Why Obamacare is Bad for America
by Marc Gindin
July 5, 2012
Admit it. You have an acquaintance, a coworker, maybe even a -- gulp -- friend equivocal about, or even in support of, Obamacare because it gets health insurance to more people. Maybe you've argued about this at length in the past, both of you agreeing to disagree but you, in your own mind, wondering what more you could have said to make your point that Obamacare is bad for the country. Good news: you've stumbled on to the right article.
We now lay out the case that Obamacare is bad for America. There's nothing complicated or twisted about this argument; in fact, these issues are quite obvious.
So why is Obamacare bad policy? Well, first, Obamacare is bad for America because a majority of people don't want it. Support for repeal, according to months of polling data by Rasmussen Reports consistently holds between 51 and 60 percent of Americans, an incredible level of opposition for a federal law. The oft-repeated line that Obamacare was rammed down the throats of Americans is true -- because a majority pressured their representatives to vote against it. No law with such a weak level of support gets off the ground on very solid footing.
So the fact that such a comprehensive overhaul like Obamacare is so unpopular makes it bad policy on its face. But perhaps your acquaintance believes that government was ahead of the curve here, knowing it had to do something to address the growing health care crisis? Not so much -- because the crisis is one largely of the government's own making. It was government, after all, that passed the Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986 that forces hospitals to provide care for anyone, anytime without regard to citizenship, legal residence, or ability to pay. Sounds compassionate, right? For free-riders it is. For everyone else it's VERY expensive, for as more and more people, especially lower income folks and illegal aliens, utilize emergency rooms as their primary care providers and do not pay for services, hospitals try to find some of that money through higher and higher costs pushed onto those who DO pay -- including individuals and insurance companies. What's the fix? Get the government out of hospital care mandates and let emergency rooms cater to those who CAN pay -- either because they have the means or because they have insurance. Stop forcing hospitals to offer precious man hours and resources to freeloaders.
But EMTALA isn't the only government mandate that has made health insurance more expensive. The health insurance industry is so heavily regulated that states -- and now the federal government -- decide exactly what insurance polices must cover, how much to cover, where customers must reside to purchase coverage, and who else in the customer's family must be eligible to piggyback on that coverage. As a health insurance consumer, an individual has very little choice now regarding who to buy insurance from or what type of insurance to buy. Perhaps a younger, healthier adult would prefer to buy a cheaper catastrophic plan that covers the bigger, yet less likely events, choosing to pay for smaller expenses like doctor visits and basic lab work out of pocket. Obamacare bars this. Perhaps a consumer in Pennsylvania likes a plan offered by an insurance company in Ohio and would like to purchase that policy. Obamacare does nothing to permit insurance companies to sell policies across state lines. Perhaps an individual just wants to disconnect from the system, not carry insurance, and pay for medical care completely out of pocket because he has the means. Obamacare bars this as well (unless one pays the penalty/fine/tax, that is). So with fewer companies selling insurance with fewer choices, the market breeds far less competition, and prices rise. Think about that local cable company that owns a near-monopoly on television signals in many areas around the country -- and how expensive those monthly bills are. So what's the fix here? Get the government out of the market and allow insurance companies to sell insurance in all 50 states with the coverage types and levels people want.
But your acquaintance has one final concern: the uninsured. These are the folks with pre-existing conditions who private insurance companies consider bad risks, folks who often can't get a private insurance policy or can't get one that isn't prohibitively expensive. What are those unlucky folks to do in a country without EMTALA, without a guaranteed insurance plan? Some may have savings. Others can take jobs with health benefits. Still others might lean on family, friends, their religious institutions, or programs in their neighborhoods and towns for financial support. And in the most dire of circumstances, there is no prohibition on states from creating health benefits for their highest risk, least insurable citizens with the consent of the taxpayers of the states. In the end, many states might do this -- some might not. But in a country of 50 sovereign, competing states, someone who is desperate, someone needing a certain level of state-provided or state-subsidized health benefit can look to every state for the best option and move to the one that will help the most without being trapped by Obamacare, which may or may not be designed to help.
The real question for your acquaintance, your friend, your coworker, your business partner, your mother -- whoever -- is that if government has created the health care crisis by forcing prices upward through its own destructive policies, how on Earth is it feasible that Obamacare will fix the problem instead of compounding it? The real solution is to unwind decades of federal interference in health care: repeal EMTALA, free the health insurance markets and allow insurance companies to compete against one another, and free people who really do need help to get it from the most local of sources first -- friends, family, charitable folks, and folks in their communities. With this approach America preserves a top-notch health care system that works for almost everyone while controlling costs and providing the services people want. That, in the end, is a win for everyone.
