Be ready with a fix if Obamacare fails

Published 10:37 pm Tuesday, October 1, 2013

Be careful what you wish for. Republicans in Congress are going to great lengths to show they want to repeal the Affordable Care Act. But perhaps they haven’t thought this through.

If Obamacare fails — as Senate Minority Leader Mitch McConnell assures us it will, on its own or with congressional help — the result won’t be a return to the old way of paying for health care. That shipwreck has sailed, so to speak.

The result would likely be a single-payer system, a “Medicare for all” like the Canadian and British systems. And Republicans have only themselves to blame for that likelihood.

During the debates about Obamacare throughout 2010, even the Republicans acknowledged serious flaws with our existing health care system.

One of the major problems then was that a system based on employer-provided health insurance works best when most people are, in fact, employees.

Another problem was the distance between the payer and the payee in the system. Because third parties (government and insurance companies) paid the bills — often bills that patients and doctors themselves never saw — market forces were stymied. Patients were happy to order up extra tests and treatments, because they weren’t paying the bills, and doctors were forced to practice medicine defensively (with lots of extra tests and treatments) because of the threat of lawsuits.

Both of these problems are only exacerbated by Obamacare, and the lingering recession that still depresses our workforce rolls. Fewer people than ever are working full time. Many are now working part-time (and many jobs that were formerly full time cut hours because of Obamacare) and many have given up looking for work altogether.

And the government is even more involved in the health insurance industry, with new rules that will inevitably chip away at the profitability of insurance companies. In theory, if enough healthy young people sign up, then they might balance out the weight of the new enrollees with pre-existing conditions. But in all likelihood, they’ll put off buying insurance until they need it.

And even Obamacare’s rule that young adults can stay on their parents’ insurance policies until the age of 26 means a financial loss for insurance firms.

But here’s the thing: Republicans already have said that even if Obamacare itself is repealed, they’ll keep those popular (but unprofitable) provisions.

So where does that leave us? With the GOP’s prediction that Obamacare will implode — a prediction that looks increasingly likely.

But Democrats are ready. Here’s what Congressman Bernie Sanders wrote on Tuesday for the (London) Guardian newspaper.

“The only long-term solution to America’s healthcare crisis is a single-payer national healthcare program,” he contends. “The good news is that, in fact, a large-scale single-payer system already exists in the United States and its enrollees love it. It is called Medicare. Open to all Americans older than 65 years of age, the program has been a resounding success since its introduction 48 years ago. Medicare should be expanded to cover all Americans.”

Republicans wish very fervently for Obamacare to fail, and it might.

But the GOP had better be ready with an alternative.