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by
Rick Moran

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October 20, 2013 - 6:41 am

Ross Douthat has written an interesting “after Obamacare meltdown” scenario that seems to me far more likely than Democrats trying to get a single-payer system through a Republican House or even past the Senate with 60 votes.

But if the fix-it effort moves too slowly, it’s possible to envision a worst-case scenario unfolding. If the Web site doesn’t work soon, even liberals concede that the mandate would have to be delayed, because you can’t very well fine people for failing to buy a product they can’t access. And that combination — a hard-to-navigate online portal and no penalty for staying uninsured — could effectively discourage all but the most desperate customers from shopping, which in turn would create an unsustainably expensive insurance pool, driving prices up and driving people away, and potentially wrecking the entire individual insurance market in short order.

If this happens, there will be a lot of schadenfreude on the right at the spectacle of technocratic failure. But the wreck of the exchanges may actually be worse for conservative policy objectives than a more successful rollout would have been.

That’s because while conservatives think the Obamacare exchanges are overregulated and oversubsidized, they are actually closer to the right-of-center vision for health care reform than the Obamacare Medicaid expansion, which is happening no matter what transpires with Healthcare.gov. So if the exchanges fail and the Medicaid expansion takes effect (and, inevitably, becomes difficult to roll back), we’ll be left with an individual market that’s completely dysfunctional and a more socialized system over all.

In that scenario, the Democratic Party would probably end up pushing, not for the pipe dream of true single payer, but for a further bottom-up/top-down socialization, in which Medicare is offered to 55- to 65-year-olds and Medicaid is eventually expanded even more.

Meanwhile, the task for serious conservative reformers — already not the most politically effective bunch — might actually become harder, because they would have to explain how their plan to build an effective, exchange-based marketplace differed from the Obama White House’s exchange fiasco.

So while Republican politicians may be salivating over a potential Obamacare crisis, the conservative policy thinkers I know are not. They’re hoping, as I’m hoping, that this isn’t as bad as it looks. The chance to say “I told you so” is always nice, but not if the price is a potentially irrecoverable disaster.

The problem with the “set up to fail” conspiracy theory — aside from the fact that dozens of HealthCare.gov website contractors, HHS employees, and White House officials would all have to be involved and presumably sworn to silence — is the same one that Republicans had in trying to defund the law: it’s impossible to get through Congress. No Republican is going to vote for a single-payer system, nor would they support, as Douthat suggests, an expansion of Medicare. Obama and the Democrats are stuck with what they have and if it proves to be impossible to implement, it is extremely unlikely that Republicans will support further top-down, pseudo-socialist measures to fix it.

This is why it would behoove the GOP to have, at the ready, a concrete, modest proposal to introduce in both Houses after the president delays the individual mandate: a repeal of certain sections of Obamacare in order to substitute far more realistic and workable, market-based solutions to the health insurance problem.

Most Republicans would have no problem expanding the healthcare savings accounts, or allowing insurance companies to sell across state lines, or allowing companies to offer far more than the idiotic four plans that Obamacare pushes as “choice” for consumers. Carefully crafted tort reform would also meet with a lot of Republican support. Risk pools at the state level — a GOP idea — could help get coverage for the chronically ill. There may be some Republicans willing to support an expansion of Medicaid to cover the truly poor — not those making a whopping 133% above the poverty line.

And no Republican would oppose getting rid of the individual mandate.

It’s not “comprehensive” reform, but such nonsense shouldn’t have been attempted in the first place. The problems with inadequate coverage, lack of coverage, and inability to get coverage would begin to be addressed — not all at once in a coercive and wildly expensive “reform” package, but in a prudent, responsible, gradual manner that recognizes problems with the health insurance system did not happen overnight and the solutions to it aren’t going to be found by waving a magic government wand over 1/6 of the economy and proclaiming the problem solved.

President Obama was fond of lying about GOP ideas for health insurance reform during the debate over Obamacare, saying Republicans had no proposals of their own. It’s time to expose the president’s lies and craft a genuine market-based approach to health insurance that the American people could support while avoiding the quicksand that has engulfed Obamacare.

