The GOP Health-Care Reform Plans Are Worse Than Useless: Nick Gillespie on Kennedy

What part of "First, Do No MORE Harm" do congressional Republicans not understand?

I was on Fox Business' Kennedy to talk about the Senate Republicans' now-on-hold plans to reform Obamacare. The eponymous host started out by talking about an excellent letter from Sen. Rand Paul outlining the Kentucky Republican's opposition to his own colleagues' plan. Among other things, Paul objected to the plan's refundable tax credits, which he convincingly argues create a new entitlement. What is wrong with politicians that they will do anything but talk seriously about bring market forces and price signals into health care?

Watch above for our discussion. And click below to learn why the reforms being pushed by House and Senate Republicans represent not just a failure of nerve but a failure of vision about how best to actually "repeal and replace" Obamacare. The GOP currently runs the House, the Senate, and the White House. If they're not up to the task of creating a system that increases the quantity and quality of health care now, they never will be.

Read Reason's coverage of health-care reform here.

Comments

[FreeRadical]

I think one of the core roadblocks to real reform is this idea that insurance must cover pre-existing conditions. That idea has become deeply embedded and is taken for granted. If you resist that idea, you are a monster raining down death upon us.

You can't reform insurance by destroying it's very substance. Insurance is about managing risk against future unknown perils.

People with pre-existing conditions are in a tough place and need some kind of help. But they don't need insurance.

[Curt]

Yep. They can't understand the difference between insurance and membership at CostCo.

To them, it's not a hedge against future risks of high and unexpected costs that hit suddenly. It's not a system where they pay $500/month for years and years so that they aren't crushed by a sudden $50,000 charge. It is a discount payment plan where they should be able to contribute nothing and then only pay $500 towards the $50k charge.

I take it for granted that I pay in more than I receive in the short term, but will roughly break even over the course of my life. Meanwhile, I won't be destroyed by a single, huge bill.

[Curt]

Of course, then there's the others who simply don't give a damn. To them, insurance is in simplest terms the way that healthcare is paid in these times. There's people who can't afford healthcare. So we can either give those people insurance for free or give them healthcare for free.

But don't fret that you or some other normal person will have to be the one to pay for their healthcare. No, no. We're just going to pay for that by reducing profits of those greedy ass doctors, clinics, and hospitals. Whatever else we need will simply be taken from the rich... just the 1%.

[FreeRadical]

This is it. They picked the insurance route because it was a convenient pre-existing conduit through which to provide government benefits.

Never mind that the concept of insurance itself will be destroyed. That is a feature, not a bug.

[Tony]

That's why the mandate is there. We force insurance companies to cover people they wouldn't otherwise cover, so in order to keep them alive we make healthy people insure themselves. That's the whole method of this law.

[Gandydancer]

Except that doesn't work. People resist overpaying for insurance and politicians haven't had the stones to actually force them to overpay enough to cover all the health welfare they've promised. Hence the attempts to use risk corridors and the like to sluice tax dollars into the Obamacare system.

But there is a real problem buying insurance one year at a time and expecting it to cover multi-year disasters. Obama's "You can keep your insurance" lie didn't help.

[Tony]

How about direct a government subsidy for healthcare for them, then? The only real alternatives are the Romney-Obamacare three-legged-stool method or just leave people to die for the crime of being sick. Unless you have another proposal?

[FreeRadical]

I would rather have a direct, clean subsidy for people stuck in bad situations than this destruction of what insurance actually is.

But I support neither idea. You are so constricted in your thinking. If I don't agree with you that government is the only answer then I want to "leave people to die for the crime of being sick". Just like Remy's satire from yesterday.

It's a hard nut to crack, and I don't have the solution. I think these things would help: Legalize bare-bones policies. Encourage people to save for their care. Free the market so that things like cash-only clinics became more numerous. Stop covering trivial matters like check ups and birth control with insurance. Reduce regulation of drug development. I know there's more stuff I'm not thinking of.

And I also think charity will have a large effect in an environment of less government aid. But people like you dismiss charity with sneering wave of the hand.

