If Obama loses on individual mandate, does single-payer win?

| June 22 2012
Christopher Cook

The foregoing is one prediction, found on CNBC, for what might happen with the Supreme Court decision on Obamacare:

Perhaps Most Likely: A Split Result

Perhaps the most likely scenario is that the Court might strike down the individual mandate, or the expansion of Medicaid included in it, or both — but that it would uphold the rest of the law.

And that would bring with it still more uncertainty.

“From the insurance companies’ standpoint, [it would be] the worst outcome by far,” Litan said, because insurance companies would still be required to provide coverage to high-risk applicants who ask for it, “but they would lose the risk-pooling aspects of Obamacare.”

It might even mean fewer opportunities for individuals to purchase insurance on the independent market — ironically, the exact opposite of what the law originally intended.

Insurers have already begun lobbying Congress to fix that potential imbalance. But the current political environment in Washington makes it less than likely that Democrats and Republicans will work together. That could lead to still more uncertainty.

“If only the mandate is thrown out, look for insurance availability to dry up,” said Bill Maruca, co-chair of the health law practice group at law firm, Fox Rothschild. “Insurers might not be willing to wait for political fixes…and simply drop out of the market.”

It has been posited in many quarters over the last two years that Obamacare was unworkable from the start, but that the authors see that as a feature, not a flaw. For all intents and purposes, this is a form of “conspiracy” theory, though it doesn’t necessarily involve a secret cabal plotting in an underground temple over snifters of 200-year-old brandy.

Essentially, the idea is this: The Obamacare legislation is designed to drive private insurers out of the market, and to drive employers to give up providing health insurance to their employees. This, in turn, will drive people into the public system. If the system becomes overwhelmed and unworkable due to lack of funding, the system will collapse and people will clamor for a comprehensive fix. Since the private insurance market will have already been decimated, the only remaining option (so it will be said) is single payer. The idea in this theory is that single-payer, a.k.a socialized or national health care, was the goal all along, but the architects of Obamacare know that the American people will not accept it all at once. So, they devise a system whereby they finish off the already-beleaguered private insurance market, cause untold chaos spurring demands for a fix, and then they offer the big fix: fully nationalized health care.

So far, there has been no dispositive evidence produced supporting this theory. We do have the historical record of the left, and of political machinations, generally, which indicate that such things are certainly possible. But as of now, this is not known to be true or false.

Whatever the actual intent, however, the result may end up being similar. Obamacare, as written, is unworkable. If aspects of it are stripped out while others remain in place, it becomes even more unworkable. The ensuing crisis would create opportunities for the left to ram through more extreme legislation, riding a wave of public demands that something be done.

After all . . .

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