Health Care

A Chainsaw Man Explains How to Fix Obamacare

Healthcare reform can be deceptively simple.


Billy Wayne Shiflett was reading the newspaper the other day when I stopped in to pick up the chain saw he had sharpened for me. That's one of Billy Wayne's many admirable qualities: He still takes the news in paper form.

"Course I do," he said once when I remarked on the fact. "You ever try to sop up a spill with an iPad?"

Hard to argue with that.

Billy Wayne pushed the paper aside when I came in.

"Morons," he muttered.



"Oh, them. No argument here. What'd they do this time?"

"It's what they ain't done. Can't get their act together on Obamacare repeal. Taken 'em seven years just to knock together a rough outline."

"Well, it's complicated," I said.

"No it ain't."

This floored me.

"It isn't?"

"Nope. Just pass a law says the old law ain't in effect no more."

"I don't think it's that easy," I said. "There are a lot of angles to consider."

"Such as what?"

"Well, a lot of people can't afford to buy health insurance."

"So help 'em out. Give 'em a tax break. Folks who work at big companies get their health insurance tax-free. Let everybody get it that way an' even things out."

"All right," I conceded. "But not everybody pays enough in taxes. Some people don't pay any income tax at all."

Billy Wayne nodded. "S'pose not. So if they're poor just give 'em the difference."

"You mean a refundable tax credit?"

"That what they call it?"

"I believe so," I said.

"Well there you go."

"I think that's their plan," I said. "And it's fine for people who can get insurance. But sometimes insurance companies turn down people who have a pre-existing condition."

"Like Becky."


"Waitress over t'the IHOP. Sweet gal. Got this big ol' thing on the side of her neck, pains her awful. Had it for years."

"I was thinking more like heart disease or cancer, but yes. Like that."

"Easy fix," Billy Wayne said. "You take all those folks like Becky an' you put 'em together in one big group an' you write special policies just for them."

"A high-risk pool, you mean?"

Billy Wayne shrugged. He took an oil-stained rag from his back pocket, blew his nose loudly, carefully studied the results, then tucked it back into his pocket. I was glad we hadn't shook hands when I came in.

"That sounds good in theory," I said smugly. "But it will never work in practice."

"Why not?"

I made ready to bowl Billy Wayne over with the irresistible force of my argument.

"High-risk pools have been tried," I said. "Many times. They never end well."

"They don't, eh?"

"No sir, they do not."

"How come?"

"Well, for one thing, they're based on a flawed premise," I said. "Insurance works by spreading risk around, which spreads the cost around. High-risk pools concentrate the risk, so they concentrate the cost."

"Meaning what?"

"Meaning they're really expensive. The one that Minnesota ran required more than $173 million in subsidies in one year."

Billy Wayne pinned me with a gimlet eye. "How's that different from Obamacare?"

"I'm sorry?"

"I saw one a' them 'fact-checker' things you media types love so much a while back. Said Obamacare run up $1 trillion in taxes in 10 years. One trillion dollars just to help people get health insurance. Sure sounds like a 'subsidy' to me."

"Well, yes, but The Commonwealth Fund says the Affordable Care Act spreads, and I quote, 'risk across a broad population to decrease per capita costs and allow for more affordable and comprehensive coverage for all.'"

Billy Wayne laughed. "Ain't no dang different," he said. "Healthy people still payin' for sick ones to see the sawbones. Money's still comin' outta our pockets in the end. My daughter, she pays more'n twice what she used to for health insurance, thanks to Obamacare. She's young and healthy, see? So her insurance never cost much. Now it does."

"But according to a piece I read in The Washington Post," I retorted, "high-risk pools are characterized by high premiums, waiting lists, lifetime caps on coverage, and temporary exclusions for pre-existing conditions."

"Don't have to be," Billy Wayne said. "All depends on how you write the law."

"That could get very expensive."

