Jeb Bladine: ‘Repeal and replace’ has a faulty premise
I’ve never been a big fan of the Affordable Care Act as America’s health care solution, partly because it so significantly complicated administration of our company health plan, and also because it did nothing to reduce costs. We all should take an interest in the current “repeal and replace” debate about so-called Obamacare.
Snippets of that debate can be humorous. President Donald Trump, for example, provided comic relief from the dead-serious national discussion when he spoke to a meeting of the nation’s governors at the White House: “We have come up with a solution,” he assured his audience, “that’s really, really, I think very good.”
That was typical Trump bravado, since there is no solution ready for prime time. Republicans in Congress are arguing over broad ideas for using either tax credits or tax deductions to help Americans purchase health insurance, but the details of any health care plan are far from vetted.
Trump continued with a comment that left my mouth agape: “Now, I have to tell you, it’s an unbelievably complex subject. Nobody knew health care could be so complicated.”
Well, like most people, I knew long ago health care is complicated beyond belief, and from what I’ve read about possible replacement plans, it won’t suddenly become simple and straightforward.
We haven’t prepared for an assault on Medicare from the population bulge of Baby Boomers now in their 70s. We have allowed partisan politics to run amok for decades, never focusing on the core needs and challenges of quality health care.
Unfortunately, the rush to enact one group’s “solution” is likely to go astray due to false premises and unintended consequences.
Writing last month in the Conservative Review, attorney Daniel Horowitz said the idea of manipulating a few policies to replace Obamacare is “built upon an erroneous premise … that it must be replaced with something similar.”
When government enacts complex regulations, there always are unintended consequences. Horowitz argues that we should repeal Obamacare, eliminate mounds of regulations, and depend on the marketplace to expand health care access and affordability through innovation and competition.
I agree with Horowitz that “repeal and replace” is based on wrong assumptions, but I don’t share his confidence in the private insurance marketplace. The United States stands almost alone as a developed, wealthy society without some form of universal health care.
We’re going to arrive there eventually, so we might as well start now.
Jeb Bladine can be reached at email@example.com or 503-687-1269.