I am
starting to suspect that wily old Mitch McConnell is a step or two ahead of the
game, and has absolutely no desire to see the GOP’s purported Obamacare “repeal
and replace” bill actually pass the Senate. As is increasingly obvious,
neither the Senate nor the House bill is a genuine redesign of health care
financing, but rather a tinkering with the structure of Obamacare in hopes of making
it a little less counterproductive.
Charles
Krauthammer deftly identified the scenario ahead for this faux-reform, should
the GOP “succeed” – and it is a predictable disaster:
Rush
transcript via Grabien:
“I
think the best political outcome for the Republicans is that this never emerges
from the Senate and the issue will then be behind them. Yes, they will suffer
from not having delivered on a promise but if they pass anything like this, you
will have endless stories about, sob stories about people who have been hurt by
the inevitable changes and the Republicans are going to bear the albatross of
healthcare that the Democrats bore for eight years and it really damaged them.”
In one
sentence: “Why would the GOP voluntarily take ownership of a disaster crated by
the Democrats?”
It is
clear to me that the only way to fix the health care financing system in the
United States is to put payment in the hands of patients, who have an incentive
to shop carefully for the best value. This means some version of a tax-favored
health care savings account with the ability to utilize unspent funds for
future years, or for other consumption in the long run. Needless expensive
complexity is introduced when third parties (insurance companies, governments)
pay for care.
But
such a radical restructuring would hurt many private interests. Entire
bureaucracies would become redundant, as would many currently viable businesses
that live off of the complexity.
I
suspect McConnell’s game is to allow Obamacare to collapse, and for the Trump
administration to supply exemption from its requirements to states where no
insurance companies participate in Obamacare exchanges. As that number of
states increases, Obamacare is effectively repealed.
The
GOP base, which has been promised repeal and replace for almost a decade,
deserves better than taking ownership of a fundamentally flawed system.
