Government & Politics

Compromise on ObamaCare Isn't Really Possible

The philosophical divide on health care is likely unbridgeable.

Robin Smith · Dec. 12, 2016

The philosophical divide between Left and Right on health care is likely unbridgeable.

Not one single Republican voted for the grossly misnamed “Affordable” Care Act, henceforth ObamaCare, because of principled opposition to a government-mandated service effectively operated and paid for by said government. Democrats had a half-century-old dream of single-payer health care, and high off their election victories in 2006 and 2008, crammed the first helping of it down the country’s throat on their own. And make no mistake: They own it.

Those early days of Barack Obama’s administration were also the days of House Speaker Leader Nancy “we have to pass it to find out what’s in it” Pelosi and Senate Majority Leader “Dirty” Harry Reid. From their perspective, there was no need for GOP input and none was sought, primarily due to the vast contrast in solutions to reduce costs and increase access to care, two of the stated goals (read: BIG lies) of ObamaCare.

What a difference eight years makes. Americans watched “Hope & Change” morph into the morass of excessive government taxation and overregulation, yielding public dissatisfaction and distrust, especially related to health care.

But campaign promises and cool rhyming rhetoric that makes fun bumper stickers are a lot easier than unwinding a massive entitlement that impacts millions. States who expanded their welfare program for the poor, Medicaid, took ObamaCare money to do it and will be impacted most based on the volume of dollars and numbers of people involved. Individuals who, attempting to be law-abiding citizens and avoid an IRS penalty, are now paying for a one-size-fits-all insurance plan that may have replaced a less expensive plan deemed “unacceptable” by the Obama administration. Where do these folks go and what options would be available in the case of a repeal and replace scenario?

President-elect Donald Trump chose Tom Price, a prime ObamaCare opponent, to head HHS — a key signal in the repeal and replace strategy. Incoming Democrat Senate Minority Leader Chuck Schumer has already promised, “We’re not going to do a replacement. If they repeal without a replacement, they will own it. Democrats will not then step up to the plate and come up with a half-baked solution that we will partially own. It’s all theirs.”

So collaboration, compromise or whatever you want to call it is not very promising or likely. That’s not surprising due to the chasm separating the views of Left and Right. Leftists believe government runs health care best, while the Right wants reforms that put doctors in greater control of treatment decisions and patients in charge of their choice of providers based on the free market.

Please remember that ObamaCare exists because there is a real need for health care reform. Democrats harnessed their energies together when they controlled the White House and Congress. Obama’s signature legislation simply put the government in charge of health insurance and mandated sameness with only federally approved plans available for purchase. The resulting one-size fits all approach of DC knowing best caused skyrocketing premiums for fewer choices, along with soaring out-of-pocket expenses. Candidly, ObamaCare has failed in every aspect of its declared goals except access to insurance coverage due to mandates.

Democrats are quite happy with moving toward a single-payer arrangement where the government creates the list of services to be covered. Hospitals and insurers signed on to ObamaCare because they thought they could enjoy the predictability of guaranteed payment and a larger customer pool. But it’s the path to their ruin.

It can’t be said enough: There is virtually no true consumerism in health care today, which would actually bend the cost curve of health care down, thereby increasing access. But the first fight of a replacement to ObamaCare will likely be between those who want patient-centered health care and those who want to “ease” out of ObamaCare to “protect patients.” Democrats, as Schumer enlightened us, aren’t going to help do anything but move to single-payer health care.

Will Republicans apply their principled stances from the campaign trail to either create tax credits to incentivize the purchase of health insurance, just like big employers get? Will barriers be removed to permit groups of citizens to form associations and create their own pool for insurance purchases at reduced rates? Will state laws protecting in-state insurance sales only be amended to permit purchases across state lines? Will incentives be in place that generate price transparency in physicians’ services, hospital charges, drug pricing, etc., and that permit patients to choose the most affordable service and create competition? Will block grants be sent to states to innovate with their Medicaid populations?

For a replacement health package to be accepted and moved forward, the first agreement must be to align the goals and outcomes of the patient, as the priority and consumer, the physician and the payer. With this singular focus and agreement, the special interests lose their grip and America’s health care can truly be about health and care, not insurance coverage and government control.

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