We Don’t Have to Repeal Obamacare to Eliminate It — Mike H

 

The American people are not going to be receptive to repeal of Obamacare because it sounds radical at this point. But that’s OK, because we don’t have to sell repeal in order to get elected and we don’t have to pass repeal in order to trivialize Obamacare.

We simply need to pass very reasonable sounding “fixes” that will have the effect of neutering the legislation while not disruptively altering the status quo.

First, we obviously get rid of the mandate, freeing people to buy the healthcare products they want.

Then, we pass legislation that allows companies to sell products will little or no regulation. If done in the ideal fashion, we would overule the state regulations using the same supremacy of federal law that has made Obamacare such a nuisance. Companies could sell products that meet what people want, in the amount they want, for the price they are willing to pay. When the left complains that the proletarians won’t have all the coverage that the benevolent caretakers think they should have, just point to the Obamacare option: it’s still there.

In addition to this, many of the good ideas that have been proposed as part of a replacement to Obamacare can be implemented, overriding parts of Obamacare in the process: decoupling health insurance from work and taking your plan with you, eliminating the tax preference for employer-provided plans, etc.

Most of this should be an easier sell than “lets eliminate everything we have and replace it with all this new stuff right now,” which would trigger citizens’ status quo reflex and turn them against us.

Then we wait … and allow businesses and entrepreneurs to solve the problem for us.

Things could shift quickly but smoothly under this new paradigm. The flailing remnants of ObamaCare can be left to continue to do what they do best: fail. 

When people have all but forgotten about ObamaCare — or become even more disgruntled by dealing with it during the transition — they will either beg us to put it out of its misery or allow us to quietly drop it when no one’s paying attention any longer.

It’s not repeal and replace; it’s replace then repeal.

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  1. skipsul Inactive
    skipsul
    @skipsul

    The only problem I foresee here is that any R’s that don’t stand up for Repeal will be branded as squishes.

    • #1
  2. Mike H Coolidge
    Mike H
    @MikeH

    skipsul:

    The only problem I foresee here is that any R’s that don’t stand up for Repeal will be branded as squishes.

     Well, if Rob’s right about Ricochet’s budding influence in Washington, I am hoping this will get them thinking about nuanced ways of getting what we want without the need for a direct frontal assault. It’s an attempt to acknowledge the biases inherent to the squishy low-information median voter instead of actively ignoring it until we find we couldn’t quite make the sale.

    I also believe this is a good strategy for dealing with seemingly impenetrable laws, so I have hopes that my ideas above are somewhat generalizable.

    • #2
  3. Whiskey Sam Inactive
    Whiskey Sam
    @WhiskeySam

    Won’t work.  Unless it is repealed, it will continue to be tinkered with and turn into a mess just like every other bureaucratic program we’ve made this mistake with.  Short of complete repeal, it never stops.

    • #3
  4. Mike H Coolidge
    Mike H
    @MikeH

    Whiskey Sam:

    Won’t work. Unless it is repealed, it will continue to be tinkered with and turn into a mess just like every other bureaucratic program we’ve made this mistake with. Short of complete repeal, it never stops.

     Then I guess we’re stuck because I imagine repeal is going to feel an awful lot like Romney’s election in a couple years. Shear partisan will often leads to shear partisan depression.

    • #4
  5. DocJay Inactive
    DocJay
    @DocJay

    The issue conservatives will face has to do with special interests controlling the fix.

    • #5
  6. skipsul Inactive
    skipsul
    @skipsul

    DocJay:

    The issue conservatives will face has to do with special interests controlling the fix.

     Always the danger – the horse trading inherent in any legislation.

    • #6
  7. Midget Faded Rattlesnake Contributor
    Midget Faded Rattlesnake
    @Midge

    skipsul:

    DocJay:

    The issue conservatives will face has to do with special interests controlling the fix.

    Always the danger – the horse trading inherent in any legislation.

