3 Ways to Make Obamacare Less Completely Awful


I'm no fan of Obamacare, which to my mind competes with Medicare and Medicaid as not simply godawful but a deeply offensive use of government power.

The federal government should no more be in the business of guaranteeing health insurance than it should be in the business of surveilling its citizens or bombing foreign countries independent of war resolutions. I think the Supreme Court's decision to rubber-stamp the individual mandate even as it rewrote the law to make it constitutional is one of the great blunders of American jurisprudence.

As a libertarian, I ask you: What else is new? Obamacare is not just a dumb law but a deeply offensive one (on this at least, the American people have my back). That doesn't mean it can't be made less dumb and less offensive.

And so, in my latest column for The Daily Beast, I suggest three immediate reforms to Obamacare that would make it less horrible.

They include allowing people of all ages and situations to buy catastrophic plans, forcing insurers to compete in a national market for customers, and, most important, reducing impediments to vastly grow the supply of medical care in all possible ways. This last is really key. Government programs are never going to lead to the sort of innovation that will extend and improve lives. It's always going to be crazy dreamers, nut-job visionaries, and greedy bastards who do that.

Think about it: Nearly three dozen states have "certificate of need" laws governing when new hospitals can be built or existing ones can expand. In those states, existing providers can effectively veto new competition. That's idiotic under the best of circumstances. Under Obamacare, it's downright criminal. Columbia economist Frank Lichtenburg calculates that in terms of medical interventions, nothing beats pharmaceuticals when it comes to increasing and extending the quality of life. Yet under Obamacare, it's still going to cost $1 billion and 10 years to bring new drugs to market.

Read the whole piece.

NEXT: Nick Gillespie and Meredith Bragg on 10 Hilarious Anti-Gamer Quotes From Pols and Pundits

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  1. Almanian’s list of Three Improvements to Obamacare

    1) Repeal it
    2) Repeal it
    3) Secede from the fucking union.

    Aggressive. Overreaching even. Fuck it – it’s time.

    1. 1. Repeal.
      2. Do not replace with another socialistic healthcare scheme.
      3. Get government out of medical services and insurance.

      1. If you just got rid of the individual mandate and all of the coverage mandates, you would go a long ways to at least limiting the damage this thing is doing.

        1. yepper

        2. As long as its on the books, its like a fucking weed, always pushing to grow back.

          Repeal. Reform is a mug’s game. Don’t talk reform, because it undercuts repeal.

          1. Don’t just repeal this law. Repeal all laws passed immediately before and after it to remove the taint from the books completely.

          2. Yeah. It has all got to go. I don’t see why repealing it would leave those who bough insurance through the exchanges without coverage. They keep saying that but I don’t see how.

  2. The certificate of need thing is really amazing. These assholes have gone down the rathole of central planning to such a degree that as part of a program that is supposed to reduce medical costs, they have made it harder to build new hospitals. I don’t think that is the result of some evil conspiracy. I think it is the result of people allowing ideology to drive their thinking to such a degree that black becomes white.

    1. Amazing & stupid, I agree, but also very old news & nothing whatsoever to do with the ACA, or the feds (since ’87):


      This is unfortunately a battle that needs to be fought state by state.

  3. I know it is radical in this day and age, but how about a free market health care system? Anyone game?

      1. Would it be funny if instead of ushering in the Utopia of single payer, this monstrosity ended up discrediting government intervention so much that the feds at least got out of the healthcare business altogether or least out of everything but medicare?

        I know I am dreaming here and I don’t mean to start a debate about how that could really happen. I am just imaging the epic butt hurt that would ensue.

        1. If history is any measurment of how things play out, butt hurt is not enough to ever justify the roll back of any government program. No matter how ineffecitve, rediculously stupid, big of a failure, or destructive said program is. It might make “We the people” hate it, but that won’t make the politicans that make a living from ripping the productive amongst us off, even flinch.

        2. I wonder if they could come up with a nominal “reform” of Obamacare that in reality guts it and takes huge strides in a free-market direction.

  4. Insurance is exactly the same as health care, you racist.

  5. which to my mind competes with Medicare and Medicaid as not simply godawful but a deeply offensive use of government power.

    Actually, the ACA should absorb those two programs.

    The benefits include:

    Automatic means testing
    Fraud prevention
    Reducing the role of government
    Innovative private cost cutting

    1. Look Shreek showed up on a thread where he could suck Obama’s cock and lie and distort criticisms against him. Let me get my surprised face.

      1. I proposed that to progressives and they went ballistic.


        You are much like them.

        1. Palin’s Buttplug|5.12.14 @ 11:09AM|#
          “I proposed that to progressives and they went ballistic.”

          So even the proggies are tired of your act?

