One of the key questions at the heart of the shutdown debate is: Has the Obamacare train left the station? The president has the signature he’ll show you to insist so. But others beg to differ. Others want better. Among them is Sally C. Pipes, president of the Pacific Research Institute and author of the new Encounter Broadside, The Cure for Obamacare. Pipes talks to National Review Online’s Kathryn Jean Lopez about her prescription and the future.
KATHRYN JEAN LOPEZ: What’s the best answer to the question of what Obamacare means for the life of America?
SALLY C. PIPES: Obamacare has just celebrated its three-and-a-half-year anniversary. This is the federal government’s largest entitlement program since President Johnson’s Great Society, which he introduced in 1965. That was the year that Medicare and Medicaid were born.
Obamacare puts more control of our health-care system in the hands of the federal government. It is a program that moves this country on a clear path to European socialism.
It is my belief that Obamacare will not lead to universal coverage or bend the cost curve down. In fact, the CBO has recently announced that 33 million Americans will still be uninsured in 2023 and the cost from this year to 2022 will be $1.8 trillion, double the original estimate and the president’s goal of $900 billion over ten years.
The ultimate goal of the president and Senate majority leader Harry Reid is a Canadian-style single-payer “Medicare for All” system. The Senate majority leader made that clear during his PBS interview on August 10.
This is not the type of health-care system that Americans want. It is clear in the polls. They want affordable, accessible, high-quality care, but not the long waiting lists and rationed care that will inevitably result if Obamacare is not repealed and replaced.
LOPEZ: What’s actually happening today?
PIPES: October 1 is the day that the state exchanges are supposed to open, where individuals and small businesses can enroll for purchasing health insurance.
As it happens, only 14 states and D.C. decided to operate their own “marketplaces,” while 36 states have given the federal government either on their own or in partnership with a state the power to establish the exchanges.
It is noteworthy that some states — Colorado, Oregon, and D.C. — have announced delays. I predict many more delays will be announced today. And the small-business exchange — SHOP — will have only one plan available this year, and enrollment is delayed one month so far.
LOPEZ: When will people really feel it?
PIPES: I think people will immediately start to feel what Obamacare means for their health care. They will find the exchanges very complicated and coverage expensive. It will be very upsetting when those who lose their employer-based coverage find out not only the cost but also that they probably won’t have access to the same doctors and hospital networks that they had before. Even though the employer mandate has been delayed one year, many large companies are already moving employees to part-time status so they won’t have to provide coverage, ending spousal coverage for those who have access to coverage under their own employment, and shifting workers into private exchanges like those being offered by Towers Watson and Aon Hewitt.
So much for president’s oft-repeated statement that “if you like your insurance and you like your doctor, nothing will change.” Things are changing and the American people will be upset.
LOPEZ: What can people forced onto the exchanges today reasonaly expect?
PIPES: Premiums in the exchanges in most states will be a lot more expensive than they had been led to believe. A state like New York may show a slight reduction in the cost of an individual plan, but that is because New York State has a very dysfunctional and small individual market.
The “young invincibles” are the key to Obamacare’s exchanges’ surviving. If they do not sign up in large numbers and instead opt to pay the individual-mandate penalty of $95 or 1 percent of income starting January 1, 2014, it will hard for insurers to stay in business in the exchanges — because the older and sicker enrollees will have a lot more claims than premiums will cover.
The president and the administration are well aware of this problem and that is why they are spending millions on ads to attract young people. I don’t think it will work.
LOPEZ: Is there really any point trying to defund and further delay aspects of it?
PIPES: My ultimate goal is “repeal and replace,” but this cannot be accomplished as long as President Obama is in power. On “defund and delay,” I think it is important to continue to make the American people aware of this terrible law and what it means for their health care. Discussing options for delay is a very important part of our message today.
Recent polls show that awareness about the exchanges’ opening is very low. The Commonwealth Fund’s poll showed that only 2 in 5 adults are aware of the exchanges. A recent Kaiser Family Foundation poll revealed that nearly three-quarters said they were very or somewhat concerned that they would pay higher prices for coverage under Obamacare. This is not what the president promised. He said over and over again that the average family would see its premium decline by $2,500. This was refuted by the Congressional Budget Office.
LOPEZ: What is the cure for Obamacare?
PIPES: My cure is in my Encounter Broadside The Cure for Obamacare. We need a health-care plan that empowers doctors and patients, not the federal government.
My plan focuses on:
Changing the federal tax code so that individuals can also purchase coverage with pre-tax dollars;
Providing a refundable tax credit for those who need assistance and who don’t have employer-based coverage;
Expanding the availability of Health Savings Accounts;
Allowing the purchase of insurance across state lines;
Encouraging state-level medical-malpractice reform;
Reforming Medicare and Medicaid;
Eliminating the Electronic Health Record mandate; and
Eliminating the Essential Benefit mandate.
Adopting such a plan will lead to universal coverage and lower costs.
LOPEZ: Who else is prescribing an effective cure?
PIPES: There are many scholars and politicians who are articulating plans similar to mine. They include politicians like Dr. Tom Price, Dr. Tom Coburn, Paul Ryan, Steve Scalise, and Phil Roe, to name a few. Think-tankers like Grace-Marie Turner, Tom Miller, Avik Roy, Ramesh Ponnuru, and others all have good plans.
The American public needs to support politicians who endorse market-based reforms. Education is key.
LOPEZ: Does your cure have any shot?
PIPES: My plan and others by those I have mentioned do have a shot, but only if the Republicans take the presidency, keep the House, and take the Senate in 2016. Then, early in 2017, repeal-and-replace legislation could be introduced and passed.
If not, we will be on the “Road to Serfdom” and there will be no off ramp.
LOPEZ: Where would you have people refocus today, as the law is in the news?
PIPES: We need to focus on the failures of Obamacare and then put forward a replacement agenda so people can see that there is a better way. Just saying “No” is not a solution.
LOPEZ: What should people ask lawmakers — local, state, and national?
PIPES: Lawmakers at all levels need to hear from their constituents that they do not want government making decisions for them. Individuals and families should be making decisions about how best to live their lives. It is this philosophy that built this great nation. Let’s build upon it, not destroy it.
– Kathryn Jean Lopez is editor at large of National Review Online.