The executive director of an association of physicians that promotes patient-centered, free-marked health care says Speaker Paul Ryan’s American Health Care Act (AHCA) “cements” the “basic flawed premises” of Obamacare.
Jane Orient, M.D., of the Association of American Physicians and Surgeons, observes that while some Republicans admit the AHCA is “not perfect,” many are also focused on whether whatever happens with the bill will help them remain in power after the 2018 midterm elections.
“The 2018 election will be a ‘bloodbath’ for Republicans if AHCA is not passed—or else if it is passed,” she notes. However, while the “political” reality looms, Orient observes the “actual” reality Americans must face is that Obamacare is an entitlement that has already had seven years to embed itself into American life.
In addition to the overall entitlement concept that health insurance is now considered by Affordable Care Act (ACA) supporters to be a “constitutional right,” Obamacare has created many “mini-entitlements” as well with its “essential benefits” package that includes “free” birth control for 55 million women and mandatory coverage for services such as mental health and addiction treatment. Under the ACA, these “benefits” must be included in all health insurance plans – whether individual Americans need them or not.
“It is very difficult to take away an entitlement,” Orient says, “and while the media will be focusing on sad stories, the real losers with clout are not sick and dying individuals but the hospital/Pharma/managed-care cartels.”
Orient explains the paradox inherent in the health insurance entitlement myth:
Coverage is not the same thing as care. Denizens of the Healthcare Swamp adroitly confuse the two. Coverage often blocks care, as with narrow networks, and inevitably drives up the cost. Government cannot provide care. Increasingly, it cannot even finance care, as governments at all levels are mired in deficit spending. Its programs forcibly redistribute a decreasing pool of assets. Guaranteed issue (no “discrimination” against people with pre-existing conditions) is not insurance. It destroys insurance; low-risk individuals will not buy it unless forced to do so.
“AHCA does not get rid of the basic flawed premises of ACA,” Orient continues. “Arguably, it cements them further.”
“The worst feature of AHCA is perpetuating the myth that ‘non-discriminatory’ coverage for pre-existings is insurance rather than a pipe dream,” she states.
The Republicans’ plan will only be successful, Orient says, if it allows a free market to develop outside of third party payment for all medical care via health insurance.
If the managed third-party system fails, and competition does develop, Orient predicts Americans will be able to obtain high quality medical care at lower costs.
Orient also observes Obamacare supporters’ focus on whether people will “lose coverage” with repeal is explained with less sadness by the Congressional Budget Office (CBO) analysis. The CBO cites a rise in the number of uninsured as stemming from “repealing the penalties associated with the individual mandate.”
In other words, many Americans who purchased Obamacare to avoid paying the penalty for being uninsured would choose to return to being uninsured once the individual mandate is repealed.
“Millions of Americans see ACA insurance as such a bad deal you have to force them to buy it,” Orient emphasizes. “They would choose to reject it.”
Does Orient see any “good features” in the AHCA? Only a few, she says.
“Tax ‘credits’ are subsidies if people don’t owe taxes,” she asserts. “But if credits refund payroll taxes, ending discrimination against people who buy their own coverage, that’s a step toward fairness and freedom.”
“So is the liberalization of health savings accounts—especially if people have savings because they are freed from requirements to buy expensive comprehensive coverage, and to pay for people who decline to purchase insurance as long as they are healthy,” she adds.
Orient says she hopes the AHCA is “properly amended” so that it won’t serve as “a way station on the road to a full crony capitalist/government takeover.”
“The ultimate goal must still be the restoration of a free market,” she observes. “We need to get rid of the subsidies, mandates, and regulations that stand in the way, feeding the Swamp and propping up ObamaCare. ACA needs to die. The unshackled free market needs to kill it, before or after Congress repeals every last word.”