The Sabotage Device Within Obamacare

Much of the March/April issue of the Washington Monthly is about conservative efforts to sabotage key first-term accomplishment of the Obama administration via the regulatory and other implementation processes.

But Phillip Longman’s article, “The Republican Case for Waste in Health Care,” focuses on an even more imposing threat: the language embedded in the Patient Protection and Affordable Care Act of 2010 by Republicans and health industry lobbyists that if left in place could well sabotage Obamacare from within. It’s all the more ironic because the provisions in question largely prevent the use of that great conservative totem (in other areas of public policy), cost-benefit analysis. And that means the cost effectiveness improvements that are the key to Obamacare’s financing, and to its intended beneficial effect on the health care system generally, could be largely ruled out from the beginning.

How big a deal is this? It couldn’t be much bigger...