Stephen Green on the GOP’s proposed American Health Care Act (AHCA):
I’m still not convinced that a bad law with GOP fingerprints on it is an improvement over a worse law with Democrat fingerprints on it. Politically it could be much worse.
This is the bind the Republicans find themselves in. For seven years they have promised to repeal ObamaCare if voters would only put them in power. Now, voters have delivered, giving the GOP control of both houses of Congress as well as the presidency, and they are expecting Republicans to step up and deliver as well.
And that’s a problem, because Republicans can’t deliver, and the truth is they never could.
Once ObamaCare was passed, the cake was baked. Though ObamaCare remains as unpopular now as it ever was, the political reality is that once you’ve given people some benefit, it’s nigh impossible to take it back.
Americans are rightly outraged with ObamaCare. They had it forced on them along a strict party line vote. Then they watched as, despite Obama’s repeated promises, their premiums skyrocketed and they lost both their doctors and their health care plans. The mandates, regulations, and extra taxes that came with it just added insult to injury.
You’d think, given it’s unpopularity, ObamaCare would be easy to repeal. And it would be, except for one thing. Amidst all the mandates, broken promises, and runaway costs are a couple of things that people actually want– the biggest of these being that ObamaCare forced insurance companies to cover preexisting conditions.
People love that. And now that they have it, they aren’t going to give it up. Ever.
The thing is that covering preexisting conditions is hugely expensive. If we’re talking about cancers and other terminal illnesses, treatments can easily cost tens or even hundreds of thousands of dollars.
Traditionally, insurance was meant to actually insure against something that may or may not happen in the future. You pay (relatively) small payments up front in order to transfer the risk of a very expensive treatment that may be needed in the future to someone else.
As soon as you throw preexisting conditions into the mix, you’re no longer talking about insurance. You’re no longer asking (or, in the case of ObamaCare, forcing) a company to assume the risk that you might need expensive treatment in the future; you’re now expecting them to absorb the costs of something that is certain, ongoing, and very expensive.
The scam of ObamaCare is that it demands that “insurance” companies provide a much more expensive product to a much larger number of people without charging more for it. It’s not hard to do that math and realize that it doesn’t add up.
ObamaCare was doomed from the start, which is why the “death spirals” we are now experiencing were predicted from the start.
It’s also why any ObamaCare replacement that forces companies to cover preexisting conditions will fail as well. Either premiums will have to skyrocket to cover the extra costs, or (if they are not allowed to charge more) insurance companies will close up shop and seek more profitable ways to invest their money. (Which will force us into “single payer” — i.e. fully socialized health care, which will be even worse than what we have now.)
Economist Thomas Sowell has spent years pointing out that there are no “solutions,” only trade-offs. The trade-off here is that we can have coverage for preexisting conditions or we can have cheaper health “insurance.” But we can’t have both.
That said, no one ever said that people are rational. They want what they want, and they don’t want to pay for it. So they will continue to demand the impossible, and they will continue to vote for politicians that promise the impossible.
And that’s the bind Republicans are in. Because there is no way to win this game. And they will get the blame when it all blows up in our face. Already, the new bill is being referred to as “GOP-care,” “Ryan-care,” and “Trump-care” by various talking heads. Eventually we’ll settle on one of those names or something similar. And, the re-branding done, “ObamaCare,” which lit the fuse in the first place, will fade from memory, leaving Republicans holding the bomb when it goes off.