Republicans have been talking “repeal and replace” of ObamaCare since its inception. Trump included this mantra in his campaign. The question has always been, replace with what? Republicans have been vague and unsure, and thus unconvincing, about what their “replace” actually entails. This has allowed the Left to frame the debate along socialist/statist lines.
For example, the New Jersey Star-Ledger ran an op-ed a few months ago titled Obamacare lifts working poor. Would GOP cut them off? The gist of the article uses the standard statist tactic; framing of the issue in statist terms.
For example, in regard to ObamaCare’s new signups, who rely heavily on government subsidies, the article states that in repealing and replacing ObamaCare, “Republicans have no realistic plan for these people.”
Statists disingenuously frame the debate as a choice between socialized medicine GOP style and socialized medicine Democrat style. But the real alternatives are government planning of everyone's healthcare with taxpayer money, or each individual planning his own healthcare with his own money. The current GOP has no competing government plan—that’s true. And that’s precisely the point. To a statist, any “plan” that doesn’t put government in charge of “these people” is no alternative.
But thoughtful people, including some Republicans, have regularly put forth proposals to liberate the health insurance market, if not create a fully free market, so people can have more control over their own healthcare—Eliminating insurance mandates that dictate the content of health insurance policies and thus drive up costs; eliminating cost-raising state-imposed trade barriers that forbid insurers from competing across state lines; ending tax and other government policies that tie health insurance to employers and other third parties like unions, making health insurance portable like auto, home, and life insurance (which would eliminate most pre-existing conditions problems); expand tax-free health savings accounts, to name a few.
Repealing ObamaCare and replacing it with these and other free market reforms would replace much government planning with individual freedom to plan one’s own healthcare. It would also end the subsidies that back up the 20 million ObamaCare subscribers, ending the immoral government forced redistribution of some people’s money to pay for other people’s health insurance—subsidies that themselves are made “necessary” by intrusive government policies to begin with. All ObamaCare did was create a whole new class of parasites while doubling down on the policies making healthcare less and less affordable.
All of the problems that ObamaCare was allegedly created to “fix”, such as skyrocketing health insurance prices and pre-existing conditions, were caused by government policies and programs like Medicaid and Medicare to begin with. The solution is not one government plan or other—more of the same government interference poison—but no government planning of our healthcare. The choice is not, which government plan, but who plans—government or the individual. It’s a choice between the the vice of dependence vs. the virtue of self-reliance.
That said, now that 20 million more people have been thrown onto the government dole, I would grandfather their subsidies in for a period of time. Save their subsidies while repealing ObamaCare and replacing it with free market reforms, such as that offered by "PatientCare.” Once deep free market reforms bring in a wealth of choices across the income spectrum, end the subsidies. We still may not have a fully free market. But it would be a huge moral and practical step in right direction. A free market doesn’t guarantee that everyone will have what they consider satisfactory healthcare. But the natural incentives of a free market—profit-motivated producers seeking customers by appealing to consumers’ inclination to get the best value for their dollars—tends to maximize quality, affordability, and innovative solutions to problems in a rights-respecting, non-predatory way.
One typical statist response to proposals for free market reforms that I have seen advanced is that without government interference, we would all “be at the mercy of insurance companies.”
But in regard to a free market versus government control, which state of affairs would we really be put at someone’s mercy—competing private companies who cannot force you at gunpoint, or monopolistic government programs that can?