Select Page

We the People vs the Elites



By Grace-Marie Turner, Galen Institute

Of all the craziness that came out of the Davos meeting earlier this year, one quote particularly struck me. One speaker said (paraphrasing because it has vanished from search engines), “We elites are more united than ever, making it all the more baffling why the masses are not following along with our solutions to tackle these big global challenges.”

Disgusting, I know. Maybe it’s because they want to take away our food, heat, and cars. 

We “ordinary people“ have had it with “elites” controlling our lives, and we are seeing the blowback in elections around the planet, including this week in Ireland where two woke constitutional amendments were rejected.

So that brings me to Obamacare. It has been in effect for 10 years and was signed into law 14 years ago tomorrow. The Biden administration is celebrating the program, saying more people are enrolled in Obamacare than ever

That’s true. If you cripple other sectors of the insurance market and massively subsidize people to join your plans using taxpayer dollars, you can grow your numbers.

ACA supporters say that Congress has tried and failed “at least 50 times” to repeal the law.  Wrong.  We kept track of the changes made to the highly flawed law in just the first few years, and we counted 70 including key provisions designed to fund the law, like the Cadillac tax, and others to try to make it marginally more functional.  Many of these changes to the law were ordered by the Obama administration without congressional authorization.

Premiums and deductibles have soared for patients not eligible for huge taxpayer subsidies—for skimpy coverage that limits access to the best hospitals and doctors.

And what a boon that has been for the insurance industry! In fiscal 2023, federal subsidies through the ACA Medicaid expansion and the exchanges totaled $218 billion, almost all flowing to insurers.

“The ACA’s Medicaid expansion has produced a windfall for health insurers, with federal spending on expansion enrollees equal to $126 billion in 2023 per CBO (the state share would add about another $13 billion),” Paragon President Brian Blase writes.

The Los Angeles Times exclaimed: “Medicaid is rarely associated with getting rich….But some insurance companies are reaping spectacular profits off the taxpayer-funded program in California, even when the state finds that patient care is subpar.”  

The insurance sold in the exchanges increasingly looks like Medicaid but with a high deductible for coverage that is not accepted by many top-rated doctors and centers of medical excellence, as John Goodman explains.

I attended a meeting many years ago—before Obamacare passed—attended by policy colleagues from across the ideological spectrum.  One said that Medicaid, not Medicare, is the most convenient platform upon which to build a single-payer health system.  

Before the Covid expansion expired, more than 94 million people were enrolled in Medicaid.  So they are on their way.  

But the American people are fed up with massive taxpayer subsidies for inferior coverage that serves mostly to make enormous health care companies even richer.  

Dr. Joel Zinberg writes in “Not So Affordable Care” that “the public and legislators should ask why we should fund these unsuccessful government experiments…Beneficial changes to the American health-care system are far more likely to come from the private market than from unelected bureaucrats in Washington.”

That is the future, Davos elites.  It starts with patients getting control over their health spending and their future.


Grace-Marie founded the Galen Institute, a public policy research organization, in 1995 to promote an informed debate over free-market ideas for health reform.