November 6 and The Future of Healthcare Reform in the US
-By Preetam Kaushik
The past eight years have all but confirmed the worst fears of Conservatives regarding the healthcare reforms passed by President Obama. The nation stands more divided than ever before, largely as a result of the irresponsible subversion of the US political system by the Democrats in 2010.
By trying to shove their version of socialist health care reform down the throats of freedom-loving Americans, the party and their (former) President has done almost irreparable harm to us all.
One can understand the scale of this monumental folly when you consider the fact that even a determined Republican President, backed by a conservative majority in both houses of the Government could not dismantle this blot on the US political landscape.
But all that could change come 2019, with Americans poised to deliver their mandate in the 2018 mid-term elections. The ailing healthcare system is at the center of this fierce struggle and one could even consider the elections as a virtual referendum on the future of US healthcare.
US Conservatism has been enjoying a resurgence in this decade. But to consolidate this wave, the Republican Party needs to deliver on the promises that ensured their victory.
And since health care reform was the central pillar of the conservative manifesto, understanding the current state of healthcare (and Obamacare) in the US is crucial to understanding which Party will control the Senate and House of Representative into the next decade.
Healthcare – Impact of Two Years Of Trump Presidency
Healthcare reform has been largely a mixed bag for conservatives in the first two years under President Trump. The repeal of the odious Individual Mandate was surely one of the biggest blows against the ACA. This historic victory for individual liberty and freedom of choice was achieved as part of the long-awaited GOP tax reform signed into law by the Trump administration.
But surely, the lowest ebb was the failure to repeal the ACA in 2017, despite controlling the required number of votes in the Senate. The opposition of Republicans like the late John McCain and Lisa Murkowski doomed the repeal effort, but they were only reacting to the bungled efforts of Republican leadership under Paul Ryan and Mitch McConnell.
Their proposed replacement of Obamacare, the AHCA, was widely decried as a watered down version of the ACA. It pleased neither the conservatives nor the moderates, and was ridiculed by many as Obamacare Lite.
With Republican party failing so spectacularly, it was down to President Trump to step up and deliver on his campaign promises. And it must be said that whatever the perceived shortcomings of this presidency, lack of Presidential will is certainly not one of them.
Several executive actions of the President has dealt decisive blows to Obamacare and helped reduce the severity of future fiscal deficit.
By allowing association health plans to be sold outside the government regulated marketplace, he has succeeded in returning health insurance to its optimal position as a free market commodity.
The President also stopped the Cost Sharing Reduction (CSR) payments to insurance companies. These were basically a burdensome regimen of government subsidies under Obamacare. By stopping CSR, Trump has further weakened the system to a point where it should implode under its own weight.
Other small steps were also taken by the administration to further weaken the ACA. These include reductions in ads and budgets, as well as a shortening of the Obamacare enrolment periods.
The Current State of Healthcare in the US
Despite these decisive measures, the ACA is still hurting the fiscal deficit and the economy. In 2016, the government deficit rose by $1.6 trillion, half of which was due to healthcare costs. As of 2018, health care costs account for close to 20% of the US GDP.
And the rate of increase in spending is expected to grow by at least 5-6% in the coming years if the ACA system is allowed to continue in the present form.
With constant rising costs, more and more Americans are struggling to gain access to healthcare. And with the lack of an open, transparent, pan-US marketplace to drive down insurance costs, the situation will only worsen.
American citizens deserve better and wider health coverage. But having a big government provide that is not a sustainable solution. With the constant shadow of fiscal deficit, the last thing the Federal government needs is more spending and inefficiency.
The Ideological Split on Healthcare Reforms In The US
Historically, healthcare reform has been a contentious issue in the US. Our system is one of the most expensive and least efficient in the developed world. If there is one thing conservatives, progressives, and everyone else can agree on, it is that the system as it exists is quite broken.
But the problem with Obamacare is that it tries to see increased government intervention, spending, and bureaucracy as an answer. That is like pouring gasoline to douse a burning fire!
Backers of the ACA would counter that it has extended coverage to at least 17 million citizens. Democrats and left-leaning progressives harbor delusions that a government controlled system of universal healthcare is the answer to all the ills of the system.
It may have worked in other countries like the UK and the EU nations, (with serious issues of over-expenditure, inefficiency, and other economic costs), but such a system would never work in the US, with its already expensive healthcare market.
Attempts at several states like Vermont have failed spectacularly, mainly due to uncontrollable administrative costs. So to most sane conservatives and libertarians, any solution has to start with more free market and less government.
Some dissenting conservatives would go as far as suggesting a unified single-payer system as the answer. While that is certainly worthy of a debate, there is little doubt that the system as it exists under Obamacare is to the benefit of no one concerned.
Healthcare & Midterms – Cause vs Effect
There is an air of partisan frenzy in US politics at the moment. The recent chaos surrounding the Kavanaugh hearings highlighted the deepening split between Republicans and Democrats, conservatives and progressives.
The stakes are high since the control over both houses of the legislature is up for grabs in November. The Republican wins in the recent past were based on the central promise of healthcare reform, and the party and conservative establishment have decided to throw the weight behind the same in November as well.
The Democrats also see the protection of their landmark reform as some sort of a rallying cry. And with 26 Democrat senators facing re-election, ten of them in states that voted for Trump, the party has its task cut out when it comes to holding on to its numbers in the Senate, let alone try to take control.
But in the House of Representatives, the picture is reversed, with 39 Republicans opting not to stand for re-election. The control of the House could fall into Dem hands, as they need just 24 seats to have numerical superiority.
And such an eventuality would deal a serious blow to the Republican and conservative agenda, and also to the Trump presidency. Any chance of a second shot at ACA repeal would surely be a bridge too far in that scenario. Here is to hoping that it doesn’t come to that.