In a recent post Jonathan Turley opined about the growing disaster inside Britain’s National Health Service — a warning sign for any nation tempted by the political sugar high of government-run healthcare.  https://jonathanturley.org/2025/12/27/the-uk-health-care-disaster-is-a-cautionary-tale-for-americas-rising-class-of-armchair-socialists/

The NHS, long celebrated as the crown jewel of European social democracy, now begs sick people to stay away from hospitals that can no longer provide basic care.  Emergency rooms are overflowing, routine procedures are being canceled and a predictable seasonal event, i.e., winter, has become a calamity the system simply cannot cope with.  For decades, British leaders have described an annual “state of emergency,” but today, that emergency has become permanent.

This cautionary tale should be front-and-center as Washington prepares to once again extend the so-called “temporary” subsidies propping up the Affordable Care Act.  These subsidies were originally sold as a bridge — a short-term fix until Obamacare delivered lower premiums, more consumer choice, and a self-sustaining insurance market.

Of course, none of that has happened and American healthcare is now more costly, more bureaucratic, and more dependent on government dollars than ever before.  And yet, the answer from Washington is to extend the subsidies and make them permanent.  But as the saying goes, there is nothing more permanent in politics than a temporary benefit.

The moment a tax credit, subsidy, or entitlement become a part of a family’s budget, it becomes their baseline reality.  Taking it away doesn’t feel like returning to normal — it feels like a loss. Psychologists call this loss aversion: the pain of losing a dollar hurts far more than the pleasure of gaining one.  Economists refer to it as a “ratchet effect,” where benefits, not dissimilar to prices at the supermarket, rise during emergencies and never ratchet back down afterward.

Politicians understand that giving a benefit mean votes but taking one away loses elections.  That’s why sunsets are written into legislation, but sunsets rarely set.  The federal income tax, introduced as a temporary wartime measure in 1913, became the primary fuel of the modern federal government.  Social Security expansions sold as protections for the vulnerable now represents the most politically untouchable spending in the budget.  And COVID-era programs that were supposed to vanish with the virus are still being defended as moral necessities.

Temporary becomes permanent not because the economics demand it, but because the politics punishes the alternative.  Which brings us to Obamacare subsidies and the collision between two forces – the fiscal reality of a failing program, and the political reality that undoing subsidies will lose the election for the party that advocates for it.

An electoral truth is that voters may not reward what they receive,  but they will always punish what they lose.  So, today, some Republicans appear willing to join Democrats in extending the life of a severely broken policy to avoid the electoral backlash of taking something away.

Barack Obama famously promised that under Obamacare, premiums would drop and “if you like your doctor, you can keep your doctor,” a claim later dubbed “Lie of the Year.”  Meanwhile, costs have soared, insurer participation has shrunk, and doctors have exited networks.  The law failed, it’s that simple, yet the only discussion now is how much more money government should pour into a black hole.

As health-care costs rise the political temptation is to let government take full control. Democrats admit the Affordable Care Act hasn’t made care affordable, but instead of fixing what’s broken, they insist the answer is a single-payer system modeled on the same nationalized bureaucracy the Washington Post describes as “broken” in Britain.

Every year that subsidies are extended is another year the insurance market withers.  Every month spent papering over structural problems is a month closer to a future in which genuine market reform is no longer politically possible.  Once voters believe government is responsible for healthcare affordability, any effort to unwind subsidies is fruitless.

This is how most of the EU has backed itself into a corner.  The longer a flawed system survives, the more powerful its defenders— not because the system works, but because people fear losing what little it provides.

We have a window for reform and a chance to address cost drivers, break up regulatory monopolies, strengthen price transparency, increase competition, and return decision-making to patients and doctors rather than bureaucracies and insurers.  But that window narrows with every “temporary fix.”

Britain’s NHS should stand as a vivid reminder that once dependency calcifies into entitlement, reform becomes politically toxic and collapse becomes inevitable.  And politicians who cannot fix what’s broken will eventually defend what’s broken to the bitter end.

And this ladies and gentlemen is the promise of Obamacare subsidies.  Temporary or stop-gap programs become permanent, emergency spending becomes annual spending, and long-term solvency is disregarded in favor of short-term electoral results.

Obamacare was a bad deal from the get-go, and the longer real reform is delayed the more likely we will follow in Britain’s path.

Quote of the day: “Obamacare was never actually affordable …” — Cigna Group CEO, David Cordani