Posted on 03/11/2017 12:12:01 PM PST by Kaslin
First of all, the preferred free-market plan for health care policy should be no plan whatsoever. The idea that we need a federal top-down strategy to manage a huge chunk of the economy is at the very heart of the problem. We don't need a federal plan for health care. Yet Republicans have allowed liberals to frame the entire health insurance debate in these anti-market terms.
So the American Health Care Act, or AHCA, is obviously weak tea, falling far short of a promised free-market solution, much less a full "repeal" of Obamacare. It's a half-measure that endeavors to fix Obamacare with small doses of deregulation while failing to repeal its core. It's almost as if Republicans were trying to mollify their constituents and save Obamacare at the same time.
President Donald Trump tweeted something about a three-phase rollout, but the specifics of the other two parts have yet to be confirmed. Perhaps the full proposal will reflect better on Republicans. But considering the noise moderate senators have been making and Trump's own views on entitlement programs, it's unlikely to meet conservative expectations. So what can be done?
In a piece highly critical of the plan, the Washington Examiner's Philip Klein, who has done some of the most insightful writing on Obamacare, states, "the GOP will either be passing legislation that rests on the same philosophical premise as Obamacare, or will pass nothing at all, and thus keep Obamacare itself in place." What if this is the choice?
We know the Democratic Party's plan for health care: Constrain markets to create monopolies that can be controlled by a federal regulatory regime (this is why liberals oppose markets expanding across state lines); and rather than worrying about access, choice or cost, continue to incentivize the growth of the welfare state. When this situation becomes untenable, pass single-payer. What Democrats understand but Republicans often don't is that you can reach your goals incrementally.
Obamacare was ignored as soon as it was passed. A law that was sold as a tool to reign in rising costs quickly became a moral edifice that alleviated an imaginary humanitarian crisis (the defense of it is now almost exclusively focused on people losing Medicaid). Meanwhile, Obamacare was used as a tool for social engineering and coercion, allowing technocrats to dictate how a third of the economy functions. If you control the bureaucracy, laws become incredibly malleable. One day, Democrats will be back and, without even partial repeal, all the same mechanisms will be available to them.
So the question remains: Is something better than nothing?
Halting federal funding of the nation's largest abortion mill is a victory. Offering states more flexibility to run their own Medicaid programs is a victory. Expanded health savings accounts and the creation of real-life illustrations of successes is promising. Getting rid of the individual mandate is a victory, as is allowing consumers to purchase insurance across state lines. Repealing nearly all of Obamacare's taxes -- other than a postponement of the Cadillac tax -- is a win.
It's possible, of course, that AHCA negotiations will begin with moderate proposals and transform into something free market-oriented. With widespread opposition from conservative groups -- Heritage Action for America, FreedomWorks, etc. -- the American Health Care Act looks like a non-starter. Then again, who are we kidding? The truth is that conservatives probably find themselves in the same situation frustrated liberals did in 2009. Despite prevailing mythology, Democrats never compromised in good faith with the opposing party; they compromised with their own moderates. It only takes a few senators to hold an entire party hostage.
It's also worth pointing out that no federal entitlement program has ever been repealed or replaced, or really even weakened. This was the fight that spurred Republicans to win hundreds of seats and take the House, Senate and presidency. The fact is that many politicians who benefitted most from Obamacare's failures were lying to their constituents. Either these Republicans don't have the mettle to back a full repeal or they don't have the ideas to create a new plan. So perhaps Obamacare Lite is preferable to Obamacare because it's the best this crop of legislators is going to do. Also, as history has shown, making substantive policy changes doesn't get any easier as a term wears on. This might be the last chance to do anything.
Another infuriating aspect of this fiasco is that Democrats will treat any Obamacare "repeal" bill as if it were an assault on all that is holy and patriotic. This rhetoric shouldn't have inhibited Republicans; it should have freed them to pass bills that incorporate the ideas they supposedly believe in. Why would they let the same people who told America that Obamacare would be a political and functional success now lecture them on how unpopular a repeal bill will be?
It's just one of the many mysteries of the GOP.
“I shouldn’t eat too many donuts.”
That’s up to you. Socialism or free market is up to all of us.
OCare has been about which provider would be the last one. Folks say “let it collapse” but they forget that there will still be all those congressionally passed laws in place and there will be only one provider remaining. That is referred to as single provider.
And there will be a law on the books requiring the government to reimburse them each year. A socialist doesn't care if the provider is called “Anthem” or the Fed, since the fed will be reimbursing.
So, in my opinion we are marching toward single provider, the laws are already on the books, and everyone is encouraging it to get here faster by clamoring for collapse.
Current law won't allow the last provider to collapse.
You have a good point.
However, I am not as smart as President Trump, nor do I have his instincts.
I have to trust him.
Besides, the RynoCare plan has been public, what, 3 or 4 days? It's a little early no matter what else.
See #82
I just cannot speak with authority about what you postulate.
Yep. We all need to relax and see how this plays out.
Pre-ACA was not that great and was certainly not a free market. Trump and Republicans have a mandate to “repeal and replace”. Nothing ever said it had to be done simultaneously, and it shouldn’t.
Repeal it. No mandates, penalties, required coverages, no taxes, no paying insurers’ losses, no expansion of Medicaid. Just repeal it. With it gone, there will be pressure to do something that will actually decrease HEALTH CARE costs in a replacement bill, which CANNOT be simply subsidizing insurance costs.
