The Congressional Budget Office has a new forecast of the fate of Obama care over the next 10 years. And the verdict is…the system is not in a death spiral. Premiums are forecast to rise faster than inflation, which is bad, and the number of people without insurance is forecast to rise slightly, which is bad unless you believe for some reason that these people are not entitled to the same human rights you are entitled to, for whatever reason, but that system is “stable”, i.e. not in a “death spiral”

The paragraph below caught my eye for a couple reasons. First, Obama care is only 10% of all government health care expenditures. Medicare is also only about 10%, which is amazing and I suspect almost everyone has the wrong idea about that. Medicaid and the Children’s Health Insurance Program are a whopping 40%.  Subsidies for corporate health insurance are the remaining 40%.

Net federal subsidies for insured people in 2018 will total $685 billion.
That amount is projected to reach $1.2 trillion in 2028. Medicaid and the
Children’s Health Insurance Program account for about 40 percent of that
total, as do subsidies in the form of tax benefits for work-related insurance.
Medicare accounts for about 10 percent, as do subsidies for coverage
obtained through the marketplaces established by the Affordable Care Act
or through the Basic Health Program.

So what surprises me is that we are covering the elderly pretty thoroughly and pretty cost-effectively, while coverage for the poor seems to be both inadequate and extremely cost inefficient. And certainly, the system of hidden tax subsidies for corporate workers is grossly inefficient. So why does the public put up with all this? First, old people love to complain but at the end of the day they are reasonably well taken care of at a reasonable price. Upper-middle-class professional workers receive high quality care and don’t realize how heavily-subsidized and cost-inefficient that care is. These two groups make up a lot of the swing voters. The majority of those swing voters have bought into the decades of neo-fascist propaganda that the poor are undeserving for one reason or another, and therefore their sense of natural human empathy is damped down. and the poor themselves are not politically mobilized. Big business in general might be just as happy for government to take the responsibility for health coverage off their shoulders, but they are not really disadvantaged financially by the present system so they don’t fight it. The big exception of course is the insurance/finance industry which benefits directly from the inefficiencies of the current system, and certainly is politically mobilized.