There is an increasing drumbeat as to whether President Obama made a serious political mistake early in his presidency by focusing so much of his time -and the country's - on health care reform.
Not that reforming the health care system isn't important. But given the dire economic circumstances the country faced - and still faces - and the manner in which this particular health care bill was passed, it could go down as one of the costlier political stands of the last half century.
Whether this sweeping law is declared unconstitutional by the U.S. Supreme Court in the next couple of weeks is almost beside the point. The decision to push it through over the partisan objections of every Republican in Congress poisoned the political environment in Washington for the rest of the president's first term.
There's no doubt that some of its components were and remain popular.
It allows children to stay on their parents' health insurance plans until the age of 26 and it prohibits insurance companies from dropping sick clients while requiring them to cover pre-existing conditions.
But the president's claim that those things could be done without increasing the overall cost of health insurance was rather obviously not the case from the get-go.
The law requires the uninsured to get insurance or face a federal fine. There are two problems with this requirement; one constitutional, the other practical. The individual mandate that requires one private citizen to buy a service or product from another private citizen raises serious constitutional questions.
But the practical problem with this provision is that it makes more sense - as the law is written - for a young person to forgo insurance and pay the fine because the fine is less than the average policy costs. And this can be done risk-free because the law requires insurance companies to cover pre-existing conditions and insurance companies are no longer allowed to deny coverage to the sick. If you could wait to buy homeowners insurance until after you were robbed or your house burned down and still get paid, why wouldn't you?
At a time when businesses are hesitant to hire, the Affordable Care Act has made them even more hesitant to do so. The law requires many employers to provide health insurance for their employees or pay a fine. If you increase the cost of labor, which this law does, fewer jobs will be created.
Moreover, the law doesn't bend the health care cost curve any way but up. While the current system is a mess of health care consumers, third-party payers and the overuse of an overburdened system, "Obamacare" makes it worse. Insured people use the system more than uninsured people. If you insure more people, the system will be used that much more and overall health care spending will have to go up, not down.
Regardless of how the Supreme Court rules on its constitutionality, the law will remain unpopular with many. More Americans dislike the law than like it (44-37 percent, according to the Kaiser Foundation.)
It's gotten to the point where even Austan Goolsbee, the University of Chicago economist and up until recently an adviser to the president, has suggested that President Obama should admit the law was a mistake - at least (and obviously) in political terms. But it's hard to imagine this president - or any president - admitting to such a thing, especially in the midst of a re-election campaign. (Imagine George W. Bush telling the nation that the invasion of Iraq was a big mistake as he ran for re-election in 2004.)
Still, it is quite clear that in his rush to pass something monumental, Obama failed to see the political fallout, economic shortcomings and expense of this massive and unwieldy reform attempt.
In 2009 and 2010, the president and his party controlled both legislative branches and the White House. You can blame the Republicans for being obstinate, but ramming this bill through the way the Democrats did showed a faith in their own rightness and superiority that was not warranted. Their party paid for it in the 2010 mid-terms.
President Obama already has admitted to campaign donors that health care reform is probably going to have to be revisited next year.
He's certainly right about that.
With or without him in the Oval Office.
- Delaware County Daily Times