Charles Krauthammer on Obamacare

From Washington Post:

I do wonder why this isn’t more of a campaign issue among the GOP and why not more of this is in the discussion.

Obamacare dominated the 2010 midterms, driving its Democratic authors to a historic electoral shellacking. But since then, the issue has slipped quietly underground.

Now it’s back, summoned to the national stage by the confluence of three disparate events: the release of new Congressional Budget Office cost estimates, the approach of Supreme Court hearings on the law’s constitutionality and the issuance of a compulsory contraception mandate…

Rarely has one law so exemplified the worst of the Leviathan state — grotesque cost, questionable constitutionality and arbitrary bureaucratic coerciveness. Little wonder the president barely mentioned it in his latest State of the Union address. He wants to be reelected. He’d rather talk about other things.

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  • Kyle J

    The first reason the issue hasn’t been out there in the public discussion as much is simply because the issue is so uncomfortable for Romney, and he’s done a masterful job getting his opponents to ignore it for the most part.

    The second reason, I think, is that the Dems are slow-playing the GOP on the issue now. The GOP managed to win the public opinion battle (or at least make it a non-winning issue for the Dems) by distorting what the law does. Now, the president is waiting for the GOP to push repeal/overturn, at which the point the stories will shift to what the law actually does–ensure affordable coverage for nearly all American using market-based mechanisms. Repeal will mean kicking 30 million people out of health insurance they would otherwise have access to.

    As for Krauthammer, he deliberately distorts the cost figures. Accurate portrayal here:

    Also interesting to note how much “Obamacare” and “Ryancare” have in common:

  • Jim

    It seems that the Republicans have invested far more time going after each other than they have going after President Obama on anything, let alone healthcare.

  • On the Democratic side, it is being brought up a lot as one of the main reasons that Obama should be re-elected. So I don’t think that it is really true that Obama is avoiding it.

  • “Congressional Budget Office cost estimates”

    Be careful here. Republicans are pulling a fast one – also know as “lying” outside of politics and punditry.

    The CBO report actually concludes that the new law “will, on net, reduce budget deficits over the 2012–2021 period.”

  • Jon Altman

    I’m sure Krauthammer would like this essentially Republican plan just fine if it had been passed under the leadership of President McCain.

  • Kenton

    The repeal of Obamacare is not an issue in the primary season because all of the Republicans support it (the repeal, that is). After a nominee is chosen, I expect it to surface as an issue in the general election, regardless of how the supreme court rules.

  • I would add that it is not a credit to “JESUS Creed” to be repeating talking points from the likes of Krauthammer – a hack’s hack.

  • scotmcknight

    scott f,

    Au contraire. One of the intents of this blog is to discuss even political topics in a reasonable and charitable manner. I’m no Krauthammer fan, but he often finds a way to express a point with savage clarity and with rhetorical potency.

  • Roland

    Obamacare’s benefits to the previously uninsured notwithstanding, Krauthammer’s main arguments in this piece are very sound…

    (1) Cost: “Obamacare was carefully constructed to manipulate the standard 10-year cost projections of the CBO…” Exact cost projections are still a guessing game, but two things are clear: (a) Every revised estimate, be it from government or private analyses, keeps rising from the original estimated cost. (b) Nearly every major social program (Social Security, Welfare, Medicare, etc.) in history has ultimately been far more costly than what it was originally projected to be. This does not in itself make them bad programs, but from a cost basis, it lends credence to the likelihood that Krauthammer’s numbers will be proven correct – if not an UNDERstatement.

    (2) Constitutionality: “If Obamacare is upheld, it fundamentally changes the nature of the American social contract. It means the effective end of a government of enumerated powers — i.e., finite, delineated powers beyond which the government may not go, beyond which lies the free realm of the people and their voluntary institutions.” The SCOTUS will soon render its judgment on this matter, likely in a 5-4 decision either way. Krauthammer expresses a chief concern behind the fact that a consistently strong majority of Americans oppose Obamacare.

