speaker’s (he makes enough from a single speech to pay his premium and his out of pocket max for an entire year) tragic $197.37 rate hike by quoting Jeff Spicoli, calling Frum a Wahmbulance (Obamacare covers that), and calling it a day.

But of course, I was very clear that I was not claiming any serious personal hardship from my rate increase. The reason my column was newsworthy is that thousands of other people have found—or will soon find—themselves in the same boat.

If that extra $2,400 per year in insurance premiums were the end of my ACA costs, I’d congratulate myself on getting off easy: I’ll also be paying considerably more than that in higher taxes to support the program. As I said, I’m not a hard-luck case. … [However] It’s not only plutocrats and one-percenters who will find themselves worse off; not only the comparatively affluent retirees enrolled in Medicare Plus programs. Self-employed professionals who earn too much to qualify for ACA subsidies will soon discover what I have discovered: They are paying more for a worse product.

The District of Columbia is an expensive place in which to live. Those Washingtonians who earn too much to qualify for subsidies probably do not regard themselves as wealthy. An extra $2,400 a year to keep a high-deductible policy may feel to many of them like—if not a hardship—then certainly a serious nuisance.

Talking Points Memo today offers a chart suggesting that the losers under Obamacare will number about 3 percent of the population. Why, that’s only…9 million people. Nine million of the best educated, most affluent, and most vocal people in the country. How much trouble can they make? So really—it’s no story. 

By contrast, at the opposite end of the political spectrum, James Taranto of The Wall Street Journal announced his “Schadenfreude” at my impending rate hike.

It’s not easy to discern exactly what Taranto is arguing here. His gnarled column is again and again constrained to acknowledge that my particular assessments and predictions has proven to be correct. But what is clear is that Taranto thinks that my $200 per month rate increase represents some much-deserved comeuppance.

Taranto's “comeuppance” idea rests on two odd assumptions/insinuations. The first odd assumption is that I supported ACA and somehow therefore invited nemesis upon myself. Let the abundant record show I did not. The second, even odder assumption/insinuation is that I have been somehow cluelessly surprised by the ACA’s high costs. Any such surprise would be very negligent of me, since I’ve been writing about the higher taxes in the law since 2010 and have been paying them since January 2013.

Taranto’s larger point, however, is to vindicate those conservatives who advocated the massive resistance approach to the ACA. That would seem a tall order. The massive-resistance faction has pushed the Republican Party to disaster after disaster, culminating in the total fiasco of this year’s government shutdown and near national bankruptcy. Its policies have tainted the Republican brand to the point where—in a year when Republicans might be expected to capture the Senate—they are instead worrying that they might lose the House. And of course Obamacare remains the fixed law of the land despite all these maneuvers, just as I predicted three and a half years ago.

Yet it’s Taranto’s view that no lessons should be learned from any of these experiences: “Especially in retrospect it seems smart for the GOP to have said no to legislation that was horribly ill-conceived, not to mention unpopular.” Anything else, and “Republicans would actually bear some of the blame for the debacle that is ObamaCare.”

But of course, if you have the opportunity to prevent or mitigate a debacle—and you fail to use that opportunity—then, yes you do bear some of the blame. Maybe not the moral blame, but the real world practical political blame. Political action is judged by its consequences. The consequences of Republican radicalism since 2009 have been almost uniformly negative—for the country as a whole and for the interests and principles the radicals claim to champion. That’s the point I’ve been trying to pound into the heads of massive-resistance conservatives this past half-decade. Apparently, I must keep pounding.