Entitlement Reform at Last
Almost every promise made eight years ago about Obamacare turned out to be a falsehood. That is first and foremost why the law must be repealed.
No, you couldn’t keep your insurance plan, doctor or provider in many cases. No, it didn’t save $2,500 per family (more like cost $2,500 more per family). No, it didn’t lead to expanded patient choice. And yes, the tax increases and insurance mandates damaged the economy and cost jobs. We are now left with insurance markets that have entered a death spiral. The entire health insurance market will financially implode unless it’s changed.
The fundamental lie of Obamacare is revealed in the law’s very title: the Affordable Care Act. Democrats and Barack Obama can sing the praises of this law until the cows come home, but no one with a straight face can say that it has made health care more “affordable” — except to the millions to whom we gave coverage for free. For millions of others, premiums skyrocketed by almost 25 percent last year, and as more insurers flee the market, those cost hikes are the tip of the spear. In Arizona, premiums have doubled — in one year.
This is the system liberals are now fully embracing and defending.
The House Republican bill is far from perfect and still leaves too much of the Obamacare infrastructure in place. I was asked by CNN’s Erin Burnett on Thursday night whether the GOP plan will fulfill Donald Trump’s promise of declines in premiums and deductibles. I hesitated.
Eventually, the increased competition from allowing Americans to buy out-of-state health plans should bend costs down, but that could take a while, given the collapse of the insurance market the GOP inherited this year. Will Trump take the blame for that? Maybe.
The advantages of the GOP bill are significant. Letting states strip away Obamacare’s so-called “essential benefits” formula will lower costs, especially for young people. The GOP plan will allow 20- to 40-year-olds to buy stripped-down, catastrophic-coverage plans at very low premium costs. It will allow Americans to decide for themselves the types of services they want to have covered. I don’t want coverage for dental care, contraceptives, mental health or drug-abuse treatment. Why should I have to pay extra costs for what I don’t need?
Young people will no longer have to underwrite the costs of old people. By moving those with pre-existing conditions out of the insurance pool (but providing them with direct subsidies), costs for the rest of us will fall and will be actuarially balanced. In other words, we will have a real functioning insurance market.
At least six major anti-growth tax hikes will go away, including the surtax on capital gains and dividend income, the foolhardy medical-devices tax, the tax on new life-saving drugs and vaccines and the tax on health plans.
Moving toward a block grant system for Medicaid will give states less money over time, but will allow the states the flexibility to devise their own quality programs at lower costs. If states realize they are wasting their own health care dollars, rather than Uncle Sam’s, they will be more conscientious about controlling costs. This block grant formula has worked in states such as Rhode Island and Indiana to sweat out costs and improve services. Medicaid is blowing up the federal and state budgets at the same time. It is already a quarter-trillion dollar annual program and growing.
In the end, the House bill is a partial fix that should stop the Obamacare bleeding. Eventually, we need to surgically remove government interference in the health care market whenever and wherever possible and move back to a genuine doctor-patient relationship. The free enterprise system has been lowering costs and improving service in every other sector of the economy, but not in medicine — one of the most important.
Many liberals, including Bernie Sanders, are now promoting the idea of moving in the opposite direction: a federally administered insurance and health delivery market.
For those who are attracted to that idea, we already have such a system. It is called the Veterans Administration, a health care system in which patients are dying while they wait for care. This is a disaster in every way, as Americans have discovered in recent years, to our horror.
For now, we can say goodbye to Obamacare. Let’s hope this isn’t too little too late.
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