When it comes to Obamacare, Barack Obama and Ted Cruz agree on one thing: If the Affordable Care Act is allowed to take effect, the American people will like it — or at least learn to live with it.
That was the planted axiom of Cruz’s 21-hour demonstration against Obamacare in the well of the Senate. The Texas Republican has made this point more explicitly in the past, warning “there has never been any major entitlement that has gone into effect and has been unwound.”
The president hoped Cruz would be proven correct in remarks Thursday. “”Once it’s working really well, I guarantee you, they will not call it Obamacare,” Obama boasted.
Massachusetts is an example that seems to bolster their case. Romneycare shares the same basic architecture as Obamacare. It has succeeded only in increasing insurance coverage in a state that already had a relatively small uninsured population by national standards. But Massachusetts has the highest health insurance premiums in the country. The law failed to reduce emergency room visits as promised. There are longer doctor wait times and physician shortages. In one county, new patients wait 205 days to see a doctor.
Yet polls show Romneycare is popular in the state. According to the Massachusetts Medical Society, 84 percent of residents were happy with their coverage. Despite generally bad news, support for the law rose to 63 percent in 2011. Just 21 percent were opposed.
But Massachusetts is an affluent state. Most people already had health insurance and Romneycare proved less disruptive to existing arrangements than Obamacare already promises to be. The health care reform was bipartisan, bringing together Mitt Romney and Scott Brown with Ted Kennedy and the Beacon Hill Democratic bosses. Both Republicans and Democrats have a stake in the law. Some costs could be offloaded to the federal government.
None of those circumstances obtain nationally. As full-time workers go part-time, companies shed workers entirely and dump health insurance plans, insurers bow out of state exchanges and premiums rise across the country, millions of Americans are likely to continue to find fault with Obamacare.
“All is not lost in the quest for a more free-market, fiscally responsible health-care system,” writes the Manhattan Institute’s Avik Roy. He is correct. But those who assume Obamacare will simply collapse under its own weight are wrong too.
Liberals will blame every Obamacare failure, every “glitch,” will be blamed on the remaining private sector elements of the health care system. They will push to fix those glitches by further expanding the federal government’s role in health care, in much the same way that the most vocal Romneycare critics in Massachusetts are single-payer advocates.
That’s why Democrats who supported the public option, and even single payer, were willing to accept Obamacare. That’s why Obama — who opposed the individual mandate in 2008 and whose original health care proposals bore only a passing resemblance to what he ultimately signed into law — accepted it. And it is why his administration is willing to issue waivers and accept delay after delay.
Obamacare partisans believe that getting anything implemented at all will lead inexorably to something closer to their ultimate goals for U.S. health care. The only way they will be wrong is if Republicans take the inevitable Obamacare failures and make the case — for the first time — for a genuine free-market alternative. Just as markets with a government safety net meet basic human needs for food, clothing and shelter, they can provide health care and control costs through competition.
That will take more than a filibuster. And it will take more than the cynical Republicans approach that gave rise to Romneycare — and by extension Obamacare — in the first place.
But the good news is this is not as straightforward as Medicare and Medicaid, both entitlements with huge fiscal challenges that threaten their beneficiaries’ quality of care. Obamacare is much more susceptible to free-market reform and even repeal. Its government-managed competition can give way to real competition.
As Obamacare struggles out of the gate, the president and his supporters will say, “Pay no attention to the man behind the curtain.” But people will see the costs with their own eyes.
The time for talking is over. But the time for fighting is not.
W. James Antle III is the editor of The Daily Caller News Foundation and author of the recently released book “Devouring Freedom: Can Big Government Ever Be Stopped?“ Follow him on Twitter.