     Yes. Even in a repeal. (“Sure, I’ll agree to this repeal if you agree to XYZ in return…”)

    The question of how, exactly, political shenanigans will in practice undermine what in theory could be good policy, usually leaves me feeling pretty stymied. I sense I have no talent for making sense of this aspect of politics. I hope other people do.

    • #7
  8. user_697797 Member
    user_697797
    @

    I guess I don’t understand the concept of decoupling my health insurance from my job.  I like my health insurance.  I like that it’s subsidized by my employer.  They pay for 80% of it and give me  additional money in an HSA.  Am I missing something, here?  Wouldn’t decoupling require government intervention since employer driven healthcare seemed to be the preferred free market arrangement?

    • #8
  9. user_653084 Inactive
    user_653084
    @SalvatorePadula

    Bob Laing:

    I guess I don’t understand the concept of decoupling my health insurance from my job. I like my health insurance. I like that it’s subsidized by my employer. They pay for 80% of it and give me additional money in an HSA. Am I missing something, here? Wouldn’t decoupling require government intervention since employer driven healthcare seemed to be the preferred free market arrangement?

     It’s not a free market arrangement. Employer-provided health insurance is largely a result of the fact that it is tax-exempt compensation.

    • #9
  10. skipsul Inactive
    skipsul
    @skipsul

    Bob Laing:

    Am I missing something, here? Wouldn’t decoupling require government intervention since employer driven healthcare seemed to be the preferred free market arrangement?

     Employer driven was never the “preferred” arrangement – it was a result of continuous government meddling.

    During WWII, wages were frozen.  To attract talent, firms had to offer perks.  Health insurance was one.  To assist this, employers can deduct insurance costs as expenses.  So, let’s say I pay you $35k.  I pay payroll taxes on that.  But I also cover your insurance premium of another $6k.  I get to expense that out.  If I paid you the full $41k, you and I both would pay more in taxes.  Even if you went and spent that full $6k on insurance yourself, that’s post-tax money you’re spending.

    That is an insane arrangement. 

    One of the HUGE drivers of health cost increases has been this decoupling.  You don’t see your real health costs so you spend more than you would as price signals are hidden from you, as your employer I expense your insurance.

    Still don’t get it?  Imagine buying your groceries this same way, or your clothing.

    • #10
  11. user_697797 Member
    user_697797
    @

    Salvatore Padula:

    Bob Laing:

    I guess I don’t understand the concept of decoupling my health insurance from my job. I like my health insurance. I like that it’s subsidized by my employer. They pay for 80% of it and give me additional money in an HSA. Am I missing something, here? Wouldn’t decoupling require government intervention since employer driven healthcare seemed to be the preferred free market arrangement?

    It’s not a free market arrangement. Employer-provided health insurance is largely a result of the fact that it is tax-exempt compensation.

    Forgive me for not understanding how decoupling would work, but I’d wager that my employer would continue to offer health insurance as a perk.  And how would we decouple? Make insurance no longer tax exempt and hope that leads to an elimination of the benefit, or force insurance companies to deal with consumers one on one?

    • #11
  12. skipsul Inactive
    skipsul
    @skipsul

    Bob Laing: Forgive me for not understanding how decoupling would work, but I’d wager that my employer would continue to offer health insurance as a perk.  And how would we decouple? Make insurance no longer tax exempt and hope that leads to an elimination of the benefit, or force insurance companies to deal with consumers one on one?

     You buy car insurance and life insurance one-to-one, right?  No problem there.  Plus it would be independent of your employer, so if you changed jobs you would still have it.

    Either eliminate the deduction for employers, or allow it for individuals and you make the cost of it moot too, as it would be the same for everyone.

    I am an employer, I would prefer very much to not have to mess with the whole business.  I own a small business – every year I have to spend hours with a broker poring over different plans, quotes, networks, and law changes, only to be told by at least 1/3 of my employees that whatever plan I picked just doesn’t fit them. 

    Honestly – would you buy ANYTHING else this way?  How about your car?  How about your shoes?

