WASHINGTON — The Affordable Care Act (Obamacare) turns out to represent dreadful miscalculations by both the president and his Republican adversaries.
Doubtlessly, Barack Obama imagined that achieving something close to "universal" health insurance would guarantee his legacy. It would make him the liberal heir to Franklin Roosevelt and Lyndon Johnson.
Forget it. Even if Obamacare worked flawlessly — that's now a joke — it's too small to rank with the New Deal or Great Society.
Meanwhile, Republicans say Obamacare threatens liberty and would lead to a federal "takeover" of health care. This is a fiction that, pursued fanatically with policies risking anarchy, has earned the GOP a deserved public backlash.
As readers of this column know, I'm no fan of Obamacare. Before it was introduced, I advised against it. It would be divisive, I argued. Just when the country — suffering economic collapse — needed to rebuild confidence, it would subvert confidence.
Later, I objected that it didn't do enough to control spiraling health spending. Finally, I worried that the ACA's costs and complexities would deter some firms from hiring. I still believe all these criticisms.
What I don't believe are liberals' and conservatives' self-serving myths.
In their world, defending or destroying Obamacare has become a defining political choice of our time. Actually, it isn't. Partisan arguments are disconnected from health-care realities. To see why, let's examine some myths.
Start with the conservative variety, which brought us the (partial) government shutdown and the debt-ceiling brinkmanship.
Conservatives fear that once people start receiving insurance subsidies, they'll become hooked on their newest "entitlement."
Game over. Government runs health care. The trouble is that this game was over decades ago.
Governments now pay nearly half of all health care costs, mainly through Medicare and Medicaid. Government also subsidizes health care through the tax code by not counting employer-provided insurance as taxable income.
American health care is a messy mixture of government intervention and private markets. Doctors, hospitals, drug companies and medical device makers exist mainly in the market.
The government regulates and pays them. The system is flawed. Costs are high. There is waste. Still, conflicts reflect muddled public opinion: Americans reject "socialized medicine" but believe health care is a "right."