Commentary Magazine


Topic: workplace insurance

Moving on from ObamaCare

The Wall Street Journal editors crack: “Progressives of the world are demanding that the House stage a Pickett’s charge and pass the Senate’s Christmas Eve bill, as if it were all merely a matter of political will.” But alas, there is the matter of the votes. And there is no majority in or out of Congress for a massive health-care bill of the type Obama spent a year pushing. The editors dryly observe, “The real problem is that ObamaCare is a deeply unpopular bill—even in Massachusetts.”

So what’s next? Some Democrats actually would rather do nothing. Move on to jobs. Let the public cool down. Don’t remind the voters of why they hate closed-door deal makers. You can see their point. But it is not as if something couldn’t be done. And now, with ObamaCare finally at death’s door, alternative proposals could actually get some consideration:

An incremental reform could use targeted individual tax credits to help the uninsured buy coverage immediately—while gradually shifting the tax code away from its current bias for workplace insurance only, without cannibalizing people’s current coverage. States could be encouraged to experiment with Medicaid block grants, or to set up “exchanges” in which insurers would be held accountable but also compete to offer the benefit mix that consumers find most valuable.

And then there is tort reform, which to everyone — other than trial lawyers — makes eminent sense and can eliminate excess cost without adversely affecting care.

Republicans who have circulated numerous market-oriented proposals might actually get a hearing now. Reps. Paul Ryan and Tom Price and Sen. Jim DeMint, among others, had conservative plans that never got consideration as long as the Congress was fixated on an uber scheme with government in command of the health-care system. Ironically, it may be the Republicans who now want to let the public hear their ideas and the Democrats who’d rather lick their wounds and change the topic.

Whether an alternative, focused set of proposals emerge or not, remains to be seen. The Washington establishment is stunned and it will take some time, I suspect, for everyone to recover their bearings. However things progress from here, we should keep one thing in mind: As in medicine, the first rule of legislation should be “do no harm.” A great deal of harm has been averted and for that we should all be very grateful.

The Wall Street Journal editors crack: “Progressives of the world are demanding that the House stage a Pickett’s charge and pass the Senate’s Christmas Eve bill, as if it were all merely a matter of political will.” But alas, there is the matter of the votes. And there is no majority in or out of Congress for a massive health-care bill of the type Obama spent a year pushing. The editors dryly observe, “The real problem is that ObamaCare is a deeply unpopular bill—even in Massachusetts.”

So what’s next? Some Democrats actually would rather do nothing. Move on to jobs. Let the public cool down. Don’t remind the voters of why they hate closed-door deal makers. You can see their point. But it is not as if something couldn’t be done. And now, with ObamaCare finally at death’s door, alternative proposals could actually get some consideration:

An incremental reform could use targeted individual tax credits to help the uninsured buy coverage immediately—while gradually shifting the tax code away from its current bias for workplace insurance only, without cannibalizing people’s current coverage. States could be encouraged to experiment with Medicaid block grants, or to set up “exchanges” in which insurers would be held accountable but also compete to offer the benefit mix that consumers find most valuable.

And then there is tort reform, which to everyone — other than trial lawyers — makes eminent sense and can eliminate excess cost without adversely affecting care.

Republicans who have circulated numerous market-oriented proposals might actually get a hearing now. Reps. Paul Ryan and Tom Price and Sen. Jim DeMint, among others, had conservative plans that never got consideration as long as the Congress was fixated on an uber scheme with government in command of the health-care system. Ironically, it may be the Republicans who now want to let the public hear their ideas and the Democrats who’d rather lick their wounds and change the topic.

Whether an alternative, focused set of proposals emerge or not, remains to be seen. The Washington establishment is stunned and it will take some time, I suspect, for everyone to recover their bearings. However things progress from here, we should keep one thing in mind: As in medicine, the first rule of legislation should be “do no harm.” A great deal of harm has been averted and for that we should all be very grateful.

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