I’m going to make a solid effort here to understand the reasoning behind the repeal of Obamacare. I’ll try my best to withhold my shock and depression over this issue, at least for a few minutes. Let’s make a list of all the reasons why repeal makes sense to those voters who will continue to support their congressmen (or senator) after he votes for the AHCA:
- It was President Obama’s signature piece of legislation and Obama is the devil. He is a black, Muslim, Kenyan, socialist who nearly destroyed the country. We must destroy his legacy. By definition, if he was in favor of such a program, it must have been profoundly damaging to the American economy.
- As a libertarian, I detest any Government interference in the economy. I believe in free markets and the ability of price to effectively allocate resources. Everything will be better if the government gets out of the way. I’d be in favor of getting rid of Social Security and Medicare as well.
- The obesity epidemic in this country has shown us that people must be responsible for their own health. If they are sick then it’s their fault. Why should I have to pay any taxes towards their healthcare? Why should my premiums be higher to average out an insurance pool. I have no pre-existing conditions.
- I am fabulously rich and perfectly able to buy as much health coverage as I want. If you have failed to make a lot of money like me then you must accept the consequences.
- I am on Medicare or have fabulous coverage through my employer so this is not really important to me. If people die from this repeal then that’s not my problem. I’d just like to see my taxes go down, and Roe vs Wade revoked.
- How did the government raise taxes on capital gains or force me to buy healthcare insurance when I don’t want to. That’s an infringement on my liberty!
Obamacare is just made up of two things: a restriction on charging people more for their pre-existing conditions, and a series of subsidies for poor people [Medicaid, high risk, and older people). That’s it. So if you hate it you have only a few things to get angry about. You must hate sick people, poor people or you must make a ton of money from capital gains. You must not know anybody who is between the ages of 50 and 65 who have been sick or might get sick. (Is that possible?)
The other option, of course, is that you think that Obamacare is a much more intrusive system which tells doctors how to do their jobs. It doesn’t. Ask the AMA what they think. Maybe you believe that subsidies are the same as socialism. If everyone gets healthcare they’ll become lazy economic leeches.
In this debate, there is sort of a sweet spot – around the age of 45. When you’re that age your parents are old enough for Medicare so they are not affected by any of this. You’ve been healthy all your life and your insurance rates before Obamacare were reasonable, or you got your insurance through your employer. You’re too old to have more children so prenatal care or child delivery coverage is irrelevant. Such a person may not realize that cancer can hit somebody younger than 65. They are on the edge of a cliff, premium wise. Simply being 55 is a preexisting condition in and of itself. Ageism makes it very hard to get a new corporate job if you get laid off. These “nearly old” are unemployable and uninsurable. 45 year-olds don’t realize how close they are.
In the end, it comes down to compassion versus a tax cut. It’s a matter of recognizing that the state has a logical role when it comes to establishing insurance pools. Every actuary and every other country in the world understand this. As with climate change we are unique in that we have a significant (vocal) minority who prefer not to have a plan when it comes to long-term complicated issues. They simply hope that supply and demand will take care of things since they (and their donors) can’t or won’t. Consequently, CO2 emissions are not taxed to pay for negative externalities [secondary spinoff effects]. Similarly, prices do not allocate healthcare resources effectively. There there is no “elasticity”. Simply put, demand does not decline if price rises. That’s why the United States free market version of healthcare is so spectacularly less efficient than every other socialized system in the world. We pay more but receive the same services as any Dutchman or German. There is no state monopsony.
It’s hard to admit when free markets, don’t work. When you read Ayn Rand at the age of 16 you completely bought into her depiction of government as evil. How can you recant or explain to other true believers that there seem to be a few holes in the storyline? Will someone call Milton Friedman? You decide it’s better to ignore these glaring exceptions so you can reduce regulation and government corruption. Voters don’t want to hear about complexity anyway. So in the name of your God – Free Markets you declare:
If 24 million uninsured people must die in the gutter or go bankrupt to pay for hospital care then – so be it!