The Political Realities of “Fixing” ObamaCare

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Megan McArdle is well worth a read on why Congressional Democrats designed ObamaCare in the flawed way they did and what the consequent political reality means for Republicans’ likely steps for repeal-and-replace.  Both those who would prefer to save the law and those who would prefer to trample it to dust should consider the political reality.

Option One:

For Republicans to fix the system as it stands, they would have to jack up the parts people hate — not to deliver new benefits, but mostly just to keep the existing system from flaming into a tailspin. Only the price tag would now be much higher, for boring technical reasons I’ll leave in a footnote.

Option Two:

Yet repeal and replace now seems almost as unlikely, because it means taking something away from voters — stuff that polls really well, such as, er, prohibiting insurers from looking at pre-existing conditions.

Option Three:

Of course, the last option — doing nothing while the individual market flames into a tailspin — doesn’t look all that hot, either.

McArdle states that she’d probably go with a variation of the third:

I’d announce a blue-ribbon commission designed to study the matter and propose a comprehensive alternative. I’d give it plenty of time to study and make recommendations. Then I’d wait and see if 2017 brings more premium hikes and insurers pulling out of smaller counties — disasters that could then be blamed on Obama…

The key point, here, is that we’re in this situation — with our healthcare system, economically, and politically — because President Obama and his fellow partisans who controlled both chambers of Congress felt they had to, and had the power to, push through something big (as the vice president put in vulgar terms at the time).  But the American people didn’t want what the Democrats were pushing, so a party-line Congress created a system destined to fail and hoped its failure would teach Americans to want the socialized medicine that the party wanted to provide.

November made that possibility so unlikely that McArdle doesn’t even mention it.



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