{"id":10480,"date":"2017-08-01T13:58:14","date_gmt":"2017-08-01T17:58:14","guid":{"rendered":"http:\/\/jimbovard.com\/blog\/?p=10480"},"modified":"2017-08-01T17:38:28","modified_gmt":"2017-08-01T21:38:28","slug":"fff-obamacare-reform-and-paternalisms-pratfalls","status":"publish","type":"post","link":"https:\/\/jimbovard.com\/blog\/2017\/08\/01\/fff-obamacare-reform-and-paternalisms-pratfalls\/","title":{"rendered":"FFF: Obamacare Reform and Paternalism’s Pratfalls"},"content":{"rendered":"

\"\"<\/a>Future of Freedom Foundation <\/a>\"\"<\/a><\/p>\n

Obamacare Reform and Paternalism\u2019s Pratfalls<\/h2>\n

by James Bovard<\/p>\n

One of Donald Trump\u2019s first actions as president was to issue an executive order to reduce the regulatory burden of the Affordable Care Act. Obamacare has been intensely controversial since it was enacted in 2010. The battle over its reform or replacement will very likely continue for most of this year, if not most of Trump\u2019s term in office. It remains to be seen how much effort the Trump administration will make to repeal, replace, or reform Obamacare.<\/p>\n

While the media often portray Obamacare as a holy humanitarian rescue mission, it has profoundly disrupted millions of Americans\u2019 health care, while sharply inflating health-care costs for more millions. Obamacare is the most prominent paternalist policy in recent decades. Any evaluation of whether it can be fixed should begin by considering the limits of paternalism.<\/p>\n

The word \u201cpaternalism\u201d originally referred to a father\u2019s power over his children; contemporary paternalism means governments treating citizens like children. The more paternalist policies are adopted, the further the citizenry is infantilized. As children grow older, they acquire more autonomy and are less restricted by their parents\u2019 rules and values. In contrast, the welfare state piles rule upon rule, edict upon edict \u2014 and the only certainty is that citizens will be presumed less competent in the next decade than they were in the previous decade.<\/p>\n

Law professor H.L.A. Hart defined paternalism as \u201cthe protection of people against themselves.\u201d According to Donald VanDeVeer, author of Paternalistic Intervention, \u201cA paternalistic act is one in which one party interferes with another for the sake of the other\u2019s own good.\u201d<\/p>\n

The paternalist state advances by multiplying its levers over private behavior. These levers are enforced by government penalties: the more the government claims to protect citizens, the more it must punish them. Yet, at some point, the sheer number of threats government makes, supposedly to protect the citizen, destroys the citizen\u2019s \u201cdomestic tranquility.\u201d This is the vicious cycle of paternalism: the more power the government acquires to control people, the more the citizen naturally fears the government.<\/p>\n

Paternalism offers the social-economic equivalent of happiness through political conquest and obedience \u2014 happiness by surrendering the keys to one\u2019s own life to one\u2019s political overlords. The goal of the welfare state is not to make people happy, as people themselves understand their own happiness; instead, it is to make them \u201chappy\u201d in ways their superiors think they should be happy. According to philosopher Hans Kelsen (one of Friedrich Hayek\u2019s nemeses), \u201chappiness in an objective-collective sense\u201d means \u201cthe satisfaction of certain needs, recognized by the social authority, as needs worthy of being satisfied, such as the need to be fed, clothed, housed, and the like.\u201d Thus, the \u201csocial authorities\u201d (i.e., government employees) are granted sweeping discretion to decree which desires or aspirations of private citizens are \u201cworthy of being satisfied.\u201d<\/p>\n

Democratic Party leaders in the Congress and the White House decided that people could not be \u2014 or deserve to be \u2014 happy unless they had health-insurance policies that the feds approved. For instance, Obamacare is driven by the heavy penalties on anyone who fails to purchase insurance policies that satisfy federal overseers ($695 per adult or 2.5% of annual income, whichever is higher). Punishing people was a nonissue for the Obama administration and the vast majority of Obamacare supporters. Anyone penalized by the feds is irrelevant as long as politicians can boast that a single additional person received government-subsidized insurance \u2014 at least according to some of the liberal and media scorekeepers.<\/p>\n

The more power government acquires over people, the more the system of governance rests on a blind faith in the rulers\u2019 benevolence. Paternalism presumes that government will serve the people even better than the people could have served themselves. And why? Because government knows best. But that means nothing more than \u201cgovernment employees know best.\u201d And why do they know best? Because they work for the government.<\/p>\n

