Whenever government attempts something beyond the proper role of
government (protection of life, liberty, and property), it causes unintended
consequences—usually exactly opposite to the stated goals of the interference.
That is an axiom of the Spherical Model. It comes up often when we’re talking
about government policies. Today we’ll look at an example from this past week.
This US Senate came out with their version of “repeal and
replace,” which, pretty much like the House’s version AHCA (American Health
Care Act), doesn’t repeal, and only slightly modifies the original, inaptly
named Affordable Care Act.
The ACA—or Obamacare, since it’s on him—claims to want to
provide more affordable health insurance for the uninsured. It did so by
astronomically raising insurance costs, reducing choice, forcing Americans to
make a purchase whether they would choose to or not, and added in forcing
companies to pay for practices against their beliefs (which the courts have
somewhat corrected after attacks on nuns and others whose religion finds
abortion unconscionable). People lost the health insurance they had. People
lost their doctors. People found health care scarcer and more expensive. And
the whole system is spiraling downward.
Let’s add that the ACA claimed it had the right to force all
citizens to purchase health insurance as “a legitimate exercise of its
expressly delegated power to regulate commerce among the states. The trouble is
that the mandate does not regulate commerce at all. Rather, it forces people
into commerce on pain of a financial penalty,” quoting Robert George in the Prager U video "Why We're Losing Liberty."
Another helpful video on today's topic is "Why Is Healthcare So Expensive?" A good 2 1/2-minute summary:
Meanwhile, since the ACA's partisan late-night scurrilous passage
in March 2010, Republicans have been promising to repeal the whole of Obamacare
and replace it with free-market reforms.
But now that they are in power, they hesitate—because the Democrats, amplified by the media, which is lopsided in favor of Obama and his ilk, announce that getting
rid of the higher costs and less care of Obamacare means they want to kill thousands of people. Lies seem to have an effect on weak seekers of approval.
So, from the House we got the AHCA, American Health Care
Act. At least they didn’t call it affordable. But it doesn’t actually provide
health care either. It intended to adjust a few minor things. And it certainly
wasn’t a repeal of the ACA as promised from 2010 through the election of 2016.
The freshly named BCRA, or Better Care Reconciliation Act,
which is what the Senate is calling their version, does nothing to provide better
care, or more affordable care—with a few provisos mainly put off until past some
other election or decade. Nor would I say it reconciles reality with the
pretended goal of more affordable health care for all. (The real goal of
government, when it steps beyond its proper role is always to wield power.)
The BCRA will not pass with any help from Democrats. That
means it requires all but possibly two Republicans to vote in favor. (There are
52 Republican Senators, plus VP Mike Pence to break a tie.) But Senators Ted
Cruz, Rand Paul, Dean Heller, Ron Johnson, and Mike Lee all oppose it as
currently written. Senator Heller thinks it needs more money going to Medicaid
than any previous version, so let’s set him aside for now. The other four want
to keep their promise to repeal the ACA and replace it with free-market ideas.
There are many who think they should just give up on their
principles and go along to get along, even people I respect generally as
conservative (Hugh Hewitt, for example).
I think it would be instructive to hear what these holdouts have
to say. Together, they said this: "There are provisions in this draft that
represent an improvement to our current health care system, but it does not
appear this draft as written will accomplish the most important promise that we
made to Americans: to repeal Obamacare and lower their health care costs."
Senator Cruz said, "Of course I'll compromise, if—and
the 'if' is critical—we're moving in the right direction, if we are expanding
freedom, if we are improving economic growth, if we are defending our
nation."
Senator Lee wrote an op-ed giving his reasoning. I’ll just share parts of it:
No, the Senate healthcare bill released yesterday does not
repeal Obamacare. It doesn’t even significantly reform American healthcare.
It cuts taxes. It bails out insurance companies. It props up
Obamacare through the next election. It lays out plans to slow Medicaid
spending beginning in 2025, but that probably won’t happen. And it leaves in
place the ham-fisted federal regulations that have driven up family health
insurance premiums by 140 percent since Obamacare was implemented.
As the bill is currently drafted, I won’t vote for it.
He’s not against compromise
entirely; he’s been there done that:
[A]s one of the most conservative Republican Senators, I
would have to compromise with the least conservative Republican Senators to get
something done. And compromise I have!
At the beginning of this process, I wanted a full repeal of
Obamacare. Despite campaigning on that very thing for eight years, my
Republican colleagues disagreed.
So then I called for a partial repeal, like we passed in 2015—and
which conservatives were promised by our leaders in January. A partial repeal
would at least force Congress to start over on a new system that could work
better.
Again, no.
So then I advocated repealing Obamacare’s regulations, which
have been the primary drivers of spiking premiums. I repeated this suggestion
at every single meeting of the working group, and at every members’ lunch for
several weeks. Yet when the Better Care Reconciliation Act was unveiled
yesterday, the core Obamacare regulations were largely untouched.
What would make this clearly bad
bill palatable to vote for?
Conservatives have compromised on not repealing, on spending
levels, tax credits, subsidies, corporate bailouts, Medicaid, and the Obamacare
regulations. That is, on every substantive question in the bill.
Having conceded to my moderate colleagues on all of the
above, I now ask only that the bill be amended to include an opt-out provision,
for states or even just for individuals.
Here’s his reason:
The only hope for actually solving the deep, challenging
problems in our health care system is to let people try out approaches other
than the ones a few dozen politicians thought up inside the D.C. bubble.
And so, for all my frustrations about the process and my
disagreements with the substance of BCRA, I would still be willing to vote for
it if it allowed states and/or individuals to opt-out of the Obamacare system
free-and-clear to experiment with different forms of insurance, benefits
packages, and care provision options. Liberal states might try single-payer
systems, while conservatives might emphasize health savings accounts. Some
people embrace association health plans or so-called “medishare” ministry
models. My guess is different approaches will work for different people in
different places—like everything else in life….
To win my vote, the Republican health care bill must create a
little space for states and individuals to sidestep Washington’s arrogant
incompetence, and see if they can do better.
Recent history suggests they couldn’t possibly do worse.
Just make a little room for choice. Allow a free market to
try to find solutions. It doesn’t seem like that much to ask. And maybe he’ll
get it.
I don’t know how to get policy passed that would do what is
needed—but I do know what is needed. If we want affordable health care, we need
government out of the way. The free market eventually leads to innovation and
lower costs. Every time it’s tried. If only we tried it more often.
No comments:
Post a Comment