"You figure that out all by yourself, genius? Look…" Billy Wayne leaned over the counter and pointed a stubby finger at me. "Some people get really sick and it costs a hell of a lot o'money to get 'em right. More than they'll ever make. So somebody else has gotta pay for it, or either we let 'em die. Not too many folks like that second choice. Now we can all pay for it by forcin' everybody to buy insurance and tellin' insurance comp'nies how to write they policies an' all. Or we can all pay for it with taxes. Seems to me Obamacare does a lotta both, an' none of it very well.

"Either way, we're all gonna pay for it, one way or another, until people can't stand to pay no more. Eventually we're gonna spend so much on health care, ain't gonna be no money left for nothin' else. An' then somebody's gonna hafta put his foot down an' say we're just not gonna pay for some things no matter how sick you are. Ain't a country in the world don't have limits on how much doctorin' people get. We're no different. .. Least not until we figure out how to make doctors work for free."

"Like you, you mean?"

"Hell I do," Billy Wayne said as he reached for my chainsaw. "That'll be eight seventy-five, plus a little something for the governor."

This column originally appeared at the Richmond Times-Dispatch.

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  1. Train all government workers in the medical arts. They’re public servants, aren’t they? What’s the use of having servants if they won’t do the work you want them to do? And I’ve heard public servants are selfless, dedicated, hard-working, noble, pure-hearted individuals who want nothing more than to serve their fellow man and are willing to work long hours for low pay so delivering healthcare services as a side job should be no problem for these saints who walk among us.

  2. Billy’s name ought to be “Guillaume”, because he talks like a Frenchman.

    1. That’s right. He’s a Frenchman who’s pretending to be a redneck. And he’s doing a piss poor job at it. Must be hard to sip a fine imported Pinot Grigio while chainsawing a tree. Any redneck could down two trees whilst simultaneously downing two bud lights in the space of five minutes.

  3. You know what Obama said about health insurance? He said health insurance was too important to be left to the individual. When he said that, fifty years ago, he might have been right. But today, health insurance is too important to be left to politicians. They have neither the time, the training, nor the inclination for strategic thought. I can no longer sit back and allow Communist infiltration, Communist indoctrination, Communist subversion and the international Communist conspiracy to sap and impurify all of our precious bodily fluids.

    1. Obama also said that trying to fix the healthcare problem by mandating insurance, would be like trying to solve the homeless problem by mandating homes.

    2. Cynic: +1 Kubrik. Well done.

  4. Billy Wayne Shiflett

    True fact: The Shif(f)let(t)s are an enormous, fractious phyle spread throughout the Piedmont and Blue Ridge regions of Virginia. In some rural areas, they make up half of any given kindergarten class and up to 80% of emergency room admissions. You can determine the socioeconomic status of a given Shif(f)let(t) by how many letters they have in their name. A Shiflet will almost certainly have a criminal record and is likely to lose a toe at some point in his or her life; a Shiflett (or a Shifflet) may eventually live in a dwelling that cost MORE than their truck; a Shifflett probably owns a Ford or John Deere dealership and has been outside of Virginia on purpose.

    1. And don’t even get him started on the Shifflettes!

      1. And if you drop the second syllable, you will almost certainly be peddling gold and predicting economic collapse.

  5. I like this’a’here Billy Wayne fellow. A lot.

    1. Would have worked even better if he was a woodchippin’ man. Woodchippers have been made great again.

      1. *fist bump*

      2. You think this feller works on chainsaws, but dudn’t work on woodchippers?

      3. Found a woodchipper in Fallout 3. Kept it with me. Was thinking it would come in handy if I ever ran into a New York Federal Attorney. But then I noticed it weighed fifty pounds! Screw that! Sold it to Moira and never looked back.

        p.s. Yeah, yeah. I know there’s a mod that can turn one into a Peter Jackson style melee weapon. But still, Moira got entertainment out of it. She scares me sometimes.