And even if they don\u2019t know best, as long as their pretenses are accepted, politicians can seize far more power over citizens. When Congress considered Obama\u2019s proposed health-reform legislation, the highest-profile expert it relied on was Jonathan Gruber, who was christened \u201cthe Oracle of Obama-care.\u201d Gruber received a $297,000 federal contract to help lead the legislative charge for the Affordable Care Act with his \u201cblack box\u201d computer program. The Washington Post reported that \u201cGruber and his staff of three could provide answers overnight, when it often took weeks to run the same questions through the Office of Management and Budget or the Congressional Budget Office.\u201d<\/p>\n

The biggest paternalist coup of the last half-century required vast deception. Gruber explained in 2013 how Obamacare was sold to the public: \u201cLack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter or whatever, but basically, that was really, really critical to get this thing to pass.\u201d Gruber admitted that the Obamacare \u201cbill was written in a tortured way\u2026. If you had a law which \u2026 made explicit [that] healthy people pay in and sick people get money, it would not have passed.\u201d Gruber described one Obamacare provision as a \u201cvery clever basic exploitation of the lack of economic understanding of the American voter.\u201d The bill also exploited congressmen\u2019s feeble grasp of the issues but it would have been undiplomatic to mention that. Once politicians decided to brag about the increase in the number of Americans with health insurance, the odds of rational policy that respected citizens\u2019 rights took a dive.<\/p>\n

Paternalism delivers happiness via an iron fist. People pursue happiness, governments impose happiness. Paternalism presumes that people will be happier doing what they are told than what they choose to do. Kant declared, \u201cNobody may compel me to be happy in his own way. Paternalism is the greatest despotism imaginable.\u201d Kant based his ethics on the moral value of each person as an end in himself; paternalism necessarily sees people as plug-ins to fulfill political visions and bureaucratic timetables. Once paternalism gets rolling, individual preferences cannot be allowed to delay the official advance of progress. Whole-wheat bread is more nutritious than white bread, but would that be justification for the government food police to go into each recalcitrant\u2019s home, seizing his white bread, and jamming whole wheat bread down his throat? The damage done by forcing even healthy morsels down someone\u2019s throat \u2014 in all but extreme cases, in which the beneficiary is on the verge of death \u2014 will almost certainly exceed the nutritional benefits of the food itself.<\/p>\n

The people must be subdued before they can be saved. That is why the Obama administration issued more than ten million words of regulations and regulatory guidance for the Affordable Care Act.<\/p>\n

Maximizing submission<\/p>\n

Paternalism is also often the enemy of the rule of law and democracy. Once Obama got his signature bill pushed through Congress, he acted as if he was entitled to issue endless decrees to buttress it politically. One of the most controversial \u201creforms\u201d consisted of bankrolling insurance companies to deter skyrocketing premiums. On January 13, 2014, a group of IRS financial managers were summoned and escorted into a conference room and permitted a peek at a secret Office of Management and Budget memo explaining why the Obama administration was entitled to spend $4 billion on subsidies for consumer health insurance. IRS officials were wary because they felt pressured to make outlays they considered illegal under the Affordable Care Act. As a New York Times article two years later noted, \u201cThey were told they could read it but could not take notes or make copies. The O.M.B. officials left the room to allow their visitors a moment to absorb the document, and then returned to answer a few questions and note that Attorney General Eric Holder had been briefed and signed off on the legal rationale.\u201d<\/p>\n

Congress refused to finance the program but \u201cthe Obama administration spent the money anyway and has now distributed about $7 billion to insurance companies to offset out-of-pocket costs for eligible consumers,\u201d the Times noted. Federal judge Rosemary Collyer ruled in May 2016 that the payouts violated the Constitution because Congress had appropriated no funds for that purpose. But top Obama administration policymakers considered the peek-a-boo routine a sufficient hat tip to obeying federal law. It was important not to let due process and honest government stand in the way of creating bragging points for White House speeches.<\/p>\n

The welfare state seeks to maximize happiness by maximizing submission, as if confinement were the key to contentment. Are modern citizens supposed to be made happy because government coerces and restricts them in so many ways \u2014 or despite that? Is the subordination of the individual to the State supposed to make the individual happy, or supposed to make the State happy? How can we distinguish between coercion to punish and subjugate people and coercion to make them happy? The sanction of coercion matters less to most citizens than how often and harshly they are threatened and punished.<\/p>\n