    (3) Coerciveness: “Consider the cascade of arbitrary bureaucratic decisions that resulted in this edict…” He then offers a list. These are real, not imagined. And to me, they portend a frightening prospect for the future.

  • Kyle J


    (1) “Nearly every major social program (Social Security, Welfare, Medicare, etc.) in history has ultimately been far more costly than what it was originally projected to be.”

    That’s a statement of ideological belief, not historical fact. The prescription drug benefit adopted under GWB’s administration, for example, has turned out to be less expensive than originally projected. (The fact it was financed solely through deficit spending is a different matter.) If anything, the CBO is being too conservative because it’s not assigning $ savings to the various cost-saving initiatives contained in the health care reform act.

    (2) If, on the other hand, Obamacare is struck down, it will eventually mean the end of most existing federal social programs. Why should people be mandated to pay into the Medicare system and then utilize its care? That may be a result that would satisfy the die-hard libertarians, but it’s hardly a result the large majority of Americans will find to be a good thing.

    (3) How frightening are the coercive powers that health insurance companies hold now? Choosing not to cover someone with a preexisting condition who doesn’t get insurance through their employer? Denying coverage once someone becomes ill because of a loophole in the contract? For Krauthammer et al., the government is always the bogeyman.

  • Mark h

    Wow. We really don’t trust anyone, anywhere, at any level. I’m sure Obamacare will, come in under budget like everything else (sarcasm intended), Dems will admit some misleadings, making comcessions so only those needing or choosing will be part of their program; and Rebs will forgive, choosing to move toward the center to make this work for the poor and those taken advantage of by the insurance moguls, and our petty bantering will all look really silly when all is said and done.

  • Tim

    All Australians – and we have a solid conservative/liberal divide here too, with the liberals on the nose – are staggered at the bizarre opposition to universal medicare in the US. Medicare in Australia – the free guaranteed basic health support of every single person – is a cardinal right that every Australian enjoys.

    We naturally have private health cover too (and the Government is a for-profit player fin that market too incidentally) for those who want it, with preference places to private hospitals, a private room, dentistry, glasses etc.

    But the majority cannot afford it, and if beggars belief that Christians in the US would not think providing free basic medical care to every single US citizen in the wealthiest nation on earth is not a no-brainer!

    Why is this? Are you still paranoid that somehow a society helping its fellow neighbours is socialism? If we can pay for each others roads, why not this??

    And that ordinary people are out protesting against it? This is deeply perplexing for us (esp Christians) watching.

  • JohnM

    Kyle J #10 – What was the prescription drug benefit projected to cost and what has it cost? I don’t know, I’m asking.

    Why do you think the end of Obamacare would mean the end of most existing federal social programs?

    I understand the part about being mandated to pay into Medicare, but not sure what you mean by being mandated to utilize its care.

  • scotmcknight

    Tim … I don’t want you to understand this as my defense of those who oppose Obamacare, but please understand that your amazement at the American resistance to national healthcare is exactly proportionate to many Americans’ amazement with your national healthcare. In other words, your amazement is their amazement. For some Americans national healthcare is incomprehensible as sensible! Why? We’ve never had it. (Then come the political, economic, and personal arguments.)

  • Kyle J


    Here’s a piece that covers the Medicare prescription drug cost question. Quoting Paul Ryan, of all people.

    Regarding your second question: Both Social Security and Medicare effectively coerce people into participating. (I suppose you can technically turn down the benefits, but you’ve effectively purchased them already.) If the Supreme Court overturns health care reform, what happens when some sues and says they shouldn’t be compelled to participate in those programs? Slippery slopes run both ways.

  • Kyle J


    The part that’s frustrating is how many Americans refuse to recognize the extent to which the government is involved in making their own health benefits available–Medicare, the favorable tax treatment and protections against denied coverage that comes with employer-provided insurance, etc.

    In a true free market health insurance system, only people who don’t need it can get coverage. There’s no profit in covering sick people.

