Obamacare isn’t just bad policy; it’s also a lost opportunity to advance positive health-care reforms. This is a critical point for the public to understand as the Supreme Court considers Obamacare’s constitutionality, and as we begin a presidential election in which the future of the health-care system will be a central issue.
The debate isn’t between Obamacare and the status quo. No one thinks our current system is optimal. It’s inefficient and costly, it encourages the over-consumption of care, and it unfairly disadvantages those who don’t receive insurance through their employer. The question is which direction we should go. Should we follow Obamacare’s path of greater government control or find a different way to encourage greater efficiency, control costs, and improve outcomes?
If Obamacare is struck down or repealed, policymakers should move quickly to reform our health-care system in a way that returns the control of resources to individuals and creates a more competitive health-insurance marketplace. For starters, they should equalize the tax treatment of individual and employer-sponsored health insurance.
But to really reform our medical system, policymakers will have to tackle Medicare, because it shapes the medical system as a whole. Congressman Paul Ryan and Senator Ron Wyden have laid out a blueprint for reforming Medicare that would be a giant leap in the right direction.
Let’s hope that Obamacare is quickly laid to rest so we can begin the important national conversation about these next steps.
— Carrie Lukas is the managing director of the Independent Women’s Forum.
THOMAS P. MILLER
Repealing Obamacare is necessary to preserve individual liberty, maintain limited government, improve health care, and restore economic growth. Prospects for doing so hinge on a half-dozen key battle fronts, and success thereafter hinges on several, if not all, of them.
Legal: The Supreme Court could overturn the entire Affordable Care Act later this year as unconstitutional. That’s possible, but not likely. But even a partial victory — simply nullifying the individual mandate — would unravel the political glue that holds this unwieldy and unworkable law together. Congress would have to fix or replace whatever remained.
Political: It will take a new president to sign any law to repeal Obamacare, let alone replace it with better health policy. This November’s elections also will determine whether Obamacare opponents regain working control of the Senate.
Legislative: Fully repealing the entire health-care law would require 60 votes in the Senate. But a budget-reconciliation measure could remove its essential features (“debone it”) with only a narrow majority in both houses of Congress.
Administrative: Obamacare’s complex wiring for implementation could short-circuit on its own and threaten to crash most of the health-care system. Many states are refusing to submit to federal command and control. Imaginary structures and lab experiments (health exchanges, real-time income information, Washington-created “innovations”) won’t be ready for prime time. By necessity, we will have to build something else that is effective, cheaper, and sustainable.
More appealing alternatives: The time to fill in a “replace” agenda is long overdue. Good ideas exist, but they need to move from the imaginary to the practical stage and hang together as a whole.
Timing: Repeal-and-replace needs to happen before new subsidy dollars under Obamacare start flowing to millions of Americans in 2014. Our future health and prosperity can’t afford further doses of toxic medicine for another four years.
— Thomas P. Miller is resident fellow at the American Enterprise Institute.