Obamacare in Limbo: Repeal or Let Die

by Jon N. Hall3/6/17
At Hot Air, we read that on Jan. 4 President-elect Trump tweeted: “Republicans must be careful … that the Dems own the failed ObamaCare disaster. On Jan. 11, Business Insider quoted Trump thus:” “They own it right now. So the easiest thing would be to let it implode in 2017 and, believe me, we’d get pretty much whatever he wanted. But it would take a long time.” So back in January, Mr. Trump seemed to think that the right course was to be proactive and repeal.

But on Feb. 15, The Daily Wire ran a compelling article headlined “Why Trump Should NOT Repeal or Replace ObamaCare (Just Let It Die)” by John Nolte, who counsels otherwise:

Why should Trump and the GOP deal with the headaches? Why take the political hits? Why face two years of the Left rioting and the national media calling you a Nazi? To finish off the destruction of ObamaCare, all Trump and the GOP have to do is a whole lot of nothing….

In other words, let Obamacare continue in its “death spiral,” which is what Obamacare is now in, according to insurance giant Aetna. (Mr. Nolte also offers up some fine suggestions for fixing the nation’s healthcare, and with brio.) And in “Trump Administration Withdraws Some Obamacare Ads as Deadline Nears” at Bloomberg on Jan. 26, we read (italics added):

Robert Laszewski, a health-care consultant who’s critical of Obamacare, called the move to halt the advertising “short-sighted.”

“Doing this just gives Obamacare advocates ammunition to later say Obamacare failed not because it was deeply flawed but because the Republicans killed it,” he said. “If the Republicans believe Obamacare is failing, then just let it fail and let it be clear it failed because it was flawed, not because the Republicans sabotaged it.”

Good point, but the same concerns can also be raised about any executive order on Obamacare, such as the president’s directive to the IRS to not enforce the individual mandate on this year’s income tax returns. The same thing might be argued if the GOP is not forthcoming with funds for the various bailouts that are embedded in Obamacare, like the “risk corridors” bailouts.

When predicting Obamacare’s imminent demise, one needs to remember that the system has two sides. There’s the welfare side, i.e. the expansion of Medicaid, and then there’s the private sector side. The first component of Obamacare to fail would likely be the exchanges. That’s because they involve private health insurance companies that must make a profit. These companies are leaving the exchanges. But the Medicaid side of Obamacare isn’t concerned with profits, nor does Medicaid have a dedicated tax and “trust fund” like Social Security and Medicare. The Medicaid part of Obamacare will likely keep on limping along, getting regular infusions of money from the poor taxpayer.

So one can’t be so sure that all of Obamacare will fall on its own; it may need a little shove. But repeal will reap the political grief for the GOP that Nolte writes about and that we’re seeing at town hall meetings. On Feb. 20, the Kansas City Star ran “Republicans are walking into Democrats’ Obamacare swamp” by columnist Dave Helling, who writes: “By repealing and replacing, Republicans will own the American health care system for the next four years.”

GOP members of Congress should read Helling’s short op-ed. And besides the warning that Republicans will “own” America’s healthcare if they’re not careful, he touches on healthcare pricing. And as if on cue, Fox News’ Tucker Carlson did a segment on Feb. 21, “Health Care Pricing Has Been Rigged,” that featured former hospital executive Steven Weissman:

Mr. Weissman also focused on the issue of pricing at the Daily Caller in January when he wrote on “Healthcare Sticker Shock”:

Both political parties are attacking the problem from the wrong end — health insurance. Premiums are a direct function of the amounts paid for hospitals, labs, physicians and drugs. The only way to materially reduce insurance premiums and healthcare as a percentage of GDP is to address these underlying healthcare costs.

Weissman believes the American healthcare system is based on predatory pricing. As an example, he reports that tests from the same lab can differ in prices by a factor of 40. It’s interesting that one of the pillars of Obamacare is the policy of “community rating,” which dictates that everyone will pay the same prices for insurance premiums regardless of any pre-existing conditions. Yet, the pricing done by doctors and hospitals is all over the place. “No congressperson can oppose legitimate pricing or defend our predatory system,” Weissman writes. “The desire for legitimate healthcare pricing is the one … unifying American issue.”

In sum, doctors and hospitals are charging folks whatever they can get. But they might be driven to do that to offset losses they incur from patients on Medicaid and from patients who still, even with Obamacare, are using emergency rooms. It’s called “cost-shifting,” and it runs a-riot in healthcare. The cure is this: Every item on a medical bill, regardless of whether it’s for major surgery or an aspirin, must have a set price that is the same for all payers, regardless of whether the payer is the government, an insurance company, or an individual paying out-of-pocket.

That requirement might seem like common sense, a no-brainer, eminently fair, and quintessentially American, but it’s not the case with our healthcare. And if such a requirement were implemented, it would present a big problem for government systems like Medicaid. At CPAC on Feb. 24, the president said:

I tell them from a purely political standpoint, the single-best thing we can do is nothing.  Let it implode completely — it’s already imploding.  You see the carriers are all leaving.  I mean, it’s a disaster.

