Self-shackled with a tremendously unpopular overhaul of American medicine that they passed without a single Republican vote, Democrats are now clinging to the hope that voters will offer them a chance to “fix” what they have wrought. For three major reasons, however, that hope is likely to prove futile. One, Democrats have shown no genuine interest in fixing Obamacare. Their talk about fixing it is merely that: a talking point. Two, they have no ideas for fixing it (aside from adding another metal to the list of government-dictated insurance options). Three, and most important, Obamacare isn’t fixable. Like a house that’s horribly designed, shoddily built, and sitting on an uneven foundation, it isn’t something that invites fixing. It invites tearing down, clearing the lot of the debris, and building anew — using the blueprint from the right sort of conservative alternative (one that protects Americans’ existing insurance).
On the third point, Democrats’ “fix-it” rhetoric clashes badly with their earlier assertions about Obamacare. Before passage, Democrats described Obamacare as “comprehensive” legislation, whose complex component parts were so intricately intertwined that making substantial changes to them wasn’t an option. On the eve of the “health-care summit” (where Paul Ryan had a few things to say to President Obama), Health and Human Services Secretary Kathleen Sebelius said, “I think the president remains committed to the notion that we have to have a comprehensive approach, because the pieces of the puzzle are too closely tied to one another.” Such “comprehensive” approaches call out for comprehensive repeal, not piecemeal fixes.
The Affordable Care Act . . . bans insurance companies from discriminating against people with pre-existing conditions. However, unless every American is required to have insurance, it would be cost prohibitive to cover people with pre-existing conditions.
Here’s why: If insurance companies can no longer deny coverage to anyone who applies for insurance — especially those who have health problems and are potentially more expensive to cover — then there is nothing stopping someone from waiting until they’re sick or injured to apply for coverage since insurance companies can’t say no. That would lead to double digit premiums increases — up to 20% — for everyone with insurance, and would significantly increase the cost [of] health care spending nationwide.
So any Democratic “fix” would have to either (a) keep the hated individual mandate in place, (b) remove the ban on “discriminating against people with pre-existing conditions,” or (c) make Obamacare even more expensive. Republicans should ask Democrats which of these three they’d prefer.
The reason Obamacare cannot be fixed is that it is comprehensive. It’s a comprehensive attempt to consolidate power and money in Washington at the expense of Americans’ liberty, funnel much of that money to Obama’s insurance-industry allies, compel Americans to buy those insurers’ products, and send the tab for all of this back to a citizenry that never wanted Obamacare in the first place. How do you tweak that?
In short, the notion of a fix is fanciful. Obamacare is beyond repair. As Yuval Levin wrote shortly after its passage, Obamacare
is not even a liberal approach to escalating costs but a ticking time bomb: a scheme that will build up pressure in our private insurance system while offering no escape. Rather than reform a system that everyone agrees is unsustainable, it will subsidize that system and compel participation in it. . . .
Because Obamacare embodies a rejection of incrementalism, it cannot be improved in small steps. Fixing our health care system in the wake of the program’s enactment will require a big step — repeal of the law.
That’s exactly right. Obamacare can’t be fixed, but the American health-care system can be — and the first step in fixing our health-care system is repealing Obamacare.
— Jeffrey H. Anderson is executive director of the 2017 Project, which is working to advance a conservative reform agenda, including a winning alternative to Obamacare.