English law professor A.V. Dicey observed a century ago, \u201c\u2018Protection\u2019 \u2026 is tacitly transformed into guidance.\u201d The welfare state, in its daily operation, appears more devoted to controlling people than to benefiting them. Every extension of benefits is premised on an increase of controls \u2014 sometimes on the person to be benefited, sometimes on other people (taxpayers, businesses).<\/p>\n

But there is no virtue in forcibly taking care of people who otherwise would have taken care of themselves. Many paternalist policies are the equivalent of the kidnapping of little old ladies by Boy Scouts and forcing them to cross streets so that the Scouts can fill their quota of good deeds. Many of the people who chose not to buy health insurance had sufficient income or savings to take care of the health emergencies they were likely to face at their age.<\/p>\n

Paternalism presumes that individual people are \u201cwelfare receptacles\u201d waiting to be filled to the correct level by their superiors. Welfare-state happiness must be a type of happiness that can be mass-produced by inefficient government bureaucracies \u2014 a \u201cclose enough for government work\u201d happiness, a happiness that exists because government agency annual reports claim to have fulfilled their goals.<\/p>\n

The more coercion government uses in the name of progress, the more oppressed people will feel. Government is often like a lifeguard who begins a rescue by standing on the shoulders of a person who is not drowning. The bigger the government, the heavier the political dead weight on the average citizen. In order to lift himself, the citizen must also lift \u201chis fair share\u201d of the entire government. The heavier the weight of government, the greater the odds against self-help. The expansion of government by itself, of itself, becomes an increasingly negative factor in the life of the individual person. Citizens are left to glean the remnants of their own lives from what the politicians have not already seized.<\/p>\n

There is no way to fix the Affordable Care Act that would respect the rights, property, and freedom of American citizens. The federal government has thrown so many wrenches into health care since the 1965 creation of Medicare and Medicaid. Americans cannot afford any more Washington solutions designed largely to boost campaign contributions and reelection rates.<\/p>\n

This article was originally published in the April 2017 edition of Future of Freedom<\/a>.<\/p>\n

Thanks to the Washington Times for the artwork (from an oped I did for them several years ago)<\/p>\n","protected":false},"excerpt":{"rendered":"

Future of Freedom Foundation Obamacare Reform and Paternalism\u2019s Pratfalls by James Bovard One of Donald Trump\u2019s first actions as president was to issue an executive order to reduce the regulatory burden of the Affordable Care Act. Obamacare has been intensely controversial since it was enacted in 2010. 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The Wall Street Journal called Bovard \"the roving inspector general of the modern state\" and Washington Post columnist George Will called him a \"one-man truth squad.\" His 1994 book, Lost Rights: The Destruction of American Liberty, received the Free Press Association\u2019s Mencken Award as Book of the Year. His Terrorism & Tyranny won the Lysander Spooner \"Best Book on Liberty in 2003\" award. He received the Thomas Szasz Award for Civil Liberties work, awarded by the Center for Independent Thought and the Freedom Fund Award from the Firearms Civil Rights Defense Fund of the National Rifle Association. Bovard\u2019s writings have been publicly denounced by FBI director Louis Freeh, the Secretary of Agriculture, the Secretary of Housing and Urban Development, the Postmaster General, and the chiefs of the U.S. International Trade Commission, the Drug Enforcement Administration, the Equal Employment Opportunity Commission, and the Federal Emergency Management Agency, as well as by many congressmen and other malcontents.","sameAs":["http:\/\/www.jimbovard.com","https:\/\/www.facebook.com\/jim.bovard","https:\/\/x.com\/jimbovard"],"url":"https:\/\/jimbovard.com\/blog\/author\/admin\/"}]}},"_links":{"self":[{"href":"https:\/\/jimbovard.com\/blog\/wp-json\/wp\/v2\/posts\/10480","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jimbovard.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jimbovard.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jimbovard.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jimbovard.com\/blog\/wp-json\/wp\/v2\/comments?post=10480"}],"version-history":[{"count":5,"href":"https:\/\/jimbovard.com\/blog\/wp-json\/wp\/v2\/posts\/10480\/revisions"}],"predecessor-version":[{"id":10485,"href":"https:\/\/jimbovard.com\/blog\/wp-json\/wp\/v2\/posts\/10480\/revisions\/10485"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/jimbovard.com\/blog\/wp-json\/wp\/v2\/media\/8308"}],"wp:attachment":[{"href":"https:\/\/jimbovard.com\/blog\/wp-json\/wp\/v2\/media?parent=10480"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jimbovard.com\/blog\/wp-json\/wp\/v2\/categories?post=10480"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jimbovard.com\/blog\/wp-json\/wp\/v2\/tags?post=10480"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}