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The Independent Institute
Commentary

The Affordable Care Act First Does Harm, Period


Much about Barack Obama remains mysterious, but he was easily the most left-wing member of the U.S. Senate. As president of the United States his left-wing orthodoxy is best manifest in his signature health plan. Obamacare follows a principle beloved of Karl Marx and other socialist founding fathers: From each according to his ability, to each according to his need.

Note the first word: from. In this order of priorities it is more important what the individual gives up and what the state takes. The individual’s particular needs are secondary, and Obamacare follows this pattern precisely.

The president’s announced intention is to bring “quality, affordable,” health insurance to the uninsured. That is not likely to happen for some time, if at all, given the debacle of the rollout. But Obamacare has already succeeded in threatening 10 million people in the individual market with the loss of their health plan by January 1.

Those people purchased health insurance they believed best met their needs. It was what they wanted, and in many cases they were happy with their plan and wanted to keep it.

President Barack Obama told the nation multiple times, “If you like your health care plan, you’ll be able to keep your health care plan. Period.” But despite recent disclaimers, that turns out to be untrue. Millions of others are happy with the employer-provided coverage they now stand to lose.

So Obamacare is first and foremost a taking. It not only follows Marx’s “from each” principle but violates the principal precept of medical ethics: primum non nocere or “first do no harm,” also known as non-maleficience. Faced with a health-related problem, in other words, better not to attempt something that will cause more harm than good.

Consider now the second part of Marx’s principle: to each according to his need. Under Obamacare, individuals do not determine their own needs. They get only the kind of health care that government officials, in their infinite wisdom, want them to buy.

A single male in his sixties does not need lactation services or maternity care but will be paying for it anyway. That’s why the plans the government wants individuals to buy are so much more expensive, with higher deductibles and weaker benefits. And to get the government-approved plan, with subsidies, you visit the various exchanges. To say the least, these aren’t exactly working as advertised and remain highly suspect on information security.

CGI Federal, Inc., the contractor in charge, could not even explain why the federal website was not ready on October 1. Neither could it name the “best and brightest” the president said would fix everything. Why were the best and brightest not hired in the first place? That is an interesting question, but ultimately it doesn’t matter.

Karl Marx and other socialist founders believed themselves part of vanguard supposedly exempt from normal human foibles and possessed of extraordinary powers to plan society for the greater benefit of all. As F. A. Hayek and others have noted, no vanguard can possibly possess the wisdom and knowledge to accomplish that.

Obamacare serves as evidence of that reality, as did the former Eastern Bloc, along with Cuba and North Korea in current times. For all their failures, those societies reserve special treatment for the vanguard. That is also true of Obamacare.

In recent testimony Obama’s Health and Human Services boss Kathleen Sebelius could not tell legislators how many individuals had signed up, but she did know that she was not one of them. Secretary Sebelius expressed contentment with her own federal health plan.

She likes it and the Affordable Care Act allows her to keep it. So in addition to first causing harm by taking health insurance plans away from millions of individuals, Obamacare succeeds in preserving ruling-class privilege. Period.


K. Lloyd Billingsley is Policy Fellow and Communications Counsel at the Independent Institute.