By ruling for the government in the case of King v. Burwell, the Supreme Court
once again tied itself into rhetorical and logical knots to defend Obamacare.
In King, the court disregarded Obamacare's clear language regarding eligibility
for federal health care subsides, on the grounds that enforcing the statute
as written would cause havoc in the marketplace. The court found that Congress
could not have intended this result and that the court needed to uphold Congress's
mythical intention and ignore Obamacare's actual language.
While Obamacare may be safe from court challenges, its future is far from
assured. As Obamacare forces more Americans to pay higher insurance premiums
while causing others to lose their insurance or lose access to the physicians
of their choice, opposition to Obamacare will grow. Additional Americans will
turn against Obamacare as their employers reduce their hours, along with their
paychecks, because of Obamacare's mandates.
As dissatisfaction with Obamacare grows, there will be renewed efforts to
pass a single-payer health care system. Single-payer advocates will point to
Obamacare's corporatist features as being responsible for its failures and
claim the only solution is to get the private sector completely out of health
care.
Unfortunately, many Republicans will inadvertently aid the single-payer advocates
by failing to acknowledge that Obamacare is not socialist but corporatist,
and that that the pre-Obamacare health care system was hobbled by government
intervention. In fact, popular support for Obamacare was rooted in the desire
to address problems created by prior government interference in the health
care marketplace.
Republicans also help the cause of socialized medicine by pretending that
Obamacare can be fixed with minor reforms. These Republicans do not understand
that replacing Obamacare with "Obamacare Lite" will still leave millions of
Americans with inadequate access to quality health care, and could strengthen
the movement for a single-payer system.
Republicans' failure to advocate for a free-market health care system is not
just rooted in intellectual error and political cowardice. The insurance industry,
the pharmaceutical industry, and the other special interests that benefit from
a large government role in health care are just as -- or perhaps even more
-- influential in the Republican Party as in the Democratic Party. The influence
of these interests is one reason why, despite their free-market rhetoric, Republicans
have a long history of expanding the government's role in health care.
Those who think a Republican president and Congress will enact free-market
health care should consider that the last time Republicans controlled Congress
and the White House their signature health care achievement was to expand federal
health care spending and entitlements. Furthermore, Richard Nixon worked with
Ted Kennedy to force all health care plans to offer a health maintenance organization
(HMO). Even Obamacare's individual mandate originated in a conservative think
tank and was first signed into law by a Republican governor.
Instead of Obamacare Lite, Congress should support giving individuals direct
control over their health care dollars through individual health care tax credits
and expanded access to health savings accounts. Other reforms like long-term
group insurance could ensure that those with "pre-existing conditions" have
access to care. Another good reform is negative outcomes insurance that could
help resolve the medical malpractice crisis.
America's health care system is just as unsustainable as our foreign policy
and our monetary system. At some point, the financial and human costs of Obamacare
will prove overwhelming and Congress will be forced to replace this system.
Hopefully, before this happens, a critical mass of people will convince Congress
to replace Obamacare with a truly free-market health care system.