As Congressional Republicans continued to debate whether to repeal ObamaCare with something good, something ok, or something bad, it might be a good time to look back at Ron Paul's columns "The Right Lessons from ObamaCare Meltdown" and "ObamCare's Best Alies: The Court and the Re
The decision of several major insurance companies to cut their losses and withdraw from the Obamacare exchanges, combined with the failure of 70 percent of Obamacare's health insurance “co-ops, ” will leave one in six Obamacare enrollees with only one health insurance option.
If Obamacare continues on its current track, most of America may resemble Pinal County, Arizona, where no one can obtain private health insurance. Those lucky enough to obtain insurance will face ever-increasing premiums and a declining choice of providers.
Many Obamacare supporters claimed that the exchanges created a market for health insurance that would allow consumers to benefit from competition. But allowing consumers to pick from a variety of government-controlled health insurance plans is not a true market; instead it is what the great economist Ludwig von Mises called “playing market.”
Unfortunately, if not surprisingly, too many are drawing the wrong lessons from Obamacare’s difficulties. Instead of calling for a repeal of Obamacare and all other government interference in the health care market, many are calling for increased penalties on those who defy Obamacare’s individual mandate in order to force them onto the exchanges.
Others are renewing the push for a “public option,” forcing private companies to compete with taxpayer-funded entities and easing the way for the adoption of a Canadian-style single payer system. Even those working to restore individual control over health care via tax deductions, credits, and expanded health savings accounts still support government intervention in order to provide a “safety net” for the poor.
Of course, everyone — including libertarians — shares the goal of creating a safety net. Libertarians just understand that a moral and effective safety net is one voluntarily provided by individuals, religious organizations, and private charities. Government has no legitimate authority to take money from taxpayers to fund health care or any other type of welfare program. Government-run health care also does not truly serve the interest of those supposedly “benefiting” from the program.
Anyone who doubts this should consider how declining reimbursements and increasing bureaucracy is causing more doctors to refuse to treat Medicaid and Medicare patients. Medicaid patients will face increasing hardships when, not if, the US government's fiscal crisis forces Congress to make spending cuts. When the crisis comes, what is more likely to be cut first: spending benefiting large corporations and big banks that can deploy armies of high-powered lobbyists, or spending benefiting low-income Americans who cannot afford K Street representation?
Contrary to myth, low-income individuals did not go without care in the days before the welfare state. Private, charity-run hospitals staffed by volunteers provided a safety net for those who could not afford health care. Most doctors also willingly provided free or reduced-price care for those who needed it. The large amount of charitable giving and volunteer activity in the United States shows that the American people do not need government's help in providing an effective safety net.
The problems plaguing the health care system are rooted in the treatment of health care as a "right." This justifies government intervention in the health care marketplace. This intervention causes increasing prices and declining quality and supply. Ironically, those who suffer most from government intervention are the very people proponents of these programs claim to want to help. The first step in restoring a health care system that meets the needs of all people is to start treating health care as a good that can and should only be provided via voluntary actions of free people.
By ruling for the government in the case of King v. Burwell, the Supreme Court once again tied itself into rhetorical and logical knots to defend Obamacare. In King, the court disregarded Obamacare’s clear language regarding eligibility for federal health care subsides, on the grounds that enforcing the statute as written would cause havoc in the marketplace. The court found that Congress could not have intended this result and that the court needed to uphold Congress’s mythical intention and ignore Obamacare’s actual language.
While Obamacare may be safe from court challenges, its future is far from assured. As Obamacare forces more Americans to pay higher insurance premiums while causing others to lose their insurance or lose access to the physicians of their choice, opposition to Obamacare will grow. Additional Americans will turn against Obamacare as their employers reduce their hours, along with their paychecks, because of Obamacare’s mandates.
As dissatisfaction with Obamacare grows, there will be renewed efforts to pass a single-payer health care system. Single-payer advocates will point to Obamacare’s corporatist features as being responsible for its failures and claim the only solution is to get the private sector completely out of health care.
Unfortunately, many Republicans will inadvertently aid the single-payer advocates by failing to acknowledge that Obamacare is not socialist but corporatist, and that the pre-Obamacare health care system was hobbled by government intervention. In fact, popular support for Obamacare was rooted in the desire to address problems created by prior government interference in the health care marketplace.
Republicans also help the cause of socialized medicine by pretending that Obamacare can be fixed with minor reforms. These Republicans do not understand that replacing Obamacare with “Obamacare Lite” will still leave millions of Americans with inadequate access to quality health care, and could strengthen the movement for a single-payer system.
Republicans’ failure to advocate for a free-market health care system is not just rooted in intellectual error and political cowardice. The insurance industry, the pharmaceutical industry, and the other special interests that benefit from a large government role in health care are just as — or perhaps even more — influential in the Republican Party as in the Democratic Party. The influence of these interests is one reason why, despite their free-market rhetoric, Republicans have a long history of expanding the government’s role in health care.
Those who think a Republican president and Congress will enact free-market health care should consider that the last time Republicans controlled Congress and the White House their signature health care achievement was to expand federal health care spending and entitlements. Furthermore, Richard Nixon worked with Ted Kennedy to force all health care plans to offer a health maintenance organization (HMO). Even Obamacare’s individual mandate originated in a conservative think tank and was first signed into law by a Republican governor.
Instead of Obamacare Lite, Congress should support giving individuals direct control over their health care dollars through individual health care tax credits and expanded access to health savings accounts. Other reforms like long-term group insurance could ensure that those with "pre-existing conditions" have access to care. Another good reform is negative outcomes insurance that could help resolve the medical malpractice crisis.
America’s health care system is just as unsustainable as our foreign policy and our monetary system. At some point, the financial and human costs of Obamacare will prove overwhelming and Congress will be forced to replace this system. Hopefully, before this happens, a critical mass of people will convince Congress to replace Obamacare with a truly free-market health care system.