Replacing Obamacare

YouTube download / PBS Newshour video / Trump lays out his vision to repeal and replace Obamacare.
 
Stan Escudero / Headline SurferBy STAN ESCUDERO
The Guidepost
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DAYTONA BEACH, Fla. -- Obamacare is falling apart like a decaying corpse.  If nothing is done, within two years at most costs will have escalated to the point where most can no longer use it.  But as it collapses it will also drag down a good part of our health care system with it.

This will come as no surprise to its designers on the Marxist Democrat Left, who always intended for it to fail.  They just wanted it to last long enough to create a sense of entitlement among the several millions who would use its socialized medicine to obtain a greater degree of government-funded health care than they had had in the past.  At that point, the Dems calculated, repeal would become politically impossible.

Believing that Hillary would win the 2017 presidential election, they anticipated that she would replace the failed program with single-payer, government provided health care for everyone except for a very wealthy few (like the Clintons and the Hollywood elite) who would be able to afford boutique health care.   This would have ensured a far more powerful, intrusive government with greater control over all its citizens.

Fortunately for America, Donald Trump and the Republican Party disrupted the Democrats’ scenario.  But the Dems succeeded in part anyway.  The principle of socialized medicine has been conceded.  We will never be able to go back to a health system determined by the market.  The argument at the moment is not whether the government should provide and control health care but rather over the extent of government involvement and how to make that involvement most efficient and cost-effective.

Having rallied the American people to reject Obamacare at the polls last November, GOP lawmakers are discovering that “repeal and replace” is not so simple.  Although Obama rammed the so-called Affordable Care Act down the country’s throat with not a single Republican vote and with the last few Democrat votes gained only via massive corruption, his acolytes were smart enough to lay traps by adding in several costly provisions which would find quick and widespread favor with the people.  These include, among others, preventing insurance companies from denying coverage due to pre-existing conditions, enabling children to remain on their parents’ policies until age 26 and instituting a substantial tax on certain beneficial medical devices. 

Any Republican replacement of Obamacare will have to include at least the first two of these and these provisions are proving to be very expensive.  But House and Senate members will not take the political risks involved in deleting these programs so somehow they will have to be paid for.

The insurance companies cannot afford to offer them without very substantial and politically unpopular further raises in premiums.  The government cannot subsidize these costs without either raising taxes, continuing to try to force the healthy young to buy insurance they do not want or need, or cutting other government expenditures at a time when the new Administration is promising tax cuts, additional spending on defense and infrastructure, and has rejected cuts in middle class welfare such as Medicare or Social Security.  So where will the money come from?

Some can come from increased tax revenues generated by the economic growth which will stem from President Trump’s economic and tax policies but these cannot begin fully to take effect or in some cases even be passed into law until the impact of the replacement for Obamacare is known.  The most likely alternative is to borrow more, which will drive up the deficit and the debt at least for a couple of years, providing the Democrats a basis for attacks on Trump policies in the 2018 election and perhaps encouraging the gradual move away from the dollar as the primary global reserve currency - an increasingly dangerous circumstance.

I do not pretend to have a solution for this series of dilemmas, but I am among those who are disappointed that, having demanded the repeal of Obamacare for eight years, the House Republicans, who would have to originate the replacement bill under the Constitution, have yet to come up with at least an agreed framework for such a replacement. 

My preferred solution would be to return to a market-driven system, recognizing that there will always be some who, through poor planning, bad luck or just plain stupidity, will suffer from lack of health care insurance.  It is the job of government to ensure equality of opportunity, but not equality of attainment.  But that will never happen.  It is already too late for such a Darwinian solution.

What I fear is that the Republican members of Congress, always seeking to avoid responsibility for anything controversial, will give birth to a product which seeks to be everything to all people and succeeds only in failing as badly as that which it replaces.  But this time the GOP will own it.  Should what the media will inevitably come to call “Trumpcare” ultimately fail also, the door will be wide open to the single-payer, government-provided health care system which the Democratic far left has always wanted and American individual freedoms will have been further and perhaps fatally eroded.

What I fear is that the Republican members of Congress, always seeking to avoid responsibility for anything controversial, will give birth to a product which seeks to be everything to all people and succeeds only in failing as badly as that which it replaces.  But this time the GOP will own it.  Should what the media will inevitably come to call “Trumpcare” ultimately fail also, the door will be wide open to the single-payer, government-provided health care system which the Democratic far left has always wanted and American individual freedoms will have been further and perhaps fatally eroded.

Our Representatives in the House, perhaps working with the 33 Republican governors absolutely must get this right, incredibly complicated though it is.  To do so they will have to struggle constantly not just against the political and practical complexities of socialized medicine in a still somewhat capitalist economy, they will also have to fight the constant criticism and obstacles which will be thrown in their way by the left wing media and the Marxists who now control the Democrat Party.  And they must complete their work in time to allow passage of personal and commercial tax reforms as both taxes and health care will have major impacts on the 2018 out year elections. 

This will likely be the most difficult and most significant legislative task which Republicans in both Houses will ever undertake in their lives.  But it must be done.  It must be done right and it must be done soon.

Stan Escudero
March 1, 2017
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Short Bio

The Guidepost By Stanley Escudero
Stanley Escudero is a retired career diplomat, businessman & native Floridian, who lives in Daytona Beach Shores, Florida, with his wife, Jaye. He served as chairman of the Volusia County Republican Executive Committee in 2011-2012. Escudero was appointed to the Daytona State College Board of Trustees in 2015, By Gov. Rick Scott. Escudero, writer of the 'The Guidepost' politcal column since 2010, is a member of the inaugural Class of 2017 Headline Surfer Hall of Fame. All news content copyright-protected intellectual property of NSB News LLC, which may not be duplicated or re-published in whole or in part without advance approval of the publisher. Headline Surfer® is published by award-winning journalist Henry Frederick.