Repeal and Unleash: Shrugging Off Government in Health Care

After eight long years of "We have a better way!," congressional Republicans are proving a case for their own irrelevance.

The repeal-replace concept isn't particularly difficult to understand or to implement, unless one is trying to do something entirely different while keeping up appearances.

There are a great many viable, wise, and well structured reform plans from which the congressional camera-whores might choose.  This issue has been on the front burner for so long now, the enabling legislation (and the structures that would spring from it) is as close to "plug and play" as one might ever find in government.  And yet...

The House and the Senate each chose to start from scratch, eschewing the heavy lifting already done by true policy experts in favor of hastily cobbling together a turd of a bill, which, unsurprisingly, they seemed quite keen on keeping under wraps until enactment.

Why?

Because, for the Republican leadership, this is no longer about health care (if it ever really was).  It is now about rent-seeking, political positioning, and power consolidation.

The Republican leadership do not see a second term in the cards for Trump (indeed, they will fight to ensure that outcome) and are looking ahead to the next election cycle, where they will require the donations and support of insurance companies who have been trained to suckle at the government teat.  That is why the Senate bill is one part reform and ten parts bailout to insurance companies.

Under a "weakened-Trump, knock-down-drag-out" election scenario, the Republicans also hope to hold on to the support of ordinary Americans eager to keep a single-payer zombie from rising again.

More importantly, though, these mewling establishment kittens realize that any meaningful reform will take several years to fully implement and bear fruit in terms of cost-savings, premium reductions, and expanded access to care (all things that only a true free-market solution can deliver) and find themselves loath to defend a transition in progress in the rough-and-tumble of the next two election cycles.

So...what we are seeing here is the equivalent of punting on second down.

Our "leaders," unable to gather the votes for a purely political fig leaf of reform (designed to pay off the insurance companies as described above), are now putting their "prevent" defense on the field as quickly as possible, believing that their offense will be unable to score in time.

While this may be a fine strategy for the benefit of the players, it is a huge middle finger, stuck high in the air, to the "fans," who are sick of their team playing "not to lose."

The "clean repeal" isn't a repeal at all; it is kicking the can down the road for two years while calling it a repeal.  It is fluff – complete theater designed to claim fulfillment of a campaign promise while doing absolutely nothing for two years, during which time the entire health care industry will be unable to plan a damn thing because it has no idea what to plan for.  This isn't a win; it's a self-inflicted wound.

Do a true repeal, with a sunset provision for only the existing policies reliant on the repealed law, designed to give those affected people sufficient time to transition themselves to other policies.

By doing this, you unleash the industry itself to innovate for the larger majority of insureds (who are not dependent on exchange-based policies), creating the alternative system based on the free market that will ultimately replace all of Obamacare.

Best of all, this will be created by those who know the industry best rather than dictated by know-it-all politicians desperate to keep their hand in the mix lest they lose one scintilla of power.

It would also be wise to include a dose of preventative medicine in the "unleash" portion of the bill – to enshrine restraints on the power of government, Constitution-style; to interfere in the practice of medicine; and to forever free us from relentless efforts to conflate health insurance with health care, such conflation being the preferred modus of the statist to facilitate ever increasing usurpations of power in the name of "reform."

We don't need a "replace" from Congress; we need an "unleash."  The people and the free market can do the rest.

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