        1. I think it was supposed to be a part for the Rock-It Launcher, which looks like it has a woodchipper hopper on top in the first-person view. If there is any schematic in the game that uses it, I haven’t found it yet.

          I stashed it in my Megaton house just in case, because it amused me. Libertarian Moment!

  6. How about we make the draft gender neutral, draft everybody who approves of Obamacare, and send them through medic school? Then assign them to various street corners to treat who or what ever shows up.

  7. When I read the headline I was hoping it was just a video of a guy chainsawing through the 11,000 pages of the ACA.

    1. That would be the preferred chainsaw-related solution, yes.

    2. A was hoping the picture was a woodchipper and it was topped off with gas. In goes all the unconstitutional ObamaCare nonsense.

      1. Didn’t Rand do that once?

  8. This story definitely happened. No doubt about it.

    1. It would be more believable if this conversation was between a friend and his 8-year old son.

      1. Or at the very least with a taxi driver.

    2. Ever heard of artistic license? Or is it that hard to believe that a Barton Hinkle would own a chainsaw?

    1. It fixes the cable?

    2. They take a coffee brake?

  9. Who knew a Friday the 13th reboot could go so deep in the weeds.

    1. Only you’ve been here long enough to notice that.

      1. Eugene has nowhere else to go.

        1. “DOR” Gene. Say it!

  10. “Well, it’s been nice chattin’ with you today, Mr….?”

    “Hinkle. Barton Hinkle.”

    “Barton Hinkle? What kinda faggoty ass name is that?”

  11. This is some grade A bullshit. I know the guys who sharpen chainsaws and they do better under Obamacare.

    1. I doubt you know “the guys who sharpen chainsaws.”

      1. If you borrow a chainsaw from the father-in-law and are appreciative of using it, then you take it to a small shop that fixes lawnmows, sharpens pruners, sharpens lawnmower blades and sharpens chainsaw teeth. So some people know guys who sharpen chainsaws.

    2. So yeah, people who get free shit like getting free shit and would prefer to keep getting free shit.

    3. This article says nothing about the insurance policy of the guy sharpening chainsaws.

  12. Or, you know, just ban the Feds from doing literally anything concerning the medical field at all… That would be what, half a page?

    No, that’s much too complicated. Much better to have a law that’s more than 20,000 pages long!

    Simple as that!

    1. Or, you know, just ban the Feds from doing literally anything concerning the medical field at all

      That would be a good start. Then maybe stop doing anything not required by the constitution.

      1. Well, they think the commerce clause requires the Feds to regulate wheat grown on your own property for your own consumption, so let’s just try to stop them from doing stuff.

        1. Not quite. They think the commerce clause allows that sort of regulation. I chose the word “requires” for a reason.

    2. The VA, any medical research grants, federal student aid for med students, medicare, medicaid, medical expense deductions on your taxes, pre-tax dollars for insurance, federal funding for hospitals, emergency rooms…

      You could write such a law easy enough. Passing it? Would be problematic.

  13. Obamacare is a trap Republicans can not escape. If they keep the popular, expensive parts of Obamacare, their base revolts. If they eliminate the popular, expensive parts, they lose independents. Either way, Democrats take over Congress in two short years, and single-payer socialized medicine is inevitable.

    The only possible way out is to take this once-in-a-lifetime opportunity to replace Obamacare with Statecare. Turn over health care to the states in the form of block grants that phase out over time. We need to raise awareness for the Statecare solution. Please sign the Petition at

    1. Man, remember that time signing a petition did something?

      Yeah, me neither.

  14. So what exactly is chainsaw man’s solution for the problems of the high risk pool? Yeah, it shares ACA’s costing spreading scheme, but it’s more expensive and possibly even more unstable.

    I read a rough outline of Rand Paul replacement plan and it looks really good (although it still allows for tax credits for HSA). It eliminates the mandates and restores cheaper plans. Work from there.

