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What If We Thought of ObamaCare as a New Model for Future Government Programs?

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By Lambert Strether of Corrente.

What if I haven’t been nearly cynical and paranoid enough?

I’m going to hurl myself into the void on this one, partly because I’m still feeling the effects of the full moon, partly because the shortening days are really starting to get to me, but mostly because I don’t know the answers to the questions I’m going to raise. So please forgive the rambling, and the almost complete lack of linky goodness. Also too, it would be irresponsible not to speculate!

* * *

One of the pervasive tropes that factions in the political class have propagated in the “left”-leaning discourse of the present moment is that the Republicans/Tea Party/conservatives are reactionary and backward-looking, that they want a future where the United States has returned to an inferior past, like the Gilded Age, or even the antebellum South.[1] There’s even a whole cluster of tropes that conservatives like say Wisconsin’s Scott Walker or Alberta’s Ron Harper are really seeking secession and the restoration of the Confederacy. (OK, I made up the part about Harper.) Never mind the teleology implicit in that view, also implicit in the concept “progressive” (progress toward what, one might ask). But for the sake of the argument let’s accept it. But do we ever consider the notion that the Democrats/”progressives”/liberals also have a future in mind for us, forward-looking but just as horrific in its own way as a future that’s backward-looking? I don’t think we do, and in this post I would like to fight my way towards doing so.

Consider ObamaCare. What is Obama’s essential architecture:

  1. A market set up by the State (ObamaCare’s “marketplace”)
  2. In which citizens must purchase a product (the mandate to purchase health insurance)
  3. From private rent extracting[2] entities (the insurers).

And why? Why pick that architecture? Shorter: Because The Market. In longer form: Given the proven success of other models worldwide — whether centrist, like single payer, or left, like a national health service — the choice of this market-based solution can only have been ideological; indeed, the touching faith in The Market shared by the legacy parties and the political class in general is quasi-religious in nature, and the mandate is equivalent to conversion by the sword. (The good faith conservative critique of ObamaCare, abandoned for whatever reason in favor of frothing and stamping about “Jawbs!”, rate shocks, and The Collapse Of Civilization As We — and most definitely “we” — Knew It, was that people shouldn’t be forced to enter a market because liberty.) Note that there’s plenty of reason to think, even accepting the moral primacy of markets, to think that ObamaCare won’t be able to structure a particularly good market, if the welfare of the citizens/consumers forced into it is a concern. First, Choice, handmaiden of The Market, has been shown to create anxiety and depression; too many choices make people just as unhappy as too few. Second, there’s no real reason to think that ObamaCare’s market won’t be just as much of a lemon market as the market or private health insurance. Indeed, one might make the case that ObamaCare has nothing to do with health care at all: ObamaCare makes no pretense of being universal, or “bending the cost curve,” or improving health outcomes (although it may do so, its advocates are notably reluctant to make that claim[3]).

So, if we accept the radical claim that ObamaCare isn’t about health care[4] then what on earth is it about? Let’s return to the architecture above, and imagine a 2021 “progressive” program called, oh, HillSecurity (or MittSecurity, or CorySecurity). This program would “save Social Security” and it would look like this:

  1. A market set up by the State (HillSecurity’s “marketplace”)
  2. In which citizens must purchase a product (the mandate to invest in a personal retirement account via a payroll tax and, possibly, additional contributions)
  3. From private rent extracting entities (large financial firms).

But where is “Social Security,” you ask, in 2021? Well, it’s a “public option” in the HillSecurity Marketplace, just as, in 2017, Medicare became a “public option” in ObamaCare’s marketplace.[5]

Because think about it, liberals: If you accept that the delivery of health insurance should be structured like ObamaCare, is there any reason to deny that Social Security should be? Or any other government service for which a “marketplace” can be structured? (Police? Fire? Parks? So-called “public” transportation? Why not tax collection, in a happy troilism with debt collection and repo?)

One of the happier features of the radical claim that ObamaCare is a model for other rental extraction systems yet to be built, is that it explains why what seems to be a misfeature of the ObamaCare Federal Exchange is in fact a feature. Many have been puzzled by the Federal Exchange site designer’s decision (that is, by the White House’s decision) to put an extremely onerous registration process first, before “shopping” and price comparison can even begin. After all, purchasing insurance on Exchanges was supposed to be like purchasing an airline ticket online, and Expedia doesn’t force you to register before comparing prices for flights. And Best Buy doesn’t demand to see your ID before you look at their flat screen TVs.

But suppose that the Exchange put registration first because it’s most important? After all, if one wished to roll out rental extraction marketplaces for many government services, the first requirement is to be able to uniquely and accurately identify citizens consumers in all their transactions, in order to ensure not only payment, but compliance with all the other rules of the marketplace.[6] And ObamaCare supplies that infrastructural requirement: It is quite rigorous — worse than Apple — in its demands for identifying information, demanding not only a valid email address — what other government program does that? — but rejecting applications and demanding paper confirmation whenever the consumer reporting agency to which name and address confirmation has been outsourced throws a flag.[7]

So, that’s the claim, right or wrong: ObamaCare’s “marketplace” architecture puts citizens at the mercy of rental extractors in marketplaces, and can be built out into the delivery of many other government services, especially Social Security; and that ObamaCare puts a key piece of infrastructure in place for that process: A single unique and computer-discoverable transactional identity for every citizen consumer that can be used to enforce compliance with whichever rental extraction regimes the citizen consumer has signed up for.

Well, as I said, pure speculation. Tin foil hat time! And what’s that high-pitched warbling sound? But if I am right, it seems to me that a “progressive” future where the chief duty of a citizen is to “choose” to bend the knee to one or another mandated rentier is every bit as horrific, in its own way, as a “reactionary” future of deference to slaveholders or feudal lords. Perhaps the “progressive” vision is a little more subtle. But is it any less brutal? Surely there is some other way?

NOTE [1] But not, say, an edible forest as described in 1491.

NOTE [2] Modulo, possibly, co-operatives.

NOTE [3] The touted wellness programs are, if perhaps not scams, certainly not evidence based.

NOTE [4] Or Obama, for that matter, unless we factor in the Presidential Library doubtless to be paid for by a very select segment of a grateful populace.

NOTE [5] Naturally, Medicare and Social Security will have been crippled, to provide a “level playing field” that avoids “unfair competition” with private entities.

NOTE [6] For example, smokers can be charged higher premiums under ObamaCare, which is an incentive to cheat when answering that question. However, given sufficient information, that answer could be cross-checked (say, by a consumer reporting agency that had access to purchase records). And there’s no particular reason that this logic should be restricted to smoking. Why not, in President Bloomberg’s world, soda? Of course, the integration of consumer data with EHRs will never happen. That would be science fiction stuff.

NOTE [7] As a glorious bonus, ObamaCare forces citizens consumers to spend hours cleaning up bad data that the credit reporting agencies own and rent — for free!

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108 comments

  1. Skeptic

    Well, that Trojan Horse Theory sounds pretty good to me.

    A long time ago, I began to view Life as a series of Transactions. So your phrases “transactional identity” and “rental extraction regimes’” certainly strike a chord in my lifestyle strategy which is to limit my Transactions with government and their 1% owners. This is not completely possible to do but some steps can be taken, one of them is to buy products and use services that are not connected to their Big Picture.

    Thus allow me to engage in your line of thinking. I own a 2007 Japanese manufactured compact car. To keep the warranty in force, I had to comply with the required maintenance schedule. Fortunately, you are given the choice of having this maintenance done by the BIG Manufacturer or an outside certified mechanic. Again fortunately, there are still independent certified mechanics. So, I used an independent certified mechanic over the BIG Manufacturer. Over the years I have had the car, I have built up a good relationship with this mechanic and get good, honest, reliable and sometime amusing service. And, he doesn’t even have a computer! Well, maybe a diagnostic one.

