As the Republican health-care bill continues to stall in the Senate, President Trump has finally called for the same thing Kentucky Sen. Rand Paul and House Freedom Caucus members have been calling for all along – a repeal of Obamacare first, followed by a replacement at a later point.
The belief, presumably, is that with no bill in place whatsoever, stubborn Republicans and even maybe a few Democrats might be more willing to work on a viable replacement bill. Sound logic, but assuming the gambit is played and it works, there are still several unalterable facts that make the passage of a workable “viable replacement” health-care bill nearly impossible.
To begin, more and more people are coming to recognize the fact that the architects of Obamacare likely knew their bill was merely a slippery slope to the liberal health-care cure-all – a single-payer system. In fact, conservative author and pundit Charles Krauthammer recently conceded that, indeed, a single-payer system is where this whole thing will likely end, regardless of what Republicans are able to pass now.
“I would predict that in less than seven years, we’ll be in a single-payer system,” Krauthammer said in May. In his view, the American public have “sort of accepted the fact that the electorate sees health care as not just any commodity, like purchasing a steak or a car.” Instead, it’s become something “the government ought to guarantee.”
Becoming? How about the fact that, for all practical purposes, it’s been that way for over 30 years?
Ever since the passage of the Emergency Medical Treatment and Active Labor Act (EMTALA) in 1986, mandating that hospital emergency departments across the nation treat everyone regardless of their ability to pay, health care has essentially been a “right.” And those who complained about Obamacare’s passage because it “unlawfully” (at least until SCOTUS deemed it lawful) required people to purchase insurance likely didn’t consider that EMTALA quite “lawfully” required emergency departments to perform such treatment with no reimbursement provisions built in whatsoever.
The bill was a slippery slope, of course, because not only did it require people to perform work for no visible reimbursement (not to compare the two in any real sense, but when has America done THAT before?), it also led to increased medical bills and, as a result, increased insurance premiums for everyone else.
This eventually led to the demand for government to “do something!” about the uncontrollable rise in health-care costs, which led, of course, to Obamacare.
Since, as anyone in Washington knows, one you give a “benefit” to people it becomes next to impossible to take it away, the absence of a massive health-care bill, though that would be the least expensive option for the most Americans, isn’t debatable anymore. In fact, the bill’s promise to repeal just a portion of Obamacare’s “goodies” is the primary reason behind its tremendously low polling. Where once the majority was against Obamacare, now the majority support it, budget deficit be damned. Health care is now a “right,” and most Americans want government to have a heavy hand in it. So even if Obamacare gets repealed, it will be “replaced” by another massive, bureaucracy-based system that isn’t popular and may not work.
Given this sad state of affairs, how good can the Republican bill be? Well, in a way it depends on whether its creators are willing to go further than even Obamacare was willing to go – at least in one area.
Here’s the deal. From all accounts, the fatal flaw seems to be the absence of a measure to keep people on insurance. Obamacare, and society, has made the coverage of “pre-existing conditions” a requirement for insurance companies, and yet if, as is currently under the proposed plan, people can conceivably float on and off insurance policies as they get sick, how are insurance companies supposed to remain solvent?
There is so much debate about the fact that Obamacare “mandated” coverage by taxing those without insurance, but if society has determined health care to be a human right, and it quite arguably has been since 1986, a logical argument can be made that society long ago gave up the “right” not to be forced to purchase the only way to truly make universal health coverage possible and keep any semblance of a free market – health insurance.
Unless we move to a single-payer system and endure all the nightmares we know will come with that, as is the eventual liberal goal, the only way to make the Republican plan truly work is to create some sort of enforceable universal health insurance requirement that adequately covers the costs.
Period, end of story.
In other words, the Obamacare “tax” didn’t go nearly far enough.
We may not like it, but that’s the reality on the ground, not as we wish it would be.
Krauthammer envisioned only two options going forward, a market-based system or a single-payer system, the first of which isn’t going to happen because, you know, that whole “health care as a right” thing. ”The terms of debate are entirely on the grounds of the liberal argument that everybody ought to have it,” he said. “Once that happens, you’re going to end up with a single-payer system.”
Before we go down the long hard road of a single-payer system, isn’t it at least worth a shot to make the Republican bill a workable solution? Free up the market as much as possible – i.e. allow for different kinds of coverages, groups and geographic areas, including and especially across state lines. Let people purchase whatever they want as long as it meets certain requirements – but purchase insurance they must. And those who provably cannot can shift to Medicaid.
Society doesn’t allow people to drive unless they have insurance because it’s our “right” to not be on the road with people who could wreck our lives and be unable to pay the consequences (unless they are illegals, of course, but that’s a whole other deal). Likewise, people who refuse to purchase health insurance are essentially putting everybody else at risk … of an unworkable, unfathomable, health-care-destroying single-payer system.
To have any hope of succeeding, the Republican plan will have to do more than Obamacare ever did. And if that’s too large a pill for the Freedom Caucus and other conservatives to swallow, maybe they should consider whether or not maintaining their congressional majority is worth the betrayal of their principles.