Monday, March 27, 2017

The Obamacare Kabuki Theater Ends

It took seven years but finally the Republicans ran out of excuses for not repealing Obamacare as they repeatedly vowed to do. First, they said they needed control of the House of Representatives so they could defund Obamacare with the power of the purse. Once in charge of the Speaker’s gavel, Congressional Republicans said control of the House was not enough – they needed the Senate. In 2014, the voters made Mitch McConnell Senate Majority Leader and, again, Republicans said it was not enough – they needed the White House. In 2016, the voters gave the Republicans the trifecta: House, Senate and the White House only to find out that the real power in DC resides with the Senate parliamentarian.

Today millions of Republican voters are facing the stark reality that the GOP was never serious about repealing Obamacare. Moreover, it is very likely that a substantial number of Republicans in Congress would have supported Obama’s bill in 2009 had it not been for the Tea Party raging at their townhall meetings. Lest we forget, the idea of the individual mandate came from the Heritage Foundation, a conservative think tank. In 2012, the GOP nominated as its standard bearer Mitt Romney who, as governor of Massachusetts, implemented a healthcare bill with a similar architecture as Obamacare. And there were plenty of other signs that the GOP promises on healthcare were little more than focused tested talking points designed to please the ears of their base. In seven years, they never presented an alternative to Obamacare that the entire party – except for a few holdouts – was behind. Instead we were treated to multiple plans being introduced by different factions knowing full well that they would go nowhere but gave Republicans the opportunity to point to them and say “see we do have plans!” The Republican eagerness to pass dozens of bills to repeal Obamacare while never once passing a replacement was another clue of their dishonesty. The efforts by political consultants like Frank Luntz to tweak the talking points to say “repair” and not “repeal” was the latest indication. The signs were all there for anyone wishing to see them.

The fascinating question is why were the Republicans so successful in fooling so many of their supporters that they were serious about their commitment to rip out ACA “root and branch”? Mostly it has to do with human nature. We are engineered to want to believe what we desire is possible if only we purchase a particular product or elect a particular politician. But it has also has to do with operating on false assumption that Democrats were the impediment to repealing Obamacare. It is not the socialists that stand in the way of getting rid of ACA – it is big business interests.

Despite what many Republican voters believe, the private sector is not the same as a free enterprise, businesses are not champions of the free market - the latter is especially true of large business entities. Businesses operate to generate profits for their owners and if that means using the power of the government to create monopolies or force consumers to buy their products or bail them out of their bad decisions, they are more than happy to embrace “big government”. For decades Wall Street trumpeted the wonders of the free market until they faced staggering losses when their bets on subprime mortgages soured – immediately their tune changed from “free markets” to “free taxpayer money”.

When Hillary Clinton proposed her healthcare reform, the health insurance lobby took to the air with their Harry and Louise ads and promptly torpedoed Hillarycare. In 2009, Harry and Louise reappeared but this time was to support Obamacare. All the big players in the healthcare industry - i.e. insurance, pharmaceutical, doctors – fully support the basic architecture of ACA and made large contributions to both parties to make it happen and now to protect it. Their only miscalculation was failing to anticipate how politically unpopular the individual and employer mandates would be. The result was individuals will high medical bills entered insurance market while young, healthy individuals opted to pay the penalty. The ACA sponsors don’t want a full repeal, they just want to either find a more effective way to force healthy individuals to purchase insurance or be compensated by the government for their miscalculation.

Paul Ryan presenting a plan that kept most of Obamacare in place should surprise no one - just look at his list of political donors. He just added more tax cuts and defunding Planned Parenthood believing it would be enough of a veneer to pass the bill as “conservative”. For seven years American voters have been treated to the Kabuki theater of Democrats pretending that they were “taking on the evil insurance companies and Big Pharma” and the GOP pretending they opposed Obamacare. The curtain finally came down last Friday.