Rick Moran is PJ Media's Chicago editor and Blog editor at The American Thinker. He is also host of the"RINO Hour of Power" on Blog Talk Radio. His own blog is Right Wing Nut House.

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Top Rated Comments   
Douthat is wrong. The infrastructure for private exchange system already exists. It would be easy for Amazon, Kayak, Priceline or similar sites to add health insurance to their product lines. It would only take a stroke of a pen from the regulators. It wouldn't even take a change in the law. A private exchange system is much simpler than healthcare.gov. It only has to match buyers and sellers. There are no regulations to consider. If some people have their panties in a bunch about healthcare for the poor than they could develop a voucher program to give a subsidy to the poor. This system could easily replace both medicare and medicaid for far less money. Paul Ryan has already proposed such a system to medicare to the hoots and boos from the Democrats.

There are many reasons why the Democrats don't like the idea presented above, not least is the belief in the "You didn't build that" social philosophy. They thought it would be snap to develop a web interface because the government can build anything better than the private sector. It is just a matter of accounting and control as a famous socialist leader once put it. Well, that leader, Lenin, didn't live long enough to see that mere accounting and control is the least of it.
40 weeks ago
40 weeks ago Link To Comment
>>"It’s time to expose the president’s lies and craft a genuine market based approach to health insurance that the American people could support"

It's long past time for this. Romney should have totally disavowed Romneycare, claimed he'd learned valuable lessons demonstrating he had humility and capacity to "grow and learn," offered a truly patient-centered, common-sense and market-based plan as the key platform in his campaign, and attacked Obamacare relentlessly. But Romney was a politically tin-eared coward, and there you go.
40 weeks ago
40 weeks ago Link To Comment
In other words, Rick, the Defund Obamacare approach was right all along.

It was the Establicans who argued that Obamacare should be left alone to fail under its own weight.

Anyway, a conservative reform approach would be to have medical "insurance" operate like every other form of insurance known to man: you only use it when something major happens. And anyone who uses it otherwise does so at their own risk.
40 weeks ago
40 weeks ago Link To Comment
All Comments   (48)
All Comments   (48)
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To get rid of obamacare there are only two choices. Either vote for a Democrat who swears to oppose it or vote for a Republican who swears to oppose it. For those citizens who refuse to vote you are requesting that you be taxed to support others and you will still have to buy your own health insurance. This is nothing more than a Ponzi scheme brought to you by a Chicago punk.
40 weeks ago
40 weeks ago Link To Comment
Do the progressive Dems, and for that matter Repubs clamoring for repeal, understand that the inherent structure of the ACA legislation is the foundation for a virtual, intra-state, free-market health insurance platform? Well, it is.

And thanks to Chief Justice John Roberts, legislative modifications may be made with a simple majority in the House and Senate because the ACA has been adjudicated as tax legislation. It's exempt from Senate filibuster.

Modifying the ACA in a way that essentially privatizes the entire endeavor (more accurately, contracts out to the private sector) would not be difficult. Tax penalties can be reduced to a flat annual fee, and the mandate then rendered meaningless.

It's even possible a simple additional regulatory clause opening plan design to the market might not even need legislative approval..."the Secretary of HHS SHALL, at their discretion..." Such bureaucratic power cuts both ways, no?

Of course, this would be easiest if a Republican won the White House in 2016. If that happens, even if Repubs do not control both the House and the Senate, perhaps it would be possible to find a Dem or two to join a majority.

SO, instead of the Republicans digging a deeper hole for themselves by shutting down government and wasting valuable political capital on what currently is a Sisyphean task, the smart move is to focus instead on winning seats in 2014 and/or the White House in 2016, then using the existing legislation to craft a true market-based platform.
40 weeks ago
40 weeks ago Link To Comment
The "exchanges" need to offer a true "market basket" of features allowing each and every consumer to fashion their own, unique plan - not the one-size-fits-no-one that the Progs attempt to cram down your throat.
40 weeks ago
40 weeks ago Link To Comment
"you can’t very well fine people for failing to buy a product they can’t access."

