The sordid saga of the Republican Party’s attempts to do something about ObamaCare closed a chapter yesterday. Party leadership threw in the towel on both repeal and replacement, and I presume will move on to the next big legislative item (tax reform). Depending on your beliefs regarding ObamaCare, and your party loyalty/affiliation in general, you’re either happy, sad, or angry with this turn of events, for varying reasons. Trump declared, in that subtle, nuanced and conciliatory Trump style, that they’re just going to let ObamaCare fail. Some on the Left are angered by this, as if such a failure would be the result of an active effort to make it so. Truth is, ObamaCare’s speeding for the edge of the cliff, and it will not need any sort of push to go over.
Eventually, there will have to be a reckoning. Whether it happens with this Congress, the next, or the one after that remains to be seen, but no matter who tackles health insurance next, they’ll have to work with a poison seed planted by a set of lies.
Obama hawked his signature health care reform bill with several clear-cut promises, promises he broke. He declared that “you can keep your doctor,” that “you can keep your existing plan,” that people earning under $250K a year would not see tax hikes, that it would not add to the deficit, and that premiums would decrease. Lies or broken promises, you decide, tomato/to-mah-to, it’s all the same. And, don’t give me any garbage about “sub-standard” plans. If that’s the first thing that pops into your head in response, you need to flush out your brain pan and start thinking for yourself.
Nevertheless, and despite both these lies and the major problems ObamaCare is currently experiencing, many people are defending it, and especially its most popular provisions.
One in particular, the pre-existing condition mandate (i.e. the rule that a company cannot deny coverage based on pre-existing conditions), is so popular that there’s no chance any GOP replacement will not include it, and even if the GOP managed repeal without replacement, there will be massive pressure to pass independent legislation to perpetuate the mandate.
That is Obama’s greatest victory, that is what will doom any health plan that the Republicans might come up with, and that is what will (I hate to say it) very likely drive this nation to a single-payer system, unless enough congressmen grow a pair and do the right thing.
Yes, the right thing. A government mandate that pre-existing conditions* be covered when someone who had no health insurance enrolls in a plan is the worst sort of moral hazard. It enables people to simply wait until they get sick to buy insurance. And, as insurance gets more and more expensive (thanks, Obama), more and more people will do the math and realize they’re better off going out of pocket until they need big health care.
ObamaCare’s crafters recognized this, and wrote the individual mandate/penalties to counterweigh this moral hazard. Unfortunately for ObamaCare, the escalating premiums still tip the scales in favor of paying the penalty. AND, with the penalty being extremely unpopular, it’s likely that whatever the GOP comes up with will not have sufficient counterbalance to the pre-existing mandate’s moral hazard.
This will doom whatever is enacted, for the aforementioned reasons. The press, good liberal water-carriers that they are, will spin this as the GOP’s fault, and continue the relentless drive to single-payer. It may not happen now or soon, but there will come a time when the Democrats are back in the White House, and we’ll end up with a shitty, horrifically expensive, poorly-performing, deficit and debt-busting single-payer system that will become the “new normal,” along with heavy new taxes (probably in the form of a VAT or other regressive system) to pay for it. Liberals will crow, the rest of us will suffer, the poor and working classes will remain trapped in stagnation or worse, the American economy will be crippled, and Obama will get to gloat about how he set the wheels in motion.
The pre-existing mandate, nestled in a monster of a law that was sold with a pack of lies, will be an enduring legacy of President Obama’s tenure, and will be the lever that eventually makes single-payer the law of the land. No matter if Trump dismantles the entirety of Obama’s pen-and-phone history, Obama’s “liar’s victory” will be his true legacy, and the nation will be much the worse off for it.
- The pre-existing condition issue is one born out of government meddling (specifically, the laws that created market distortions in favor of employer-provided health insurance, and the resultant coupling, lack of portability, etc that prevents one from buying into a particular plan for life). It’s a problem, not as big a problem as some assert, but a problem nonetheless. It can be addressed with pro-market reforms that lead to the decoupling of employment and insurance, the transition of insurance purchases to individual responsibility, and an expiring window of opportunity to buy into policies without pre-existing condition exclusions. In other words, the mandate need not be permanent. This is, of course, a VERY tall order, which is why I don’t expect it to happen.
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