    If on the other hand, I had had all my maintenance work done at the BIG Manufacturer, they would have the complete record on my car and on my personal maintenance habits and predilections. They might have been able to sell me a few “hot apples pies with that” and find I am a somewhat pliable, compliant person who maybe never questions a maintenance bill or some work that maybe the vehicle did not need done. All this on computer of course and accessible to the analysts in Tokyo. BIG DATA, you know. Keep in mind that BIG Manufacturer’s personnel are experts at extracting maximum revenue from their amateur customers. Sounding a little like Obombercare?

    For those who see outrageous crazzzy CONSPIRACY THEORY here, I must go on. This BIG Manufacturer’s vehicle has a device in it that notifies you when the care needs maintenance. Turns out there was a class action lawsuit against BIG Manufacturer that the odometers were defective, reading too high! First ask yourself how in this advanced day and age odometers can be defective. Secondly, maintenance schedules are determined using the odometer reading. Thirdly, leasing rates and contracts are determined by the odometer reading. This class action was won by the plaintiffs against BIG Manufacturer. This only came to light because a lawyer leased one of these vehicles and kept meticulous track of his mileage for expense purposes. Otherwise, this matter would never have seen the light of day.

    So, ample evidence for me that the fewer the Transactions with .gov and the 1%, the better.

    1. craig

      Abolition of cash is the real endgame. The State wants to be able to see every transaction. Everything you buy, sell, use, everyone you pay or get paid by, everywhere you go: nothing ‘off the grid’.

      Once your state-mandated transactions (RIP, Commerce Clause) are routed through a common state-created identity verification system, it’s not that big a step to then mandate a state-issued electronic ID badge/debit card.

      This will be sold as a convenience to the user, for fraud and identity theft protection. In reality, it will be aimed at maximizing the hidden benefits that accrue to the regime and its friends (IRS tax collection, NSA surveillance, data ‘sharing’ with e.g. OfA and ACORN).

      People may not call this scenario the Mark of the Beast outright (only bitter clinger kooks believe that religious stuff anyway), but it’s not substantively any different from that.

  2. H. Alexander Ivey

    Lambert

    You have a good idea here. Examine the system by its required inputs and delivered output. Mix in the general gestault of the mechanism used by the system (the internet), consider the POV of the designers and engineers building the system (no privacy concerns, no social ethos), and I think Obama Care makes sense.
    You are right, the outcome, by Republicans or Democrat, is the same: indentured slavery.

    1. sue

      Mr. Strether,

      What if Obama healthcare $ubsidies are no different than Bush-Cheney Medicare part D-a giveaway to insurance co’s, just as Bush program was a giveaway to pharmaceutical co’s, in pursuit of corporate campaign contribution capture…what if this is the “new corporate culture”?

      1. redleg

        That’s the name of the game – looting.
        Iraq war = looting tax $$ via no bid/oversight contracts.
        Medicare D = looting.
        Bankruptcy reform = looting.
        TARP = looting.
        Obamacare = looting.
        etc.

        In return, the pols get campaign contributions/cushy jobs and their staffers get revolving door opportunities.

        It’s a feature, not a bug.

  3. Bill Michtom

    I think you mean Obamacare here: “What is Obama’s essential architecture?”

    Otherwise, the answer is carbon-based life form.

  4. Mcmike

    Yes, it is a giant step deeper into the totalitarianism of the corporate state. What makes it so shocking i think, is it is a particularly brazen, open, bold step. But it is still just another step on a journey for which we have been long preparing. And been being prepared.

    But i dont see anything left or progressive about it. Sure, partisan dems defend it, and delusional libs that have not thought it through.

    But the thing itself, it pure fascist corporatism – with the government serving as the enforcer for the corporate state.

    The thing is not so much driven by an ideology of a supreme market, but by the necessary corolary: of the citizen as generic supplicant consumer.

    1. bh2

      “Yes, it is a giant step deeper into the totalitarianism of the corporate state.”

      Simpler to state what it is in plain language: fascism.

      The left are fully on board with that outcome. And they will have it.

      1. Mcmike

        Who on “the left” is fully on board with fascism?

        If you mean establishment dems, I would argue that they are not at all “of the left”, with the exception of a handful of mainly harmless social/civil questions, and abortion (not so harmless).

        But to be truly of the left, one is, by definition, anti-fascist.

        1. sue

          Obama has indeed already defined that the “professional (educated) left” is his enemy-he flatly so stated.

          Interesting, isn’t it-the right has no such “follow their leader problem”.

          1. NateWhilk

            Where did Obama use the exact phrase, “professional left”? All I’ve come up with is that Robert Gibbs, Obama’s press secretary at the time, said it in August 2010. There he was referring to people like Maddow who wanted Obama to go even further left. He also said, “I hear these people saying he’s like George Bush. Those people ought to be drug tested. I mean, it’s crazy.”

        2. bluntobj

          It’s not an opposite; if you think of “left” in its more extreme forms, such as communism, is very closely related with fascism. The only difference is the degree of illusion of ownership that was permitted.

          1. sue

            Sir,

            Do you seriously believe Obama was calling out communists within his own party, when choosing to castigate his “professional left”?

            1. bluntobj

              Sir,

              This is a reply to mcmike’s statement:

              “But to be truly of the left, one is, by definition, anti-fascist.”

              Where did you get the idea that I was referencing Obama or anything he may have said or done?

        3. Tedd

          “But to be truly of the left, one is, by definition, anti-fascist.”

          Nonsense. Many, many mid-twentieth century leftist intellectuals initially supported fascism. Leftist philosophies are generally internationalist, rather than nationalist, but, other than that, you can’t tell the players apart without a program. American progressivism, with it’s emphasis on nationalism and crony capitalism, and its demonizing of bankers, is practically a dead-ringer for German National Socialism, if you leave out the anti-semitic part.

          1. Andy Freeman

            > American progressivism, with it’s emphasis on nationalism and crony capitalism, and its demonizing of bankers, is practically a dead-ringer for German National Socialism, if you leave out the anti-semitic part.

            You haven’t been paying attention. The “pro-Palestinian” wave in modern progressive politics is very anti-semitic. They call it “anti-zionist”.

          2. Strangely Enough

            Nonsense, indeed. Unless one can ignore the fact the establishment Democrats don’t appear to be very “progressive,” and are certainly not “the left.”

            Why do people on the “right” try to equate leftists with Nazi’s? I imagine Prescott Bush would have been surprised to find out, in addition to being a supporter of German industry under Nazism, he was also a Bolshevik.

            1. Tedd

              Fair enough, the crony capitalism might be mainly a product of “establishment Democrats.” But the rest is pretty standard progressive fare. And pretty standard progressive vote for those “establishment Democrats.”

  5. financial matters

    Very good post and warning for the future. Medicare and social security are relatively simple programs which is why they work. They don’t get into the opaque financialization world where money flows upward.

    A lot of good work has been done on civil rights but financial rights have been an afterthought and left to the wrong people and therefore have sabotaged various types of social progress. I see MMT type programs as trying to educate people on how ‘finance’ can work for the benefit of the general public. Their policy prescriptions such as Job Guarantee and Living Wage can go a long ways towards wealth redistribution.

    http://neweconomicperspectives.org/2013/09/a-financial-sovereignty-strategy-for-egypt.html

    ‘The Job Guarantee program can be adopted through the democratic process as an overarching plan to restore financial sovereignty, promote full employment, sustainability, higher quality of life, and long-term prosperity. All of this is desirable, feasible, and affordable. Those who think otherwise and yet still aspire for a democratic society in Egypt will by sorely disappointed to know that there can not be true democracy without full financial sovereignty to deliver social and economic justice for its people.’

    Dr. Fadhel Kaboub is an Assistant Professor of Economics at Denison University (OH) and a Research Associate at the Levy Economics Institute (NY) and the Center for Full Employment and Price Stability (MO). His research focuses on job creation programs, monetary theory and policy, and the political economy of the Middle East. For more on his work, visit http://www.kaboub.com

    1. Banger

      The American people do not want a job-guarantee program and would never agree to a full-employment system. Why? Because in our culture there have to be winners who gain fabulous advantages, rewards, and praise and losers who must gnash their teeth and either die or come back to the competition filled with intense desire to succeed by any means necessary–or so the myth goes.

