Obamacare’s Clinging to the Dysfunctional Health Care Status Quo Is an Enormous Asset

Dr. Martha Perez examines Maria Lebron in a room at the Community Health of South Florida in February in Miami.

Photo by Joe Raedle/Getty Images

Josh Barro had a great item today about how conservatives are deluding themselves with the idea that Obamacare implementation snags are going to make it unpopular. Ed Kilgore and Jonathan Cohn both have smart thoughts on these lines themselves, but I think Barro gets it most straightforwardly and cynically correct: “Implementation won’t much affect the 78 percent of Americans currently covered through Medicaid, Medicare, or employer group health plans,” and among the remaining 22 percent, the predominant effect will be to get some subsidized health insurance.

The implementation issues are all about problems in the effort to deliver subsidized insurance to that remaining slice. The idea that there’s going to be a massive backlash against Democrats from people upset that there are administrative hassles involved in getting their new insurance subsidies is a conservative fantasy.

Then there’s a contrary liberal fantasy indulged by Duncan Black:

The problem with the optimist’s take on the implementation of Obamacare is that it leaves out the fact that our health insurance system sucks and at some point it will all be seen as Obamacare. Even if the legislation does genuinely improve the system overall, it’ll still be a horrible system. A horrible system known as Obamacare.

Nope! Reality-based people of all ideological stripes regard America’s health care status quo as basically a mess.

But dissenting from that consensus is a majority of the American public, which likes their insurance just fine.

And while people are wrong about that, it turns out that they also have a wrongheaded affection for the health care they themselves are receiving. When Obamacare was being debated, this was the huge public opinion challenge. The top leadership of the Democratic Party was very committed to health care reform, but the bulk of the public was happy with the status quo and easy to frighten. When Obamacare becomes the status quo, people will still be happy with the status quo quo and easy to frighten.