        2. Except there is no “privatization” in having PPACA absorb other government programs. That’s the opposite of private.

          Private means NOT government. Combining medicare and medicaid under PPACA is not private, it’s government to the max.

        3. I believe that fascism is the word that you are seeking.

  6. how about a free market health care system?

    That’s crazy; everybody knows health care is not a commodity subject to market forces. It’s different.

    1. It’s a moral thing. Can’t have free market health care because rich people profiting off sick people is immoral. That’s why all health care should be administered by the government, since government doesn’t give immoral profits to rich people. Sure government is wasteful and lacks incentives to do a good job, but that’s more moral than profits for the rich.

      1. It’s a moral thing. Can’t have free market health care because rich people profiting off sick people is immoral.

        What if the patient is one of the Kock brothers and the doctor is fresh out of medical school with a hundred thousand dollars of student debt? Would it still be immoral for the doctor to give away his skills for the patient?

      2. You have no idea.

        I have an elderly neighbor who has colon cancer. After taking care of her at her home, I invited her to live in my house as her condition grew worse.

        After a couple of weeks of me caring for her almost around the clock, she started having hallucinations. Even though she could barely stand, she wanted to go home. I had just started Hospice care for her. They told me to call them anytime I had a problem.

        I called them Friday night and told them she was having problems and had said “I think I have been molested”. There is zero chance of this and I thought that the Hospice would provide some anti-anxiety medication for her. Instead, since the word “molested” had been mentioned, they basically placed her in a nursing home. So now instead of my free and loving care, government “health care” workers watch her, for a small fortune, while she is confined to her bed or a wheelchair.

        They provided nothing in the way of anti-anxiety medicine and now she is in a strange place without her dog (or my 9 year old daughter who she adored)

        All this because they care about her welfare? Not at all. It is all about their personal liability. They “care” as long as it pays well and is convenient. They can not even conceive of someone actually caring for someone because that is the way they would hope to be treated if they found themselves in a similar position.

        They are truly evil.

        1. Indifference is the true evil.

        2. But, you’re not, and your daughter sees that. That is good.

  7. Go drink some more paint thinner, Shreeek.

    1. No, no! He huffs paint thinner and drinks Sterno.

  8. A free market system! But that’s what we had BEFORE OCare!111!

    Absolute chaos and terror, no regulations whatsoever, and KKKochporashunz screwing people left and right! All that ENDED with OCare!

    I don’t want to go back to that, you wingnut Teafucking, ratbagging robber baron freaks!

    1. Good luck repealing Medicare.

      I support it but the Cubs winning the Super Bowl is just as likely.

  9. I don’t get the whole repeal and replace thing.

    If you put out a fire in your house, do you then replace it?

    If you remove a cancerous tumor, do you then replace it?

    Fuck Republicans.

    1. I will second “fuck Republicans”.

      And Donkeys.

      Fuck TEAMS.

    2. I never got that either, seems like it’s for the benefit of the media more than anything else. To the media it would be a disaster if the government just stopped doing something.Plus I think team red is divided on this half just want it gone but don’t have the balls to say it. The other just wants to run state medicine “better”.

    3. The “replace” part is to handle the objections of those who became convinced that, pre-Obamacare, health care in the US was a vast wasteland. The trick is to have the federal government “do something” that is actually in a free-market direction.

  10. I think I hear shrieking again, but I ignore it.

  11. Seems to me, the problem with Obamacare is that most people who hate it actually love it. (Nick not included.)

    Everyone loves “they have to give you a policy even if you’re sick,” and also “they can’t base your premium on your health condition.” (Forget the laws of economics!)

    Voila, you have Obamacare.

    1. “Everyone loves “they have to give you a policy even if you’re sick,” and also “they can’t base your premium on your health condition.” (Forget the laws of economics!)”

      Free shit buys votes.

  12. If government has the obligation to protect its citizens, ppublic healthcare is not a bad thing to have.

    At the least, catostrophic life-saving treatment should be available to citizens.
    One can make the access mean-tested. But having none or offering crappy or ineffective life-saving healthcare service is unacceptable to people that are not conservative or libertarian (some libertarian).

    In the USA, one can be involved in a catastrophic car accident on the highway in which the injured are transported by helicopter to trauma units with experts waiting to save a life. I’ve always marvelled at this and use it as an example of a good, caring, non-callous, society. Had the helicopter and specialists and trauma unit only been available to the wealthy, we would not have it. I’m glad it is available to all.

    But besides all of that, Obamacare does require a lot of work. The only thing I like about it is that they bullied insurance companies to not drop people, raise premiums individually, and accept anyone. I like it. I can’t imagine a profit driven insurance company liking it.

