If there is anything more frustrating about the idiotic debate about Obamacare subsidies, it is that nobody wants to address the reason why health insurance has gotten so darn expensive.
Republicans are correct that the Obamacare "reforms" were a disaster, and that, at least for some of the people involved, the whole point was to design a Rube Goldberg system that would inevitably collapse from sheer cost and inefficiency. Their goal was to use Obamacare as a version of the Cloward-Piven strategy I discussed earlier to force a transition to a completely government-run system.
It boiled down to "Make the system so bad that it has to be torn down and replaced." I don't believe every Democrat wanted to go that route; some just wanted to create a temporary fix that would kick the can down the road, and wound up making things much worse.
Republican strategist Adam Goodman and Democratic strategist Lucy Caldwell discuss healthcare and ACA subsidies:@adamgoodman3: "The system is darn broken, it just doesn’t work the way it should work, not for the investment we're making."@lucymcaldwell: "I don't see that the… pic.twitter.com/9boXd6lluy
— Washington Journal (@cspanwj) November 10, 2025
My wife and I don't currently purchase insurance on the open market, and that is true for most people. The failure of Obamacare to constrain insurance costs is an abstract issue for them; for those who do have to purchase insurance on the open market, the rapid increase in prices is an existential threat. I know this because, when we bought our own insurance right before and after Obamacare kicked in, our costs increased by 400% (insurance plus deductibles) within a couple of years.
Since then, prices have escalated out of control. We simply couldn't afford to buy health insurance on our own now.
So...Democrats are right that without subsidies, many people—ironically, upper-middle-class people who were never supposed to be subsidized—would be priced out of the market. That is why I predict that Republicans will vote to extend most of the subsidies they have been refusing to vote for during the shutdown. It would be political suicide not to do so.
What Republicans won't do is put forward a permanent fix to a broken system, because too many people's oxen would be gored. As awful as the system is, and as likely it is to completely blow up at some point in the future, unraveling Obamacare and all the previous "fixes" that destroyed our healthcare and insurance markets looks to be far too complicated and far too painful for people and institutions that benefit greatly from the system as it exists.
If you think reforming Pentagon procurement is tough to the point of near impossibility, that pales in comparison to returning to a system that is largely a free market with transparent prices and subsidies for only the people who truly can't afford to buy it on their own.
Too many doctors, hospital systems, health insurers, and pharmacy benefit managers are profiting from the current system. Many people are enjoying access to luxury services that insurers are required to provide, which they would never choose to purchase on their own. Nobody has to shop for the best quality and prices, and nobody is forced to make tough choices about costs and benefits.
Hence, every change that is made is not intended to fix the system, but to offer more benefits for more people in order to gain political favor.
Republicans believe, probably rightly, that doing the right thing would be politically devastating and would almost certainly be quickly reversed, even if they could somehow manage to force reforms through Congress and the bureaucracy. So, except for a few stalwarts, they kick the can down the road.
Democrats believe that they can keep the current system going quite a while before it collapses of its own weight, and when it does, the solution offered will be to create the government-run system they have always wanted. And when they inevitably have to cut costs, they can look to Canadian solutions (you know what they are—rationing care and medical murder) to keep the costs under some control.
They are also far less concerned about trade-offs between guns and butter, either because they believe that the goose of capitalism will always lay golden eggs no matter how much they abuse it, or because they are willing to trade American prosperity and dominance for a comfortable retirement of the American hegemony. Europe chose that path, with stagnant economic growth, decline in power, and the erosion to extinction of its culture.
You and I may find that "solution" appalling; they do not, obviously. Look at how Germany is deindustrializing to the point of economic contraction, and mass importation of migrants is wiping away the cultures of once-vibrant countries. The transnational elite is satisfied with the decline, as long as they can live off the wealth that still remains.
Ancient Rome chose a similar path: bread and circuses, and it took a century or two for the empire to collapse, giving us the Dark Ages. Every step along the way, wise men warned that the path chosen would lead to ruin, but ruin took so long to arrive that nobody could muster the courage to face the wrath of people who benefited from the status quo in order to fix it.
When we speak of the "Uniparty," we are both right and wrong. It's not so much that the Democrats and Republicans in Congress have similar priorities (other than getting reelected), but rather that Democrats want to refocus society on distributing the enormous wealth that we have created, while Republicans have no idea how to salvage the free market and free people system in the face of the enormous political costs they would pay to even try.
Look at SNAP, for example. It was never designed to subsidize 12% of the population, or create a system where SNAP recipients could spend 20% more on food than the people who pay for it. But even stopping SNAP benefits for a few days was a crisis. And limiting SNAP benefits for soft drinks, Doritos, Fruit Loops, and prepared foods that are wildly unhealthy is a non-starter in most of the country. Work requirements for able-bodied people is, apparently, beyond the realm of possibility.
That should be an easy reform, yet it is politically impossible.
It is horrific, but Republicans are probably right that if they did what was necessary to reform a social insurance system that is sapping the life out of our economy, they would consign themselves to political irrelevance in much of the country, and therefore at the national level for a decade or two. Nobody thanks the person who hurt them now, even if it means a longer and healthier lifespan in the future.
At least not until the crisis is so severe that you get Argentina under the pre-Milei government. It seems that people only accept this when faced with an economic disaster, realizing that without some pain, there can be no gain.
As Europe shows, people are willing to accept a slow decline into relative poverty as a necessary cost to enjoy the benefits of free things now. You see it in welfare recipients, who accept the price of relative poverty and an inability to climb the economic ladder as the price to get free benefits now. Intergenerational poverty is the price of the welfare state, and millions of people accept it happily.
First, let's look at the numbers:
— Ole Lehmann (@itsolelehmann) November 13, 2024
• US GDP: $25.5 trillion
• EU GDP: $16.6 trillion
But in 2008, they were nearly equal.
What the hell happened over the past 16 years?
It's simple: pic.twitter.com/cC4YeDjwgg
Even elites accept it, despite not directly enjoying the benefits themselves and having to pay some of the costs associated with this insane choice. They live comfortable lives, soothe their consciences by paying a tithe to the poor, and hope that the bread and circuses will keep the plebs happy enough not to revolt.
Liberals will often say things like, "The United States is the wealthiest country on earth, but we don't have anything like the welfare benefits of Europe, even though we can afford them more than they."
Apparently, they don't see the contradiction in their logic. The United States is significantly wealthier because we don't have as large a welfare state and have a freer market. The bigger and more intrusive the state, the less vital the economy. See: Europe. And Europe will, soon enough, not be able to maintain the welfare state they are so proud of. Consider the UK healthcare system to see how unpleasant state-run healthcare can be.
The good news is that America has a lot more fat of the land to consume than anywhere else in the world. It is true that we have decades, if not longer, before the burdens become so high that disaster strikes. While much of the US economy is in stasis, and many people have chosen to downsize their expectations in favor of a more secure life, there is also a vital entrepreneurial sector that continues to create massive wealth.
But listen to the Democratic Socialists. They have set their sights on destroying that, too. It is a big, fat cash cow for them. And eventually they will start eating it.
Republicans are, I fear, fighting a rearguard action. Most of them in Washington want to slow down the path to decline, but I fear that few of them believe they can reverse the trend.
Obamacare's rapid failure and the Republicans' inability to take on the burden of reforming a broken system is just one more symptom of the larger problem.
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