The Real Meaning of Obamacare

Back in 1996, I wrote a book called The High-Risk Society. The book was based on the vision that Americans had to embrace risk and innovation in order to achieve faster growth and long-term prosperity.

An essential part of that vision, however, is the creation of a much stronger safety net.  If we are going to ask Americans to take risks for growth, to accept disruption in return for innovation, they have to be protected from the worst consequences of failure.

In particular, it becomes much harder to take a chance on growth if it means you might lose your healthcare. That’s why Obamacare, despite being ungainly and awkward, is an essential step towards a high-growth economy. People who want to start a new company or join an innovative new enterprise shouldn’t have to worry about whether they will be able to get healthcare. People who want to work halftime and go back to school shouldn’t have to worry about whether a sudden medical problem will throw them in the poorhouse.

Obamacare is a step towards unleashing the creative juices of Americans.  There are lots of problems, of course. We need to ensure that the new Obamacare bureaucracies don’t strangle innovative companies. But now that the basic mechanisms are in place, we can move onto the more important task of empowering innovative and hardworking Americans.

Comments

  1. Do not agree , growth will stall and Obamacare will drag economy down

  2. Wrong on the basic fact that the mechanisms are *not* in place, as the majority and most disruptive of them have yet to take effect. The ones that simply fall as mandates to the states run a serious risk of not being properly imemented (if at all) in some hostile states. The provisions that are taking effect are already causing layoffs in smaller proportions. This situation will probably only worsen as businesses attempt and often fail to adjust to the myriad of provisions in this law.

    Universal health care might possibly be a good for the reasons you post above (though there is a robust argument that removing the basic responsibility for providing for one’s own healthcare may be a moral hazard, and may through the way it changes the relationship of man to the state actually stifle the healthy-risk-taking behavior you imagine it will unleash). However, foisting the concern onto the private sector was not the way to do it.

  3. I absolutely agree that in a economy of creative destruction and fast paced growth, healthcare needs to be delinked from employment. The old model of tax deductibility for employer plans was meant for our parents, who typically stayed with the same job for a long period of time. But Obamacare doubles down on this through its employer mandates, and for those of us who have the least skills and work at entree level jobs, will have the most punitive effects on employment, particularly in finding full time work. The individual mandate will further hit take home pay for young people as they tend to not have moved far enough in their career to find a job that offers insurance or make a wage high enough to afford a plan through the mandated state exchanges- these plans will likely be very expensive due to added federal and state requirements on select coverage.

    That essentially leaves a large segment of Americans, both currently uninsured and soon to lose their coverage due to economic and unintended side effects of this bill, at the mercy of Medicaid, a costly yet poor quality plan meant for the most poor among us. Doctor reimbursement rates here have already been cut before the bill was passed, which means we are only crowding more people in a system of diminishing returns.

    What we need is a focus on transitioning to portable plans, like the transition from defined benefit retirement to 401ks, IRAs, etc. Expanding the tax status given to employers to individuals would be a start, or perhaps incentivizing medical savings accounts. More choice, not less, should be the vehicle to lower costs and change the way healthcare is delivered.

    • Michael Mandel says:

      Obamacare was never a cost-cutting plan, it was a plan for extending coverage. Of course we can think of all sorts of alternatives we would like better. The only problem is, there was no feasible political path for the others.

  4. the hitman says:

    So, punishing someone for not purchasing a product makes take risks! I have never read anything more asinine!

  5. Small business owner says:

    Our business is small. Just the owner and one employee. We started our practice from scratch with zero patients. It is always a struggle to build a practice, but add in the 2013 Obamacare medical excise tax along with lost business due to larger companies laying off in our community, then it’s hardly a risk worth taking. People don’t realize the initial risk of starting a business. It costs a lot of money upfront which usually is borrowed. There’s usually more money going out than coming in for the first couple of years, which in turn affects our personal household bills and savings. With this new law about to be fully executed, we find ourselves in a terrible situation. I find this article to be on the same par with individuals who lack basic mathematical knowledge as well as economic knowledge. I say that with all do respect, but people have this false idea that Obamacare is free, yet someone like us ends up paying and are somehow lost in the equation. With an already struggling first-year business, how can we possibly handle another blow? As I stated before, it’s basic mathematics.

  6. Our business is small. Just the owner (my husband) and one employee. We started our practice from scratch with zero patients. It is always a struggle to build a practice, but add in the 2013 Obamacare medical excise tax along with lost business due to larger companies laying off in our community, then it’s hardly a risk worth taking. People don’t realize the initial risk of starting a business. It costs a lot of money upfront which usually is borrowed. There’s usually more money going out than coming in for the first couple of years, which in turn affects our personal household bills and savings. With this new law about to be fully executed, we find ourselves in a terrible situation. I find this article to be on the same par with individuals who lack basic mathematical knowledge as well as economic knowledge – I say that with all do respect – but people have this false idea that Obamacare is free, yet someone like us ends up paying in the long run and are somehow lost in the equation. With an already struggling first-year business, how can we possibly handle another blow? Our only hope is that when this law goes into place, Congress will realize the damage it’s causing and replace it with only necessary provisions. That being said, even if it gets “fixed,” I’m not sure the scoialist mentality we’ve encouraged in the country will ever be fixed, and that concerns me more than even the chance of losing our business.

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