  • DRT

    I miss this place. Oh, to be able to hang out somewhere and not be called to repent…thanks for providing this oasis Scot.

  • DRT

    If you are not friends with the Prez then you missed his FB today.

    It’s been exactly two years since President Obama signed health reform into law, and Obamacare is making millions of Americans’ lives better. If you’re proud to be standing alongside the President who got it done, stand up and say “Hell yeah, I like Obamacare”: http://OFA.BO/G5k4zA

  • Tom

    The Republicans had years to try and fix the helthcare issue and didn’t. At least the President cared enough to take it on. It is a moral issue and needs a good solution. After years of doing nothing, now the sit back and take shots at those who actually did something.

  • JohnM

    Kyle J – I’m misunderstanding Ezra Klein’s post, or you are – or I’m misunderstanding you.. Let me quote one paragraph from Klein to show what I mean:

    “Another reason that the program’s costs came in lower than expected is that fewer people signed up. The Congressional Budget Office estimated that 93 percent of Medicare enrollees would participate. Instead, 77 percent did. That meant costs were lower than projected, but not because the program was more effective than we thought it would be.”

    Seventy-seven percent participation. Now if it’d been mandatory 🙂 In any case the article seems to be making a point opposite of what you intended. What am I missing?

    Yes, social security and medicare “coerce” people into paying into the system – and I use quotes because I am no taxes-are-theft libertarian – but they don’t force anyone to purchase a product. If medicare required, under threat of fine, someone to undergo a procedure they didn’t want or think they needed THAT would be like Obamacare.

    The mandatory part bugs me a bit. However, I’ll admit the fact that I have and would seek to have health care insurance in any case kind of takes the sting out of mandatory. On the other hand I also see one more law backed by yet another threat hanging over the heads of the people. Don’t you ever get tired of that? That’s one thing. I also see one more entitlement (when the genie’s out of the bottle…)piled on top of the ones that we already have, and want to have, but don’t want to pay for. Nobody in this country is taxed enough.

  • Kyle J


    Prescription drug benefit is discretionary. Basic Medicare coverage is not.

    The word “entitlement” carries a negative connotation. Is it really a bad thing to be “entitled” to basic health care services? Keep in mind the population that benefits most from health care reform is the working poor. Conservatives trying to use the language of welfare here:

    I absolutely agree that taxation levels need to rise to match the level of services the large majority of the population favors. Even major GOP leaders don’t want to do anything to cut the three major federal spending categories in the near term: defense, Social Security, Medicare.

  • Kyle J


    As to whether the “threat” part concerns me, I worry more about the threat to someone who can’t get insurance coverage under existing rules and ends up dying or going bankrupt than I do about the threat of someone paying a small fine because they won’t buy insurance coverage, given that they’re pretty likely to still seek care I they get sick.

  • Jon Altman

    Everyone uses health care at some point. Hospitals are (and have been for years) REQUIRED to treat everyone needing emergent care regardless of ability to pay. The “cost shifting” from those who don’t pay to those with insurance is estimated at $1,000/person. All the ACA does is get the “free riders” to pay. This “personal responsibility” is VERY much a Republican idea-one praised by Mitt Romney in 2009. IF the same law had come down through the leadership of President McCain, Krauthammer would be praising it to the skies. The only “principle” of his that is offended is the principle that “nothing Obama does is good.”

  • CGC

    Hi Everyone,
    Well, this discussion shows how polarized Americans are on this issue and alot of it along party lines I suspect as well. Talk about coersion and no choices. We either vote Republican or Demoncrat (those are the only two real choices the American people are given). I am quite cynical of both sides anymore. So here are my few thoughts:

    1. Health care obviously needs reform (if people want to debate that so be it but this is a strong given as far as I am concerned). Typically the choice between the two parties (which are more alike than dissimilar as far as I can see) is the government takes over an area completely or the free market is left on its own to do whatever (therefore no reform at all). There seems to be a huge middle that never registers for these two groups.

