Obamacare

Sanders-Cruz Healthcare Debate Rehashes Old Talking Points, Illustrates Problem of Government in Healthcare

Bernie Sanders tells a business owner he doesn't know about the hairdressing business, but he doesn't know about business at all.

|

CNN

Sens. Bernie Sanders (I-Vt.) and Ted Cruz (R-Tex.) debated healthcare reform at a 90-minute CNN town hall, with Sanders insisting healthcare was a right and Cruz saying instead that "access to healthcare is a right."

Cruz said on the presidential campaign trail he urged Congress to "repeal every word of Obamacare," but that that did not mean they were "done yet with healthcare reform." He repeated the primary components of an Obamacare repeal bill he's submitted, which does not actually repeal the entirety of Obamacare but does eliminate the mandate and permit the sale of state insurance across state lines, long-time Republican proposals.

But over the last seven years, while they voted dozens of times to repeal Obamacare, Republicans did little work on the "replace" part of their "repeal and replace" mantra since they didn't control the White House. But, as Peter Suderman wrote last week, Republicans have now found themselves without much of an idea on a unified way forward.

Sanders' debate performance, meanwhile, was a reminder of some of the dangers of populist rhetoric on policy making. Sanders insisted healthcare ought to be a right for all Americans. When Cruz pointed to rationing, waiting times, and lower quality service in countries with such arrangement, Sanders claimed that healthcare pricing was a form of rationing of its own. Insofar as government intervention distorts pricing incentives, he's right. Decades of government regulation, intervention and favoritism in the insurance and healthcare industries have largely divorced prices from any market forces, which can "control" prices better than any bureaucrat.

Sanders illustrated this himself, trying to answer a question from a woman who said she ran a hairdressing salon business and could not hire more than 49 employees because she could not afford to offer healthcare benefits to her employees. Sanders pressed her on specifics, pointing to hypothetical competitors against whom she would have an "unfair" advantage for not offering healthcare. At one point, Sanders said he "didn't know about" the hairdressing business. But that's precisely the problem—government bureaucrats don't know anything about business, and efforts to intervene inevitably have unintended consequences that most often drive prices up and quality down.

President Trump—who signed an executive order suspending all fees and penalties associated with the Affordable Care Act has said all kinds of things about Obamacare and healthcare reform that could be interpreted in any way—was barely mentioned in the debate. Trump's travel ban executive order wasn't mentioned at all, even when Cruz pointed out that healthcare services in the United States were so superior that people came from the world over. The executive order swept up people from banned countries who had made previous arrangements with healthcare providers in the United States for specific services, arrangements that aren't as easy to make, and may not always be possible, in other countries. A Canadian provincial official offered to help children frozen out of their procedures in the U.S. to come to Canada—normally Canadian immigration officials can, and do, deny entry to immigrants whose illnesses are deemed a threat to public health, or could cause "excessive demand on health or social services." Such fears fuel anti-immigrant sentiment, and the larger the guarantees politicians like Sanders can actually secure, the easier the sentiment becomes to fuel. A government of handouts isn't sustainable, with or without immigration.

Normally, a Republican president would not accept the premise that healthcare was a right—that's far from certain in this case. And even when Republican presidents do, it doesn't prevent government healthcare expansions like President Bush's Medicare Part D. Republicans have offered a number of different Obamacare-related plans, but the White House has not yet set a pace. Given how little pushback the vast majority of Republican members of Congress are giving the Trump administration so far on historically unorthodox policy positions (Trump could not promise in his Super Bowl interview that Americans would get tax relief this calendar year—an easy promise for a Republican president with a Republican Congress to make), the possibilities for what could happen next with healthcare are endless. As may be Obamacare.

If you missed it last night, you can watch the whole debate, and wonder what might have been in 2016, below:

NEXT: The Carrot, the Stick, and the Buggy Whip

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. Count Chocula versus Grandpa Gulag.

    Awesome.

    1. I thought it was the zodiac killer.

  2. You just know Cruz was geeking the hell out over the thought of recovering a bit of his ego after the Republican nomination process by getting back into his wheelhouse (debate), and against an easy opponent.

    1. I think it is kind of funny they had a debate and i like them a little better for it….as cruz sanders and warren to me are the most obnoxious senators

    2. Cruz vs. Medicare! This must have been agonizing for your patriotic loyalties, like Nickelback attacking Degrassi Junior High!

      1. Drake alone could kick all of Nickelback’s asses.

        Trump may have foiled our Canadian Manchurian Candidate (still working on the name), but we will succeed, damn you!

  3. I was sort of shocked when sanders said he would allow people to get drugs from other countries. No one needs 23 suppliers of drugs!

    1. A frugal drug addict might.

  4. Like watching two monkeys fight over the worlds nastiest banana at the zoo.

  5. Please don’t let me die.

  6. The only ‘rights’ human beings have are to life, liberty and property. Anything that requires theft and coercion, harming the right to life and liberty of others, cannot be a right. The actual right to life and liberty requires that everyone be free to live, work and trade however they wish, with others who consent to live, work and trade with them.

    One big problem with the non-voluntary government is the non-voluntary part. Socialism (of all kinds) can sound good, until you run out of people to rob… or they decide to fight back.

