Kathleen Sebelius, right, secretary of health and human services, Denis McDonough, White House chief of staff, and Valerie Jarrett, a senior advisor to the preesident, prior to Obama's remarks about the Affordable Care Act, at the White House in Washington, Oct. 22, 2013. Sebelius has faced a barrage of criticism for the botched rollout of the online insurance exchange. But the health secretary was far more immersed in developing policy related to the law, and in promoting it, than in the technical aspects of the website, said a person close to the White House and Sebelius.(Photo by Doug Mills/ The New York Times)
Yo, GOP! The ACA is a gift! That's your playbook!
- November 9, 2013 - 5:13 PM
For its critics in the Republican party, Obamacare is the gift that keeps on giving — if only the GOP had a clue. The ill-fated government shutdown that brought favorability ratings for congressional Republicans to record lows and may have cost Ken Cuccinelli the governor’s race in Virginia seems indicative of a strategy that is void of anything except demonizing Barack Obama.
The Affordable Care Act was always going to collapse under its own liberal weight, so why try to save the Democrats from themselves by repealing the ACA’s most onerous provisions? In fact, the GOP should have never let any of the so-called waivers to the law stand right from the start.
Even as it stands, and despite the president’s assurances, the not-so-unintended consequences of the law have indeed moved hundreds of thousands off their current health plans into much more expensive ones. The good news is that for the first time in a generation the cost of “universal” health care is becoming painfully transparent to most Americans.
This was the always the silver lining to Obamacare — that is, enforcing the law was the best way to repeal it. In fact, the fallout from the misguided legislation may be the best political opportunity to reform the system since World War II wage and price controls started us down the path of government-directed health care.
The truth is for decades we have deluded ourselves into thinking that first-dollar coverage for every possible malady with little or no copay or deductible is a form of insurance. It is not — it is prepaid medicine.
Moreover, the idea that lawmakers can mandate insurers to cover more and more freebies and expect premiums to go anywhere but up was an obvious departure from reality. (Not that we should shed any crocodile tears for big insurance, as it was more than willing to get in bed with the administration to pass the ACA on the myopic notion that subsidies and purchase requirements would offset its increased costs.)
The “essential service” mandates under Obamacare, including the absurdity of pediatric eye care for childless couples or seniors, merely doubled down on the 2,271 coverage requirements under state law as cited by the Council for Affordable Health Insurance (naturally, compassionate DFLers have catapulted Minnesota to the fourth-highest state with the most “benefits”).
None of these, however, compare to the mother of all mandates in the ACA: requiring insurers to cover claims for an event prior to the purchase of coverage. Yet contrary to conventional wisdom, the “preexisting condition” problem is for the most part a direct result of bad public policy, not market failure.
Real insurance spreads the risk among as many people as possible who are subject to the same risk; if not, then the industry prices the elevated risk accordingly, e.g., high-risk auto insurance. Obamacare’s community rating system has the net effect of not allowing the industry to price risk according to those who are consuming the most health care services — so everyone else pays.
But if the industry is allowed to discriminate, as the president puts it, who would insure the 60-year-old in poor health at a reasonable rate? The answer to this straw man is of course: no one.
The reason is clear. You’re not supposed to be waiting until old age to buy insurance. And were it not for the perversity of a tax code that all but requires most people to rely on employment for health care, the average American wouldn’t be. They’d be buying catastrophic care insurance on the individual market at a young age and pay premiums into a “guaranteed renewable” contract over time, which would cover them when they needed it later in life.
So there you have it, Mr. and Mrs. Republican. Remove the mandates to lower the cost of insurance, change the tax code so that the deduction goes to employees (not corporate America), and get individual choice and portability back into health care.
Now, if you’d only run with it.
Jason Lewis is a nationally syndicated talk-show host based in Minneapolis-St. Paul and is the author of “Power Divided is Power Checked: The Argument for States’ Rights” from Bascom Hill Publishing. He can be heard locally from 5 to 8 p.m. on NewsTalk Radio, 1130-AM and at jasonlewisshow.com.
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