famous promise that Americans would be able to keep health
plans they like, even after the passage of Obamacare, has proven to
be so much bullshit. Caught between immovable quotes and
irresistable reality, Barry and friends now double down, explaining
to us that, yes it was a lie, but the deception was for the greater
good, whether or not we individually have been shafted. Welcome to
a world of bare-faced paternalism, in which pundits and presidents
sigh in relief at finally treating us all as so many little pieces
in the snap-together Lego world they’re cobbling together to
replace whatever it was that we inhabited before.
President Obama himself dismissed complaints from people losing
their health coverage because of the Affordable Care Act with an
updated version of “gotta break a few eggs.” In Boston, he shrugged
said, “a lot of people thought they were buying coverage, and
it turned out not to be so good.” Since Americans were too stupid
to recognize that their health plans were “substandard,” it’s no
great loss that they were swept away. People should shut up and
shop for a new plan that complies with the law, he suggested,
access to care.
Ezra Klein of the Washington Post took a
similar for-your-own-good view of the Affordable Care Act’s
Health-care consultant Bob Laszewski buys insurance on the
individual market in Maryland. His plan’s benefits are excellent.
“I can access every provider in the national Blue Cross
network––about every doc and hospital in America––without a
referral and without higher deductibles and co-pays,” he
But his plan is ending. The replacements all have tighter
networks, higher deductibles, and higher premiums. And Laszewski
isn’t alone. Many Americans who currently buy insurance on the
individual markets are seeing their plans canceled and finding the
replacement plans have higher premiums or stingier benefits. For
them, President Obama’s promise that “if you like your plan, you
can keep it,” is proving a cruel hoax.
But that’s OK, you see, Klein says, because Laszewski’s
attractive insurance policy existed under the old rules, and had to
make way for the more inclusive, and expensive, new medical
But all the possible solutions have tradeoffs. Laszewski’s
preference, he said in a recent interview, would’ve been for the
administration to grandfather in more existing insurance plans.
That would’ve meant higher insurance premiums in the exchanges, as
healthier people who’re able to buy into the individual market now
would’ve just stayed there. High-risk pools or any other kind of
direct, government-provided insurance or subsidy for the sick needs
to be paid for by someone.
There are no easy solutions to the health-care trilemma. Someone
And it’s apparently the administration’s job to pick the losers
according to its policy preferences. Laszewski is too healthy and
successful to benefit from subsidies or mandates that he be sold
insurance. That makes him a loser. So screw you, Bob!
pointed, last week to David Firestone similarly rolling his
eyes in the pages of the New York Times at people upset
over the federal government’s increasingly intrusive health
policies. “Republicans were apparently furious that government
would dare intrude on an insurance company’s freedom to offer a
terrible product to desperate people,” Firestone
Yeah, such a “terrible product” that people are pissed that the
new law makes those products go away. But they don’t know better,
so the decision has to be made for them.
But perhaps the most open and honest endorsement of paternalism
you’ll see that doesn’t actually use the words, “all within the
state, nothing outside the state, nothing against the state” is in
a column by
Timothy Noah at MSNBC in which he takes Charles Krauthammer to
task for daring to use the “p” word as a criticism:
What’s most striking here is Krauthammer’s overconfidence that
the word “paternalism” will be received as a crushing blow. In
truth it is neither exceptional nor disturbing for government to
place certain limits on individual choice, even when those choices
affect nobody else.
It is illegal to kill yourself, or to sell yourself into
slavery, or to sell your organs, or to practice prostitution. It is
illegal to take certain drugs, either recreationally (because
they’re addictive and/or potentially harmful) or as treatment for
disease (because their efficacy is not yet proven and/or the side
effects are unknown). State laws place maximum limits on how
much interest to charge for a private loan. Polygamy is illegal in
all 50 states. And if a state trooper catches you driving 90
m.p.h., you will be fined, even if yours was the only vehicle on
There’s certainly room for argument about whether particular
paternalistic laws are just and humane. But any notion that
government paternalism in general is inherently illegitimate stands
well outside the mainstream of practical governance.
You’ll notice that almost all of the restrictions and bans that
Noah cites as examples of beneficial paternalism have been
specifically criticized by libertarians and other advocates of
personal freedom as government overreach—especially pernicious and
dangerous overreach in the case of drug prohibition. The one
exception would be selling yourself into slavery, which many
libertarians consider a
logical impossibility, since you can’t alienate your free will.
Maybe that ability will be available as a rider on the new exchange
Noah dispenses with that inconvenient philosophical hurdle to
his “we all dig paternalism” argument by simply dismissing
consistent objections to exactly that as “outside the mainstream of
practical governance.” Paternalism is nothing for which to
apologize, he tells us, loud and proud. It isn’t a matter of
whether we should all be pushed around by the state, but
only the specifics of the pushing. Nothing else rates
So welcome to world of paternalism as explicit policy, in which
substituting the preferences of politicians for our own choices is
a moral good, and lying to us about the outcome of rules and laws
is just fine in the pursuit of a worthy goal.
And if you object? Well, “someone always loses” in the pursuit
of the greater good.
from Hit & Run http://reason.com/blog/2013/11/04/with-obamacare-and-other-policies-were-a