As I’ve written before, our method of financing health care creates serious, unnecessary obstacles to entrepreneurship and innovation. In the name of avoiding “Socialism” we have created enormous obstacles to Capitalism with serious consequences for those trapped in our dying middle class.
The way we finance medical care is probably the worst obstacle we face to developing a real ownership culture. If Republicans are serious about making capital ownership and entrepreneurship available to middle-income Americans then we have to find ways to decouple insurance from employment and make it affordable on an individual basis.
For all the problems with the ACA, and they are legion, the Act is proving to be our first solid step in that direction. For people who live in states that embraced the law and established exchanges, the ranks of the uninsured are declining significantly and we are starting to see the first signs of what that means for commerce. From NPR:
Last year, Murray says, her husband — a freelance worker in the information technology field — was diagnosed with chronic spinal arthritis. He needed good health insurance, which he received through Murray’s job as a social worker in Chicago for a dialysis company. But Murray didn’t like her job.
Murray and her husband are both 31, with a 20-month-old daughter and a second child on the way. Before the Affordable Care Act, they couldn’t get insurance on the individual market because of his .
But under the federal health law, they now qualify for a subsidized policy that will cost $535 a month for the whole family. It’s not cheap, she says, but the coverage allowed her to quit her job and launch an online business to help other young women take care of sick loved ones.
This is not an isolated case. The problem is often called “entrepreneur lock.” Talented, ambitious people with the will, initiative, and even the capital to start businesses find themselves trapped. Launching a business is supposed to be risky, but it’s not supposed to cost you your life. The structure of our health care system, pre-ACA meant that health care might be the single largest cost of starting a business. Worse, the lack of basic legal protections meant that family members who were already ill might be left with no practical access to care whatsoever.
Republicans are supposed to be the party of commerce, but the fight over health care displays how far we have traveled from that tradition. If the US adopted some form of universal health insurance, just like every other settled nation on Earth, the biggest beneficiary in pure dollar terms would be the business community.
U.S. businesses spend a whopping $500bn a year on medical care. In America, every business must become an expert at health finance in addition to whatever it is they do for a living. That is a particular burden on the most fragile and critical segment of our business ecosystem – small business.
Republicans are also supposed to the party of individual choices. What choices are we making available with policy decisions that rob people of their savings, stymie their initiative, and threaten them with a fate far worse than bankruptcy when they pursue the American Dream? There may be no single issue that better displays the extent to which the Republican Party has lost its moral core than health care.
While failing to muster any credible alternative, because that’s hard, the party has fought the law with lie after lie after lie after lie. From death panels to RFID chips to the incredibly cynical distortion that people are losing access to health insurance, there seems to be no conscience to stem flow of deception. For a party that claims to care so much about morality, the “debate” over health care is a horrifying hypocrisy.
The ACA is a bureaucratic nightmare. It works, but the cost in terms of the size, influence, and reach of the Federal government is enormous and utterly unsustainable over time. That said, “repeal” is a childish cop-out. It is never going to happen because the public will never tolerate it. Repeal and replace sounds nice, but how are Republicans going to assemble a replacement that works better?
Health care is a dazzlingly complex subject with enormous impacts to each and every voter. The kind of people who are still chasing the ghosts of Benghazi can never muster the hard-nosed pragmatism required to tackle complex, difficult problems that do not yield to ideology. Jesus is not going to fix our health care system and Republicans have little interest anymore in matters that can’t be resolved with a prayer meeting or a dishonest Facebook post.
Health care is an issue that desperately needs the attention of the Republican Party, the old one that used to feature grown-ups. There are alternatives available that would shrink the Federal government, increase the ability of states to act as innovators, and cover everyone, but no option fits the childish demands of a party that insists that every problem can be solved by doing less about it. While the GOP indulges its fantasies, we drift toward an increasingly inevitable alternative solution to the ACA, single-payer, that will take us in the opposite direction.
Sen. Jim DeMint once predicted that the ACA would be Obama’s “Waterloo.” Now he’s out of Congress, Obama has been re-elected, and the ACA continues to roll along unimpeded. When the story is finally written, whose Waterloo will this be?