    2. If left with the two options of choosing Obama’s reform versus no reform, then I suspect this reform could potentially help society better than the no reform (which appears to how things actually work out from a pragmatic standpoint).

    3. Lastly, if the government gets huge revunues to pay for health care, and looking how our government literally borrows (or steals money depending how one looks at it:–) from social security, I have no doubt that this will become the biggest slush fund for the government to take from. Whether Obamacare is good or bad for the country is yet to be seen but this last point will be an ongoing reality because this is how our government operates and this is what both Democrates and Republicans do!

  • Kyle J


    Can you explain to me how the government “takes over completely” under Obamacare? Most people are keeping current coverage. Some are being added through Mediciad. Most getting coverage newly are purchasing it on exchanges from private companies.

    This is, in fact, the middle ground. The extreme you’re talking about on the left would be a single-payer system.

    Once again, it’s impossible to talk about the actual facts on this issue.

  • JohnM

    Jon Altman #23 – “All the ACA does is get the “free riders” to pay.” Well now, that is a point I’d be selling if I were President Obama. Why doesn’t he?

  • @Kyle J: Klein’s article is remarkably similar to’s post of 3/16:
    (their post was corrected on 3/19)

    In this case, “entitlement” doesn’t refer to the right to “receive” basic services. It’s about how those services are paid for, which is not quite the same thing. So far as I know, federal and most state law already mandates that medical treatment may not be withheld based on ability to pay.

    The biggest problem with the ACA is that it simply won’t overturn the demographics. Those high tax rates on the wealthy will have to be passed on to the middle class as well if Social Security and Medicare stay as they are.

  • CGC

    Hi Kyle,
    I can see how you might of read in obamacare as a government takeover of healthcare but this is not what I was saying. I switched mid-stream (sorry about my obscurity in writing) and simply suggested that overall, these are the two overall choices typically given between the two parties (I agree with you that Obamacare is NOT the extreme). But neither do you know how this will morf in the future? My guess if the past is any precendent at all is obamacare will lead to the government taking over the whole health care system eventually (do you really believe that will never happen?). Nor am I saying that is even a bad thing except it seems things get pretty expensive when our government does anything.

    And I noticed you never responded to my last point which I think is the most damning thing when it comes to how our government does things. I remember the last conversation I had with a Christian friend of mine, he told me that obamacare was the Christian responsible thing for our country and helping poor people. I raised the point about government dipping and his only reply was “that’s just how it is” like there is nothing anybody can do about that. But that begs the question, is that a Christian responsible thing to simply look the other way and say “well, it is what it is” and that’s it? Even if Obamacre is the best choice at this time, I would be very hesitant to call it “the Christian choice” as my friend did. Politics is too messy for my tastes to stamp Christian in there any where!

    PS Kyle, I am probably more for it than against it left with the alternatives. I only hope they take the provision out of fining people who do not have health insurance (maybe they already have, I don’t know?).

  • CGC

    PSS – I guess I should of said I only hope they take the provision out of fining people who do not have health insurance and do not pay for the government’s plan.

  • Fish

    I am compelled to point out that what is known as Obamacare was actually first put forward by Nixon and then Ford. Conservatives at that time loved the idea of every citizen being required to carry health insurance and getting rid of freeloaders on the system, exactly like we do with auto insurance.

    Teddy Kennedy shut it down, believing that the US deserved a first-class single-payer system, the gold standard as proven over and over and over again elsewhere in the world.

    I am not sure when Americans will realize that the primary output of a for-profit health care system is profit, with the resulting consequence that those who do not represent enough profit will not get enough care, or in other terms, the placement of money above life.

  • Kyle J


    The problem is that if you take the mandate out but leave the part where insurance companies can’t deny coverage, people won’t buy insurance until they get sick and need it, and that will drive insurances prices up for everyone else. It all goes together. No one has achieved universal coverage w/o something like the mandate (although there are other variations that would work).