      Connected to this attitude, our leaders always talk about “hard” work as if the “hard” part was a virtue. I don’t want work to be “hard” I want it to be smart, elegant, and give me and others time for goofing off, playing, partying which, studies show increases creativity. As long as we hear that we should be rewarded for “hard” work there’s no hope.

      1. financial matters

        I agree more with your second point. I think our culture has to be more and more enforced with a police style state especially as inequality increases.

        I think there is support for a more ground up approach. Over 90% of people were against TARP. That was the right gut feeling.

      2. Yves Smith

        I don’t agree. Tons of people are desperate for work. Polls show consistently that people rate unemployment and underemployment are our biggest economic problems now. And the works programs of the 1930s did great things, including create a lot of good public art and parks.

        1. Banger

          Of course, everyone is for Mom and apple pie so I don’t really think polls accurately reflect what people really think both consciously and unconsciously. Our mythological framework tends to be individualistic and competitive in outlook. For example, WPA programs would be viciously attacked and would those attacks would resonate and work for the majority of the American people and thus would be opposed. Americans believe, as polls show, an amazing array of contradictory things.

          All this was even true when leftist ideas had more resonance in decades past. What people want is a highly competitive capitalism that lifts all boats because all boats work “hard” and act like the mythological “white man”; second to that would be a capitalism that lifts most boats and so on. Down last on the list is a country that lifts all boats simply because we ought to have an egalitarian society.

          1. Yves Smith

            The public objects to makeworks. We have crappy infrastructure, dirty roads and parks, no child day care, etc.

            I don’t see any evidence that people object to having people paid to work. They object to welfare, payments with no corresponding work. Huge difference.

        2. Paul Tioxon

          The US Postal Service could be a good start to hire IT pros. The web designers and software engineers and other server farm network admins who would be needed to build a commercial free e-mail service. In case many reader haven’t notice, the strategy of the first one’s free kid, and then you’re an addict is being used by google. Your email is now an impossible to navigate cluster of sectors for 3 categories of emails, assorted ads blizting you everytime you log on and much too much cross merchandising of google this and google that.

          If you just want to jot a note, send a pic or a link, I believe the Postal Service could build and maintain an email site for a fee that people would pay for, if operated just like the brick and mortar post office. That is, you could subscribe or on a piece by piece basis, send anything electronically, for a flat fee, including your mortgage payment or utility bill.

          I want the USPS to build a 21st century postal service and that could bring about a lot of new jobs. Planting more trees would be cool too, but not everyone is the outdoorsy type.

          1. bluntobj

            Or a savings bank. One with 100% reserve requirements, inability to lend, perhaps with preloadable cards.

        3. redleg

          WPA constructed many invisible public works beyond parks. Invisible but way more important to the health of the citizens and fuction of our urban society: sewage conveyance and treament. At least where I live and work, much of the core sanitary sewer infrastructure was constructed as WPA program work, and it still functions as designed today.

      3. sue

        Banger,

        As U.S. education (some here have taught both in states and Europe) indulges “curve” grading system based upon few winners, majority mediocrity (cheap labor force), some losers (intentional goal), then profiteering on higher education, it is not any sort of goal to indulge a “full employment” condition.

        Remember, our “competition” goal involves creation of taxpayers for social systems-therefore higher ed is free.

        Also note U.S. primary ed. is among best in world-middle-school falls into teens, and secondary, no direct connection-link to university or vocational equivalent, falls to mid-50′s. Guess when they begin application of “curve”-
        disconnect to next level?

    2. Mcmike

      The prototype model is not ss or medicare.

      The camels nose model is debit cards for unemployment benefits, drug testing for food stamps, third party e filing of taxes and forms, and mandatory vaccines.

  6. JGordon

    There is a reason why the Romans opened the gates and welcomed the barbarians inside at the end, as Obamacare is illustrating all too well. Towards the end of empire, societal collapse is the only thing that can save most people from their increasingly insane and corrupt government.

    1. TimR

      Yes, collapse looks better and better every day… Other than the nuclear plants, which require the current infrastructure to avoid meltdown, and the harsh, sudden transition to local agriculture.

        1. ambrit

          Dear optimader;
          Yes, Pol Pot and the Emperor Mao did try something like that. The differences being that Pol Pot was an ideologue, (sound familiar Austerians?) and Mao was trying to short circuit the Chinese societies slide into Mandarinism. Local agriculture will come roaring back soon, when the aquifers that water the American breadbaskets start to play out, and when transport costs become prohibitive. Nature will make some hard choices for us, will we or nill we.

          1. sue

            And like Mao and Pol Pot, the Obama administration chose to begin by confronting-weeding out the educated-Obama’s “professional left”.

            Obviously, “Occupy Wall $treet” presented a lessor challenge. Easier to infiltrate
            non-issue specific movement than educated mind.

      1. JGordon

        The thing I wake up hoping every day is that we’ll be able to shut down these godawful nuclear plants that pose an existential threat to every living thing on earth before society does collapse.

        I have been thinking quite positively about Fukushima lately; that is was one great event of human history that might save humanity from extinction. With the early warning that Fukushima gave us, we might yet pull through this thing without sterilizing the biosphere in the near future. Depending upon whether enough of us stop being willfully ignorant simpletons, which is a bit of a stretch for Americans I admit. But I am an optimist and I have hope.

        1. ambrit

          Dear JGordon;
          Let’s not single out poor simpleton Americans. One big thing I have learned is that stupidity is a universal human trait. Given that Fukushima is an American designed nuclear complex situated in Japan, that has affected the eastern Pacific rim, I’m quite comfortable in referring to most Terran Humans as “willfully ignorant simpletons.” (And yes, on my more rational days I do include myself.)

    1. sue

      Noonan,

      Please read Sheila Bair’s, “Bull By the Horns”-you will find that dems only “approved” TARP after homeowners were promised relief program. Within the next 2 weeks, Paulson-Bush pulled their bait and switch-documented here, by twice Pulitzer Prize winning editorialists, Bartlett and Steele, in another article:

      A Reverse Holdup
      The intention of Congress when it passed the bailout bill could not have been more clear. The purpose was to buy up defective mortgage-backed securities and other “toxic assets” through the Troubled Asset Relief Program, better known as tarp. But the bill was in fact broad enough to give the Treasury secretary the authority to do whatever he deemed necessary to deal with the financial crisis. If tarp had been a credit card, it would have been called Carte Blanche. That authority was all Paulson needed to switch gears, within a matter of days, and change the entire thrust of the program from buying bad assets to buying stock in banks.

      Matt Taibi also took note of this fact:

      THEY LIED TO PASS THE BAILOUT

      Today what few remember about the bailouts is that we had to approve them. It wasn’t like Paulson could just go out and unilaterally commit trillions of public dollars to rescue Goldman Sachs and Citigroup from their own stupidity and bad management (although the government ended up doing just that, later on). Much as with a declaration of war, a similarly extreme and expensive commitment of public resources, Paulson needed at least a film of congressional approval. And much like the Iraq War resolution, which was only secured after George W. Bush ludicrously warned that Saddam was planning to send drones to spray poison over New York City, the bailouts were pushed through Congress with a series of threats and promises that ranged from the merely ridiculous to the outright deceptive. At one meeting to discuss the original bailout bill – at 11 a.m. on September 18th, 2008 – Paulson actually told members of Congress that $5.5 trillion in wealth would disappear by 2 p.m. that day unless the government took immediate action, and that the world economy would collapse “within 24 hours.”

      So Paulson came up with a more convincing lie. On paper, the Emergency Economic Stabilization Act of 2008 was simple: Treasury would buy $700 billion of troubled mortgages from the banks and then modify them to help struggling homeowners. Section 109 of the act, in fact, specifically empowered the Treasury secretary to “facilitate loan modifications to prevent avoidable foreclosures.” With that promise on the table, wary Democrats finally approved the bailout on October 3rd, 2008. “That provision,” says Barofsky, “is what got the bill passed.”