But two years don’t do anything.  The Democrats will come to us and beg for help.  They’ll beg, and it’s their problem.  But it’s not the right thing to do for the American people.  It’s not the right thing to do.

President Trump is right: we need to repeal Obamacare, not let it die on its own. And the GOP needs to know that if they don’t repeal Obamacare, they will “own” Obamacare. They will be pilloried and “primaried” out of office if they renege on their promise to repeal the ACA.

Until and unless they can correct healthcare pricing, Republicans shouldn’t even dream of “replacing” Obamacare — they should repeal only.

That means resetting America’s healthcare and health insurance back to what it was before the Pelosi-Reid-Obama axis got their hands on it; it means going back to the way things were just three years ago when Obamacare became operational. But after repeal, when they’re trying to reform healthcare and get the pricing mechanism working correctly, the GOP should avoid the Democrat’s mistake of not seeking bi-partisan buy-in. In the spirit of collegiality, Republicans could create a big red reset button and invite Democrats to punch it with them. They might even let the Dems hold the button for the photo-op.


Jon N. Hall is a programmer/analyst from Kansas City. • (651 views)

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27 Responses to Obamacare in Limbo: Repeal or Let Die

  1. Timothy Lane says:

    GOP voters want Obamacare repealed, and will be extremely unhappy if they don’t even try to do so. One thing any replacement plan needs, in order to fight the predatory pricing you mention (which Paul Ryan discussed once in a speech at Hillsdale), is total price transparency.

  2. Kung Fu Zu Kung Fu Zu says:

    The House’s new proposed repeal and replacement of Obamacare is nothing but a sham.

    http://www.foxnews.com/politics/2017/03/07/conservatives-push-back-on-obamacare-repeal-bill-vow-to-introduce-their-own.html

    If what I have read and heard yesterday and today is any indication of the contents of this proposal, then it is just as bad, if not worse, than Obamacare. One thing I love about Republicans, they shift money away from the truly needy to the middle-class and upper-middle-class constituencies. They now how to bait the hook.

    Paul Ryan, among others, should be tarred and feathered.

    And I have yet to hear Trump make a peep about the fact that the new proposal does not mention the sale of insurance across state lines.

    Last night I heard that genius, Dr. Charles Krauthammer, pontificate to us all that the Republicans simply had to come to terms with the fact that Obamacare created a new entitlement program and we had to live with that. What courage. Frankly, I have never considered Krauthammer a conservative. He is another neo-con (i.e. never was a real conservative) who was forced to leave his true home, the Democrat Party, as he was not a crazy communist.

    I believe this demonstrates the animal that the “conservative” party is morphing into. It is called a jack-ass.

    And one observation: Trump has done the easy stuff. Now it will start getting difficult. Will he do what he promised?

    • Brad Nelson Brad Nelson says:

      Krauthammer, like a lot of people, is an accommodationist. They’ll huff and puff on certain points. But at the end of the day, they’ll go with the flow.

      • Timothy Lane says:

        The basic problem – the near impossibility of getting rid of an entitlement after it takes effect — was anticipated by Ted Cruz, and is why he pushed the 2013 government “shutdown”.

  3. pst4usa says:

    Let it die? I say kill it, completely, no part left in place at all. Then start the process of figuring out how to get government out of the business entirely.

    • Kung Fu Zu Kung Fu Zu says:

      I just wrote something similar to my Congressman, Sam Johnson. The Republicans in Congress have claimed they wanted to kill Obamacare for almost seven years. They took many “show” votes on the subject as they knew Obama would never let it happen. Now that they have the power, the bastards are changing their tune in a big way.

      • pst4usa says:

        Show votes, I like that! A very appropriate description.

      • Timothy Lane says:

        Not all of them. Rand Paul certainly wants to get rid of Obamacare and replace it with a free-market-oriented system.

        • Kung Fu Zu Kung Fu Zu says:

          Not all of them.

          Only the majority of them, it would appear.

          I just listened to some congressman from Georgia named Buddy Carter, who is supposed to be some type of point man for this. The guy said nothing of substance. He kept to the talking-points mantra of how this new bill was going to, “reduce costs, give patients more choice, blah, blah, blah.”

          The man said he was a pharmacist, a group who I have always thought intelligent, but this man was a joke. He could not answer, in a substantive way, any of Tucker Carlson’s questions.

          I truly wonder if the Republicans under Ryan are so poorly prepared or do they want the repeal effort to fail.

          • Brad Nelson Brad Nelson says:

            Mr. Kung, I thought Michael Tanner had a good article on the subject.

            What I want is free health insurance paid for by somebody else. I don’t know what’s taking them so long.

