Monday, January 9, 2017

After Obamacare: My Two Cents

Things are warming up for the political battle over Obamacare repeal and replace. Last week the Democrats ran a presser that was clearly designed to say to Republicans: Be afraid, be very afraid.

Because everybody knows that the streets will erupt with rage if one hair on the Obamacare subsidies is touched. That is what Chuck Schumer was selling last week in the Dems' Make America Sick Again show.

And, right on cue, we read that Republicans are getting nervous about an Obamacare replacement.

And that makes me nervous. So, to buck myself up, I got to thinking about what I want to see with the Obamacare replacement. Two things:

  • The reform should benefit Trump voters and the People of the Responsible Self in general.
  • The reform should be acceptable to the white working class.
The whole game of Obamacare and the liberal idol of "universal healthcare" is to make health-care consumers in general pay for the subsidies and benefits handed out to Democratic Party supporters without having to recognize the costs in the federal budget. Their plan means that health care in general has to be subordinated to an administrative regulatory system and consequent distortions and injustices, instead of being a market and price driven organism that delivers what people are willing to pay for.

So I would say that the subsidies and handouts and free stuff need to be frankly put into the federal budget. Because the sly and dishonest Obamacare approach is liable to kill the health care system.

Yes, but won't that increase federal spending and increase the deficit? Yes it will, but I think of the additional outlays as crowding out other liberal stuff, like climate spending.

We need to get as close to a market-driven system as the American people will let us. Because that is how you get a health care system that responds to peoples' needs and ability to pay.

Of course, the white working class doesn't think that way; it thinks as workers and peasants, People of the Subordinate Self. So a lot of free stuff, including coverage for pre-existing conditions, will have to be included in the Obamacare reform. But these benefits, which are not "insurance" but government benefits, should be hived off from the health insurance system and made a separate high risk pool funded by government outlays.

Obviously, there are going to be losers in any change to the current system, and they would be the iconic Hillary voters, single 50-ish women with developing life-style related health problems that benefited from the compression of age-related insurance premiums and Obamacare exchange subsidies. But hey, these folks were not protected by Obamacre because their bronze plans have huge deductibles, which they hate. And they are never going to vote Republican anyway. Let us throw them a bone, and move on.

One thing that encourages me. The old game of intimidate the Republicans into concessions won't work too well, because Trump doesn't play that game. That is going to be fun to watch. It will be as Rush Limbaugh says. The liberals will keep calling plays out of their 30-year-old playbook, and be completely dumbfounded when the plays don't work.

But it ain't over till it's over.

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