Pull the Obamacare Band-Aid Off Now
Posted on January 9, 2017
Every mother will tell you that if you take the Band-Aid off quickly, it won’t hurt as much.
Every child will tell you that Mom is lying.
Pulling a Band-Aid off quickly hurts like hell. But the pain doesn’t last as long. Kids don’t like the pain, no matter when it starts.
Sometimes, though, you need to pull the Band-Aid off.
When it comes to repealing Obamacare, President-elect Trump wants to pull the Band-Aid quickly and then replace it with something much, much better.
Congressional Republican Leaders don’t want to do that. They want to fake that they are pulling the Band-Aid quickly by sunsetting the Affordable Care Act for two, three or four years. That will give them time to come up with a suitable replacement.
Replacing this law is complicated. It’s a complex piece of work that seeks to have the government control about 16% of the American economy.
For 20 million people who have signed up for the law (sometimes because they wanted to and sometimes because they had to), they don’t necessarily want to lose their insurance. Unless, of course, something better and cheaper comes along.
It is that complication that gives pause to Congressional leaders.
Sure, they passed several bills over the last several years to fully repeal Obamacare. But they never thought they would have a President in place who would actually sign those bills.
Now, with Mr. Trump ready to put his hand on the Bible and swear to uphold and protect the Constitution, the Republican Majority has their President who will sign such legislation.
And this incoming President, who won the election because Obamacare proved to be so unpopular with his voters, wants to get to work to fulfill his number one campaign promise.
The problem with Obamacare is that it shifts the costs of high-priced health insurance from the poor and the sick (and those with pre-existing conditions) to the middle class, who feel that they can barely afford their health care as it is.
And for many small and medium sized businesses, they have no choice but to share the increased costs with their employees.
Obamacare has plenty of controversial provisions that have nothing to do with the core of the problem (which is delivering affordable health care in a way that doesn’t destroy health care quality), things like mandating free contraception for anybody who wants it, as well as making it more difficult for Catholic hospitals to do their thing without running afoul of either their beliefs or government mandates.
The problem with health care in this country is that it is an unholy hybrid of government mandates with some aspects of free-market delivery.
It is not enough free market to deliver greater choice, maximum competition and better quality at lower prices, nor is it enough government mandates to basically take over the entire system and deliver crappy health care to everybody.
Republicans have long wanted to move a more free market system. They were the ones who pushed Health Savings Accounts, which would give consumers more power to bargain for their health care.
It’s a noble concept, but one that requires educated consumers who have the wherewithal to negotiate with their doctors when they are on their sick bed.
Democrats have long pushed for a single-payer system that mandates what doctors can charge, gives the government the choice to deny health care to people who aren’t worthy of care, but can do a better job of giving everybody a chance to see a doctor.
The free market doesn’t always work. That’s why we have so many plastic surgeons and so few pediatricians. But also know that socialism doesn’t work either, because it doesn’t work that well in Canada or in Great Britain or Cuba or North Korea.
The truth sometimes is somewhere in between but we are in a hybrid system now, and that doesn’t seem to be working well either.
In my view, we need to inspire greater innovation by giving consumers more tools to control their own health care spending. We need greater competition that allows health insurance companies to sell their products wherever in the country they want. We need to create high-risk pools so that people who have pre-existing conditions have a place to get care. We need to expand the Children’s health care program to make sure that no children, up to the age of 21, goes without the basics of healthy living (including free immunizations, free dental care, help with vision and orthodontia, and other essentials). We need to make sure that those on Medicare have as many options for the A and B programs as those who use Medicare Part D.
I would like most of this pushed down to the State level, to allow for the maximum of innovation and to give Governors the opportunity to design programs that work best for their constituents. We have way too much bureaucracy housed here in Washington and it is not healthy.
And while we are at it, I would love to see the FDA thoroughly revamped to allow the maximum amount of innovation in the drug delivery market.
I don’t think these changes should wait too far into the future. The longer it takes to pass the replacement plan, the more time the opposition has to derail it. Worse, the longer it takes to replace Obamacare, the longer it will take to cure the problems that are bedeviling the program.
That makes for bad politics, not only for President Trump, but also for every Republican who campaigned to kill Obamacare (which is every Republican).
IMHO, it’s better to pull the Band-Aid off now and pull it quickly. The pain might sting for a little bit, but it is better to get it over with and get to the healing part as soon as possible.