‘Repeal and Replace’ Obamacare — With the Free Market

Larry Elder,

One of President-elect Donald Trump’s major campaign promises is to “repeal and replace” Obamacare.

Vice President Joe Biden recently dared him to do so. Biden knows that 20 million Americans have health insurance that didn’t before Obamacare, and they represent 20 million stories on CNN, MSNBC and The New York Times — in the entire “health care is a right” crowd — when and if Trump follows through.

Sure, despite President Barack Obama’s promises to the contrary, some people lost their health care coverage and some people lost their doctors. And no, the average family did not save $2,500 per year as Obama insisted would be the case. And yes, health insurance premiums, copays and deductibles are going up even though Obama promised that his plan would “bend the cost curve” down.

All that matters to the anti-Trump media is that there is now an entire class of people to exert pressure against the repeal of Obamacare. Many Republicans say they want to keep “the good parts of Obamacare,” specifically the prohibition against denying insurance based on a pre-existing condition and forcing insurance carriers to keep a “child” on his or her parents’ policy until the child is 26. Republicans promised to not only repeal but to “replace” Obamacare. How can they do this — and replace it with what?

Republicans, despite their unanimous opposition against Obamacare, bought into at least two premises that its proponents argued. The first is that health care is a right — or, if not a right, at least something whose costs the federal government should reduce. The second is that, having made the decision to intervene in health care, the federal government possesses the knowledge, wisdom and judgment to reduce its costs to make it “affordable.” The feds, promised Obamacare advocates, can even make health care affordable without reducing quality.

For Obamacare to “work,” it is particularly important for young people to “buy in,” because while they are forced to (SET ITAL) spend (END ITAL) on health care insurance they are unlikely to (SET ITAL) consume (END ITAL) health care services. Obamacare transfers money from the pockets of young people (with a net worth smaller than that of seniors, by the way) into the pockets of older, health care consuming Americans.

If the goal were truly to make health care more affordable, Obamacare would be as laughably wrongheaded as other Obama boondoggles like “cash for caulkers” or “cash for clunkers.” No, the real goal is taxpayer-paid health care. Both ex-DNC chair Howard Dean and ex-Senate leader Harry Reid said so.

To reduce costs in health care, or, for that matter, in (SET ITAL) any (END ITAL) commodity, is to unleash the free market. Health care is particularly shackled by restrictions and regulations too numerous to mention. Here is just one example.

In the biographical movie “Hacksaw Ridge,” a World War II medic, Private Desmond Doss, a pacifist, refused to carry a rifle. In the midst of the carnage, during the Battle of Okinawa, Doss carried wounded soldiers and rappelled them down a cliff face to safety then treated them alongside the medics. He was awarded a Medal of Honor for saving scores of lives.

If, however, after the war, Pvt. Doss had opened an office with a shingle saying “Doss’ trauma unit,” authorities would have thrown him in jail for practicing medicine without a license. His skills were good enough for the soldiers on the battlefield, but not good enough for civilians when Doss returned stateside.

On a question-and-answer website, this question was recently posed: How do Marines feel about Navy corpsmen?

Here are some of the responses: “Personal experience — I had my middle finger sewn back on by an E-5 corpsman. When a real doctor first saw it, he shouted, ‘Who did this?!’ I asked why and the Doc said that it was the best he had ever seen. I have full use and feeling in that finger and that was 40 years ago.”

“Personal experience — I was shot in the leg. An E-4 corpsman, assisted by an E-5, treated me. No doctor could have done any better than they did.”

“History: Beginning in WWII, most ships the size of destroyers and smaller had enlisted men — corpsmen — as their only medical expert. Usually it was a Chief Petty Officer, but often was an E-6 and some had only an E-5.

“Then, as now, they did everything — surgery included. In WWII and every war since then, U.S. soldiers have had a higher survival rate than any other country’s military (enemy or allies) and most of that medical triage and vital systems treatment was by enlisted corpsmen.

“Outside the service, enlisted corpsmen are by far the preferable hire for civilian EMT and rescue jobs.”

If Congressional Republicans were serious about making health care affordable, they should sell the voters on the free market. Where’s the slogan for that?

  • DrArtaud

    Employer provided benefits used to be an inducement to attract employees to the workplace. They still are an integral part of Heavy Industry employment.

    Employers offer a wage/benefit package, i.e. it might be reported that employees in that industry make $32/hr, and I have often seen it so stated. Yet, in terms of hourly remuneration, it may be nowhere near that value, perhaps $24/hr and the rest represents the healthcare, vacation, and retirement compensation to the employee.

    If obamacare caused employees to lose their healthcare, instead shifting the employee to an ACA provider, the employer likely did not add that amount previously used for the employees healthcare onto the employees wages.

    Employees may or may not have had contributions to the plans previously offered by the employer. But assuming they did, and were moved by an irresponsible law passed by the democrats and upheld by SCOTUS, namely Roberts, depending on their wages, they likely qualified for govt subsidies.

    Free Market may seem to be the solution, and perhaps in a broader sense it is, but not as a solution for people forced off the ACA. Employees starting at their employer healthy may have developed a disease during the course of employment. Since their disease developed while insured, it wasn’t preexisting. If forced from their employer provided healthcare to the ACA, it was of comparatively little import, since the act itself required that preexisting conditions are covered. But if the Republicans cancel the ACA, untold numbers of people will now be subject to a penalty of higher insurance rates due to preexisting conditions that wouldn’t have occurred without govt’s initial meddling.

    The solution will not be Health Savings Accounts either. One article I read said they’re predicated on paying into the account, while healthy, for a number of years. Then, at 35 to 40, you’ll have amassed an effective amount. And there are other considerations.

    Article Link: Mayo Clinic - Health savings accounts: Is an HSA right for you?

    What are some potential advantages of health savings accounts?

    • You decide how much money to set aside for health care costs.
    • You control how your HSA money is spent. You can shop around for care based on quality and cost.
    • Your employer may contribute to your HSA, but you own the account and the money is yours even if you change jobs.
    • Any unused money at the end of the year rolls over (stays in your account) to the next year.
    • You don’t pay taxes on money going into your HSA.

    What are some potential disadvantages to health savings accounts?

    • Illness can be unpredictable, making it hard to budget for health care expenses.
    • Information about the cost and quality of medical care can be difficult to find.
    • Some people find it challenging to set aside money to put into their HSAs.
    • People who are older and sicker may not be able to save as much as younger, healthier people.
    • Pressure to save the money in your HSA might lead you to not seek medical care when you need it.
    • If you take money out of your HSA for nonmedical expenses, you’ll have to pay taxes on it.

    Why were health savings accounts created?

    HSAs and high-deductible health plans were created as a way to help control health care costs.

    The idea is that people will spend their health care dollars more wisely if they’re using their own money.

    Article Link: Who do HSAs Make Sense For?

    I think employers should be given an incentive to re-acquire employees that they once covered, and cover ones they had not covered.

    Shifting back to significantly employer based healthcare will more closely correlate legal citizenship with healthcare. IMHO, obamacare was necessary to permit the influx of illegal immigrants and refugees that we’ve seen.

    It will teach people discipline, they need the job to care for their family. This has been one of, if not the greatest reason, frustrated coworkers have stayed with my current or former employers.

    We don’t need a simple solution to a complex problem. Republicans are admittedly not responsible for the ACA, but if they repeal it and too many people suffer hardships, they’ll jeopardize mid-term elections by supplying the democrats material to ridicule them with.