Alternatives to ObamaCare

As ObamaCare falls apart and the public grows increasingly grouchy, President Obama has tried to head the defund and repeal movements off by claiming they don’t have any alternatives to offer.  This segues into the usual hackneyed slander about how Republicans just want to take away health care and watch people die.  That’s not hyperbole.  As recently as two weeks ago (before he nipped off for his fourth luxury vacation of the year), the President declared at a press conference, “The one unifying principle in the Republican Party at the moment is making sure that 30 million people don’t have health care.  Why is it that my friends in the other party have made the idea of preventing these people from getting health care their holy grail? Their number one priority?”

Of course, Obama conveniently leaves out that we’ll still have 30 million uninsured under his plan, too.  And that comes straight from the nonpartisan Congressional Budget Office, not a conservative think tank.  ObamaCare costs trillions of dollars, kills countless jobs, jacks up the price of insurance for most Americans… and leaves us right back where we started, as far as the uninsured population is concerned.  The net effect mostly consists of slightly rearranging the deck chairs on the S.S. Uninsured America, which is a lot like the Titanic, except passage is far more expensive, and booking a ticket is mandatory.

It’s always been untrue to claim there are no Republican alternatives.  But it’s also not good enough for the defunders and repealers to point at individual suggestions from years gone by to defend themselves against charges of legislative vandalism.  That’s no way to win a messaging war.  And we do need to plan for the post-ObamaCare world.  God knows the Democrats have, although they only like to discuss their plans in front of socialized medicine enthusiasts.  Instead of allowing the Affordable Care Act to run its course and destroy the insurance market as planned, paving the way for the bloody death-spiral nightmare of single-payer nationalized medicine, Republicans need a unified message to rally the great diaspora of ObamaCare refugees – from small business owners to unionized workers.  The GOP must be able to say, “First we repeal ObamaCare, or neutralize it until we’ve got a Republican in the White House… and then we do this.

We need one alternative plan, presented with one united Republican voice, kept simple and easy to explain, taught backwards and forwards to every elected Republican, every 2014 candidate, and every 2016 presidential hopeful.  (The latter group doesn’t necessarily have to sign on to the plan in its entirety, but they should understand it well enough to avoid interfering with the Party’s harmonized messaging.)

Sally Pipes, writing at the Washington Examinerexcerpts her book The Cure for ObamaCare to offer some good suggestions.  Most of what she proposes has been around for a long time, which is good.  Republicans can draw on the rich history of discussion about these ideas, going back to well-written think tank proposals from the pre-ObamaCare era for research and sound arguments.  It also helps to present the public with a package of ideas they’ve heard about before.  It’s a plus – a big plus – that many of the waypoints on a road map like the one Pipes presents will sound familiar to them.  “Yeah, why don’t we decouple health insurance from employment, and let insurance companies compete across state lines?” they will say.  That kind of reaction should be music to Republican ears.

The GOP shouldn’t be shy about co-opting arguments from the Left, either.  For example, plenty of Democrats have railed against the way insurance is treated as an employer-provided benefit, rather than a product purchased and owned by the insured.  They’re usually all in favor of using tax credits to promote desirable social ends, which is another of Pipes’ suggestions for improving access to health insurance.  Quote them.  Draft them into the ObamaCare Alternatives movement.  Some Democrats will become very angry at this.  Good.  Savor their anger, and use it to expose their hypocrisy and blind allegiance to Barack Obama.  You want them to end up on talk shows, explaining why they didn’t really mean anything they said before 2010, and are now totally committed to keeping ObamaCare alive, no matter how bad it gets.

Another of Pipes’ ideas is to “scrap the essential health benefits mandates that require all policies to cover a battery of health services,” since they can “raise the cost of insurance anywhere from 10 to 50 percent.”  This cuts right to the heart of the complaint raised by everyone from college students, to union members, to the residents of states where insurance was relatively affordable before the “Affordable Care Act” jacked up their premiums.

It will resonate especially well with healthy young people, who want to buy the kind of inexpensive, flexible insurance coverage that ObamaCare made illegal.  Every Republican discussion of ObamaCare alternatives should be tailored to remind young people that ObamaCare is a trap for them.  It’s designed to pick their pockets for funding, turning the fundamental concept of “insurance” as the sale of risk on its head, by dumping the highest net cost on the youngest, healthiest people.  This argument gets the attention of young voters, for both logical and emotional reasons.  They’re sick and tired of finding themselves indentured to generational redistribution programs, and they desperately need the jobs ObamaCare is killing.

Pipes recommends increased funding for high-risk insurance pools, which were “functioning well in many states before ObamaCare – providing coverage to those with pre-existing conditions, without raising premiums for everyone else.”  Separating high-risk health care consumers – whose needs are not well-described by the term “insurance” – from those with more traditional insurance needs is vital.  The American people are rightly weary of mixing costs and benefits into a thick grey socialist sludge that no one understands, and which tends to consume resources far out of proportion to the results it delivers, thanks to incompetence and fraud.  It’s foolish to raise everyone’s premiums and then subsidize almost everyone, completely obscuring the relationship between dollars spent and value provided.  High-risk consumers need help.  Give it to them, above the table, and let everyone else enjoy the fruits of fair competition and reasonable risk calculations.

The Republicans need to give people something to vote for, now that the ObamaCare disaster has given them something to vote against.  That’s how you close the deal with voters.  Offer them something that vulnerable Democrats will be afraid to oppose.  Make opposition painful.  You’ll know it’s working when Democrats are howling with despair about how they’ve been checkmated by “unfair” Republican arguments that force them to oppose liberty, individual responsibility, freedom of choice, and capitalism.

Despite all the myth-making about his fabulous oratorical skills, President Obama is a coward who only speaks in front of rigged audiences he knows he can count on for applause.  He’s got a particular fondness for young student crowds.  Let’s put him in front of some student audiences and make him explain why they can’t escape from ObamaCare, the way Congress did.  Let’s make him explain why the students can’t have a Republican alternative that would lower their premiums, make them the owners of their own competitive health care plans, and actually do something meaningful about the number of uninsured Americans.  Let’s see this alleged Constitutional scholar tell young people why he won’t support health care reforms consistent with American law and values, instead of forcing America to change in order to keep the Affordable Care Act alive.