    1. Alice, The things you like about Obama care are the strawmen it destroyed. There were almost no documented cases of insurance companies dropping people when they got sick. The problem with people not being accepted was limited to the individual market, and was mostly the result of premiums reflecting risk. The uninsured were people who could not afford insurance–but they almost never went without care as a result and you did not see sick people dying in the streets for lack of access to care. As to raising premiums individually–why is that unjust? If I smoke, weigh 300 lbs, and subsist off of potato chips, I create a higher risk. Why should I not have my premiums raised individually. Should you pay for my bad habits. Indeed, my pre-O’care policy barely went up at all despite a variety of medical claims. When it got cancelled, the premiums increased $3,000 per year so that I could support the lifestyles of the higher risks. That does not seem fair to me =.

      1. There are many many many documented cases of Insurance Companies weaselling out of claims.

        The Movie Sicko (I am not a fan of Michael Moore and I’m not pushing the movie) had 25 examples of people with insurance having all sorts of issues.

        You pick smoking and being fat as examples of people not being responsible with their health. There is skiing, kids playing football and other sports. Kids living on busy roads. Black males under 30 are more likely to be injured or killed in violence, hunting, having sex, and a bunch of other reasons why one person should pay more than the other.

        Rather than running the Ski industry out of business or making it so damn complicated to price a plan, let’s just have a flat rate for 300,000,000 people. This way, people are free to live and let live.

        My highschool friend Bob died of a heart attack at 41. He never did drugs or drink (unlike me) and was skinny. His father also died in his 40s. The risk models just start becoming crazy.

        1. To the extent that insurance companies were attempting to weaseal out of contractual obligations, that should be dealt with by enforcing the contract.

          There aren’t any libertarians who are against enforcing contracts.

          You don’t, however, have to force insurers to enter contracts against their will. If someone doesn’t buy insurance until after they get sick, they are effectively commiting insurance fraud. I know that everyone wants the sick person to get care, but that’s not the insurance companies responsibility. They aren’t there to care for people who were too irresponsible to buy insurance until after they got a serious illness.
          Nor is it the responsibility of the relatively healthy people to pay overinflated prices so they can subsidize those people rates.

          If you want to help people who have pre-existing conditions you first, enforce pre-existing insurance contracts, and second, establish a fund to pay for lifesaving medical treatment for that small percentage of people who don’t buy health insurance and then get sick, and you leave everyone else out of it. You don’t need to force innocent third parties into a massive national scheme to solve that problem.

    2. I can’t imagine a profit driven insurance company liking it.

      You don’t have to imagine it. They pushed for it. The insurance companies were big supporters of ObamaCare.

      1. The insurance companies were big supporters of ObamaCare.

        What is it about people that they simply can not understand this? The insurance companies were not only “big supporters” they “helped” write the monstrosity. It guarantees profit for these companies as part of the law.

        ObamaCare is the worst of both worlds. Overreaching government bred to the worst kind of crony capitalism. The bastard child of the two makes Rosmary’s Baby look like the infant Jesus.

  13. Catastrophic plans cost as little as $128 a month

    You call that cheap? For the specs you listed it has no business being above $60 a month.

    1. Well, if they are allowed to weasel out of the claim, it is a rippoff.

      I’m all for having catastrophic plans and just paying cash for everything else.

      1. It’s always beenn illegal for them to weasel out of a legitimate claim.

        The problem is that there are people out there who will wait until they get sick, then sign up for insurance, and then drop it as soon as they treated. This is fraudulent, but the only thing the insurer can do about it is to prove that you were already sick before you signed up.

        1. Before Obamacare, that is not fraudulent to do.

          And now, I think that’s exactly what people can do.

          1. Before Obamacare, that is not fraudulent to do.

            Err, of course it is. That’s why they were referred to as “pre-existing conditions”. Which all the O-care supporters would go batshit screamy over insurance companies denying people benefits for.

    2. They have to cover three “preventive care” doctor’s visits a year at zero cost.

      Take out the free preventive care requirement and the price would drop back to $60.

  14. “But the whole point of health insurance is to protect you from “very high medical costs.”

    Exactimundo. The problem with O’care is that people confused health insurance with health care. Health insurance just pays for covered health care. Most health care issues are fairly mundane and can be diagnosed by someone without the full training given to an MD and treated without expensive meds and surgery. With a nurse practitioner in your local Walmart, the cost of medical care could be slashed. If the FDA did not take ten years to allow companies to market medicine, all the lives lost during that delay could be saved, and the costs of getting drugs to market and hence the drugs themselves could also be slashed. Yes, we would get a few two-headed babies in the process, but the hidden losses in the form of deaths not prevented and suffering not avoided will almost be greater.

  15. Alternate alt-text: “Lemme just go get the speculum out of the freezer.”

Please to post comments

Comments are closed.