Undoing Obamacare

There’s a reason why Marxism in practice is often called creeping socialism. It’s built one entitlement—or entitlement enhancement—at a time. Once in place, entitlements are difficult to undo because reformers must survive a siege of charges that they are taking something away from someone. The “something” can be food on the table, unemployment benefits, social security, or just about anything the left has decided should be provided by government. In this instance, it’s healthcare.

The left’s narrative on repealing Obamacare is that Republicans must figure out how to improve the system while not affecting those who are currently covered, including millions who received heavily subsidized plans through the so-called Affordable Care Act. The average monthly subsidy for new enrollees was almost $300 for a plan with an average premium of less than $400. In effect, this means that newly covered Americans are paying about $100 per month for a $400 plan. The upper limit for subsidy eligibility is 4 times the poverty level, or about $100,000 a year for a family of 4. Obamacare proponents consider existing subsidies to be cemented, so any rollback would just be heartless.

The Republicans I’ve heard are playing along. Nobody will lose their plan because of reform, they say. To be frank, real reform isn’t possible if healthcare—including routine trips to the doctor—is considered an entitlement. Quality care costs money, and it’s time that Americans who can afford iPhones, Netflix, Body art, and lottery tickets accept responsibility for paying the piper.

I don’t want to be an early Grinch, but we must face facts. When government pays for something, we all pay for it indirectly. It’s direct payments that give us control over the grocery stores, gas stations, auto repair facilities, and restaurants we deal with every day. If they don’t meet our needs, we find another provider who can. But with healthcare, government and insurance companies pay most of the bills, so they call most of the shots. It’s no surprise that doctors and hospitals don’t post prices for their services and most people involved in their delivery have no clue what they actually cost. The only way to regain control is to limit subsidies to catastrophic care for the truly poor, while unleashing the market and demanding control of our own healthcare expenses.

A predominantly market-based healthcare system would be a paradigm shift for most. If you get the flu, you should decide if a trip to the doctor is worth $100. Instead, if you have coverage with a modest copay, you are more likely to go and pass the additional cost along to others in the pool, who are, of course, doing the same. Economists refer to this as perverse incentives and it drives up costs for everyone.

I’m saying what Trump, Ryan, and other Republicans are hesitant to say. Yes, some Americans should lose their subsidies. Some assistance for those in poverty makes sense, but the rest of use need to regain control of our choices. That means no mandated plans, the ability to purchase coverage across state lines, and no expectation that insurance companies will accept us as new customers after we get sick.

Here’s to a complete overhaul of the system. Unfortunately, I doubt the Republicans have the fortitude to go as far as we need to go.

13 thoughts on “Undoing Obamacare

  1. Taking away the subsidies is not taking away healthcare. Health care is not health insurance, which is what we have now. What we’ll see (hopefully) are new insurance pools that provide catastrophic care and operate across state lines. Tort reform will help but that may take time.

  2. I just don’t understand why it should cost $100 to go to the doctor. There’s got to be a better way. The market has created this price and it costs a lot less in other countries, so shouldn’t we try something else?

  3. Healthcare is insurance, just like a car insurance. I don’t want to pay $100 per doc visit and don’t want to give insurance companies the power to decide not to accept someone due to pre-existing condition, or just because they consider you as risky investment. So maybe Obamacare is not perfect and can be revised, but the idea behind it is noble. Healthcare is not a privilege, it’s a basic right that each one of us deserves.

  4. There are lots of noble ideas that don’t work. We elect a president and a congress to pass legislation that works, not just ideas with good intentions.

  5. Aliza does this basic right extend to all humans or just Americans? If it is a human right, then it would seem to imply that all people in the world are entitled to free health care. Since these services cost money, then who pays for it? If your answer is the government, then it is not a right, since we do not have a world government. It would then be the responsibility of each of the individual governments to decide this on their own. All of the free services we provide now (Medicare, Medicaid, etc.) were the results of congressional action. Thus, it is not a right at least in this country, since it required a new law. Maybe you think it should be a human right, but that does not make a legal obligation.

  6. Human rights can ( and should) be protected by laws. Governments in other countries in the world do understand that. It works in other places in the world.

  7. Aliza missed the point. If healthcare at USA standards is a right deserved by everyone, then what about the billions who don’t even have access to clean water. If it’s a right only for Americans, then you’re valuing one life over another because of birthplace. Really? If we agree that healthcare is good, then why can’t we agree that EVERYONE has to pay for it. JP is right. We can’t afford to give it away to middle class Americans. If you propose universal coverage at any level, then why not propose universal taxation to pay for it?

  8. This is a legitimate discussion but it is not about rights. Everyone in this country has a right to healthcare if payment can be arranged. We are really talking about free health care. In fact it is about making it free for people of means as Medicaid is available for millions of low income citizens. Elderly are taken care of via Medicare, vets through VA and children through SCHIP. For many who don’t fit into these categories, there are employers who foot most of the bill. You may wish to consider it a right based on some personal ethical standard, but that does not create an obligation on the part of the government.

  9. If healthcare is a “right,” then you could argue that government should provide it. Healthcare is not a right, so government should only get involved for humanitarian purposes.

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