    While I agree you can’t pin any particular public policy down as being unquestionably the “Christian” one, I do think there is a major injustice, in the Biblical sense of the term, built into our current system. Someone like me, who has a middle class job and gets his insurance through his employer (1) gets favorable tax treatment and (2) doesn’t have to worry about getting denied because of a pre-existing condition. Someone with lower class job that doesn’t provide insurance gets neither of those things. The system is stacked against the guy at the bottom but trying to work his way up.

    While Obamacare may not be the perfect Christian response, I would assert that leaving the system as it is, which is effectively what conservatives are proposing, seems distinctly un-Christian. (And if someone thinks the GOP has an alternative that addresses the problem I’m talking about, please post a link to it.)

  • CGC

    I just want you to know I am one of those guys the system is stacked against at the bottom trying to work my way up or figure out something affordable? Right now I put some money a way every month as a kind of medical account to help pay my family health bills. I currently have no health plan. If the government plan is affordable and actually pays for major medical bills, then I will be happy at least. If it’s just as high or higher than what we have today with plans that really don’t even cover major medical (when you are not a part of a group plan) and the deductable is so high that you pay everything out of pocket, then I will be worse off if I can not afford it and have to possibly pay a fine on top of things.

    Actually, I am far better off than many of the people our church tries to help. I wonder what’s going to happen to these people who not only have no health plans but I doubt do not even have the money or the saving ability to pay the government? What is the government going to do to people who do not pay the fine? I see this as a kind of achilles heel to the whole thing. Either they don’t make them pay or they threaten or actually put people in jail? Either case is a lose/lose scenario as far as I can determine for the success of this part of the Obamacare plan. Maybe there is an alternative I do not see or am I missing something?

  • Kyle J


    The third leg to the stool (and the main cost component of the plan) is subsidies to lower income individuals to purchase coverage on the exchanges.

    Here’s a concise description of the whole thing:

    The solution — originally proposed, believe it or not, by analysts at the ultra-right-wing Heritage Foundation — is a three-legged stool of regulation and subsidies. As in New York, insurers are required to cover everyone; in return, everyone is required to buy insurance, so that healthy as well as sick people are in the risk pool. Finally, subsidies make those mandated insurance purchases affordable for lower-income families.

    Read more:

    Hope that helps explain things.

  • CGC

    Thanks Kyle,
    May God’s grace and love be with you all – Chris

  • Tim, #12, there are many Americans as flabbergasted as you are over why so many other Americans – especially those defining themselves as Christians – are opposed to single-payer health care, or mixed public/private care. The costs we pay for health care are exorbitant. Our daughter – who is studying in Japan, right now – had to visit a Japanese ER right after she arrived, and before she was enrolled in their national health program. (For some reason, Japan won’t allow asthmatics to bring their inhalers – disastrous after a 14 hour flight!) She paid less out of pocket for her ER visit and her medications than we pay here for a doctor’s visit (NOT an ER visit, which is more than 3 times that), and the pharmacy co-pay. We have excellent private insurance and pay through the nose in premium payments, too!

    The only explanation that makes sense is that medical & insurance industry smoke-blowing and obfuscation mask how much people are forking over to keep the money flowing in its current direction & to its current beneficiaries. I have relatives in medicine who’ve dedicated all their spare time before retirement, and then virtually all their time thereafter to educating Americans on universal healthcare & its benefits. The problem is that for all of us who try to educate, many profiteers of the current system pay people & media to obscure the facts, & fund “studies” which further their aims. It’s downright disheartening.

  • JohnM

    Ann F-R #35 – Why are you flabbergasted that especially Americans defining themselves as Christians (I take it you doubt they are)would be opposed to specifically “single-payer health care, or mixed public/private care”? Are these explicitly Christian means of delivering health care? Does scripture mention single payer health care? Do our ancient creeds single out mixed public/private care as the chosen means of delivering healthcare?

