The delusions of Obamacare supporters: one ‘realist’ Josh Marshall

Why Josh Marshall believes TODAY that Obamacare will be a success (italics are my response).

1. No way to repeal until Jan 2017 i.e. Obama can override any veto of a repub senate and congress..PROBABLY
2. Insurance companies are locked in. Insurance companies will do whatever they can to maximize profit in a nearly amoral manner. If a small company in Oregon can suddenly get customers in Georgia, how much more attractive to them is that compared to the current ‘situation’
3. Medicaid will have increased tremendously. Yes and when the federal govt removes it’s financial support in 12-24 months the 26 states which accepted the expanded program will suddenly have that burden which some to all will not be able to AFFORD. Then what? I submit it will HASTEN the destruction of the bill, and work arounds.
4. Obamacare is good policy.

I have a much simpler view.

1. The proportion of people who will discover they have to pay more, are young and have never been sick, is going to be too large and the they will REJECT the program as a market decision.
2. Worse, a significant proportion of young people with employer provided insurance and have to pay more will not do so and DROP it
3. A significant proportion of large businesses which provide insurance will dump their people one way or another onto the exchanges and pay the cheaper fines, and a great number of such people will then either refuse to purchase the health care, or will not be able to afford it.
4. The inability of 34 states to pay for the expanded medicaid programs past the day of federal abandonment of it will demonstrate the basis of the so called ‘good policy’ must be free care if it is to succeed in any way. BTW, who will pay for this 'free care'?

Obama promised the AVERAGE family would see a drop of about $2500/year in their health insurance costs, but instead not only are the payments higher, but the copays, Rx’s., max out of pocket and deductibles are worse.

The SCOTUS named TAX rather than purchase of a vastly inferior product ..UNLESS YOU ARE STRICKEN WITH CHRONIC DISEASE AND NEED THIS PRODUCT, will be the choice of so many individuals and families, because they do not want to pay, or cannot pay will doom this project.

The FACT that for so many it IS more expensive makes it IPSO FACTO, horrendous policy. Pretending that a fixed web site, or that thousands are now getting health care for the first time (free on medicaid) makes this a success is a tragicomedy.

The main problem is cost.

Philosophy, disappearing family doctors, independent professionals all becoming salaried employees of hospitals and huge conglomerates, idiotic navigators, agents and brokers who don’t know the answers to important questions because THEY CAN’T, programs which are incomplete .. all this is the smell around the rotting flesh.

This program will fail or succeed on its cost.

PHYSICS.