Democrats Own Obamacare

Thanks to the high-profile efforts of Senators Ted Cruz, Mike Lee, and others, including the House majority, there is a stark contrast between the two major parties regarding Obamacare. One party is all-in for it, the other is indelibly etched in the public mind totally opposing it. Republicans would be foolish to change that, but even as Obamacare implodes, that’s just what some are calling on them to do.  

Writing at Fox News, for instance, Peter Morici lays out the case for accepting Obamacare and trying to change it.

Republicans should stop cheering for ObamaCare to fail. It may be dreadful, but going back to what we had before is not possible. The real political hay is to be made improving the law to lower prices and premiums — details Democrats forgot.

The political and policy ramifications of Obamacare are related, but Republicans do not oppose Obamacare simply on political grounds. Making “political hay” is secondary to preserving the liberty and economic well-being of Americans and avoiding out of control federal health spending.

The wheels have come off Obamacare. Even the website will not be ready by December 1; two months after it was launched. On the political level, why would Republicans accept the failed Obamacare now, as Democrats scurry away, and when the reality of government delivery is daily making stronger the arguments for its full repeal? 

There would indeed be a huge political cost to the bait-and-switch of accepting and trying to improve Obamacare. The real schism in the Republican coalition between grassroots idealists and the establishment plotters would grow even deeper. It is exactly the wrong thing to do.

The other problem with accepting and trying to fix Obamacare is on the policy level. Obamacare cannot be fixed. It is built on a broken foundation – price controls and the third-party-payer model. No amount of scheming, plotting, or tweaking can make it right.

Why Obamacare Was Fundamentally Broken

In the effort to mimick the effects of the free market, Obamacare designers used the exchange model that had been developed at the Heritage Foundation in the 1990s in response to Hillary Clinton’s total government takeover. Calling that a “conservative” plan is ridiculous, however, since it was merely designed to be less radical than HillaryCare. 

Obamacare’s designers then larded up the exchanges with some emotionally attractive but economically disastrous provisions:

  • Guaranteed issue, so that no one could be denied a policy based on their “preexisting conditions” — that is, regardless of risk
  • Community rating, so that prices in a county were the same regardless of insurability and with only limited increases for smoking and age
  • Very limited tradeoffs between premiums and deductibles — Bronze plans, Silver, Gold or Platinum
  • “Free” preventive services, which were later defined to include all forms of FDA-approved birth control, but under which some cancer screenings are discouraged as too expensive and fraught with error
  • A grab bag of mandatory covered conditions, without which the deep thinkers determined a policy was “substandard”
  • Another grab bag of taxes to punish people for such things as getting too much health insurance

Those provisions were going to make the insurance more expensive, economic law required it. To make the resulting plans be “affordable”, subsidies for insurance companies were added for their customers with low income. The subsidies were to go to directly to the insurance company, not to the individual customer.

The actuaries in government and the insurance industry crunched the numbers and said that even with the subsidies, there was no way people would buy the Obamacare insurance policies. The whole thing had to be made mandatory.

That’s where the mandates, including the individual mandate, the employer mandate, and the self-insured essential benefits mandate came in.  Every individual had to have insurance of the type Obamacare specified. Every employer had to offer it, or be bankrupted by punitive taxes. Every employer who was already self-insured had to add the expensive Obamacare benefits, or pay a draconian fine.

That’s a simplification of the program.

Few pieces can be removed before the Tinker Toy model falls the rest of the way apart. 

What Obamacare Opponents Should Do

It is a false choice between accepting Obamacare and going back to the pre-Obamacare system, which was already overregulated. As much as I dislike the weak slogan “Repeal and Replace,” that is what needs to happen. Obamacare should be fully repealed, and — after careful study and debate — gradual, consensus reforms introduced to undo the damage governmental involvement has caused to date.

During this reform process, there’s no doubt the left will try to add more and more government control to the health care system, because they believe government control makes everything better. We will be far better off both politically, and in national policy starting over than trying to rebuild the sandcastle while the tide comes in.

Legislative and activist pressure is needed therefore to dismantle the law piece by piece, attacking the least popular parts of this unpopular program. Rather than accepting Obamacare, which is both bad policy and bad politics, we must continue to attack it until it can be fully repealed. 

Democrats will resist any changes to Obamacare, because they know that without any one of the major components, the implosion will be all the more apparent.

Calls as Morici’s for us to give up freedom in the name of containing health care costs should ring hollow for every American, particularly those claiming to speak for limited government. Because even if a top-down governmental system of price controls and managed care could control costs, and even if it could provide better care, it would make us less free in a fundamental way. That’s not a fair tradeoff.

Republicans should avoid such nonsense, and continue attacking Obamacare.

Every Senate Democrat in office in 2010 was the deciding vote for Obamacare.

Without the vote of any one of the Senate Democrats, Obamacare would not have become law. They voted unanimously in support of the rule that forced insurance companies to cancel policies.

As it stands, Democrats are responsible for Obamacare — all of it — its rules, its cost, and every page of regulation. Without them, it would not exist.

Continue efforts to repeal this awful law, and make those responsible for it pay politically for what they have done. 

 

Image credit: NY Times