      But within days of passage, the Fed and the Treasury unilaterally decided to abandon the planned purchase of toxic assets in favor of direct injections of billions in cash into companies like Goldman and Citigroup. Overnight, Section 109 was unceremoniously ditched, and what was pitched as a bailout of both banks and homeowners instantly became a bank-only operation – marking the first in a long series of moves in which bailout officials either casually ignored or openly defied their own promises with regard to TARP.

      Congress was furious. “We’ve been lied to,” fumed Rep. David Scott, a Democrat from Georgia. Rep. Elijah Cummings, a Democrat from Maryland, raged at transparently douchey TARP administrator (and Goldman banker) Neel Kashkari, calling him a “chump” for the banks. And the anger was bipartisan: Republican senators David Vitter of Louisiana and James Inhofe of Oklahoma were so mad about the unilateral changes and lack of oversight that they sponsored a bill in January 2009 to cancel the remaining $350 billion of TARP.

      Read more: http://www.rollingstone.com/politics/news/secret-and-lies-of-the-bailout-20130104#ixzz2iQ2IU56r
      Follow us: @rollingstone on Twitter | RollingStone on Facebook

      1. Yves Smith

        You don’t understand what that passage says. I chronicled the TARP closely.

        “Troubled Assets Relief Program”. It was NEVER NEVER NEVER envisaged as homeowner relief. Any Congresscritter that says that is what he though it was about is lying. Buying the toxic assets could have helped the banks. It does absolutely nothing for homeowners. Nothing. Plus I said at the time it was proposed that was never going to work. Treasury would either have to buy at market prices (inflicting monster losses) or above market prices (subsidizing banks in a very public way, which he had maintained he was not going to do).

        Plus the clear language of the statute gave the Secretary of the Treasury authority to do what he damned well pleased AND put him above the law. Anyone who acted surprised should be ashamed of themselves.

        Plus the Bushies actually left $75 billion in the TARP for Obama for principal writedowns. And Obama refused to use it.

        1. sue

          Yves,

          Far from disrespect-our family loves your work-but are you stating there was no “section 109″ of TARP, which included (in passed version-wasn’t involved earlier versions) homeowner considerations?:

          “Section 109 was unceremoniously ditched, and what was pitched as a bailout of both banks and homeowners instantly became a bank-only operation – marking the first in a long series of moves in which bailout officials either casually ignored or openly defied their own promises with regard to TARP.

          Congress was furious. “We’ve been lied to,” fumed Rep. David Scott, a Democrat from Georgia. Rep. Elijah Cummings, a Democrat from Maryland, raged at transparently douchey TARP administrator (and Goldman banker) Neel Kashkari, calling him a “chump” for the banks. And the anger was bipartisan: Republican senators David Vitter of Louisiana and James Inhofe of Oklahoma were so mad about the unilateral changes and lack of oversight that they sponsored a bill in January 2009 to cancel the remaining $350 billion of TARP.”

          1. Jerome Armstrong

            Right Sue, and tell me, how many Democrats supported that effort to overturn it? I mean come on, it’s naive to believe that they wouldn’t have supported it, even if this homeowners clause hadn’t been there. The tell is in the lack of their even trying to right the wrong.

  7. Bridget

    I have the mind set of the baby boomer that I am. Which means that if I was twenty something again, I’d pay the penalty as a matter of principal, rather than go through the Obamacare registration process. The whole thing reeks of Big Brother.

    But I do wonder about the young people today. They voluntarily emblazon the most personal details of their lives on social media every day. They are coming of age in the midst of Snowden’s revelations, and as far as I can tell, are not unduly perturbed. A single unique computer discoverable identity may be your nightmare, and mine, but is it theirs?

  8. Clive

    I’ve always used popular TV shows as a (distorting, admittedly) mirror on countries, their prevailing cultures and the conflicts they are trying to reconcile. I don’t think it’s a bad proxy.

    In the 1980′s Dallas / Dynasty and the many imitators showed us a picture of the privileged rich leading thoroughly miserable lives, lives blighted by their misuse of power and wealth. Into their worlds came poor but honest outsiders, simultaneously both at the whims of the ruthless but at the same time their foils, usually ultimately triumphing thought their innate worthiness. The message of this genre seemed to be “better to be poor, honest, hardworking but fulfilled rather than rich and unhappy”.

    Today, I’m drowning in Revolutions http://en.wikipedia.org/wiki/Revolution_(TV_series) , Blacklists http://en.wikipedia.org/wiki/The_Blacklist_(TV_series) , and Bridges http://en.wikipedia.org/wiki/The_Bridge_(2013_TV_series) all of which have a strong theme of “who is the government ? who can be trusted ? who is on who’s side ? and are people really who they seem to be ?” These shows suggest to me that in the US a belief system is in play in a way which feeds off a profound sense of underlying paranoia, of the loss of faith in trusted institutions, that we’re being misled all the time by everyone.

    Interestingly in a more purist NC angle, the Anglo-French remake of The Bridge (“The Tunnel”) http://en.wikipedia.org/wiki/The_Tunnel_(TV_series) has a tilt towards the austerity zeitgeist — one of the characters is on the run and fearing for his survival due to reasons not yet disclosed, but he is a “a financier who got wealthy following the financial crisis” — he got rich as a result of austerity. It will be interesting to find out how the show takes this plot. Hopefully it will get a US airing.

    But definitely, if my interpretation of popular culture is correct, we’re in a bit of a dark place.

    I’ll get my tin foil hat, then…

    1. JD

      What about Person of Interest, in which a sentient, mildly benevolent “Machine” built to track every person on the planet doles out saving information to a band of merry ex-spies who save normal people?

  9. Banger

    I loved your opening paragraph–excellent example of good rhetorical style!

    I have to differ here. Obamacare is a political “grand bargain” that puts the private insurance companies within a tighter state-structure than before. The reason so many of the elites opposed the ACA is that it would be a model for future state/corporate arrangements. Obamacare forces the insurance companies to genuflect (and give us some of their most cruel practices) to the state in exchange for collecting rents whereas before they didn’t have to do anything. This also forces these companies to spend more money on lobbyists and increase the power of the state–which the corporate sector sees as rents they have to pay to the state.

    Under this system it is theoretically possible that the citizens, through the power of the state, can force the corporations to not be as malevolent as they would like to be. The insurance companies complied because they avoided being legislated out of existence (as should have happened) and lets them play the game in Washington.

    Obamacare was a result of a highly motivated FIRE sector letting Obama know that if he f!cked with them he was a dead man politically (or even actually) and the glorious marketing campaign of the Obama brand in 2008 which completely neutralized the left as a political force.

    As for this model being a future example of legislation and regulation to come–I don’t think so. The federal gov’t is in a state of paralysis that will last as far as the eye can see until the left wakes up and begins to re-assert itself to move the pendulum back to the center–without that we are moving to the neo-feudal future some of us have predicted.

    1. DolleyMadison

      Oh yeah – kind of like the AG Settlement, OCC, FDIC, CFPB et all are forcing the Banks to not be as malevolent as they would like to be? GET REAL. Have you SEEN the preliminary costs/deductibles? This is giving them carte blanche to pull out all the stops to f$ck us all. We are FORCED to pay, in my case, nearly a third of my take home pay with a deductible ($20,000) so high I will never be able to afford to go to the doctor, ever.

      1. Banger

        So then, you are saying that the ACA is worse than no ACA? I’m open to that possibility and have heard your argument and the contrary one as well. You might be right–I figured that there were all kinds of holes in the system but haven’t looked into is very deeply. What you say sounds horrible–20k deductible is kind of absurd–is that for a family or individual?

        1. DolleyMadison

          Family but we are very light users way past the ear infection vaccinations stage and past childbearing age, none of us are on any medications, etc. I think the best thing would be NO INSURANCE AT ALL. We’ll see how fast prices fall when TRUE market forces are in play…pretty sure doctors will not get away with charing $400,000 for a mastectomy as they did to my mother who was on medicare at the time.

