Obamacare is Here to Stay. Now Lets Fix it

The effort to repeal Obamacare was doomed from the start. There was no real pathway for Republicans to do it anyway, but now that Barack Obama has been reelected any hopes the GOP had for repeal have been shattered.

Lets now pretend we live in a fantasy land where the GOP is concerned with actual governance  How could they go about reforming health care reform? Democrats have often expressed willingness to make changes to the Affordable Care Act. How could reaosnable and responsible conservatives improve upon it?

David Frum tackled this question in 2011, shortly after the ACA was signed into law. You should read the whole thing. A preview:

…there are things that can be done, and here are some early priorities:

1) One of the worst things about the Democrats’ plan is the method of financing: an increase in tax on high-income earners. At first that tax bites only a very small number, but the new taxes will surely be applied to larger and larger portions of the American population over time.

Republicans champion lower taxes and faster economic growth. We need to start thinking now about how to get rid of these new taxes on work, saving and investment — if necessary by finding other sources of revenue, including carbon taxes.

2) We should quit defending employment-based health care. The leading Republican spokesman in the House on these issues, Rep.Paul Ryan, repeatedly complained during floor debate that the Obama plan would “dump” people out of employer-provided care into the exchanges. He said that as if it were a bad thing.

Yet free-market economists from Milton Friedman onward have identified employer-provided care as the original sin of American health care. Employers choose different policies for employees than those employees would choose for themselves. The cost is concealed.

Wages are depressed without employees understanding why. The day when every employee in America gets his or her insurance through an exchange will be a good day for market economics. It’s true that the exchanges are subsidized. So is employer-provided care, to the tune of almost $200 billion a year.


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