Obamacare, Dead Plan Walking

Paul Jacob
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Posted: Jan 08, 2017 12:01 AM
Obamacare, Dead Plan Walking

“Republicans would create chaos in the health care system because they are stuck,” Senate Minority Leader Chuck Schumer says, “between a rock and a cliché.”

Oh. Off by a word or two. But I don’t need to fix it.

What needs to be fixed is the whole medical-industrial complex, including the over-regulated, mis-regulated, bastardized financial system attached to it, as if an umbilical cord wrapped around a prenate’s neck.

That is, what needs fixing is the whole of ObamaCare.

Barack Obama’s “legacy.”

And our President-elect seems to agree. “The Democrats, lead [sic] by head clown Chuck Schumer,” Donald Trump tweeted last week, “know how bad ObamaCare is and what a mess they are in.”

Actually, I am not so sure Democrats do know . . . that it is they who are deep in the mess. Sure, the Democrats left the mess, but it is now the Republicans who are stepping in it. “Head clown” Schumer gloats that Obamacare cannot be repealed — or won’t be. (Which in politics is much the same thing.) The “delicate balance” that he says is the Affordable Care Act makes it impregnable. For all Republicans’ talk of repeal, “for five years now they’ve had nothing to put in its place.”

Schumer sees the trap. He set it when he and his comrades voted Obamacare in without reading it. It is so convoluted that untangling it must prove difficult, to say the least.

Besides, it shares something with nearly every other government program. This is the sad, secret truth about government growth: any new program quickly forms a new constituency with its own separate interests, and this always presents a set of . . .

Political hurdles.

That quickly become “impossible” to jump.

And it is not as if there is a consensus on what is wrong with ObamaCare. The President-elect, Schumer notes, has supported three of the “most popular” regulations in Obamacare: “pre-existing conditions,” “26-year-olds on parents’ plans,” and sex equality re: insurance rates.

What Schumer fails to mention is that these are three huge drivers of upwardly spiraling insurance prices. The Affordable Care Act “delicately balances” medical markets by shifting who pays for what, hoping that the biggest losers don’t complain too much and the obvious winners never cease protesting any threatened change.

And as long as Republicans repeat the mantra “replace and repeal,” I honestly do not see how Schumer could be wrong. Indeed, the Republicans running both chambers of Congress almost certainly know the extent of the problem. Once you buy into guaranteeing that everybody who cannot afford medical care must get it at others’ expense, and that this should be done through a complex system of regulations, mandates, subsidies, and transfer payments, taking away advantages sure becomes hard.

The nature of the trap is not unrelated to the truth of William Graham Sumner’s “Forgotten Man”: if you focus only on a program’s ballyhooed beneficiaries, you miss the people paying for it all. The losers. Who are legion, in ObamaCare’s case. The misnamed “Affordable CareAct” presents a huge burden on the self-employed, self-insured, and the previously insured, since these folks most obviously pay for all the newly insureds.

It is those newly subsidized that Schumer is counting on to raise a squawk. And since one big effect of ObamaCare was to throw people off their “unacceptable” insurance plans and into “better” subsidized plans, there are plenty of people who can protest.

Why, it is almost as if ObamaCare were designed to fail in every way but politically. Say it ain’t so, Chuck.

For all Trump’s savvy about the politics of repealing the ACA, Prez 45 seems to know little about the policy predicament. No more than he understands free trade, no more than he knows what the past tense of “lead” is. (It is “led,” in case you forgot.) Sure, he is right to call ObamaCare “a lie from the beginning,” but that does not mean that he or anyone else dares tell the deeper, trickier institutional truths.

Still, Obamacare can be repealed. But replacing it would be a disaster. The best plan is no plan. Repeal all the regulations. The federal government should completely deregulate the markets, and prevent states from ruining interstate markets in insurance and health care.

Do what the Commerce clause was designed to do.

And, chuck the FDA while we are at it. The case against it is well known.

Unfortunately, not much chucking is likely. And certainly not if Chuck Schumer gets his way — or proves himself an extraordinary prophet. He is counting on Republicans to do nothing. Despite signs that they’re cooking up something. Big.

But if Congress actually does what they say they are going to do — which Peter Suderman of Reason summarizes as repealing the law now but leaving it in place while legislators figure out a replacement — it will backfire. Suderman astutely judges the current congressional “repeal and delay” plan “tactically foolish.”

The Republican majorities in the House and Senate are not a stalwart bunch. They lack the courage of their alleged free-market convictions. They are afraid of the backlash they would get from the press and Democratic voters. And no health care system, socialist, free-market or in-between, can provide the one body part they need most:

Backbone.