GOP Saves Obamacare

The Republican majority in the Senate has given up and will not be considering a healthcare reform plan after failing to get enough Senators to back the measure, even after a number of revisions.  Thus, healthcare reform and the repeal or replacement of Obamacare is probably dead.

After campaigning for seven years on repealing Obamacare, and arguably winning a majority in the House of Representatives after only two years into Obama’s term as a result, Republicans could not come up with the votes to do anything once they had a majority in both the House and Senate and a President of their own party.

Obamacare has lived up to almost every one of the criticisms predicted when it was passed:  costs to the government (meaning the taxpayers) have risen far over predictions, premiums prices have still grown at double-digit average rates and in some places triple digits (what do you expect when you add dozens of mandated benefits to ‘basic’ coverage), and there never was a rule that would allow you to keep your own doctor despite what President Obama said to sell it.  And we now have several areas of the country that have no federal exchange plans available or only one plan to choose from meaning there is no competition whatsoever. The bottom line is that it was never going to succeed and, frankly, a number of liberal lawmakers knew that but planned in a few years to ‘save’ Obamacare and the healthcare system by going to a one payer, government medical plan for everyone.

On the flip side, the Republicans in this case were clearly all talk.   They could complain about how bad Obamacare was (and pretty much everyone agrees it simply will not survive in its current form).   But when time came to do something about it, they couldn’t agree and so they have, in effect, not only saved Obamacare but now are to be held responsible for doing nothing to fix the problems—specifically including the problem, Obamacare, that they said they saw coming for seven years.

Because they campaigned against it so hard for so long, Republicans were going to have to reform healthcare themselves.  They weren’t going to get any Democrats to help.   Republicans in the House voted over half a dozen times to repeal Obamacare when they knew that President Obama would veto it and it would never be repealed.   For the GOP to now come with the opportunity to do exactly what they had done before but this time to have it pass and signed by a President of their own party is without excuse.

Unlike the President, most of us knew that healthcare was a complicated topic.  And Republicans should have already been working on an alternative they could agree on.  When the time came to get something done, there were several areas of disagreement.

Unfortunately, a number of them including a number of Republicans governors fell into the age-old problem of not wanting to give up money once they had it.  Obamacare increased Medicaid spending by hundreds of millions of dollars.  Medicaid is a state administered program and so all of a sudden a lot of governors who were once against Obamacare now thought at least that part of Obamacare shouldn’t be repealed.  As is often the case when spending ‘free’ money (which really means that the money came from someone else so you could have it), opinions changes.  (as a related aside, that’s why many more people are ‘fiscally conservative’ until it comes to talking about money that will help them and then all that changes).

In the case of Medicaid spending, we are talking only on that specific portion of the bills that have been considered and the whole healthcare issue is far more broad.  Yet, on this one topic let’s be clear on two things:  1) help—in this case Medicaid- for people who need it is something everyone can be for at some basic level, and 2) no bill that has come to consideration has cut Medicaid funding, but only increased the funding at a slower rate.   However, let’s also be clear on the massive funding increase.  The expansion of Medicaid is projected to have one in every five people in the country on Medicaid.  Medicaid is designed as a health insurance program for the poor.  If one in five, or 20% of the population of the country, is in poverty then we have much bigger issues.

Of course, when people start saying that you can’t cut funding for this or that part of Obamacare that also means that you have to pay for it.   So the proposed bill also retained a large part of the dozens of new taxes that Obamacare put in place.

So, to be fair, the Senate bill that failed really was open to the criticisms that it wasn’t really very different from Obamacare but just changed some things around the edges.

Most disappointingly to Thinking Man, however, is that none of the proposals would have done one thing that would have affected health care costs immediately, and that is include tort and malpractice reform.   There is no healthcare reform proposal that will significantly impact medical costs without tort and malpractice reform.  Period.

There is a large volume of data that says that lawyers fees and outrageous damage awards increase health care costs dramatically and in several ways.  Doctors and hospitals, worried about getting sued practice ‘defensive medicine’ and order procedures that are unnecessary in all but rare cases.  Damage awards are so outrageous that lawyers advertise and encourage clients to sue because they know that even if they only win a small percentage that the fees they get will make it more than worth their time.

No one would be against victims of malpractice from being compensated for their suffering.   Yet, years ago when Texas was seeing a large shortage of doctors and passed tort reform, which only limited the amount that could be awarded over and above payment for actual expenses and lost wages, medical costs dropped and doctors began moving to Texas rather than leaving.

The bottom line is that any healthcare proposal will involve a series of complicated compromises.  And there may be several things that may help the crisis of Obamacare.  Republicans should have had them ready long ago.  If they lose their majorities in the next election cycle, they will have gotten what they deserved.

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