    • #12
  13. user_697797 Member
    user_697797
    @

    Sorry Skip, my first reply to Sal just beat your response to the thread.  You (and Sal) subsequently clarified things for me.  The position makes sense.

    • #13
  14. skipsul Inactive
    skipsul
    @skipsul

    Bob Laing: Forgive me for not understanding how decoupling would work, but I’d wager that my employer would continue to offer health insurance as a perk.

     Current law is such that I cannot really use it as a perk.  Under Ohio law, if I offer insurance, I must offer it to all employees.  As a small business, I can only offer 1 plan.

    AND I cannot make my employees pay more than x% of their premium.  This is ridiculously unfair to the employees who don’t take the insurance.  Think about this:

    Employee 1 takes the plan.  I pay them $X, but their insurance adds additional value of $Y.

    Employee 2 in the same position is also paid at $X, but does not take insurance.  I could pay them $Y in lieu of the insurance, but that is a recipe for a labor dispute and a lawsuit.  All employees think that the employer-paid part of the premium is non-existent, so my paying it out as cash is seen as a “raise” even though it isn’t.

    Trust me, if tax laws were sane, fewer companies would offer insurance.

    • #14
  15. skipsul Inactive
    skipsul
    @skipsul

    Bob Laing:

    Sorry Skip, my first reply to Sal just beat your response to the thread. You (and Sal) subsequently clarified things for me. The position makes sense.

     Glad we could help.  I have to live this stuff every day, it gets my dander up.

    • #15
  16. Mike H Coolidge
    Mike H
    @MikeH

    Bob Laing:

    Salvatore Padula:

     

    It’s not a free market arrangement. Employer-provided health insurance is largely a result of the fact that it is tax-exempt compensation.

    Forgive me for not understanding how decoupling would work, but I’d wager that my employer would continue to offer health insurance as a perk. And how would we decouple? Make insurance no longer tax exempt and hope that leads to an elimination of the benefit, or force insurance companies to deal with consumers one on one?

    It doesn’t have to lead to decoupling, but it probably will because you wouldn’t want your insurance to change every time you changed jobs. It makes you overly dependant on your current employer.

    One thing that would likely happen is your pay would greatly increase. Instead of giving up thousands in wages, you could buy a plan for much less that would be more in line with how much you expect to use it.

    If we really deregulated healthcare, both insurance and providers, and eliminated 3rd party payments, everything could become more like lasik. Higher and higher quality with lower and lower prices.

    • #16
  17. skipsul Inactive
    skipsul
    @skipsul

    Mike H: If we really deregulated healthcare, both insurance and providers, and eliminated 3rd party payments, everything could become more like lasik. Higher and higher quality with lower and lower prices.

     Cannot like this enough.

    • #17
  18. user_653084 Inactive
    user_653084
    @SalvatorePadula

    Bob Laing: And how would we decouple? Make insurance no longer tax exempt and hope that leads to an elimination of the benefit, or force insurance companies to deal with consumers one on one?

     When people talk of decoupling they generally are referring to eliminating the tax exemption for employer-provided health insurance. Your employer might continue to partially compensate you via health insurance, but, unlike now, it wouldn’t be subsidized for doing so.

    • #18
  19. user_928618 Inactive
    user_928618
    @JimLion

    The real future in health insurance is with hospitals and hospital groups that cut out the middle man (private or governmental) and offer their own versions of health insurance to pre-paid customers. Doctor’s groups, particularly general practitioners will also get in on the act. From a legislative standpoint, the best we can do is clear the way by eliminating legal roadblocks at the Federal level.

    • #19
  20. Covert Conservative Member
    Covert Conservative
    @

    One of lost opportunities of the Bush-43 years that continues to haunt us is the Republicans failure to significantly fix (or, improve, if you prefer) our health care system while we were in a position to do so. But the reform that was most needed — decoupling health care from employers — would have been unworkable politically. Now, however, with Obamacare in the process of breaking most coverage off from employment, we’re actually in a position to be able to return health care to true consumer control (and the cost savings and more responsive coverage that would follow) — IF there’s a congressional/presidential candidate who can unify the party on this, lead the charge and explain and sell this to the electorate.  A big IF, unfortunately.

