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Thursday, June 29, 2017

Healthcare, the Constitution, and Why are Republicans Such Fools?

Free Market Healthcare

NOT Free Market Healthcare

Any questions?

Can you imagine what it would be like if Republican politicians were put in charge of removing a stubborn Band-Aid from a child’s arm?

Republican #1:  “We can’t just rip off the Band-Aid!  It’s going to hurt and then her parents will be mad and our approval ratings will go down!

Republican #2:  “What if we brought in the finest surgeons (at taxpayers’ expense) to surgically remove her arm, rip off the Band-Aid, and then reattach the arm?”

Republican #3:  “That’s crazy!  Let’s just bring in a team of anesthesiologists (at taxpayers’ expense) to sedate the child, then rip off the Band-Aid while she’s sleeping.”

Republican #4:  “Or we could hire a circus (at taxpayers’ expense) to distract her while we rip the Band-Aid off!”

After recently postponing a vote on the Republican healthcare bill, Senate leader Mitch McConnell said, “This is a very complicated subject.”

I suppose it is complicated, but that’s in no small part because Republicans have exacerbated the problem with their foolish and misguided efforts to “fix” the Obamacare mess with the impossible, self-imposed condition of not upsetting anyone.   Furthermore, if not upsetting anyone is the goal, they’re failing miserably.  And apparently if anyone IS to be upset it can’t be the freeloaders who should be paying for their own healthcare, the insurance companies who conspired with Obama or the medical industry that profits so handsomely by gaming the system.  No, as always it must be middleclass taxpayers, most of whom already provide for their own insurance, who take the fall because these are the folks who can be depended upon to re-elect the same Republicans that keep failing them.  This is the insanity that is our Party.

The Supreme Court’s traitorous ruling notwithstanding, the federal government has no business involving itself in the healthcare of American citizens.   I know this in my heart and in my brain to be a fundamental and inarguable truth, because the evidence speaks for itself.  Just look at the mess that’s been made with respect to both our healthcare “system” (more on that later), the infinitely spiraling costs and the take-no-prisoners fighting that consumes both bodies of congress as they battle on behalf of their constituencies.  You don’t need to be an expert on the Constitution or on the Founding Fathers to see that this chaos and violation of our liberties is not the product of their design.   This is what the Constitution was supposed to protect us from.  As long as the federal government insists on inserting itself where it doesn’t belong and assuming powers that the Constitution does not expressly assign to it, chaos will always be just an election away, if not the everyday norm.  That is the principled, moral argument for repealing Obamacare.  It was wrong from the get go, therefore it must be undone.  But since so many Republicans no longer care about what is right or wrong according to the Constitution, I’ll make the practical argument as well.

The first problem with the “healthcare system” in the U.S. is that it was never supposed to be a “system.” “System” implies central planning, purposeful design and continuous regulation with the goal of producing a defined outcome.  None of this has historically been applicable to healthcare in the U.S. which, aside from the unique and polluting involvement of the insurance industry (more on that later), should be like any other consumer product bought and sold in the free market.  But the Left understands that a clever lie repeated often enough becomes the truth, and their nagging insistence, year after year, that the “healthcare system is broken” has turned myth into reality in a classic case of the tail wagging the dog.  How can the system be “broken” if the system doesn’t exist?  It was a slight of hand that enabled the federal government to justify meddling in something that the Constitution gives it no power to meddle in.  To whatever extent a U.S. “healthcare system” exists, it is not by design but by deceit and default.

One of the reasons Republicans are having so much trouble trying to cut and paste a bill that “fixes” healthcare, besides the fact that it’s outside the scope of authority of the federal government, is because they want to give voters the benefits of a free market without the negatives of a free market.  Insurance is supposed to be something you buy in case you get sick, not after you get sick.  That’s what makes it insurance.  A free market requires that you make trade-offs and sacrifices and establish priorities in your life.  Consequences, good and bad, are a necessary element of the free market system.  And here’s the really big rub:  Neither Obamacare nor the patchwork “fix” cobbled together by Republicans will “fix” healthcare because it does nothing to lower the real cost.  U.S. Healthcare costs are comparatively high due to:

Administrative costs
Defensive medicine costs
Drug costs
Impediments to competition in the market
Absence of a true consumer-producer relationship

That last one’s a biggie.  The educated consumer is a key factor to making products and services affordable, and yet it’s nearly impossible for the average person to be an informed and discerning consumer in a market dictated by deals between insurance companies and medical providers.  If congress really wants to meddle in something, paving the way to transparency and consistency in medical pricing would be a good start.  Defensive medicine costs and impediments to cross-state competition are also areas where congress could help the free market, if they would only do it instead of just talking about it.

Our reliance upon insurance companies who act as the middleman in nearly every doctor-patient transaction also inflates the cost of healthcare.  Insurance was originally designed to protect consumers from large and often unexpected healthcare costs.  Now it’s more of a payment processing system for everything from ingrown toenails on up, which means your doctor has to hire more staff to interface with insurance companies.

Finally, one in every five Americans gets their health care through Medicaid.1   This is an outrageous and inexcusable breach of congress’s fiduciary obligation to American taxpayers.  The vast majority of Medicaid recipients could be and should be paying for their own healthcare, which they might actually be able to do if our merry meddlers in the federal government would ever focus their efforts on reducing the cost of medical services and insurance rather than simply transferring the cost from one person to another.

In sum Republicans aren’t doing themselves or the American people any favors by making the repeal of Obamacare so complicated.  This is the ideal time, with their approval ratings already low and expectations waning, to go bold and rip that Band-Aid off as quickly and cleanly as they can.  Let this be the congress that helps restore the Constitution rather than helping to kill it.


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