Wednesday, May 3, 2017

On Representative MacArthur’s ObamaCare ‘Middle Ground’

Jersey Congressman Tom MacArthur has taken the middle ground on replacing Obamacare, reported the New Jersey Star-Ledger columnist Paul Mulshine.

"I'm getting attacked by the right and the left," MacArthur said when I got him on the phone from Washington, where he has positioned himself as the middle man in the fight to pass what I will label, for lack of a better name, "MacArthurcare."

"First it was the conservative Club for Growth," he said. "They said I'm not taking enough out of Obamacare. And now savemycare, a liberal organization, is attacking me because they say I'm taking too much out of Obamacare."

MacArthur's goal is to take out just the right amount.

MacArthur is “one of the leaders of ‘The Tuesday Group,’ a loose-knit amalgamation of Republican centrists” trying to put together a healthcare bill that Republicans can agree on.

Someone had to mediate the fight between the libertarian Freedom Caucus, which would be happy to repeal every aspect of Obamacare, and the moderate Republicans who want to retain popular aspects of the law.

Explaining MacArthur’s approach, Mulshine continues:

The central idea of MacArthurcare is that [people who have the worst health conditions] should be put into risk pools that would be subsidized by the government. That means the remaining exchanges would not have to subsidize those with the highest costs.

An obvious problem with that approach is that it would require significant government subsidy to keep those pools from springing leaks. But if his fellow Republicans can accept that, then MacArthur offers them a way to get rid of the hated "individual mandate" to buy health insurance.

I focussed on that last sentence as a lead-in to my comments:

MacArthur offers them a way to get rid of the hated "individual mandate" to buy health insurance.

Why stop at the individual mandate? Get rid of them all. Government policies to force so-called “essential benefits” on everyone is a major cost driver. The other day I watched a “pro-con” debate on CNBC. One guy criticized Republicans for proposing to “allow insurance companies to write policies that don’t include fertility and maternity coverage.” The answer should have been (but wasn’t), “What right does government have to not allow insurers to offer, and consumers to buy, such policies?”

Why force a woman in her 40s who is beyond wanting children to buy fertility or maternity coverage, or a man who would prefer to pay for routine doctor visits and procedures out of pocket to buy insurance for routine medical expenses? Answer: to subsidize the same coverage for others through inflated insurance premiums. All of these mandates, usually imposed at the behest of special interests looking for subsidized coverage for their own pet ailment, are forced redistribution schemes.

Insurance mandates are really socialism-through-the-back-door; the fascist approach of using controlled “private” companies as conduits for forced redistribution schemes. I submit that this is immoral. Insurers and consumers have a right to contract voluntarily to mutual advantage without government interference. The government’s job is to police the markets against fraud, breach of contract, and the like. But there is no right to healthcare. Eliminate all federal mandates, including the disastrous pre-existing conditions mandate (which is nothing more than legalized insurance theft), and legalize insurance free markets across state lines so state politicians face constituent pressure to eliminate state-imposed mandates (all you’d need is one state to legalize real, mandate-free policies, and the regulatory competition will be on to liberate intra-state insurance markets.)

To paraphrase a cliche, There is no fury like a government dependent scorned; i.e., whose subsidy is threatened. But that’s exactly what must be done. Decades of practice and theory have demonstrated that the natural incentives inherent in economic freedom—consumers seeking the best value for their dollars and producers competing for their business, each according to his own self-interest—will lead to quality affordable healthcare availability across all economic levels. A free market will not guarantee that everyone will always get what she needs. But ultimately, it is each person’s moral responsibility to support themselves. Insurance is one tool of self-support, and consumers and insurers should be free to tailor policies accordingly. But no one has a moral right to force others to support them, or expect the government to provide the force. A free market maximizes the opportunity to achieve the goal of self-support, and protects the rights of those who do from predatory politicians bent on redistribution of his wealth.

I’m not necessarily against political compromises, as long as they move the ball away from statism and meaningfully in the direction of individual rights. But I’m always suspicious of “middle grounds” between statism and individual liberty. We’ve had 75 years of such “middle grounds,” and they usually end up growing state control of healthcare and reducing liberty. So, after decades of growing government intervention, we’ve got the mother of all absurdities—unaffordable health insurance at 18%+ of GDP! Well, this tells me that the government has had its chance at running our healthcare, and it has failed. The goal should not be to guarantee coverage. The goal should be to minimize the subsidies and maximize the opportunity for consumers to buy affordable coverage that meets their individual needs, desires, values, goals, and pocketbooks. The GOP should go for free market healthcare, and explicitly sell it as the goal. If it fails to enact legislation, so be it. Better to fail on principle, rather than compromise away one’s principles. The failure will at least allow you to continue the fight. The second merely discredits you and your principles.

Related Reading:

What Does It Mean to Have a 'Right' to Health Care?—Sheldon Richman for

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