Is Obamacare Here To Stay?

by Conor Friedersdorf

That's a subject of disagreement on the right. Here's Matt Continetti:

Now, one chamber of Congress has voted for repeal, more than half the states are challenging the constitutionality of Obamacare’s individual health insurance mandate, and the law remains unpopular. Health care spending and premiums continue to rise, and the president’s claim that the law allows you to keep your health plan has been proven false. Can somebody remind us why the law’s supporters continue to think they have the winning hand?

The truth is that if Republicans in the 112th Congress spent the next two years doing nothing but debating the health care law, beginning to dismantle it, and offering alternatives, they would have real momentum heading into the 2012 election.

And here's Reihan Salam:

Realistically, it is hard to see PPACA vanishing from the face of the earth. This means that Republicans and Democrats will have to work to fix the subsidy regime, to replace community rating with a cheaper form of risk adjustment, and return to the drawing board on Medicaid. The one silver lining is that PPACA did secure a notional commitment to reducing Medicare expenditures, though it didn't provide a reliable mechanism for doing so. An optimist could say that while the last Congress did a great deal of damage, it did take a serious political hit that might make it easier for future legislators to put Medicare on a sustainable footing.

I continue to be skeptical that Obamacare will significantly improve our health care system, and ambivalent about whether we get where we need to be via "repeal and replace" or amendment. I know a lot of Daily Dish readers supported the president's bill, and I'm glad it expands access to insurance and ends recission. But I just don't see how it fixes many of the problems discussed here, here, here and here. If you take a look at those links – and whatever your take on health care, they're all exceptional pieces of journalism – you'll get a good sense of what I'd do differently. Also recommended: this piece on end of life care by Atul Gawade. That is the conversation we ought to be having, not this nonsense about "death panels."