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Repeal Obamacare

Now that the Obama Administration has finally admitted that its health industry takeover is unworkable, Senator Dick Durbin (D-IL) has called for changes to the law.  I have a better idea. Repeal it, give the health care industry time to stabilize, and then see what needs to be done.

Senator Durbin speaks to supportersEver since the Supreme Court inexplicably ruled Obamacare constitutional, opponents have debated whether to work for piecewise repeal efforts or to continue to demand full repeal. Now Durbin, the Senate Majority Whip, wants to open the law up to changes. Republicans will be tempted to supply fixes to make the law work better, while extracting concessions. Durbin made his remarks to WLS-AM radio in Chicago.

“What we need to have is a better definition of a full-time worker and how many will be affected by it,” Durbin said. “And the health insurance policy itself, the provisions that are included in it.”

The basic problem with Obamacare is that it continues the third-party-payer model, putting the government, employers, and insurance companies between patients and doctors. Any attempt to supply a cosmetic fix to that basic flaw will fail just as the current attempt has, and will lead to unforseeable consequences of its own.

It was crazy to label 30 hours per week full time, when the accepted norm is something above 35 hours for hourly wagearners and 45 or 50 hours for those on salary.  But merely changing the number of hours worked is not a solution. Whatever number is chosen will have its own disastrous consequences.

For instance, setting the number of hours for a full time employee to 35 hours will lead to everyone working 33 or 34 hours, but no more. That's better for employees than getting paid for only working 28 hours per week, but it also makes finding a second job more difficult -- and from the point of view of this discussion, doesn't help them get insurance.

The lower the number of hours per week ruled "full time", the fewer people who will be hired full time. That's not the only result, but it's enough to realize the wrong-headed nature of this policy.

To restate the Senator: 

We need to have a better definition of the provisions that are included in the health insurance policy itself.

Why on earth is there only one kind of health insurance policy? Since there is only one kind, with the only real consumer choice being an inflexible pricing structure, getting it a little bit wrong has huge unintended consequences. 

For instance, HHS has decreed that almost every health insurance policy must cover preventive care, part of which it defines as all FDA-approved forms of contraception.  Companies that offer their employees health insurance but don't cover all forms of preventive care face fines of $100 per employee per day.

There are dozens of lawsuits over that provision. One such suit, by Hobby Lobby Stores, Inc., seeks only a waiver from the company paying for 4 of the 20 kinds of FDA-approved contraception.  There is currently a temporary restraining order in the case, preventing the government from imposing a fine of $1.3 million per day.

The over-reliance on the insurance model was a flaw in our current system already, one Obamacare has compounded.  The sooner that compounding is undone, the better.  

Republicans should demand full repeal of Obamacare.  A lonely bright spot they have as a party is being able to say no Republican in the House or Senate voted for Obamacare. To open it up now and make changes would blur that record.

There is no fix for this terrible law, no redefinition of insurance, no magic number of hours constituting full time work that will tranform it from a train wreck into workable public policy. It should be fully repealed, leaving no trace but a powerful national lesson in government failure.