        2. Yves Smith

          The deductibles are coming in very high, so this is really in many cases grotesquely overpriced catastrophic insurance.

    1. NotTimothyGeithner

      Obots lack the self-awareness to be on a right-left scale with past personalities. They are very much the authoritarian followers, and in their eyes, Obama can do no wrong.

      They would easily line up for single-payer tomorrow if Obama said so regardless of anything they might have said yesterday.

      Do you remember how quickly they pivoted on the necessity of intervening in Syria to the “brilliance” of Obama by engineering a world event where the U.S. was outplayed by the Russians? They don’t care. Like Obama, they care about only Obama or the Democratic Party. Unlike the GOP followers, they lack core values or precepts which at least flavor their particular nuttiness. In recent weeks, the GOP demonstrated they don’t control their followers at least they can’t go against certain tenets such as working with a Democrat.

      1. DolleyMadison

        Yep. I am not even sure who the “Tea Party” is – but if Jeb Bush and Obama both hate them I may need to take a 2nd look…

        1. NotTimothyGeithner

          That isn’t a reason to support the Tea Party. Their tenets they are adhering to are largely dedicated to establishing a neo-feudalism with local lords as opposed to lords on Wall Street.

          They were fighting for their own backwardness and to be controlled by local ministers.

        2. Banger

          I think there are various currents in the Tea Party other than the Koch brothers and they should get a second and even a third look. I saw a great interview on Alex Jones’ show with Chris Hedges–Jones was effusive in his praise and gave Chris a great platform to talk to his considerable audience. My sense is that there are two virtues of the right and I include here a few people I know on the right: 1) they aren’t fooling around, they are serious about being in opposition to the corporate state–they are not pro J. Dimon and his band of criminals; 2) they are open to new ideas. All serious opposition to Obama and his pro-national security/police state policies is on the right. The left is still, by and large, part of the Obama party. They keep people in line by demonizing the right. BTW, I’m guilty of that–in general we need to keep an open mind and an open heart and understand that we may have allies in all kinds of places more than we have allies on the mainstream left.

          1. sue

            Let’s recall history-there was a corporate “tea party” distraction during 30′s depression era-documented in Geisst’s, “Wall Street-A History”:

            http://www.thriftbooks.com/viewdetails.aspx?isbn=0195115120

            This updated edition covers the historic, almost apocalyptic events of the 2008 financial crisis and the overarching policy changes of the Obama administration. As Wall Street and America have changed irrevocably after the crisis, Charles R. Geisst offers the definitive chronicle of the relationship between the two, and the challenges and successes it has fostered that have shaped our history

  10. Eureka Springs

    Progressive!

    When the word progressive is uttered far more citizens most certainly think of Progressive the private extractive insurance company than these charlatans. http://cpc.grijalva.house.gov/index.cfm?sectionid=71&sectiontree=2,71

    Note in the link above there is only ONE United States Senator who aligns with charlatan progressives and he ain’t a Democrat. All of those “progressives” failed us more than tea party members who at least threatened to postpone the mandate for a year.

    The day this country compelled purchase liability auto insurance all was lost. And don’t give me the run around about driving being a privilege rather than a right when our way of life depends upon so many driving. At the very least the amount extracted by insurance bean counters could have been better utilized any number of ways.

  11. Jim S

    Markets, markets, markets, entrepreneur, markets.

    What a monotonous beat that has been drummed into us these past twenty years. And the most fervent chanter is the guy who only pulls in a couple million a year and buys Pepto by the case, because he can’t afford to stop for a minute. So he chants on with his raw voice and his cracked lips, his executive hair touched with silver bobbing at his smiling nod. The ground has been adequately prepared.

  12. middle seaman

    While there is no doubt that Obamacare is a capitalistic heaven and meagerly supplies healthcare for the people, some of the assumptions in the post seem a little shaky to me.

    The Obama administration will go into history as shallow attempt at solving social problems while providing a fancy facade. Health care, education, climate change and others have been all tackled in the last 5 years, all with wrong ideas, minimal effort, lack of imagination and even smaller success. Obama’s health care is nothing but an afterthought. It isn’t an ideology.

    The left/liberals mentioned above are neither left nor liberal. No decent left would have supported Obama in 2008. In reality the “left” is a bunch of fat cats full of hate and arrogance. It’s an educated Tea Party. Liberals are well off people who want to look good but are, by and large, Eisenhower Republicans.

  13. Trent

    Obamacare was two things: 1. a distraction at the time to keep people occupied over the lack of any action taken with regards to bank bailouts and 2: a way to insure the ponzi scheme known as healthcare will be able to have a cashflow for the future. Funny how people who called you crazy at the time now come to the same conclusion

    1. jrs

      3) something for Obama to [s]bribe people with[/s] er run for reelection on. I mean you can’t run for re-election purely on: “I’ve started more drone wars and have a secret assisination program! Plus I’ve helped bail banksters! And yet the economy still stinks” now can you? And really what ELSE has Obama got that anyone could even argue was of some positive rather than negative value except Obamacare? He’s got absolutely nothing! It’s his only chip.

  14. anon y'mouse

    yes, and so the model for the privatization of schools continues along this line as well.

    the public option will never be eliminated entirely. it will merely be so defunded and hamstrung by requirements that everyone will recognize its inherent non-functionality, and thus go with McD’s School of Efficient Fry-Cookery with a voucher, and pay $49 over the subsidy price for tuition, and still have to cough up money for books, supplies, uniforms and transport.

    someone above is here apologizing for the poor companies, and how they have to bend the knee in order to obtain these rents. and this is the product of empathy? I don’t know how to empathize with a legal entity that has the same modus operandi as the brood creature in Aliens.

  15. Dan Lynch

    Lambert, it’s Neoliberalism 101 as described in Shock Doctrine.

    – privatization

    – user fees (or penalties) instead of a free service financed from the general budget

    – mandatory

    – the regulators who are supposed to oversee the ACA serve the industry instead of the people

    The ACA is to health care what toll roads are to transportation. And yes, it’s the neoliberal model for what is to come.

  16. James Housel

    Very good article. We are sliding towards a “market” solution in so many areas of our public life. Schools, prisons, healthcare. So many areas where the perverse incentive of the market is the opposite of the public good. Remember the lesson of Monopoly (the game). One person ends up w/all the money, the rest…bankrupt.

    1. hunkerdown

      It’s far easier to start the table game of Monopoly over when basic needs aren’t at stake, but arguably more necessary in the life game of Monopoly.

  17. Klassy!

    Wellness scams: One of the hospital systems here require particpants in the health plan fill out a 170 question health survey or be dinged higher rates. 170 questions! I guess they cover all their bases there. The debate around it is that they use punishment (via increased rates) if you don’t participate. Hilariously, it was suggested that people would be happier if rewards were used– i.e. reductions in your rates if you fill out the survey. What difference does it make whether it is a reward or a punishment, eventually it is all the same (considering the rapidity with which rates are increased.)
    It is so beyond the pale– collecting that much information. Right now, I don’t have to complete a health survey for my insurance, but I imagine that it is in my future and I could forsee a day when I get dinged because I fail to .say, get a mammogram per recommendations. We have no right to privacy and we have no right to deciding how we want our care to proceed.
    Health is a commodity. And, while we’re at it so is mental health which we’ve decided is entirely separate from physical health and the quality of health is dependent on our individual choices and purchasing products.

    1. TimR

      Yes, and all of this assumes that mainstream medicine knows what it’s doing in the first place and has the right answers. In fact if you start to investigate this stuff (read Gary Taubes’ _Good Calories, Bad Calories_) it’s not quite so b&w. Every major institution, including health, medicine and nutrition, has been infected by careerists who get along to go along. The science it’s all founded on is fraudulent and biased as well.

      So you will be dinged for seeking alternative treatments to the mainstream.

      1. Banger

        I think you bring up a critical point here. Is the medicine we’re getting really worth it? And what about alternative medicine? What happens there?

