Tuesday, April 12, 2022




President Biden welcomed President Obama back to the White House yesterday in connection with the signing of an executive order to fix a “glitch” in Obamacare. Obamacare itself is the glitch, but never mind. Biden exercised executive authority to expand the law’s coverage. The White House has posted a transcript of the speakers’ remarks here.

The Wall Street Journal’s James Freeman quotes Paragon Health Institute’s Brian Blase testifying before House committees in February:

In many areas of the economy, products and services have become higher in quality over time while real prices, after accounting for inflation, have declined… Unfortunately, this has not been the case for most health care products and services… prices for hospital services—the largest component of health care expenditures—have increased more than three times faster than general inflation over the past two decades. As health costs have risen, insurance premiums have correspondingly soared, even as plan deductibles have risen dramatically. In 2020, health care spending was 19.7 percent of U.S. Gross Domestic Product, a 6.4 percentage point increase and 48 percent increase from the 13.3 percent of U.S. GDP expended on health care in 2000.

Importantly, over the past few decades, there have been some noticeable advances in health, such as a decline in cardiac mortality, improvement in cancer survival rates, a cure for Hepatitis C, and new AIDS treatments. However, there is also significant waste in the health sector and health outcomes have recently stagnated despite the Affordable Care Act’s (ACA) new spending and the significant expansion of Medicaid. American life expectancy was lower in 2019 than it was in 2013, before the ACA’s coverage and spending provisions took effect.

Freeman paused here for emphasis — “More spending and lower life expectancy” — before continuing with the quotation:

…the ACA made individual market health insurance less affordable and introduced a generally inefficient set of subsidies. The ACA expanded coverage in two ways—with a large Medicaid expansion funded almost entirely by federal dollars and with new premium subsidies to help people afford individual and small group insurance that was made much more expensive because of the ACA’s extensive new federal regulation.

Nearly the entire net coverage gains from the ACA occurred through Medicaid expansion, although many people who gained coverage through Medicaid were, in fact, not eligible for the program. Enrollment in individual market… through the exchanges has largely been disappointing, falling far below original projections. From 2015-2020, exchange enrollment averaged about 10-11 million people—about 60 percent below what the Congressional Budget Office projected in May 2013 in its last analysis before the ACA’s provisions took effect.

Low exchange enrollment may be explained by the individual market premiums increasing 105 percent from 2013 to 2017. The vast majority of enrollees receive large subsidies as the premium increases have largely priced unsubsidized individuals out of the market.

RCP’s Philip Wegmann declares that the event highlighted “Biden’s triumph,” by which he seems to mean the outcome of the 2020 election. ‘Twas a famous victory, I guess. Life is nice in the White House, though not so nice that Wilmington isn’t always calling him home.

Wegmann downplays Biden’s need for help finding someone to talk to after the event. Wegmann comments: “Republicans clipped the video hoping to score some quick points online, but Biden didn’t mind getting upstaged.”

Biden doesn’t mind a lot of things he should mind, not that this is one of them, but how does Wegmann know that? Did he get a chance to ask him that, or how he got lost in the East Room?

In any event, Biden appears to be operating with substantially diminished capacity. Even when Biden was operating at a higher level, during the halcyon days of the Obama administration, Obama had a realistic assessment of Biden’s abilities.

What Wegmann calls Biden’s triumph is pegged to Biden’s 2020 electoral success despite Obama’s low opinion of Biden and his prospects. Yet every day supplies more evidence supporting the salience of Obama’s judgment in this limited respect.

No comments:

Post a Comment