The Obamacare debacle challenges a number of liberal mantras that undergird a whole set of policies and campaign appeals on which the Democratic Party has relied for decades. Here are the top 10 liberal tenets threatened by Obamacare:
1. If there is a problem, the federal government should attack it.
2. Government can compel people to act against economic self-interest by passing laws.
3. There is no downside to big government.
4. The welfare state is the best mechanism to help the poor.
5. Those opposed to big government hate the poor.
6. Government is capable of running highly complex systems effectively.
7. When addressing big problems it is best to centralize and standardize.
8. Unintended consequences of government programs are a small price to pay.
9. People will trust the government with private decisions and personal information.
10. Spending more and taxing more are evidence of concern for the poor.
All of these precepts have been challenged by conservatives, but there is nothing like a real example and personal experience to drive home a message. We don’t have just a few “glitches” or even a time crunch for putting up the exchanges, we have in Obamacare a fundamental misunderstanding of the limits of the government and citizens’ aversion to big, complicated entities. The effort to construct one big system with a highly regulated product (Obamacare-standard insurance) may in fact be the entire effort’s undoing.
Surely there is a volume of exchange shoppers, but not so great, as a Democratic congresswoman explained, in comparison to the traffic of many other Web sites and nowhere near the administration’s estimates for the first round of sign-ups (7 million) or the size of the intended beneficiaries (30 million!). The government’s decision about what people wanted (expensive, gold-plated insurance) might just be wrong. Maybe people just want catastrophic insurance or want self-insurance. Even on penalty of a fine, the government might not be able to herd all those healthy uninsured people into the system, which is the basic element for the entire exchange program to operate.
The exchanges at the state level are operating better, suggesting smaller is easier. But even there it is hard to break out who is signing up for Medicaid and who is purchasing insurance.
This is not to say government doesn’t do anything well. It calculates and sends out Social Security checks with remarkable efficiency. We have the best military in the history of mankind. But when it comes to providing personal choice and duplicating what the private sector does, it is remarkably inept. The more complicated the product and the more individualized it must be, the worse government does. (This is the giant argument for vouchers, for example, in lieu of government-run housing, job training, schools and the like.)
As for unintended consequences, we’ve had a long history in which the ill-effects of programs (e.g. pre-reform welfare) swamp the intentions by creating a raft of bad incentives (e.g. family dissolution, suppressing the work ethic). Sometimes the cure really is worse than the disease. (In the case of Obamacare, millions of people have been dropped by insurance or had hours reduced in contrast to the tens of thousands estimated to be enrolled.)
All of this suggests that the amount the government collects from taxpayers, the amount is expends on behalf of those in need and the size of the federal government aren’t the best predictors of success nor are they indications of one’s level of compassion for those who need help. That’s been the conservative rebuttal to arguments that they are cold-hearted or indifferent to the fate of the sick, elderly and poor. Now some of them may be (they have no monopoly on compassion), but opposition to big, costly and unwieldy government programs is not proof of it. It would help, of course, for conservatives to come up with better solutions and to explain their policies in terms of actually helping the needy rather than balancing the federal books. But that said, this is a golden opportunity for conservatives not only to cement their essential critique of the liberal welfare state but also to offer something better.
Conservatives will miss (again) a golden opportunity unless they make a big-picture case against Obamacare that is applicable beyond this one program and they present a constructive vision of conservative reform, which envisions a more decentralized, personalized and effective means of helping those who in need while minimizing the negative consequences. That is the task for conservatives, who should find common cause in both dissecting the problems of the liberal welfare state and in coming up with innovative solutions to make Americans’ lives better.