    Whatever the the benefits of government provided healthcare isn’t it really just an pragmatic and secular approach to meeting a perceived need? That doesn’t make it inherently wrong, but there’s no need to baptize it either, and certainly no warrant for questioning the faith of Christians who believe they see reasons to object.

  • JohnM, my comment actually reflected what I hear from my (mostly atheist) relatives who have worked as doctors, in medical schools, & as medical caregivers to everyone (including the poor, uninsured, indigent, homeless, and undocumented) when they express frustration w/ Americans’ stubborn intransigence about helping the poor, and caring for one another enough to build a social safety net for the whole community. My uncle & aunt – both medical doctors – display Matthew 25:34-40 on their fridge, and they’ve lived accordingly. Yet, they self-identify as non- Christian, because they so strongly disagree with Christians who won’t heed Jesus’ words. Furthermore, they have the financial facts, studies, statistics and the medical knowledge to back up the reasoned side for favoring single payer universal healthcare. Neither Jesus nor the reasons affect people who are “religiously” opposed to universal health care w/out profiteering (which necessitates gov’t involvement & oversight).

    Many Christians don’t appear to outsiders to be following Christ on this issue. If you don’t like their opinion & evaluation of “Christians”…

  • Joe

    “A hack’s hack” “Deliberately distorts” etc etc

    You people have met him or know him. Not. Stats can be rallied all sorts of ways. Just because you don’t like his, does not give yours any more verity. HE’s a smart guy, and no more morally self-righteousness than you all, apparently. Shee-eesh!

  • All I know is since Obamacare was passed, my share of the premiums on the health plan offered by my employer has more than doubled. Just for 2012, premiums increased by 50% (from $140 to $210 per paycheck), and they’re saying the company may not be able to pay in 2013 the portion of the family coverage they currently pay if costs continue to rise. All of this without any cost of living increase or other annual raises in our salaries in the last two years.

  • JohnM

    Ann F-R – But what do you hear from Christians? I’m not much interested in an atheist’s opinion on the authenticity of anyone’s faith, considering they must surely regard it as nonsense in any case. If the advocates of single payer universal healthcare are mostly atheists that fact hardly supports an argument for it being a Christian ideal. Assuming the financial facts and statistics do back up “the reasoned side for favoring single payer universal healthcare” that is only saying it is feasible.

  • John M, from my perspective as a Christian, which is shared by many (not all) of my Christian friends, there is
    1) no financial justification for not wanting a massive overhaul of the healthcare from for-profit in favor of nationally regulated universal health care (whether single-payer or a private/public mix such as Japan & France have), and
    2) no societal benefit from leaving so many people uncovered by medical insurance & with severely limited access to preventative health care.
    3) plenty of Christian motivation (e.g., Matt 25:34-ff) not to abandon the poor, sick, hungry and all our neighbors to people who want to profit off their health or sickness for as long as they can leech. Mutual insurance was intended, originally, to share risk and care for one another. Greed has overtaken the major industry players, which means that the effect is the people who are the most profitable to cover have the most money and the best health. Financial drains on the system – i.e., sick folks w/insufficient funds or quality coverage w/out loopholes – are to be plugged.

    Personally, I think that Haidt’s analysis of people’s moral psychology fits this discussion well. Every time the discussion comes down to the financial analyses, the vast wastefulness of our current system, and its awful injustice & inequity, people who want its continuation resort to non-rational, non-fact based arguments. Haidt found that moral reasoning isn’t necessarily in pursuit of the truth, but is frequently a post hoc mental fabrication “in support of their emotional reactions”. “If you think that moral reasoning is something we do to figure out the truth, you’ll be constantly frustrated by how foolish, biased, and illogical people become when they disagree with you. But if you think about moral reasoning as a skill we humans evolved to further our social agendas – to justify our own actions and to defend the teams we belong to – then things will make a lot more sense. …don’t take people’s moral arguments at face value. They’re mostly post hoc constructions made up on the fly, crafted to advance one of more strategic objectives.”(Haidt, The Righteous Mind)