Dems concede on ‘Obamacare’
From the political notebook:
❚ Guess who is now claiming, at least implicitly, that “Obamacare” isn’t working? Democrats.
That’s the silent premise on which the argument in favor of “Medicare for All” rests. And it is reasonably clear that the 2020 Democratic presidential nominee will be running on Medicare for All.
Obamacare was supposed to fill in the holes in our health insurance system, effectively providing universal coverage. There is Medicare for the elderly and Medicaid for the poor. Obamacare was supposed to guarantee comprehensive health insurance coverage for everyone else.
The federal government dictated benefits for employer-provided plans. Those without coverage at work could buy the equivalent through the Obamacare exchanges. In the exchanges, there would be a ban on medical underwriting and a limit on profits. And subsidies based upon income.
The call for Medicare for All is a statement that Obamacare has not worked.
Enrollments in Obamacare plans are substantially below projections when it was passed, and were even before Republicans eliminated the individual penalty for not having insurance as part of the tax cut legislation. The penalty goes to zero this year, and Obamacare enrollments have actually dropped.
There are things that the Trump administration and congressional Republicans have done to increase alternatives to Obamacare, such as extending the duration of gap coverage not subject to all the Obamacare restrictions and mandates.
But what is politically significant is that Democratic aspirants aren’t running on beefing up or fixing Obamacare. They are calling for it to be junked and replaced with Medicare for All.
Of course, Medicare for seniors is running out of money for hospitalization coverage. And Democrats are coy about how to pay for Medicare for All. The only possible source of enough money would be a European-style value-added tax to pay for the Europeanstyle health-care system.
A national debate about making health care a public good provided, directly or indirectly, by government is worth having. Republicans have failed to develop a market-oriented alternative with a sturdy enough safety net for those seriously or chronically sick.
But it should be understood that the debate is based upon a now shared view that Obamacare has been a bust. It does give those seriously or chronically sick access to a limited provider network. But it has ruined the individual health insurance marketplace for everyone else.
❚ The Phoenix Suns deal is another marker of the descent of Phoenix city government, although not for any reason that loomed large in the public discussion. The marker isn’t that the deal was made. Arena deals for professional sports teams are hardly unique, in the country or in the Valley. The marker is the add-on goodies that fetched the deal the votes.
In the end, the votes weren’t obtained by demanding concessions from the Suns that improved the deal for taxpayers. Instead, the votes were corralled by the Suns agreeing to make charitable contributions to causes favored by swing members of the city council.
Councilman Michael Nowakowski demanded that some of the rent to be paid by the Suns be earmarked for homeless programs.
Earmarking is bad public policy. All programs should compete for funding from the same general pot on an annual basis. But at least Nowakowski was playing with city funds.
Councilwoman Vania Guevara took it a step farther. She demanded that the Suns make a $10 million “community benefit investment,” including $2.6 million to Head Start, a Guevara favorite. And she bragged that Suns’ owner Robert Sarver had committed that her council district would be the principal beneficiary for the rest of the dough, “which is to be invested in schools, parks, athletic programs and more throughout the district.”
Such shakedowns for those needing city council approvals is a characteristic of failing cities across the country under liberal governance.
Municipal governance has been an unheralded economic asset for the Phoenix metro area. Our city governments have provided quality and reasonably efficient services, with clean and accessible governance.
That’s still generally true, but Phoenix city government has been developing troubling signs of slippage. The city appears to have a chronic budget imbalance that it keeps booting down the road. User fees are being siphoned off to support general programs. The city plays games with ballot measures.
It’s hard to feel sorry for the Suns. But if the cost of getting needed approvals from the city council becomes making side deals with politicians, the consequences will far exceed what happens with a particular basketball arena.