President Obama on Friday joined Vox.com to discuss the Affordable Care Act (also known as Obamacare). He made a number of claims that deserve close scrutiny.
The president said he would support a Republican replacement health law that works better than Obamacare. Insisting “If it works, I’m all for it,” Obama suggested a GOP replacement would need to include certain key components to earn his support. These conditions include affordable prescriptions and coverage of pre-existing conditions, preventative medicine, rural community health coverage and efficient use of government Medicare and Medicaid programs.
During his farewell address Tuesday night, the President reemphasized that pledge saying, “…. if anyone can put together a plan that is demonstrably better than the improvements we’ve made to our health care system – that covers as many people at less cost – I will publicly support it.”
But here’s the catch: President Obama knows that whatever Republicans propose to replace Obamacare, they’re intending to cover a similar number of Americans — at lower costs.
He knows this, because the contours of Republican plans are already public. While there are different GOP health care plans floating around Capitol Hill, the Republican Study Committee (RSC) offers an indicative example of their collective content. As with Obamacare, the RSC plan would cover pre-existing conditions (establishing a 200 percent of average plan price cap on pre-existing insurance plans).
But the RSC would also do things that Obamacare does not. It would allow Americans to buy insurance across state lines, while eliminating prejudicial tax treatment of self-employed and employer health plans. It would also increase cost transparency in the health marketplace. Each of these steps is crucial to lowering costs for consumers.
Still, the RSC proposal is just one of many. Other Republicans are pushing for greater action on the mental health front. And Speaker of the House Paul Ryan (R-Wis.) is focused on giving states far greater control over how they spend federal Medicaid and Medicare funds. Ryan’s approach would make government health programs much more efficient.
That speaks to something more.
While it’s true that the GOP has not finalized a replacement for the Affordable Care Act, it has offered enough collaborative detail to elicit President Obama’s concern. Put simply, I believe Obama knows his signature domestic policy achievement is failing, but he can’t admit it. To do so would be to repudiate his legacy. Consequentially, Obama is doubling down on government control of health care.
Consider two telling comments from the president during his Vox interview. First, he said that the real problem with Obamacare is that it doesn’t go far enough. Obama believes that government subsidies for individual insurance premiums are too small. Second, the president has said the U.S. health care system over-empowers the private sector. These comments matter greatly because Republicans adopt the opposite understanding.
For a start, Republicans believe that more government involvement in health care would be negative not positive. Instead, Republicans believe the market is the key to equitable outcomes.
The problem with government-run health systems is not that their doctors and nurses are less skilled, but that individuals must come second to the bureaucracy. Socialized medical systems fail to mitigate demand for health care because they do not give individuals a personal stake (personal choices and costs). But they also fail to fuel innovation. It is not coincidental, after all, that the newest medical treatments are mostly developed in America.
Yet Republicans also oppose socialized medicine for moral reasons. For one, as Western populations age, we’re seeing what happens in socialized systems. Just look at the United Kingdom. There, patients overwhelm under-resourced hospitals and overworked professionals. Read the stories of elderly Britons dying in hospital corridors and starving in hospital beds. These stories are exceptions, but they occur far more regularly in Europe than in America. Why? Because socialized bureaucracies force professionals to triage their patients.
But don’t take my word on this moral question. Just consider the contrast between how Americans perceive Obamacare and how President Obama perceives it.
In his response, the president simply blamed Republicans for the law’s inadequacies. That suggests Obama would never support a GOP replacement plan
In particular, watch this moment from the Vox interview in which a Kentuckian explains to the president why many Americans dislike his law. He notes how Obamacare deprives Americans of choices while increasing premiums and deductibles. The questioner was passionate and polite. But in his response, the president simply blamed Republicans for the law’s inadequacies. That suggests Obama would never support a GOP replacement plan.
President Obama is right about one thing, however: Republicans will soon own the health care issue. Policy ownership requires honest leadership. America’s health care system was too expensive before Obamacare, and it remains too expensive and inefficient today. And before Obamacare, too many of the poorest and most-ill Americans received inadequate care. To make things better, Republicans will have to unleash the market but also challenge vested interests that manipulate the market (for two, the pharmaceutical export industry and price-colluding hospitals).
But Republicans should also be clear sighted. Obamacare has failed because it puts government before people. The Affordable Care Act’s replacement must turn that principle on its head.
Tom Rogan is a senior contributor for Opportunity Lives, a former panelist on The McLaughlin Group and a senior fellow at the Steamboat Institute. Follow him on Twitter @TomRtweets.