by John Blahna
Repeal ? Yes. Immediately.
Replace ? Not so fast.
In 2017 we’ll finally have a chance to get rid of the most ill-conceived and illegitimate law to ever come out of our nation’s capitol. But let’s not rush to replace it with something that is maybe not quite as bad. Remember, the United States had the best health care system in the world before Obamacare. That’s why people were coming to the United States from around the world for care. Were prices for medical care rising? Yes, but Obamacare had nothing in the 27 hundred page bill that addressed that problem. In fact it had the opposite effect. If there is a full repeal of Obamacare without a replacement the earth will not cease to revolve around the Sun. Laws and regulations can default to those controlling laws and regulations in place before Obamacare. The first objection we will hear is “How about the millions of Americans who are getting help paying for over-priced health insurance”? The answer is that the federal government can pass legislation to allow those policies and subsides now in place to stay in place for up to three years while individuals find better plans if they feel they need “plans”. And it will not take 2,700 pages to accomplish that. There are a few other pieces of legislation that I believe need to be enacted but only after Obamacare is dead and gone.
First, let’s remember that Obamacare was brought to us by way of secret meetings, backroom deals, bribes, payoffs, countless lies, parliamentary tricks, a vote in the middle of the night and, of course, we had to pass it to find out what was in it. If we accept or try to save one page of Obamacare we’re accepting that corrupt process and Americans deserve better than that. America is better than that. That’s the only reason we need to repeal Obamacare. But there’s more. Obamacare doesn’t work. The numbers don’t add up. They never did but Obama was big into hope back when it was passed. Not facts and knowledge, just hope and change. It is the foundational and perpetual belief of a socialist that “if only we can take a little more freedom from people and if only we can take a little more money from people we can solve everyone’s problems.” However there is never enough money and freedom that will willingly be forfeited and eventually either the economy collapses or the people rebel.
As impractical as the voluminous tangled web of bad ideas is, what’s equally insidious is that Obamacare allows the Dept. of Health and Human Services to issue thousands of pages of additional regulations per year forever. It also forced the I.R.S. into the healthcare business and took away our privacy when it comes to medical care.
What I couldn’t believe at the time it was passed was that Obamacare didn’t address any of the actual drivers of increased health insurance prices. It completely ignored the laws of supply and demand and the cost of delivering care. After a full repeal of Obamacare, this is where I think we need to start. First let’s look at what is possible. In the 1950’s before the federal government became involved in medical care most families only needed one parent to work outside the home to make ends meet. Not only that – most American families could pay for all of the medical care they ever needed without health insurance. And doctors made house-calls! Not only that – those same families could put 2 or 3 kids through college without student loans. When I interview people who lived and raised families during that period they all end up asking the same question “so what the hell happened?”
There are many parts to the answer but let’s just start by saying our system of medical care, in the 1950’s, was created not by the government but by doctors, patients, communities and churches over nearly 200 years. It had developed naturally and prices for care were determined by actual free market value as opposed to today’s artificially inflated and reactionary prices. Since the 1950’s what has contributed to astronomical inflation boils down to government involvement leading to price shifting and the unchecked transformation of the genuine nonprofit hospitals into the obese, gluttonous “Healthcare Systems” we have today.
I’ll list a few items that I think need to be considered as Congress moves forward after Obamacare is repealed. And might I add, the Congress and President have the opportunity to demonstrate to the Democrats how to craft, debate and pass legislation out in the open and in the light of day.
Selling health insurance across state lines will do little to reduce premiums. Many insurance companies are already selling across State lines but as long as “Healthcare Systems” are getting away with charging $ 22,000. for a $ 2,000. procedure, for example, premiums will never go down. It’s easy to say “sell insurance across state lines” but what that really means is that States would lose the ability to regulate insurance companies at the State level. All States are unique and shouldn’t be asked to give that power over to the federal government. Perhaps all States will voluntarily agree to some minimum standards allowing people moving across country to keep the same policy.
Insurance premiums will go down only when prices for care go down.
Here are a few goals for improving care and reducing costs :
Reconnect Patients with paying for medical care. Standardization and simplification of billing codes will reduce bookkeeping costs and enable patients to be savvy consumers.
Encourage citizens who are risk adverse to shop and buy their own health insurance. This takes care of “portability” and unleashes the power of the consumer.
Increase the supply of medical care, meaning doctors nurses etc., services and products. You cannot cheat the Law of Supply and Demand. It will take a sizable increase in the number of physicians to make house-calls practical once more.
Reduce barriers to physicians being able to own and operate their own private practices again. Young doctors are more likely to move to rural and other underserved areas if they have control of their own destiny and a chance at the American dream. This will meet great resistance, however, from those obese, gluttonous “Healthcare Systems” I mentioned earlier as they have grown to believe it is their providence to own the physicians and all other aspects of medical care.
The key to reducing the cost of medical care for all Americans is Effective Competition.
Health Savings Accounts : HSA’s with pre tax contributions will be helpful as families adjust to the free market health services world but will be of little value until the other above mentioned pieces to the puzzle are in place.
If we want insurance companies to be healthy and offer affordable rates we cannot over-regulate them and dictate all product criteria and who they sell their products to. Insurance companies will not be able to again calculate actuarials until States re-establish High Risk Pools for the uninsurable. I use the word uninsurable. Some use the words pre-existing conditions. Actually some insurance companies do not have a problem with many pre-existing conditions. Some pre-existing conditions, however, are deal breakers. Would we force an insurance company to sell homeowner’s insurance to a person whose house is already on fire? Of course not. People who have a terminal illness or a condition that will cost incalculable sums of money to treat should find coverage through State administered High Risk Pools funded by a tax on all insurance written in a State and supplemented by federal funds. This is infinitely cheaper than Obamacare.
Please call your representatives in Washington today. Tell them that you want Obamacare repealed as soon as possible. No excuses. Then ask them to work slowly, carefully, deliberately and in the open to pass legislation that will accomplish the goals that are laid out in this article. Your children will thank you some day.
*** Editors note ***
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