        So do you think the Tea Party people were right?

      2. Klassy!

        I was thinking more along the lines of we could declare our unemployment level a public health crisis or our neighborhoods ravaged by predatory lending and the housing bubble bust, or any number of things along that line. But we don’t– they’re not to be solved by the market.
        I think there are things that keep us healthy and sane that don’t really have to do with medical care– traditional or alternative.
        This is not to say I am rejecting medicine, but it does seem to be used as a stand in for health.

        1. ambrit

          Dear Klassy!;
          I’m not so sure. I’m personally dealing with a fairly common health condition, (effective hypertension and coronary artery issues,) that appears to have a high genetic correlation. So, the issue may be one of perception management. Consider that most people lived significantly shorter lives a hundred years and more ago. The overall quality of those lives was poorer too. This may indeed be an artifact of the Industrial Revolution as a much earlier post about the quality of foodstuffs available to the general public over time suggested. The point being, most, if not all of the extension of modern lifespans can be attributed to the advances of Medicine. (I include Public Nutrition and Sanitation in with true Medicine. All aim to the same ends.) Since just about everyone I know is, if not fearful, at least respectful of death, the control of the power to extend life is tantamount to godhood. I’m fairly certain that I would be dead by now if it were not for a medical intervention two years ago. A hundred years ago, not only myself, but anyone with the same condition would have suffered the same fate. Now, by withholding medicine from one class of person, a literally deadly class distinction has been created. Simply put, the Haves live, and the Havenots die.
          How many times in your life have you heard the “hard work is good for everyone” meme? As in, the wealthy are somehow morally superior to those less fortunate. It is not too far a reach to shift from that to “the Poor deserve their fate.” This mirrors classical Calvinist Theology. Webers classic, “The Protestant Ethic and the Spirit of Capitalism” lays it all out far more effectively than I can. So, what’s left? Stoicism? Neo-Stoicism? Crypto-Stoicism? The possibilities are endless.

  18. Yancey Ward

    Lambert, you still don’t get it. The Democrats didn’t pick this structure because it is “Market”, they picked it because it pretends to not fund the ACA with increased taxes. Now, the insurers surely cooperated because of the rents they could extract, but the only motivation that mattered was that found in the people who enacted this legislation. As confounded as this state-mandated “market” is, the free action of the “consumers” involved is probably going to be its undoing. The next act, coming sometime in July-September is going to be the executive orders mandating “bonuses” to the insurers in the exchanges in order to get them to re-up for the following year.

    1. sue

      Could it be that Obama “picked” his healthcare initiative because it was invented by Kansas Senator-Presidential candidate Robert Dole, in contrast of Clinton care-and then implemented in Massachusetts by Republican Presidential candidate Mitt Romney? Surprisingly, Obama didn’t rub republican noses nearly deep enough in reminding Americans-republicans.

  19. clarence pest swinney

    WACKO BIRDS
    John McCain om America’s Newsroom (FOX) was asked about suspension of death benefits to military families. “Lets’ have a little straight talk he told the host. We shut down the government
    on a fool’s errand that we were not going to accomplish. Thew whole premise of shutting down the government was the repeal of Obamacare. It we had not shut down the government this would not have happened. Defunding Obamacare is not a proper choice.”
    In 1984, Newt got 72 “new” members of the House. They were like the Tea Partiers. Defund the government. Most of them were sent home in next mid-term election. The voters know mean spirits and foolish proposals and actions.
    The Tea Partiers can look for some rest at home because they will be booted next year.
    We have enough problem reducing that horrid Bush Debt without game playing on minor
    spending items.
    Revenue is never mentioned. We need much to reduce the debt. We Must tax Rich Estates and Income. An income of 10 Million pays 1% effective Payroll Tax. It goes down from there as income rises. A 50% income tax cap will stimulate the economy. They killed Obama job proposal to create 4 million jobs and in a Great Recession that is foolish. They let a huge income tax cut continue during two expensive wars.
    They do not care for the middle class or poor. Koch zillions are backing this assault on the middle class.

  20. Yancey Ward

    Here is what an honest Democrat/Progressive would have said:

    “I think everyone should have health coverage up to a certain level. Here are the various levels one can envision as a floor (insert Platinum through Bronze plans, if you like, here)- and here is what supplying every single American citizen and legal resident with each of these levels will cost, and once the Congress settles on a level, it enacts the taxes through the income tax system to pay for it. If you want a level of care above this floor, you are free to spend your own money obtaining it.”

  21. Pedro

    It’s not “progressive”. This is a symptom of Democrats tacking to the right and adhering to the neo-liberal model despite it’s base’s contrary ideology. At any rate, the marketplace infrastructure can also be seen from a different vantage point. Perhaps it was set up to show how poorly markets perform. When folks have had enough a public option can be seemlessly placed in the market alongside the private insurance providers. Also, allow the public entity to bargain on pharmaceuticals and other medical costs we will then see how ridiculous the market is.

    The catch of course is that it could go either way. It could be a trojan horse for more privatization of the government. Or, it could be seen as the entry wedge to a more comprehensive government run system that now has the data and infrastructure in place to operate. Mots progressives have at least hoped that the latter would be the case. This is the battle we will fight over the next decade or so.

    1. different clue

      Obama and Baucus certainly meant it to be a bailout for private insurance companies and a start on more forced privatisation. Their Catfood Democrat successors will certainly fight to prevent the entry of any single payer wedge.

  22. Marcie

    My opinion after being poisoned by profit-driven healthcare is not in line with this blogger’s view of healthcare as he ignores the harm being done by the medical industrial complex and their insatiable appetite for profits. As long as they own the FDA, the CDC and the NIH healthcare will remain predatory and harmful with very few cures.

    For example in 2002 a new test for ovarian cancer was available using proteomics as a diagnostic tool. It promised to change the world of diagnostics as a test could be developed for any disease using this technology. It would save billions in healthcare costs because it detected cancer early and was non-invasive only requiring a drop of blood. So why did it take until just this year for a similar test to come to market and then only recommended for women with a mass on their ovaries? Because in my opinion Big Pharma and other medical providers would lose revenue in three areas: expensive scans, diagnostic biopsies and chemotherapy drugs. Even my radiologist, whom I think the world of, told me this would eliminate the need for many scans. I could see the concern in her eyes. So the FDA steps in to save the revenues of Big Pharma by regulating the test as a medical device ensuring the technology wouldn’t make it to market for at least another decade.

    Now another, a 16 year old no less has developed a test that will detect three cancers, early for $.03 a test. And the 16 year old wants to develop more of the same. “I created a new way to detect pancreatic, ovarian and lung cancer that costs three cents and takes five minutes to run,” said, Jack Andraka. Where do you think this is going? Like all other inventions that will cut into the profits of the corporations that control our government.
    My opinion after being poisoned by profit-driven healthcare is not in line with this blogger’s view of healthcare as he totally ignores the harm being done by the medical industrial complex and their insatiable appetite for profits. As long as they own the FDA, the CDC and the NIH healthcare will remain predatory and harmful with very few cures. For example in 2002 a new test for ovarian cancer was available using proteomics as a diagnostic tool. It promised to change the world of diagnostics as a test could be developed for any disease using this technology. It would save billions in healthcare costs because it detected cancer early and was non-invasive. So why did it take until just this year for a similar test to come to market and then only recommended for women with a mass on their ovaries? Because in my opinion Big Pharma and other medical providers would lose revenue in three areas: expensive scans, diagnostic biopsies and chemotherapy drugs. Even my radiologist, whom I think the world of, told me this would eliminate the need for many scans. I could see the concern in her eyes. So the FDA steps in to save the revenues of Big Pharma by regulating the test as a medical device ensuring the technology wouldn’t make it to market for at least another decade.

    http://www.cbsnews.com/8301-18563_162-57585179/16-year-old-finds-a-new-way-to-detect-cancer/

    1. Klassy!

      Just because a test is “200 times more sensitive”, does not mean it is better at detecting cancer. A highly sensitive test can catch a lot of incidentalomas (which will require work up– leading to more tests). The test needs to have high specificity too. And early detection is not always the key to survival. Agressive tumors may be caught early, but they’re still fast growing and ultimately may not amenable to treatment. Conversely, in the case of something like mammograms we catch a lot of slow growers that might not kill, might go away on their own, or could be treated later.
      Also, this kid may have developed a test that cost 3 cents– but that one that cost 800 dollars probably didn’t cost that much either. Once there’s a patent on it, it sure isn’t going to cost 3 cents.

