The problem I have with the Replace part of most any of the extant Repeal and Replace schemes is that the Replaces ignore one of the most important lessons of Obamacare: redoing a huge swath of our economy, and of our society, in one monstrous step creates a monstrous disaster.
Repeal. Even the status quo ante is better at this point, as a temporary measure. Replace in stages, with each stage consisting of not one, but two or three or four bills in Y0 of a Congressional session. In this session, also lay out the entire plan, together with its currently intended schedule and milestones.
In Y1 of this session, see the errors and failures from Y0 and make corrections, and then enact--as two or three or four separate bills--the next stage.
If all of this has been well thought out (a stretch, to be sure, for either party), win the elections for the next Congressional session, and enact the rest of the scheduled--and corrected--stages.
As a practical matter, assuming Republicans gain control of the Senate, S0Y0 and S0Y1 will consist of passing legislation for Obama to veto. Which will shape the '16 elections favorably for Republicans and Conservatives.
One adjustment I would make would be to try to anticipate the biggest problems repeal would cause and do something temporary to ameliorate those problems in the same bill that repeals the ACA.
One of the things that worries me, now that my insurance has been killed, is that I'm thrown into the ranks of people with pre-existing conditions. If they repeal the ACA now, without making some provision for pre-existing conditions, I'm completely screwed.
I'd like to say it would be worth it, just so other people's insurance wouldn't be screwed up, too. But I'd prefer it if they found a way to let people like me get back into the system after jamming us up to no purpose. I went to huge trouble and expense to stay continuously insured, so that I would not be in this position. We should find a way to make the health-insurance wager a lifelong proposition; treating it as a year-to-year gamble, the way we treat fire insurance or car insurance, doesn't really work.
We should find a way to make the health-insurance wager a lifelong proposition
We need, first, to get back to an insurance environment. What we have now, with "coverage" mandated independently of risk, is not insurance, by definition. It's Federally mandated, privately funded, and tax subsidized health welfare.
The extent to which we should have health welfare of any sort is a worthy national discussion, but it's an impossible one to have so far.
I agree with both of you. One problem we have, which the Progressives have cooked into the system, is that if you instantly switch things to the way they should be, a lot of people who have played the game fairly will come to serious harm. This means the vast majority of people will vote against switching back to the right system.
Consequently, to get things the way they should be, I think, will probably take decades from the time when we actually decide to make the corrections. I think we'll have to have a long transition period where we suck up the expense to do right by those who have played the game fairly, and transition generation by generation.
The problem I have with the Replace part of most any of the extant Repeal and Replace schemes is that the Replaces ignore one of the most important lessons of Obamacare: redoing a huge swath of our economy, and of our society, in one monstrous step creates a monstrous disaster.
ReplyDeleteRepeal. Even the status quo ante is better at this point, as a temporary measure. Replace in stages, with each stage consisting of not one, but two or three or four bills in Y0 of a Congressional session. In this session, also lay out the entire plan, together with its currently intended schedule and milestones.
In Y1 of this session, see the errors and failures from Y0 and make corrections, and then enact--as two or three or four separate bills--the next stage.
If all of this has been well thought out (a stretch, to be sure, for either party), win the elections for the next Congressional session, and enact the rest of the scheduled--and corrected--stages.
As a practical matter, assuming Republicans gain control of the Senate, S0Y0 and S0Y1 will consist of passing legislation for Obama to veto. Which will shape the '16 elections favorably for Republicans and Conservatives.
Eric Hines
I pretty much agree with Mr. Hines on this one.
ReplyDeleteOne adjustment I would make would be to try to anticipate the biggest problems repeal would cause and do something temporary to ameliorate those problems in the same bill that repeals the ACA.
One of the things that worries me, now that my insurance has been killed, is that I'm thrown into the ranks of people with pre-existing conditions. If they repeal the ACA now, without making some provision for pre-existing conditions, I'm completely screwed.
ReplyDeleteI'd like to say it would be worth it, just so other people's insurance wouldn't be screwed up, too. But I'd prefer it if they found a way to let people like me get back into the system after jamming us up to no purpose. I went to huge trouble and expense to stay continuously insured, so that I would not be in this position. We should find a way to make the health-insurance wager a lifelong proposition; treating it as a year-to-year gamble, the way we treat fire insurance or car insurance, doesn't really work.
We should find a way to make the health-insurance wager a lifelong proposition
ReplyDeleteWe need, first, to get back to an insurance environment. What we have now, with "coverage" mandated independently of risk, is not insurance, by definition. It's Federally mandated, privately funded, and tax subsidized health welfare.
The extent to which we should have health welfare of any sort is a worthy national discussion, but it's an impossible one to have so far.
Eric Hines
I agree with both of you. One problem we have, which the Progressives have cooked into the system, is that if you instantly switch things to the way they should be, a lot of people who have played the game fairly will come to serious harm. This means the vast majority of people will vote against switching back to the right system.
ReplyDeleteConsequently, to get things the way they should be, I think, will probably take decades from the time when we actually decide to make the corrections. I think we'll have to have a long transition period where we suck up the expense to do right by those who have played the game fairly, and transition generation by generation.