    1. ObamaCare in no way creates a right to health care.

      Instead, it creates various duties:

      — US residents are mandated to purchase government-approved medical insurance
      — US taxpayers are mandated to subsidize medical insurance for low income earners (even if they have a net worth in the the millions)
      — US businesses with 50 or more employees are mandated to subsidize government-approved health insurance and it creates

      These mandates are duties to the state, not rights. There are lots of other duties established by ObamaCare, but it neither establishes nor defends any individual right.

      1. True – but I think ML may have been referring to one of Sanders’ frequent talking points, the claim that healthcare is a human right.

    2. Cruz actually addressed the rights issue head on. He read off sections of the B of R and articulated that they are all measures to bar government interference with our choices of speech, religion, privacy etc.

      Sanders was totally incapable of defending the ACA and instead moved the goalposts to single payer.

      It was cathartic to watch Bernie’s moronic talking points face rebuttal, and I think Count Chocula kicked his ass soundly. Well worth the watch imo.

  7. People spend so much time bashing Obamacare, they forget the conditions that made the status quo ante so bad for working Americans that even Republicans (remember?) proposed it. It wasn’t Obama who founded the FDA, wasn’t Obama who set up the drug patent system, wasn’t Obama who founded Medicare or expanded its distortionary effects to the consumer drug market, wasn’t Obama who passed HIPAA and destroyed its privacy provisions three years later, wasn’t Obama who banned drug reimports, wasn’t Obama who set up the ridiculously arcane, overregulated, and anticompetitive local markets all over the place, wasn’t Obama who tied healthcare to workplaces, wasn’t Obama who came up with the absurd practice of “insurance” against completely anticipated expenses. I’m probably still leaving a shit ton out.
    .
    And now we may be poised to leave the Obamacare nightmare for something worse than the status quo ante. Only a complete overhaul of the way we think about healthcare, a genuinely competitive market that modern America has never enjoyed, can make it affordable for young and less fortunate Americans. It doesn’t look like we are poised to seize the opportunity of (the just plain sloppily conceived) Obamacare’s collapse to do things right. I fear continued and justified dissatisfaction with its successor, which will be inevitably be branded “that time we tried it the free-marketeers’ way,” and fear even more what America will turn to after that.

    1. Interesting take.

    2. Now, if you can condense that down to the size of a bumper sticker we’ve got a chance.

      1. Buy your own damn insurance…or nah.

      2. Perhaps “Free Market Health Care may have its flaws, but it’s certainly better than what we have now!” would work…

    3. Problem is that anything that reduces the cost of health care reduces the incomes of those involved in one way or another with health care. And while our administrative costs are one of the drivers of our having the world’s most expensive health care, those people too enjoy earning the incomes they do because the consumers of health care services are in fact the people paying their wages and salaries. Today’s doctors, unlike those of say fifty years ago, have office staffs that suck up a part of what the patient pays for health care services. Then hospitals often have as many people working in “administration” as are working in patient care. Then, because hospitals can pass the cost on to consumers of health care services, they can “afford” to purchase expensive high tech equipment without having to wait for the prices to come down to more reasonable levels. And a lot of the use of this equipment relates back to an incredibly expensive malpractice issue, something that almost unique to the USA itself.

      To bring down US health care costs to a level comparable with what the rest of the developed world pays would be extremely difficult if not impossible without massive changes in our political system. There are things that could be done quite at virtually “zero cost”, but these would along the line of deregulation of health care to an extent that would create a great deal of opposition from those who benefit from our present day system.

  8. W’s mistake was Medicare Part D – Part B was a much earlier mistake.

  9. That exchange between Sanders and the hair salon owner was pretty telling. As I was watching it, I thought, he has no idea what she’s talking about. He’s not lying or dodging the question, he just doesn’t understand. She asked how she could grow her business when her profit margins are so low and additional employees would mean she has to provide healthcare. His answer was, well yeah, you should provide healthcare. He literally didn’t understand her question.

    1. What in his entire existence would allow hi to understand the question?

    2. The cost would likely be the same for all of her competitors. Similar to the effect the minimum wage has upon the cost of running a business. I ran a small security guard agency for a number of years. It wasn’t hard to “beat the competition” because I was willing to do some of the work myself and deal with the necessary paperwork. Unfortunately far too many small business owners expect to sit back and let the money come rolling in.

      In the case of the woman with a hair dressing business, most of these only have a few employees so the cost of paying for health insurance isn’t going be a problem for them. Then probably the owner is doing some of the work too. Pretty hard to compete in such a case unless you start hiring part timers or people willing to work as private contractors. The beauty salon my wife goes to operates that way. The hairdressers are private contractors who “rent” the equipment they use in their work. This is increasingly the way a lot of “work” is going to be performed in the future.

  10. How can health care and insurance costs be so high after “decades of government regulation, intervention and favoritism in the insurance and healthcare industries”?

    Oh, right. DUH!

    As I always say, health care is too important to put government in charge of it.

  11. Actually the issue is one of “cost”. Which is far higher than it would be under true free market conditions where the government wasn’t involved in anything more than the prevention of fraud by the providers of medical services. In such a case, the cost of US health care would likely be about 1/2 of what it is today. The elimination of professional and occupational monopolies would make us all relatively “richer” than we are today due to a much lower cost of living.

    1. Yeah, but then what of the children?

  12. My last month paycheck was for 11000 dollars… All i did was simple online work from comfort at home for 3-4 hours/day that I got from this agency I discovered over the internet and they paid me for it 95 bucks every hour… This is what I do

    =========================== http://www.4dayjobs.com

Please to post comments

Comments are closed.