  23. allcoppedout

    I had private hospital care recently – customer service and food were good – but the medical care was bad and they lost my records. The NHS put things right, though I only got toast instead of thickly cut ham sandwiches and didn’t have a room to myself I didn’t need.

    I have no idea why Americans speculate on this matter. A small experiment, say sending 1000 from the USA to the UK and vice versa for treatment would resolve a lot, including cost issues.

    Dare I say the reason for no US NHS is simply to do with not wanting any competition that would empirically contradict private, entrepreneurial BS that extends to McKinsey fantasy (as well presented as my ham sandwiches) that the US system costs so much more because it subsidises the rest of the world?

    Could it be we don’t have job guarantee (should be income) because we wouldn’t put up with crappy private sector part-time no decent conditions/pensions and bullying (like zero hours) with a viable alternative?

    We should notice in this area that “argument” is in place of viable practice to make our minds up on through actual experience and real choice.

    1. Marcie

      Allcoppedout the NHS suffers from the same problems that the U.S.A. does in a different flavor. For example I knew a woman from the UK that has the same type of poisoning I have. She had two doses of Magnevist, a gadolinium based contrasting agent (GBCA) and I had 1 dose of Magnevist and 11 of Omniscan. These are two of the worst GBCAs on the market and both Bayer and GE’s predecessor Amerisham and Nycomed knew they never should have been put on the market based on studies they concealed.

      This is a debilitating disease with many complications including the most serious, fibrosis throughout your entire body: heart, lungs, kidneys and liver. It also results in a skin condition that makes it difficult to walk and yet it took over a year for her to get a biopsy. And they tried to make it a head case saying she was mentally ill and that was her problem.

      Your system in my opinion is also flawed in that it bestows on pharmaceutical companies the right to poison with impunity with the government’s blessing. And they are terrible with CFIDS calling it a mental condition not a biological one; it is the same with Lyme disease.

      Look what they did to Dr. Andrew Wakefield that dared to say that vaccines might be causing gastrointestinal problems in children and wanted to do further research. Even not considering whether Dr. Wakefield was right or wrong, the pharmaceutical companies went after him with a vengeance. It was a preemptive strike against anyone that dares to speak badly of the vaccine industrial complex and their cash cow the MMR. And I’m not someone opposed to vaccines I just thought the relentless volatile smearing of Dr. Wakefield boggles the mind. Why don’t they do that for GlaxoSmithCline that paid $3B in fines for promoting antidepressants Paxil and Wellbutrin for unapproved uses and failing to report safety problems with Avandia?

      GlaxoSmithCline deserves to be smeared more than Dr. Wakefield whose life and career has been ruined for wanting to investigate further the MMR vaccination and the connection to gastrointestinal problems in children. Heck I would like to know the answer to that question.

  24. CJ

    Thanks for your continuing analysis of the ACA, Lambert. I’m a very frugal (and currently unemployed) person, but I think I’m going to have to send a check because unlike a lot of the moaning and groaning about this law, you’re getting into some fundamental issues that nobody else is talking about; things that need to be discussed.

    Like you, I have major problems with the information-gathering aspects of this legislation. It’s very difficult for one to be secure in their “persons and papers” when one doesn’t hold one’s papers, and this is compounded by the fact that these papers concern intimate details about our persons.

    There is another element of this large-scale health data collection that concerns me. I came across a documentary years back (sorry, no link) that followed IBM workers who had developed a rare liver cancer. The company toxicologists had secretly been collecting death records and correlating those outcomes to their on-job exposures. The military has also performed a number of secret experiments on the population without our consent (as outlined by Ed Regis in “The Biology of Doom: The History of America’s Secret Germ Warfare Project”). It seems to me the ACA is the same system, writ large, with profound implications to the concepts of liberty and freedom, not to mention health.

    Never has so much information been available to so few about so many. This is a very dangerous situation, one that I’m afraid too few comprehend, first-and-foremost, those engineers and software developers who are making these systems of control possible.

    Back when I was studying engineering in the late ’80s, we were required to take a course in engineering ethics. As far as I can tell, there is no equivalent course for software developers, and indeed, empirical facts suggest that the average software engineer has no ethics at all.

    1. jrs

      I’m not sure what software developer ethics has to do with anything, if the requirement is to build the system to require information first (and I believe that was the requirement coming straight from the government not something concocted by a software architect), as a software developer sure you could refuse to build the system once you saw the architecture, but obviously you are hired to build it.

  25. craazyboy

    Keep the government’s AND private sector’s hands off my social security!!!

    This reminds me when Bush II was patiently explaining to us that there is no money in the SS Trust Fund safety deposit box, and we really need to fix that, or some such.

    Private accounts were the way to go, then gubmint will never be able to steal your money that way.

    I had a scary dream that night. My retirement payroll tax was being used to lease a giant warehouse and in it were real items of wealth like 8-track tapes, the assembly line tooling for the Yugo automobile, the Complete Anthology of the Culture Club master recordings, a polyester leisure suite wing, hula hoops, and a whole section full of 1977 vintage personal computers complete with the CPM operating system.

    1. Lambert Strether Post author

      Thanks, Jerome.

      UPDATE Adding… If I’m right, these trends won’t play out in my lifetime (though they might in yours). It’s the paramilitaries, the surveillance, and the open elite corruption that make me want to leave the country.

  26. Dan Kervick

    You’re making this way too complicated and conspiratorial. When a standard-issue hack politician decides to fix some problem – like several million people without adequate health insurance altogether – and get it through the electoral gauntlet and legislative sausage-making machine, they look for a solution that creates the fewest number of powerful new enemies and inflicts the least damage to the stakeholders in the existing system, and perhaps even makes some additional powerful friends along the way. That’s American politics: it’s ugly, its sloppy and its corrupt. They took the very flawed US health care system as it existed, tweaked it bit without changing it in any fundamental way, and ACA is the stuff the politics crapped out.

    Why is plutocracy so hard for people to understand? The people who own the country and run its most economically powerful institutions get to decide how things work for the rest of us, and what changes they will permit. The politicians don’t run anything. They get into their official positions by putting together a coalition of masters they are willing to serve, and hoping that their list of masters turns out to be more powerful than the other guy’s list of masters, so they can win the contest for the seat.

    Forcing people to buy something, or pay a tax penalty, is no different than forcing them to pay taxes. Cry me a fucking river about the “fascism”. It sucks that some of the people we have to buy the health care from are permitted to give themselves 8-figure salaries, and buy yachts and three houses with the cash they suck out of the bank accounts of the sick and dying. But I haven’t seen a lot of brilliant ideas lately about how to dismantle the American system of plutocratic control and inequality.

    1. Lambert Strether Post author

      Portentous, silly, and false.

      Portentous: Who used the doomy word “fascism”? Not the poster.

      Silly: “Forcing people to buy something, or pay a tax penalty, is no different than forcing them to pay taxes.” Well, except for putting the rentier in the middle of the transaction so they can take their cut, of course. Which is what the “marketplaced” does. Seriously, can our lecturer on the true nature of plutocracy truly believe that paying a payroll tax toward Social Security, and being mandated to pay toward retirement from a number of plans, one of which is “the public option,” Social Security (the others being private), are the same thing?

      False: The post alleges no conspiracy. There’s no more conspiracy to the idea that Obamacare could serve as a policy model than there is to the idea that HeritageCare served as a model for RomneyCare served as a model for ObamaCare.

      Clue stick: If you want to demolish something, understand it; that is what this post tries to do. Also too, reading comprehension.

