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Is ObamaCare actually too conservative for Americans?
Americans love their Medicare and like most components of ObamaCare. Did the president veer too far to the right in his signature law?
Did Obama look too far right?
Did Obama look too far right? (Getty Images)
P

erhaps things are starting to turn around for Healthcare.gov, the federal online marketplace for insurance plans set up under ObamaCare.

Yes, a significant chunk of the backend of the website hasn't even been built yet — the parts that send payments and federal subsidies to insurers will roll out in the next month or so, hopefully, according to the Health and Human Services Department — but things are steadily improving on the part of the website consumers use.

And enrollment numbers are rising, even exceeding targets in some states where the state-run websites are working reasonably well — states invariably "controlled by Democrats who are pushing the new reform," notes The New Yorker's John Cassidy. "In places where Americans know about the comprehensive and heavily subsidized health coverage available under the Affordable Care Act and can easily access it, they are doing so in substantial numbers."

But while ObamaCare's polling numbers haven't collapsed under the weight of the botched Healthcare.gov rollout, or even dropped more than a few points, the law is still pretty unpopular. A Reuters/Ipsos poll this week found 59 percent of respondents opposed to ObamaCare, while a new Washington Post/ABC News poll clocked opposition at 57 percent. Here's how that stacks up to ObamaCare's numbers since its inception, according to RealClearPolitics:

In the Washington Post poll, the part that seems to be dragging down the law is the part that has always been unpopular: The mandate that individuals buy insurance or pay a fine — nobody likes being told what to do, right? The requirement that businesses with 50 or more employees provide insurance is actually quite popular, with 58 percent in support and 40 percent opposed.

That is why the popular comparison of ObamaCare to George W. Bush's health-care reform — adding a drug benefit (Part D) to Medicare — don't quite work, says Jonathan Cohn at The New Republic. Both programs started out disastrously, and Democrats hope Obama can turn ObamaCare around as quickly as Team Bush did with Medicare Part D, which is now a firmly ensconced "part of the policy landscape." But Bush basically gave the drugs to seniors for free.

The Bush administration added the entire cost of its Medicare expansion to the deficit, Cohn says, while "Obama and his allies adopted a very different approach." They vowed that ObamaCare would pay for itself and even, over time, actually reduce the deficit. "Critics mocked them and, to this day, few people seem to believe them. But the official projections suggest they were good to their word." Cohn continues:

But fiscal responsibility is not easy. To offset the law's new spending — and, by the way, to reduce health-care spending overall — the Affordable Care Act raises revenue and cuts spending.... By taking these steps, ObamaCare's architects guaranteed they'd make some people angry. And that is the biggest difference between what Bush did and what Obama did. Medicare Part D was all gain, no pain....

The Affordable Care Act, by contrast, has gain and pain.... The political backlash Obama and his allies are facing, evident in a series of new polls, has a lot to do with poor implementation.... But some of the backlash is a product of the policy's trade-offs — trade-offs that ObamaCare's architects embraced because, unlike their predecessors, they happened to take fiscal responsibility seriously. [New Republic]

Frustrated liberals will tell you that, despite the headline poll numbers, a significant chunk of the opposition to ObamaCare is from people who think it doesn't go far enough. Medicare itself, after all, is so popular that only the brave or foolhardy politician suggests even trimming it back. Plenty of people, especially on the Left, are miffed that ObamaCare doesn't include the "public option" to enroll in government health care, especially if private insurers don't step up.

The Washington Post's Ezra Klein has explained that this was a conscious decision by Obama and congressional Democrats, based on what they believed were the lessons from Bill Clinton's failed health-care overhaul in 1994: People are afraid of losing their health care, and ObamaCare was designed as the least disruptive way to reform America's entrenched health insurance system. The vast majority of people will keep their health insurance plans, whether they like them or not.

The problem conservative critics of ObamaCare have to contend with, says Andrew Sullivan at The Dish, is that the "U.S. pays far more and gets far less in health care than any other comparable country," especially those like Britain and Sweden with socialized medicine. The Affordable Care Act isn't perfect, he adds, but it's at least "a good faith attempt at integrating the existing structures of American health care into a better system that can expand coverage and also control costs."

In that sense, once again, I think Obama is the conservative in this — and many ideological liberals will not disagree. It may be that this conservative compromise won't work; but a more bare-bones insurance regime which does not have to include the basic needs of most lives, and skimps on preventative care, is a false economy. [The Dish]

"I'd add some more conservative ingredients to the mix," Sullivan adds, but "if you want a free market in health care, you have to let people die on the streets or in agony at home rather than seeking mandatory help in an emergency room, if they have not been able to buy insurance."

Anything else is socialized medicine, which we've had in America since 1986. The question is simply whether we want to have the most f—ed-up, inefficient, and inhumane socialized system on the planet or whether we have the political courage to tackle this. Decry Obama all you like, but he has tackled this. And the pile-on is a form of denial that we have a problem. [The Dish]

Peter Weber is a senior editor at TheWeek.com, and has handled the editorial night shift since 2008. A graduate of Northwestern University, Peter has worked at Facts on File and The New York Times Magazine. He speaks Spanish and Italian, and plays in an Austin rock band.

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