Replace it. With a new law that JUST targets and eliminates every barrier to competition for lower HEALTH CARE costs not INSURANCE costs. And do nothing else in that bill, just create a free market (not “restore” since one hasn’t existed in decades). This would include stopping states from enacting their own requirements for coverage, malpractice tort reform with ‘loser pays’ and severe limits on non-economic damage awards, allowing re-importation of FDA approved drugs so Americans aren’t paying more than other countries’ citizens do, stripping the AMA of its monopoly on licensing physicians and accrediting medical schools, streamline FDA approval for drugs already approved in other countries, etc. If it is a barrier to entry in providing health care or insurance for health care, kill it in the Replace bill.
People seem eager to let the States take charge and be “50 laboratories” for experimentation, but as a resident of Californistan I am more frightened of what my state would do to me than even Obamacare did. If left to its own devices California would impose socialized medicine and taxes to pay for it in a heartbeat. The federal government should protect people from State-run monopolies and barriers to entry just as it does corporate monopolies.
Finally, get real about entitlement spending. For Medicare and Medicaid, that means a VOUCHER for LESS than was spent per beneficiary in 2016 that people can use to buy private insurance. Get the unaccountable (and expensive) government bureaucrats out of the loop of authorizing and paying for every single test and procedure some quack wants to perform — or just claims he performed to get payment. Insurance company employees striving to preserve every bit of profit won’t blindly pay — not when they know the voucher amounts available are fixed and they can’t pass along premium increases to Medicaid and Medicare voucher holders.
Let’s repeal it, then negotiate, till we reset the clock we can’t have that discussion
Depends on where you live.
It was much better in most states. And in some it was terrific. Northeastern states sucked due to RAT HillaryCare derivatives.
It wasn’t really a free market when states dictated what had to be covered in any insurance plan, state insurance commissioners decided whether or not an insurance company could operate in the state, and the AMA and FDA decided who could and could not train and certify doctors and hospitals and who could import medications. Each state had its own limits on what procedures could be performed by nurses and physician’s assistants vs full MDs. It was a convoluted mess of monopolies and special interests.
That was not a free health care market, nor a free health insurance market anywhere in the country. Better than Obamacare dictating 3,000 pages of requirements to patients, hospitals, doctors, and insurance companies, sure. But not great. It NEEDED to be changed, but Obamacare was the absolute wrong direction.
Thanks....Wipe Obamacare off the books as if it never existed...
I had to go look at the photo and ryan’s wife looked like she swallowed a lemon. I thought it was bad plastic surgery but, nope - wow...
Replace Obamacare with nothing, ie the free market.
The "states" didn't do anything collectively, no two were alike, there were 50 different sets of public policy. Some did a pretty good job, some sucked right out loud. (high premium states)
the AMA and FDA decided who could and could not train and certify doctors and hospitals and who could import medications.
That has nothing to do with the states.
Each state had its own limits on what procedures could be performed by nurses and physician’s assistants vs full MDs.
Yes, the "50 laboratories".
It was a convoluted mess of monopolies and special interests.
No, it was a bunch of them, and that is unfortunate, but many states got it right. Those are probably the states complaining the loudest now, since their citizens had excellent coverage compared to the RAT concept of so-called "healthcare".
That was not a free health care market, nor a free health insurance market anywhere in the country.
Some of it was pretty close, and those various bits of good public policy are the prescribed guidelines for the "repeal and replace" tenets that need to be implemented.
It's no secret that insurance is one of, if not "the" most highly regulated industry in the world, and that is for good reason....protecting the public from scam artists. Your aforementioned state oppression of the industry, at the minimum, drew the line between good inexpensive coverage, and "cheap insurance" that covered nothing. In many cases they went way too far (RAT control freaks hate insurance) and killed their markets.
I doubt that anyone would appreciate a total "free market" (a charlatan free-for-all)...but free market reforms are absolutely desirable. The debate continues between total-underwriting and limited bands of premium rating (for the sake of efficiently crafting policies) The same hold true for "cafeteria coverage" and the cross-subsidy of mandated coverages.....same reason.
Better than Obamacare dictating 3,000 pages of requirements to patients, hospitals, doctors, and insurance companies
Removing the whacked-out Northeast blue states, the pre-ACA US market was very likely the best healthcare delivery system in the world.
Rules require that if ONE person objects to the bill not being read in to the record then it MUST be read in to the record.
Republicans were ordered to NOT object.
1. It becomes TrumpCare, becoming a 2018/2020 campaign issue for the Dems.
2. It removes a huge campaign issue that the Republicans can use to remove RINOs & Dems in 2018.
Louie Gohmert pointed out that the R's already passed a Byrd Amendment safe bill when they were guaranteed an Obama veto. That bill only needed 51 votes in the Senate. Trying to pass it again would show which RINOs we need to primary in 2018, as I think Ryan/McConnell would sabotage it.
So, my guess is that Ryan is trying to save Obamacare in order to save RINOs. He doesn't care about retaining the R majority in 2018, only in saving RINO seats.
when everyone was running, this is what we were promised
Just sending the same bill again, that’s the campaign promise
I agree.
Despicable bastards.
We’ll see how President Trump handles this.
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