      NOTE Stylistic points for “cry me a fucking river,” though. That’s bold!

  27. bob goodwin

    Libertarians hate corporatism as much as liberals do. But Liberals hate Libertarians even more. And that, sir, is the great compromise that “moderates” have created. We are attacking that compromise from the right, why so much snark and so little action from the left?

    1. Jerome Armstrong

      I wish I knew the answer to that question. It was certainly present during the early part of the netroots movement. Decidingly in the Dean internet campaign. Markos even wanted to write a book called “Libertarian Democrat”. Huge in 2006. Somewhere along the way, the laggards took over, Obama covered for the corporations and made it more about allegiance than about principle, the movement in the progressive was replaced by a message, complete with marketable majority, and the rest we live in today.

  28. gtg2013

    “… if we accept the radical claim that ObamaCare isn’t about health care…”

    Nothing radical about this at all. It’s an open secret, from the title of the act on down. It’s federal subsidization of the insurance industry–basically, the feds underwrite the tough, potentially non-profitable “health care consumers” (i.e.., really sick people). To say ACA is about “providing health care” is like saying no-fault auto insurance “protects highway safety.”

    1. gtg2013

      Sorry, I see “underwrite” isn’t the best word, can leave the impression that I think that the purpose of the ACA is to provide payment for health care for *patients* who need it. Think in terms of bank bailouts when “toxic assets” go bad; it’s not the people who lose their homes that the feds worry about.

  29. JTFaraday

    I think social security has already become the “public option.”

    And when you consider that the upper middle class is the D-Party’s only (real) popular constituency, those people aren’t that put out if you “chain their CPI.” It’s mostly a minor annoyance. Like, if they decide to get their panties in a knot, over “the principle” of the thing.

    If someone has a really nice retirement, it isn’t primarily funded by SS which isn’t that great. It only starts to look good if someone makes a really decent salary, didn’t take time off to raise their kids or get laid off too much, and by that point they’re probably also less dependent on it.

    This yo-yo “you’re on your own” retirement model, which already includes SS, will almost certainly flounder on the up and coming generation, although I think the up and coming generation is the cohort most keenly aware of this mentality because it has an ever shrinking list of earning options out of which to fund their economic futures.

    But truthfully, SS has always been the public option because it is not now and never has been a universal program. The self employed have always had to “buy into” it. Other people can’t buy into it if they try. It was a plan for employees, designed to convince people (read: white men) to surrender the struggle to work for themselves and become corporate employees, carrying out the corporate objectives of others and shoring up their ownership of and governance over, ultimately, everything. It worked. Now the corporatist feudal overlords are more interested in exotic lands and the local serfs are once again local yo-yos.

    Also, to defend the political class (a little bit) with reference to Obamacare and the “choice” it supposedly represents– one reason the D-Party felt it had to cater to this mentality is because the middle class salaried workforce, the “middle class” the D-Party claims to represent– was overwhelmingly resistant to change in healthcare delivery for a long time.

    They got their medical benefits “at work,” just like they got their SS and other retirement plans funded “at work,” and the idea that their way of life should change–not even give something up, just change– in any way to assist the losers (or the self employed or small business owners) was unacceptable. Catering to this mentality started way back with Hillarycare, in the go-go 90s. It takes two to tango here.

    An HR/benefits specialist could argue that employees in fact paid for ALL of this stuff–healthcare, SS, pension, 401K matching, etc– all along, in lieu of salary, it was just hidden from them (like children, who have adult business people to figure everything out for them).

    It’s only been in more recent years, in which large employers started passing more and more of the costs on to middle class employees that a constituency arose for “healthcare reform” amongst this still substantially large group of people. Reasonably, they just didn’t want to have to pay so much– and because it’s them now.

    This is one reason why I think that article that Skippy and From Mexico are passing around on the treachery of the punitive middle class is important. This mentality, which has been entirely culturally acceptable, is coming back to bite them (and everyone else) in the @ss big time. “Liberals” tend to associate this attitude with the Tea people, but it is thoroughly bipartisan. The Tea people are mostly distinguished from everyone else by the amount of froth they produce. It’s a mercy that the spittle at least, if nothing else, turns so many people off.

    The move from “get a job” and “earn your own retirement,” long the dictate from the middle class to the low paid underclass, to “fund your own retirement” (and even “create your own job”) as the more recent dictate from the upper middle class and Big Finance, is perhaps not that large a mental leap.

    People won’t be able to make that leap, but it’s not any less insular a mentality than that of the sainted Hard Working middle class for all that. The vast middle needs to stop seeing itself as purely victimized and stop participating in the “p*ss down” mentality because it’s ultimately self defeating.

    This is counterintuitive for liberals who are inappropriately nostalgic for Depression era policy making, but if anything, it is SS that is the model for Obamacare.

    Compare SS to the public school model invented by the Calvinist orothodoxy in MA, (of all things). No one “earns” their kids’ schooling. No one checks the IRS to make sure people are paying their taxes before their enroll precious darlings, (at least not yet).

    That’s had the outlines of an entitlement, (imperfectly delivered). SS is corporatist bullying.

  30. NotTimothyGeithner

    I think its really simple. This is the result of lazy, narcissistic, and arrogant people (the Washington elite) who will only work hard when the work is sexy.

    Does this effect Obama? No, not until the complaints get to him, so why should he check on the program? From his view, it has his name which means its wonderful. The elite involved in the program. Have they made money, a name, or still have healthcare or the appearance of it? Yes, yes, and yes. So why should they care?

  31. Bill Francis

    This isn’t a new model, this is the government in action. The only thing new about this is that the law was created and passed only by democrats.

    Please name anything the government has ever done that was done on time, on budget, effectively, efficiently, and was a high quality product or service.

    It has never happened and never will be.

    1. No accountability, responsibility or consequences to politicians or administration personnel.
    2. Corrupt unions, government “managers” and politicians than guarantees too many people, wages and “benefits” too costly, and shitty work.
    3. No experienced business personnel. Experienced business persons know how bad the government operates and will not work there in spite of how much money they can make. Virtually none of these fools in the administration and congress could even successfully run a lemonade stand.
    4. The dumb masses continue to vote for the person who “promises” to give them something for free.
    5. Socialism will eventually fail when it runs out of OPM (Other Peoples MOney).

  32. James DiGioia

    “If you accept that the delivery of health insurance should be structured like ObamaCare, is there any reason to deny that Social Security should be?”

    I, and I would suspect most liberals, don’t accept that it should be structured like this, but that its structure was developed this way as a compromise to conservatives who basically didn’t want the government taking over healthcare. Many liberals were calling for single-payer, but that wasn’t going to get through. If libs had it their way, I don’t think ObamaCare would be their preferred solution, but was more “best we can get” under the circumstances.

    Also, I believe your assertion about forcing registration before you’re allowed to see insurance prices was a technical problem, not a political one, and is actually intended to be fixed. I don’t remember where I read that, unfortunately.

    1. Lambert Strether Post author

      I think “most liberals” will accept this. It’s what they do. As, in fact, evidenced by the cheerfully submissive “that wasn’t going to go through.” If you want to see how a commmitted minority gets stuff done — stuff like getting the budget sequester, for example — look to the TP.

  33. b2020

    You are too focused on the explicit mandate. Education (loans, grants), Mortgage (GSE’s), 401(k). This is nothing new, not even the mandate (and even that exists – liability insurance to operate a vehicle). What is new is that the mandate is enforced and collected (possibly up front) by the IRS (again, compare to car or other mandated liability insurance) instead of being an issue of law enforcement.

    All government corruption is the privatization of public revenue, i.e. tax collection. An IRS-enforced collection (such as FICA) streamlines the process. If you look at it this way, the most interesting example is the Social Security Pre-Trust-Fund: here, the government placed itself as the beneficiary “sink” for the revenue stream, instead of 3rd party rent collectors. Mandated payment fed into a system that does not discharge its fiduciary duties and does not deliver the “benefits”.

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