As for health care entitlements, the Obama administration is quietly making war on the only workable solution on the horizon: private health insurance. About two-thirds of all Medicaid enrollees are now in private plans, as are one of every four seniors on Medicare. Nonetheless, there are few things the political left hates more than private enterprise in health care.
The Obama administration has refused to renew a waiver allowing Indiana to continue with its highly successful Health Saving Account plan for Hoosier Medicaid. And as part of Obama Care, several hundred billion dollars is going to be taken away from Medicare Advantage plans that provide seniors with private insurance, similar to the kind of insurance most non-seniors have.
The antipathy toward Medicare Advantage plans is especially hard to understand. President Obama has repeatedly said he wants to encourage electronic medical records, medical homes, integrated care, coordinated care and payment for quality not quantity. Yet the only place in the Medicare system where you can find the president’s ideas actually working are in the Medicare Advantage plans! Unwilling to accept private sector innovation, the administration has its own pilot programs and demonstration projects underway. In the president’s own words, "Let’s find out what works and then go do it." Unfortunately, government-sponsored pilot programs are no substitute for private entrepreneurship. The CBO has analyzed these programs in three separate reports here, here, and here and in each case found them to be not working at all or, at best, producing mediocre results.
As for the most important cause of inequality — our failing public schools — there is no liberal answer to that problem either. Virtually every innovative reform idea — from school vouchers to charter schools to merit pay for teachers — is being resisted by the teachers unions. But when is the last time you saw a liberal politician criticize the National Education Association? How about a liberal columnist? How about the pundits who complain most loudly about the unequal distribution of income?
It’s as though leftwing intellectuals have a tacit agreement not to criticize any group that provides electoral support for the Democratic Party.
So when Mitt Romney says the president is "out of ideas and out of excuses," I say Amen.