THE BLOG
10/28/2013 12:14 pm ET Updated Jan 23, 2014

The Kochs Don't Realize That They Are, Singlehandedly, Paving the Way to Single Payer

At some point, the federal health care website will work. Although the lamestream media loves the story, it is not really the major challenge the Affordable Care Act must meet.

The untested issue is whether the individual mandate will generate enough money to enable insurers to cover people with pre-existing illnesses while keeping premiums reasonable. The mandate requires everyone to purchase insurance (with subsidies for those unable to afford the premiums) or pay a fine of up to 1 percent of income capped at the premium for a bronze (lower coverage) plan.

It works in Massachusetts. Hence, to stop the Affordable Care Act, the Koch boys need to create fear of enrolling among the younger and less ill. [The right-wing's philosophical attack is that this constitutes a huge wealth transfer (yikes!) from the young to the old, and from the relatively healthy to the ill. But, of course, that is exactly what insurance is, e.g., from the safe to the reckless driver, from the living to the estates of the dead, and so forth, and the quid pro quo is that one is covered in case these bad things happen to you].

But, the Koch boys may find that they achieve much more than they ever dreamed.

History is replete with wars that have precisely the opposite outcome of their stated intent.

Vietnam became more, not less, of an ally of China, and, of course, Iran and the Shia expanded their influence when the U.S. did them the service of toppling Sunni Saddam Hussein. The political debacles of the government shutdowns for Republicans are well-appreciated.

The Koch Boys' war against the Patient Protection and Affordable Care Act ("ACA") may similarly backfire.

Consider the scenario for which the Kochs pine that insufficient numbers of the young and the healthy enroll in health care plans through the exchanges so that insurers are stretched to the breaking point paying for those with pre-existing illnesses who did enroll whom they would, but for the new law, previously have excluded from coverage.

For year two, insurers would have to offer the same plans but boost the premiums, pricing many people who have enjoyed health care coverage for the first time right out of the market. Even if they required state insurance board approval, their economic case would be compelling.

What happens next? The Kochs clearly believe that destroying the health insurance industry (imagine what happens to its share prices) and putting health care, again, out of reach for millions of Americans will lead to the obvious conclusion that it is all the fault of "big government".

Will it? It will become crystal-clear that the part of the industry that would be failing, and thus threatening the health care of millions of people they previously excluded, is the private health insurance sector. Medicaid and Medicare would still be humming along.

While one should never underestimate the ability of lying billionaires and their lackeys to spread disinformation, their impact is limited by the reality of heart-wrenching experiences in peoples' lives. The operating premise of Koch disinformation is that only the sick will enroll. Hence, if the system implodes then only the sick will be thrown overboard.

People may want something in the abstract, but their intensity of deprivation increases dramatically when they had it, and it is then wrested from them. After World War I, it was described as, "how do you keep'em down on the farm after they've seen Paris?".

The right-wing will indeed face more of a backlash then they do today. Sure, they can assert that if we had only listened to them, "none of this would have happened". True, enough. But, the "this that happened" is to those with pre-existing illness not the turmoil in the insurance industry, but their ability to receive adequate health care. They will not forget it.

Moreover, consider how devastating this is for the right-wing. First, people will have had a good taste of what adequate medical treatment can provide. Second, the right has absolutely nothing to offer in its place -- the likelihood that people will fall for the "just purchase insurance across state lines and limit tort damages for malpractice" as a solution to their problems will go from negligible to less than zero. Third, this free market solution, that the right-wing Heritage Foundation pioneered, will have been shown not to work.

Finally, it will not be difficult to explain to the elderly that Paul Ryan proposes a plan nearly identical to the Affordable Act to replace their Medicare. I, and others, immediately warned that it would be very difficult for the elderly to get coverage, especially those with more than 3 chronic illnesses that account for about two-thirds of the total annual spending in Medicare. Imagine the political impact of going to retirement communities and showing them what Paul Ryan had planned for them by pointing to the Koch-induced failure of the regulated free market experiment for those between 26 and 65.

By sheer contrast, we have today's Medicare. It works and works well for the older and sicker part of our population. Why would anyone not believe that a solution -- Medicare-for-All -- would not work just as well, if not better, for the younger and healthier?

David Koch is 73 years old, and under treatment for prostate cancer. One wonders, therefore, if he has experienced first-hand the benefits of Medicare himself. If so, he will rest comfortably knowing that his multi-million dollar campaign to destroy the Affordable Care Act led directly to Medicare being made available to everyone.

Although I personally hope the Kochs' attacks fail, and the Affordable Care Act works as designed, if their attacks succeed, the Kochs may, in this decade's most delicious irony, pave the way for Medicare-for-all, and thus unwittingly become heroes of the Left. Daddy Koch, who bequeathed Koch Industries to his boys, also helped found the John Birch society that, e.g., accused President Eisenhower of being a communist, will be turning over in his gilded grave.

Instead of the Affordable Care Act becoming President Obama's Waterloo, the Kochs' war against it may turn out to be their Iraq. Who, after all, believes Bush actually intended to strengthen Iran and the Shia?

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