Conservatives, as usual, are conflicted. On the one hand, they’ve been mounting a massive assault against the Patient Protection and Affordable Care Act (commonly called, as you know, ACA). Their arguments run something like this (taken from the subtitles to a series of Heritage Foundation papers): ACA … violates personal liberty, cuts jobs and wages, busts the budget, undermines state flexibility, raises premiums, crowds out private coverage (our cue to shed a few tears for health insurance companies), undermines seniors by cutting into Medicare Advantage, and, that old standby, reduces patient choice.
But, with their usual lack of self-knowledge, conservatives fail to understand that ACA is just what the doctor ordered for them. In fact, as a conservative creation (the Heritage Foundation again, as well as “Romneycare”), it could also act as a model for conservatives in their continuing campaign to dismantle civil society. We owe a debt of thanks to the illustrious Michael Lind of the New America Foundation for telling us this cautionary tale at Salon in an article about what he and many are calling the “botched rollout of the Affordable Care Act’s federal exchange program.”
Lind begins by acknowledging a post by the Roosevelt Institute’s Mike Konczal at Rortybomb, in which Konczal points out (as summarized by Lind), that, in fact, the “worst features of Obamacare … are the very features that conservatives want to impose on all federal social policy: means-testing, a major role for the states, and subsidies to private providers instead of direct public provision of health or retirement benefits.” [Emphasis added.]
In other words, Lind writes (his emphasis this time), “Conservatives want all social insurance to look like Obamacare. The radical right would like to replace Social Security with an Obamacare-like system” and steer Americans “into tax-favored savings accounts like 401(k)s.” Meanwhile, instead of Medicare, “compel the elderly to buy private health insurance from for-profit corporations.”
Most conservatives are so blinded by their deep-seated aversion to President Obama that they can’t see or refuse to admit the extent to which ACA aligns with their vision for America’s present and future. But, regarding problems with the ACA’s launch, Lind writes that “the smarter conservatives who are thinking several moves ahead” ― he cites Ross Douthat of the New York Times ― “understand that this failed rollout is a significant problem for conservatives. Because if all the problems are driven by means-testing, state-level decisions and privatization of social insurance, the fact that the core conservative plan for social insurance” relies on the same initiatives means that they would have to go back to the drawing board.
Meanwhile, Lind writes, when Democrats and certain progressives treat the ACA “as something it is not ― namely, a great victory of progressive public policy on the scale of Social Security and Medicare [they] may inadvertently be digging the graves of Social Security and Medicare.” In other words, “If Obamacare ― built on means-testing, privatizing and decentralization to the states” ― forgive the repetition ― “is treated by progressives as the greatest liberal public policy success in the last half-century, then how will progressives be able to argue against [similar] proposals by conservatives” when applied to Social Security and Medicare?
Next thing you know, Lind predicts
… conservatives and Wall Street-backed “New Democrats” [will] begin to argue that, with Obamacare in place, it makes no sense to have two separate healthcare systems for the middle class — Obamacare for working-age Americans, Medicare for retired Americans.
Instead: “Let’s require the elderly to keep purchasing private insurance until they die!” Then, he writes: “Once Medicare has been abolished … Social Security won’t last very long.” Conservatives “will introduce a plan to replace Social Security with a system of individual mandates and fines to compel working-age Americans to invest in for-profit Wall Street mutual funds during one’s working years, and … buy annuities from for-profit money managers at retirement.”
Skeptical? In fact, we may once again fall prey to conservative smooth talk. Lind again.
We will be told that, in a world with computers and globalization and apps or whatever, simple, universal, one-size-fits all social insurance is obsolete. In the “new economy,” public policy needs to offer as many baffling choices as airlines or gyms, like the ridiculous bronze, silver, gold and platinum plans of Obamacare.
The irony is bitter.
Throughout the process, the right-wing Republicans and neoliberal Democrats will ask, “How can progressives object to means-testing, privatization and 50 state programs, when those are the very features of the Obamacare system that our friends on the left celebrate as a great achievement?”