Henry David Thoreau once said: “If I knew for a certainty that a man was coming to my house with the conscious design of doing me good, I should run for my life”; this succinctly and accurately sums up the entire debate of healthcare for the past several decades. We should take the good intentions of regulation out of healthcare, and leave people free to make their own decisions on how to conduct their lives.
John McCain heroically returned to the Senate in July to dramatically kill any possibility to discuss changes to the Patient Protection and Affordable Care Act (ACA). To be clear, he isn’t the only GOP Senator to renege on his promise to repeal the ACA but, he is the picture of a politician who cares more about his legacy and his reputation (as a maverick) than he does about his word or what is best for the country. He thinks that by bucking his party with RINOs like Murkowski and Collins he is establishing some grand post-political tradition. He is not; the American people know better and so do the Democrats.
The Democrats haven’t broken rank on a major piece of legislation in at least a decade. When the GOP gave them the opportunity to voice their support for their coveted single payer, they lock step voted present, not in favor, to deprive the GOP of a political win; to the democrats, like John McCain, politics come before principles. John McCain isn’t a fool, he’s a disgrace, and those that follow in his footsteps share his well-deserved shame.
In the month of July, the Senate considered three options to alter the ACA . But let’s be honest about what these options were. Their titles notwithstanding, none of these were full repeals; some were better than others and any would have represented progress to removing the national socialist catastrophe that is the ACA . The bill that was known as “Repeal and Replace” was graced with an amendment from our very own Rob Portman to effectively maintain Medicaid spending. Portman, like McCain, and every other Republican, ran on a guarantee to repeal the ACA but, when the time came, he decided to follow in the footsteps of big government Republicans like McCain and Kasich and prop up the ACA.
While both parties are to blame in the disaster known as ObamaCare, only the GOP promised to repeal the law. The Democrats, to their credit, have expertly wielded their political savvy, ownership of language and culture, and hive voting strategies to pass and maintain the ACA as the law of the land. The GOP, meanwhile, suffering from infiltration from leftist, preening elitists, and feckless leadership have neither the political will nor (it would seem) the desire to repeal, modify, or even discuss changing the ACA ; AGAIN, as we’ve been promised for nearly 10 years now.
Trump, in a rare demonstration of political savvy, is now using executive tactics, enabled by Obama and the Democrats, to attack both Congress and the ACA itself; he’s threatening to withdraw subsidies for politicians, their staff, and insurance companies in the absence of congressional action. Trump has said he’d make an announcement with regard to this action. Trump should be using every regulatory trick that Obama used to establish the ACA to tear it down. He should, however, be careful to undo regulations that Obama implemented (like the subsidies) and avoid regulating by fiat. He should avoid unconstitutional executive actions like those propping up the law that Obama issued with his pen and his phone. He should let it crumble to force action on the part of the Congress. If protection is withheld from the GOP to justify their fecklessness they’ll have no choice but to act.
Trump, the great deal maker, deserves his share of credit for the failure of these bills to be passed. Though he is acting well in light of the failure, he should have been out selling repeal as aggressively as Obama sold passage. Instead, he sat back, whined that he and his pen were lonely in the oval office and that he was unhappy with his Attorney General. Trump does one thing indisputably well: campaign. Someone from the RNC, in his staff, or congressional leaders should have told him to get on a plane and get into Ohio, Arizona, Alaska, Nevada and sell the repeal. He should be reminding people why he was elected; why the ACA is a bad law. He could have prevented the rise in approval with which the American public perceives ObamaCare. With any luck, he’ll both start to campaign for the bill and cancel all subsidy payments to all parties designated by Obama’s pen and phone.
While repeal is gathering itself back together and making plans for another vote, members of both houses of Congress should be collecting their thoughts on what a better system would be, how they can reconcile between the chambers, and pass a free market solution into law. A free market solution should include cross state sales of insurance but, it shouldn’t be limited to that. If international companies want to sell Americans insurance plans, they should be free to sell them and Americans should be free to buy them. We should be considering reasonable limits on medical liability lawsuits; for example, medical malpractice lawsuits should resemble our libel laws: the defendant should have to show intent to cause harm or knowingly cause harm through inaction. We should not be forced to buy products we neither want, nor need, and we certainly should not be forced to subsidize the poor decisions of others. Medicine has become an absolute financial boondoggle in every sense of the expression. We should make every effort to make hospitals resemble the efficiency of Wal-Mart. Medical professionals should compete for our businesses with the quality of their care and transparently published pricing. For far too long, patients are directed to doctors allowed by the insurance companies. Consumers are further distanced from the true costs of over-priced service when “insurance pays the bill.” This is an abandonment of free market principles that has led to lower standards of care and out of control, opaque pricing.
In an ideal world, the Affordable Care Act would be repealed and free market solutions would be implemented. Unfortunately, repeal doesn’t seem likely in the near future. The silver lining of this seemingly bleak observation is that we may not actually need the repeal. Trump has already instructed the IRS to not enforce the individual mandate. The only thing that needs to be repealed is the guarantee of coverage for pre-exiting conditions. If coverage for pre-existing conditions is no longer guaranteed, and these free market reforms are implemented, the industry will quickly become more efficient and provide higher quality care for Americans than the ineffective publicly funded options. Americans, as they do in every other facet of life, will choose the better of their available options. Of course, all of this could be achieved by a more attractive private market compelling private health providers to stop accepting publicly funded solutions.
In short, Congress only needs to act to liberate the free market; to tear down onerous regulations holding innovation at bay; and to allow medicine to proceed the way any other good or service has evolved in our history.