Congressional Republicans are moving forward with their plans to repeal much of the Affordable Care Act, which you know as Obamacare.
We’re told the party is struggling to find a replacement for the law. We shouldn’t buy it. The GOP will eventually find a way to end much of Obamacare and then will cobble together something that looks like a replacement — tax credits to buy insurance, high-risk pools, expanded health savings accounts.
Some people will mourn the passing of Obamacare; others will celebrate. The merits of the decision aside, though, the political impact is clear: By repealing and replacing, Republicans will own the American health care system for the next four years.
They will almost certainly regret it.
President Barack Obama said lots of silly things during his two terms, but his biggest blunder was his promise that Americans could keep their doctors under Obamacare.
The statement was laughable. Insurance companies change coverage plans and physicians all the time.
But the damage was deeper than the consequences of a simple, inaccurate statement. Obama and Obamacare tied the federal government directly to health care. Every medical event, from treatment costs and deductibles to drug prices and premiums, somehow became the federal government’s responsibility.
It was a ridiculous political commitment, doomed to failure. When it failed, Obama and the Democrats took the blame.
But they had also changed the terms of the debate. The cost and quality of health care are now considered government functions, at least as far as voters are concerned.
Republicans aren’t really resisting that idea, which is why they promise to “replace” Obamacare.
Here’s the danger: America’s health care system is a mess, unlike any other goods or services you buy. If you doubt that statement, call the hospital and ask how much it would cost to fix a broken arm. Be prepared to wait.
Health care costs change from insurer to insurer, hospital to hospital, day to day. Your medicine might cost $150 in February and $15 in May. Co-pays and deductibles are wildly inconsistent. Doctors come and go, record-keeping is indecipherable, comparison shopping impossible. Outcomes are mixed.
On top of this disaster, Democrats grafted Obamacare. Once they did, every medical slip-up, every confusing bill, every $10,000 emergency room visit could be blamed on Washington and Obama.
Now Republicans are walking into the same swamp. Replacing Obamacare will make American health care their responsibility. And that’s an impossible place to be.
If premiums or deductibles go up, if choices are reduced, if policies are canceled — well, you won’t have Obama to kick around anymore. If costs go down, the GOP will get and deserve the credit.
Which outcome seems more likely?
Neither party has addressed the real challenge, which is the exorbitant cost of health care services. Until that happens, the finger-pointing will continue — and, in America, it will still cost too much to be sick.