- - Tuesday, January 13, 2015

ANALYSIS/OPINION:

OVERCOMING OBAMACARE: THREE APPROACHES TO REVERSING THE GOVERNMENT TAKEOVER OF HEALTHCARE

By Philip Klein

Washington Examiner, $9.99, 114 pages

A folk song inspired by Philip Klein’s latest book might be called “Shall We Overturn?” Just imagine a Bizarro Pete Seeger croaking out, “Shall we overtuuurn? Shall we overtuuuurn? Shall we overturn Obamacare some day?”

“Overcoming Obamacare” is short and sharp with flashes of wit. The book comes to 114 pages soaking wet. Mr. Klein finds it “easier to find a three-legged ballerina” than to get at good information on health care prices to shop around. A disagreement about tax deductions versus tax credits turns a meeting of “mild-mannered” conservative health care wonks “into a bloody scene from ‘Game of Thrones.’”

Nowadays, liberal New York Times economist Paul Krugman defends Obamacare to progressives by arguing it is really a “Rube Goldberg device” giving America “a rough approximation of a single payer system.” Mr. Klein shows us the gears, the levers, the drainpipe and that ball with the catapult.

“Obamacare simply requires insurers to cover those with pre-existing conditions. Doing that in isolation would have required employers to simply offer insurance to sicker Americans at rates nobody could afford. So that led to another provision that prevented insurers from charging sicker people more.

“That, in turn, led to the individual mandate, which provided more reassurance to insurers that they’d be able to sign up enough healthier customers to offset the costs of … the very sick. [O]nce government mandated that individuals purchase insurance, bureaucrats had to define what constituted insurance, and the Obama administration’s narrow definition of insurance limited choices for all other Americans,” Mr. Klein writes.

Since individuals were now forced to buy insurance, “it was only fair to provide subsidies to those who could not afford it.” Those subsidies had to be paid for with annoying taxes on things such as medical devices, allegedly lavish health insurance policies and, for some strange reason that may or may not have to do with John Boehner’s orangeness, tanning.

And thus, to square the circle of insurance companies “denying coverage to those with pre-existing conditions” — a problem which, Mr. Klein reminds us, “by some estimates affected less than 1 percent of the population,” the geniuses in the Democratic Party “disrupted the entire healthcare system.”

Americans almost across the political spectrum hated the disruption. It cost the Democrats first the House of Representatives, then the Senate — and plenty of governors mansions and state legislatures along the way. And yet, President Obama shows every sign of digging in his heels in defense of his signature legislation. Republicans face constant charges that they need to be “for” something, not just against Obamacare.

The author (full disclosure: a friend and former colleague) is perhaps the best conservative journalist on the Obamacare beat today, so he knows just how false that charge is. “People are always saying ‘the Republicans have no replacement plans.’ Well the problem is, they have too many plans,” he quotes Pacific Research Institute boss Sally Pipes as saying in Chapter 1. Mr. Klein’s task is to help us think through those plans by looking at the policy and the politics of these proposals set against Obamacare.

Republican ideas for what to do instead of Obamacare fall into three broad camps that he calls the reform, replace and restart schools. Reformers would retain a lot of the framework of Obamacare but use it to somewhat more free-market ends. Replacers want to repeal Obamacare and replace it with a fairly robust system that would do many of the same things that the Democrats say Obamacare will do: increase coverage, subsidize the poor, etc. Restarters want to scrap Obamacare and reorient American health care in a much more free-market direction than existed when Obamacare was passed.

Mr. Klein’s heart is with the restarters, though he does recognize many political difficulties with that approach. While Obamacare is unpopular, some of its provisions are not. Reforms that are seen as disruptive of American health care, even briefly, may not go over well with voters.

Yet he sees some discomfort as absolutely necessary if the GOP is to get anywhere in the next few years. “Republicans,” Mr. Klein writes, “didn’t lose on healthcare when Obama won in 2008 or when he signed his bill into law in 2010.” Rather they really lost the debate “when they failed to put in place a comprehensive free-market plan when they were in charge.”

Jeremy Lott is the author of “The Warm Bucket Brigade” (Thomas Nelson).

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