Tell that to the energy industry people who have to pay fines for not meeting ethanol mandates for a supply that doesn't exist.
40 weeks ago
40 weeks ago Link To Comment
Funny you should bring that up.
40 weeks ago
40 weeks ago Link To Comment
Secondarily, as to implementation of the ACA, it may be,(not that we may safely leave it to chance), that it will follow the history of Prohibition, and die simply because a large portion of our populace will ignore it. If millions of citizens do nothing at all about it, how will those millions be dealt with? Will their Social Security be confiscated- so they can go on Welfare and Medicaid and thus receive unlimited, free, medical care? So they can visit the Emergency Room daily, and run their bills up to the tens of thousands per month? And multiply that when the welfare mama brings her six illegitimates to have their runny noses wiped? The obamanites are stupid, but not so stupid that even they can't see the necessary consequences of their boondoggles. Therefore, the ACA and similar catastrophes are deliberate; intentional attempts to destroy our economy and vitiate our freedoms egregiously.Within a legal and moral context we must cry out, "off with their heads" and put an end to the communization of our America!
40 weeks ago
40 weeks ago Link To Comment
No, no, no! First, our Constitution does not authorize Government to meddle with health care. Ergo, the Tenth Amendment precludes it from doing so. We must repeal the so-called Affordable Care Act, (it is not affordable), and let the free market dictate the cost and availability of healrhcare. If individual states wish to subsidize their citizens, that is their business. But entities such as medicare and medicaid should never have been manufactured and must be laid to rest. In our experience most of the recipients of governmental handouts are frauds who could pay their own way or be supported by family or churches, etc. And many of the medical professionals who treat them are also tincuppers, charging often for services never rendered or unnecessary. Government promotes such theft by paying only a small portion of the amount charged, and paying even that little bit many months after the service has been rendered.
Anyone who supposes that adding the cost of healthcare for tens of millions to the present cost and then adding the cost of governmental operation of the program will not increase the overall cost is not smart enough to vote pro or con. Either that or not moral enough to acknowledge the truth that we workerbees cannot afford to subsidize the tincuppers, especially when we cannot afford medical care for our own families.
40 weeks ago
40 weeks ago Link To Comment
Another call for a slower path to socialism. There is always going to be a way to make a case such as Moran makes. Always a rationale for a slower pace to socialsim.
If that's his standard of what is best or possible then part company we must do. What is at stake is the entire American experiment.
40 weeks ago
40 weeks ago Link To Comment
If the USSR were alive and well today the ACA might have been theirs - and healthcare.gov may well have been their website. When I read about people trying for hours on end to enrole I'm reminded of those b&w pictures of bent figures in a long line in the snow on a dark damp evening somewhere in the USSR - waiting as a state-run shop slowly grinds out the day - serving the patronage in their inept uncaring manner - impervious to thoughts of moving faster to serve better the customer.

Kind of feels like the USSR took over our Dept of Motor Vehicles doesn't it?

But this isn't the USSR - this is America and Americans expect more from businesses and the .gov websites we use on a daily basis with little or no problems. What they are getting from the ACA and healthcare.gov is USSR-esk - both in service and product. Shoddy - just shoddy. Americans expect better - we are better.


40 weeks ago
40 weeks ago Link To Comment
Hey Moran, the 'republicans' who attacked Cruz so maliciously have probably positioned themselves to gain financially from Obamacare....wouldn't that be a hoot if some really slick ,uh, "journalist" were to discover that tidbit of info? Anyway, Cruz's attackers otherwise are just completely 'gut'-less and always seem to want to 'really' fight at some later date, not now, but always later...and this time they 'promise' you we'll 'really' take it to them (democrats), but they never do....why? I am just cynical enough to believe it's either 1) they're crooked as snakes, and thieves to boot, and have found a way to make money from their votes, or 2) they really are poossies who are too scared to buck their masters (party leaders/lobbyists...same thing). Many of us are simply tired of the same old sh!t and want someone to stand and fight, not compromise our freedom, not negotiate our liberty, but fight and defend them both.

Remember BENGHAZI!
40 weeks ago
40 weeks ago Link To Comment
Heritage has admitted that promotion of an individual mandate was THE most flawed position in their history. Personal responsibility via health insurance sounded Conservative, but forced participation made them rethink their position. Rightfully so.
40 weeks ago
40 weeks ago Link To Comment
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