            • Timothy Lane says:

              Megan McArdle had an article that was even harsher, arguing that Ryancare solves nothing. She argues that they were following the old cript: we have to do Something, this is Something, so it’s a good idea. I call this short-term pragmatism, and it’s not a good idea. The link is:

              https://www.bloomberg.com/view/articles/2017-03-07/the-republican-plan-is-even-worse-than-obamacare

            • pst4usa says:

              So, if I say the same thing Brad and mean it, “What I want is free health insurance paid for by somebody else”, Am I;
              Greedy? Stupid? Lazy? Un-American? Evil? or All of the above?
              I’m going with all of the above, I would have liked to come up with ten, in honor of the 10th Commandment, but I got interrupted and have to get back to work.

              • Timothy Lane says:

                Anyone who succeeds in getting people who don’t know him to pay for his lifestyle is greedy — but not necessarily stupid or even lazy.

              • Brad Nelson Brad Nelson says:

                So, if I say the same thing Brad and mean it, “What I want is free health insurance paid for by somebody else”, Am I;
                Greedy? Stupid? Lazy? Un-American? Evil? or All of the above?

                I refuse to answer that. I won’t get caught in an infinite loop. I just have this advice for you and everyone else:

                + Eat your vegetables
                + Get some exercise
                + Easy on the fat, salt, and Cheetos (donuts are not a food group either)

                Relax. Don’t sweat the small stuff. I’m not going to say something as stupid as “be happy” for I think most people drive themselves to unhappiness with that as a goals. So I’ll say, Be useful. Be productive. Be helpful.

                And know that 9 out of 10 people right now are socially insane. And I think you know what I mean by that. Take comfort in your well-chosen friends. Enjoy your family (if you can). Watch a good movie. Read a good book. Waste no time on bitching and complaining, although by all means work for positive change.

                You know my displeasure with Trump, but it’s nothing compared to my contempt for Paul Ryan. These fools are not going to fix anything. So let’s fix ourselves. Let’s control what we can. While most of those around us go socially insane, let’s do as Kipling said which was:

                If you can keep your head when all about you   
                    Are losing theirs and blaming it on you . . . you’ll be a Man, my son.

              • Timothy Lane says:

                According to Hugh Thomas in The Spanish Civil War, “If” was a favorite for Jose Antonio Primo de Rivera, son of the old dictator and founder of the Falange Español,. He was executed by the Loyalists early in the Spanish Civil War.

  4. Brad Nelson Brad Nelson says:

    As rants go, this is a pretty good one by Kurt Schlichter: Hi, GOP: You Are Terrible and Obamacare Jr. Stinks

  5. Brad Nelson Brad Nelson says:

    Rand Paul sounding like the one clear head in the Republican Party.

  6. Brad Nelson Brad Nelson says:

    Here’s an article by John Hawkins on the subject. You may agree or disagree on the particulars of this. But this seems to be that most rare of things online: a coherent thought.

    • Timothy Lane says:

      Hawkins is one of my favorite Town Hall columnists. I’ve even had a few of his articles printed out over the years, and might have done more if it were easier to do. (Especially now, when we live in a hotel and almost never get out.)

  7. Brad Nelson Brad Nelson says:

    A rare article of substance and clarity at American Thinker. This one by Karin McQuillan (shunted off and buried in the blog section) is rather good.

    • Timothy Lane says:

      David Brat is an economist, who defeated Eric Cantor in 2014 by pointing out the deleterious effects illegal immigration has on workers. Naturally he’d know more about what insurance really is than a typical politician (and especially a wonk like Ryan).

      • Kung Fu Zu Kung Fu Zu says:

        Don’t confuse us with the facts. We know what we think.

      • Brad Nelson Brad Nelson says:

        On the issue of health care, Trump has so far lived down to every expectation of those who were dubious of this guy fixing anything that required being steeped in sound economics, philosophy, and Americanism. And this stooge of a president has threatened to support primary runs against any Republican who votes against this steaming bowl of excrement. Wonder what Rush’s take is on this. I don’t listen to him anymore.

        • Kung Fu Zu Kung Fu Zu says:

          What’s not to like about the Republican “Repeal and Replace” of Obamacare?

          http://www.reuters.com/article/us-usa-obamacare-immigration-idUSKBN16S2RX

          These bastards really should be horsewhipped.

          • Brad Nelson Brad Nelson says:

            I think many people here have known for quite some time that the Republican Party is little more than Socialism Lite. That Trump is backing this stuff is no surprise because he is a liberal and big-government man.

            By why this particular plan? Figuring this out is like trying to get into the mind of a criminal, degenerate, or kook. I don’t know what positive thing Trump sees in this. Either you repeal the bits and pieces of socialized/statist healthcare and move to free market solutions or you move boldly toward the end goal of single payer. It’s hard to see how this muddle can be a product of a smart businessman. Trump has stepped in it. And I really didn’t think this would be the issue wherein we saw the leopard’s spots.

        • Timothy Lane says:

          Yes, the House bill has its good points, but it still doesn’t have a full repeal of Obamacare. And meanwhile, Trump plans to give his liberal daughter Ivanka an unofficial White House position with a security clearance. His administration includes plenty of good conservatives, but also an increasing number of his fellow New York liberals. We may have already seen “peak Trump” from our point of view.

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