    1. Probably just subsidize the hell out of it. It’s going to happen one way or another if universal coverage is the goal.

    2. You’d think a guy holding a chainsaw could come up with a much better solution.

      1. Some kind of final solution, maybe?

  15. Chainsaw man. Chainsaw man.
    Does what a chainsaw can.
    Sops up spills, with iPads,
    Kicks Obamacare in the nads.
    Look out! Here comes the Chainsaw man!

    1. Thank you, thank you. I’ll be here all week. Tip the fish.

  16. Chainsaw man better, keep your head.
    Don’t forget what your, user’s manual says.
    Healthcare change gonna, come at last.
    Now your premium is, raising fast.

  17. RE: A Chainsaw Man Explains How to Fix Obamacare
    Healthcare reform can be deceptively simple.

    Here’s a simple plan for Obozocare.
    Repeal it and deregulate the healthcare industry.
    Oh, wait.
    Then the government won’t be involved in our daily lives.
    We can’t have that.
    My bad.

  18. To cut healthcare spending, we need to cut the cost of healthcare.

    Cut administrative overhead.

    Cut physician wages. You don’t do this with a mandate, you do it by making it easier for foreign doctors to immigrate, and more importantly, to practice medicine.

    1. Or, just pass the AHCA…..t-ahca.pdf

    2. “Cut physician wages. You don’t do this with a mandate, you do it by making it easier for foreign doctors to immigrate, and more importantly, to practice medicine.”

      Cut their wages and US will end up with something like the NHS! Too many US doctors are already quitting due to Obummer Care and malpractice costs. (Only exception is cosmetic surgery which is getting cheaper) Better off figuring out what cosmetic surgeons are doing correctly. US already has too many foreign doctors, some of which we might be better off without.

      1. So too many foreign doctors are keeping the prices high? How does that work?

      2. If physicians had to compete in a market they’d quit whoring as expert witnesses testifying that merry-jew-wanna is 99% as bad as Afghani smack.

    3. Let pharmacists prescribe. Why should they get all that training just to count pills?

  19. We need to let people buy cheap, catastrophic plans with high deductibles.

    1. “We need to let people buy cheap, catastrophic plans with high deductibles.”

      We need to…. do nothing. “Do nothing” should be a new political party for 2020.
      (Note: “do nothing” requires deleting all statutes that involved “doing something”)

      1. “let” would fall under “do nothing.”

    2. Once upon a time I had catastrophic insurance for $5.95 a month.

  20. High risk pools are BS. It is clear that every rational person would choose, before he was even born, and not knowing what health problems he’d have, to participate in a general insurance pool. We’d all agree to that, because it’s the best way to spread the costs incurred by the truly unfortunate. Therefore, let’s just wade through all of this nonsense and assign everyone a National Health Insurance ID at birth, and assess them a premium split evenly across the entire population, and set annually by Congress.

    Let’s leave the actual practice of medicine alone to innovate. But let’s eliminate this notion that somehow it makes sense to have insurance companies competing with each other to “innovate” in the provision of health care.

    Oh, and let’s also mandate (at the federal level) complete price transparency for all tests, procedures, and services.

    I have come to this conclusion only after accepting that we are a society based on altruism-collectivism in certain fundamental ways, such that no hospital or doctor will ever actually refuse care to the sick or dying. Given that, what I propose is the best way.

    1. “It is clear that every rational person would choose, before he was even born, and not knowing what health problems he’d have, to participate in a general insurance pool.”

      Clear as mud.

      1. Clear as a Veil of Ignorance.

    2. If I’m 20 years old and living off student loans, why on earth would I want to go halvesies on medical insurance with a rich old fart?

      1. I hope you’re not spending all that loan money and never figure out the definition of insurance.

  21. The exercise gyms are lobbying for tax deduction of their fitness club fees. This deduction would increase the contrast between government-job lard-butts and normal productive folks.

  22. Calendar is very good for time management

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