Using health care to reward and punish



The Unablogger

You can take the guy out of Chicago, but you can’t take Chicago out of the guy.

As is routine in Chicago-style machine politics, President Obama has crafted his health insurance plan in a way that rewards his supporters and punishes his political foes.

Take senior citizens, for example. They didn’t buy Obama’s act in 2008. Official exit polls showed that they were the only age group that backed Republican John McCain over Obama.  McCain’s margin over Obama was actually 3 points greater than George W. Bush’s senior margin over John Kerry. Those geezers were asking for it, and Obama is giving them what they deserve (in Chicago payback terms).

Obama’s new health plan, like both the Senate and House plans that the American people have overwhelmingly rejected in national polls, is funded in large part by cutting half a trillion dollars from Medicare, which is health care for the elderly. The reduced reimbursements to medical providers will cause many of them to stop serving Medicare patients, creating a shortage of medical services to Medicare patients. Obama’s plan doesn’t provide new health care; it just takes health care away from seniors in order to give it to some of the currently uninsured. Most of the currently uninsured voted for Obama; most seniors didn’t.

Seniors are being punished in a potentially deadly way. Medicare cuts will kill them off quicker, so they can’t continue to vote against Obama.

Part of the Medicare cuts is the elimination of the Medicare Advantage program. Eliminating that program is a payoff to AARP for its endorsement of Obamacare. AARP, you see, makes most of its money from selling insurance to seniors, totally dwarfing its revenue from members’ dues. It turns out that Medicare Advantage is effectively a competitor of AARP’s own endorsed “Medigap” insurance plans. Rubbing out this competitor will result in much higher profits for AARP. Again, it’s the Chicago way.

Then there’s the voters who earn over $200,000 a year, who gave Obama a 6-point margin over McCain. Now these wealthy Americans are being spared from earlier proposals to pay for the plan by limiting their itemized tax deductions. Sending seniors to an early grave is much better in the Chicago way.

And then there’s single people vs. married people. In the 2008 election, 65% of unmarried voters backed Obama, compared to only 47% of married voters. That’s an 18-point gap. The result: Obama’s proposed return of the “marriage penalty,” by which married couples are taxed more than similarly situated singles. Under Obama’s newest health care plan, an unmarried couple who each earns up to $200,000 a year from all sources will pay no Medicare tax on their investment income. But an otherwise identical married couple will pay up to $5,700 in additional Medicare tax. Married people must be made to pay for their ill-conceived support of McCain.

It’s the Obama/Emanuel/Axelrod Chicago way.