[Tony]

The sneer is only because every other civilized country on earth has figured out some means of delivering universal healthcare and more cheaply per capita than our system. The only thing standing in the way of a real solution, other than lobbyists, is a free-market ideology that simply cannot address the problem. And it can't address the problem because it can't address any problem whose premise is that some product or service isn't available to people universally, as I'm sure you'd agree.

[FreeRadical]

Why don't you acknowledge the serious problems with those universal healthcare systems like long wait times and rationing? And the fact that demographics and the small sizes of those countries makes a big difference?

Also, "every" "civilized" country provides universal healthcare? That is a bold claim, but I don't know the numbers myself.

I'm not sure I agree with your last sentence because I don't know what it means. Could you re-state?

[DesigNate]

Of course, we pay for their protection (I thought you were against us being world police). Let's reduce our NATO and UN involvement and see if all of those other countries are able to continue their happy fun time spending sprees.

Also most of those countries spend approximately 8% of GDP on government run or provided medical care. The percentage of medical care paid for publicly in the US is also approximately 8% of GDP. site . And that doesn't even cover every American. One would think that if we're spending about the same percentage as every other civilized country, our programs should be top notch.

Oh wait...

[FreeRadical]

Also, as usual, you didn't actually engage in any of the ideas that I brought up. I simply don't believe that perfection is possible. I think reforms like I described can get about as close as we can. You'd rather created an enormous government bureaucracy that will become corrupt and atrophied over time in your irrational quest for "prefection".

And, as DesigNate states, we pay for their defense. We pay for their drug research. We create the innovations that keep things getting better.

[Curt]

"What is wrong with politicians that they will do anything but talk seriously about bring market forces and price signals into health care?"

Simply enough, they know that people are stupid. They know that when people hear talk about "market forces" that those people will never connect the concept to all of the amazing, wonderful things that are available to normal, everyday people. They realize that in the United States, the Poverty Line is essentially defined by how difficult it is to pay for the data plan on your iphone.

No, they realize that when people hear talk about "market forces", it is translated as an explanation of why Joe Bag o'Donuts can't afford the McMansion and Porsche that his company president has. Those words are a symbol of how Joe isn't part of the 1% while some other lucky asshole is... despite not working near as hard as Joe.

[LoneWaco]

worse for who? not me.

[DesigNate]

Seriosuly. I already lost my health insurance 3 years ago and finally had to completely go without it this year thanks to Obamacare. Let me tell you, it was super awesome having to decide whether I would take the ass fucking of the penaltax for not having insurance or keeping a roof over my daughter's heads.

Having said that, this bill is fucking retarded on so many levels. I really don't understand why they can't just do a full repeal of the previous turd burger.

[Tony]

You should work harder not to be a poor looter.

[DesigNate]

Wow, super compassionate and liberal of you Tony. I see you don't really care about people being able to afford health insurance. Unless they're the right kinds, eh fuckbag?

Oh, and I work my ass off enough that I don't qualify for the subsidy, so I'm not a looter, just one of those middle class guys you're always carrying on about needing to help.

[Tony]

Of course you know I'm mocking your kind. You think in a world without any government healthcare program you'd be better off on the healthcare front? I mean without invoking any free-market unicorns and such.

[Gandydancer]

Absolutely he'd be better off if so much healthcare weren't paid for through government. and most of the rest by a third party payment system mandated by the tax code. The main problems with healthcare in the US is that it's so f**king expensive and the pricing is so not transparent. And that's down to government interference.

[I'm Not Sure]

"Of course, I want people to have health care," Vinson said. "I just didn't realize I would be the one who was going to pay for it personally."

http://www.mercurynews.com/201.....-bay-area/

[Gandydancer]

"The GOP currently runs the House, the Senate, and the White House. If they're not up to the task of creating a system that increases now, they never will be."

Well, Trump has been sucking up to the GOPe ever since he locked up the nomination, but he was after all mostly significant as a demonstration that the GOPe could be defeated if the electorate that it usually cheats is given a non-GOPe option. Of course the GOPe is utterly incapable of undoing the system that undermines the quantity and quality of health care, but declaring that the party "never will be" seems quite defeatist so soon after the Trump demonstration project. It's not as if any other party will do it. The current crop of GOPe Congresscritters needs to be replaced wholesale, is all. Did someone say that saving the country would be easy?