Resuscitating the Healthcare Debate

The plan to repeal and replace Obamacare has Republicans in a precarious position. 

A hundred years ago, our healthcare system was pretty simple. There were no government regulations, and the few doctors there were, offered their services in exchange for whatever payment they could negotiate with their patients. Like most of our economy, it was a free market system. The term “universal healthcare” was non-existent.

Since then, with rapid advances in medical care, life expectancy has nearly doubled, but not without cost. Someone had to pay for research, for educating our medical professionals, for the manufacture of medicines, and for increasingly expensive treatments. To help defray those costs, which were ultimately passed on to patients, the concept of health insurance was born around 1929.

As it evolved, most working Americans acquired their health insurance through their employers, usually at reduced rates. Charitable foundations and various government programs like Medicare, Medicaid, and SCHIP (State Children’s Health Insurance Program) were created for those who could not afford insurance.

The system was far from perfect. Though nearly every American had access to emergency care and basic healthcare, countless individuals without insurance were still unable to pay for emergency care, long-term treatments or costly procedures. But our society survived this way for almost a hundred years.

Then in 2008, the Democrats won the House, the Senate, and the Presidency. They looked to Europe and argued that ours was the only civilized nation in the world that did not offer universal health care to its citizens. They equated healthcare to the basic inalienable rights of life, liberty, and the pursuit of happiness, defined in our Declaration of Independence. They never considered that healthcare is considerably more costly than the human rights spelled out by our Founding Fathers. They decided that every American should be entitled to the same quality healthcare as those who pay for health insurance. On a strictly partisan vote, they implemented the Affordable Care Act - Obamacare. Its purpose was not to merely expand government-provided healthcare. Instead, it offered health insurance policies to millions of previously uninsured Americans. In many cases, it imposed them.

Obamacare was never the utopian universal health care system that Democrats had envisioned or promised. It was instead an unsustainable massive entitlement, funded by hard-working Americans. To implement it, the federal government had to essentially take over the private health insurance industry. It was kept afloat through government mandates, subsidies, and regulations. Of course, this was not without consequences.

From the beginning, Republicans warned about serious flaws in the plan. They predicted that oppressive government regulations would cripple the insurance industry and hurt our economy. They argued that healthy, young people would not participate in insurance pools, driving up costs for older, less healthy participants. They foresaw increasing costs to the consumer, coupled with decreasing quality.

They were proven to be right. Contrary to Democrats’ assurances, millions of Americans with long-held policies saw astronomical increases in their premiums and deductibles. Many lost their doctors and hospitals of choice, and some were forced out of their plans entirely. Additionally, many economists argue that employers, in an effort to evade Obamacare’s onerous mandates, began hiring fewer full time, and more part-time employees, contributing to the decline in our economy.

So now with a Republican President, a Republican majority in the House and Senate, why is repealing and replacing Obamacare proving to be such a daunting task? Only in politics do principles and commitment ebb and flow with public opinion, and Republicans are coming to grips with the difficulty of rescinding an enormous entitlement, now that it’s firmly entrenched.

Today, the debate has been revived, but now it’s solely among our Republican politicians. They no longer argue that our Constitution doesn’t guarantee healthcare for all citizens, or that a country already saddled with $20 trillion in debt can’t afford universal healthcare for more than 300 million citizens. They’re no longer talking about the folly of compelling private companies to insure against something that has already occurred. They’re no longer comparing Obamacare to socialized medicine.

This is the new debate: On one side are those Republicans determined to keep their pledge to repeal and replace Obamacare. On the other are those who fear the political backlash it would cause. They are focused on keeping the main provisions of the law intact while calculating which tweaks would best satisfy their constituents.

Republicans were right during the first healthcare debate. But how do they now repeal a well-entrenched entitlement, with which the Democratic Party has saddled the nation? If their ultimate plan causes millions of newly insured Americans to lose their subsidized policies, there will be widespread outrage. If it is essentially the same as Obamacare, it will fail, and Republicans will rightly be blamed for making a bad situation worse. If they do nothing, millions of supporters will feel betrayed. Any way you look at it Democrats have good reason to gloat.