    • #20
  21. The Mugwump Inactive
    The Mugwump
    @TheMugwump

    What would be the cost of a policy covering up to $250,000 for a catastrophic accident or illness with a $10,000 deductible?  I’m guessing about the same as a minimum liability policy on a ten year old car.  Because some of us don’t live a platinum lifestyle.        

    • #21
  22. The Reticulator Member
    The Reticulator
    @TheReticulator

    Nobody in the USA is more opposed to ObamaCare than I am, and I think you have the right idea.

    • #22
  23. Western Chauvinist Member
    Western Chauvinist
    @WesternChauvinist

    Funny thing is, this strategy is not unlike the Democrats’. Just ignore or arbitrarily override the portions of the law that aren’t working.

    Finally! The long-awaited holy grail of bipartisanship!

    • #23
  24. Mike H Coolidge
    Mike H
    @MikeH

    Think we could call it the Free Market Option?

    • #24
  25. Proud Skeptic Inactive
    Proud Skeptic
    @ProudSkeptic

    Mike

    Though the details may end up being different from what you are suggesting, your underlying point is a very good one.  This thing needs to be picked apart and the remnants allowed to die.  ObamaCare shows all of the signs of being a dysfunctional law that hangs around for decades because like a cancerous tumor, it had reached into too many places to be cut out all at once.

    The tricky thing…as others have hinted at…will be how to sell it to the voters.  It will take a clever approach since the “repeal” folks aren’t going to want to hear anything else and any campaign centering on “replace” is going to cause any open eyed conservative voter to wonder what the Republicans are up to.  Again…the Republicans, in failing to define who they are over the last couple of decades, have caused themselves big problems with credibility.

    It will take a skilled candidate to pull this off.  Not sure who in the Republican Party could do this.

    • #25
  26. skipsul Inactive
    skipsul
    @skipsul

    Mike H:

    Think we could call it the Free Market Option?

     “Free Market” is a poison pill term.  Too many voters distrust is as a code word for corporatism and cronyism, or else “being thrown to the wolves”.  

    Try something else.  Phrases with “Individual” or “Personal” play better.

    • #26
  27. Mike H Coolidge
    Mike H
    @MikeH

    skipsul:

    Mike H:

    Think we could call it the Free Market Option?

    ”Free Market” is a poison pill term. Too many voters distrust is as a code word for corporatism and cronyism, or else “being thrown to the wolves”.

    Try something else. Phrases with “Individual” or “Personal” play better.

     How about “free will.”

    • #27
  28. Albert Arthur Coolidge
    Albert Arthur
    @AlbertArthur

    Mike H:

    Think we could call it the Free Market Option?

     Call it the Protecting Gays, Women, and Fluffy Bunnies Option and then dare the Democrats to vote against it.

    • #28
  29. Albert Arthur Coolidge
    Albert Arthur
    @AlbertArthur

    Proud Skeptic: the Republicans, in failing to define who they are over the last couple of decades, have caused themselves big problems with credibility.

     This is perhaps a different discussion, but I disagree with you that Republicans have not defined who they are.

    • #29
  30. skipsul Inactive
    skipsul
    @skipsul

    Mike H:

    skipsul:

    Mike H:

    Think we could call it the Free Market Option?

    ”Free Market” is a poison pill term. Too many voters distrust is as a code word for corporatism and cronyism, or else “being thrown to the wolves”.

    Try something else. Phrases with “Individual” or “Personal” play better.

    How about “free will.”

     Too heady a concept.  Think in marketing terms.  AA’s concept is good too in that regards.  Use the phrase “Free Will” and people will think you’re talking religion.

    • #30
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