Repeal vs. reality.

• Author: Orient, Jane M.
• Position: Medicine & Health - American Health Care Act

"We had hopes that AHCA--if properly amended--would have been a wedge of freedom rather than a weigh station on the road to a full crony capitalistic government takeover. The ultimate goal still must be the restoration of a free market."

THE ATTEMPT by House Speaker Paul Ryan and other Republicans to "repeal and replace" the Patient Protection and Affordable Care Act (ObamaCare) ran into a buzzsaw of opposition from both sides of the aisle. Most proponents of the American Health Care Act concede that the Act was "not perfect," but there is "political reality" to consider--what can make it through the congressional sausage-making machine? Already Congress is telling us the most important consideration for them: staying in power. The 2018 election will be a "bloodbath" for Republicans if a second version of AHCA is not passed--or, actually, even if another itineration is passed.

The outcome of the midterms supposedly depends on how unhappy the American people are, but the political reality is that the happiness of the donor class is far more important. Most of the donor class resides in the infamous swamp. Perhaps the best thing to say about AHCA is that it had the right enemies: the American Medical Association, big hospitals, and some big insurers (who all favor ObamaCare).

It is very difficult to take away an entitlement, and ObamaCare entitlements have had seven years to take root and spread. Coverage is not the same thing as care. Denizens of the health care swamp adroitly confuse the two. Coverage often blocks care--as with narrow networks--and inevitably drives up cost. Government cannot provide care. Increasingly, it cannot even finance care, as government at all levels are mired in deficit spending.

ObamaCare forcibly redistributes a decreasing pool of assets. Guaranteed issue (no "discrimination" against people with pre-existing conditions) is not insurance. It destroys insurance; low-risk individuals will not buy it unless forced to do so.

Ohio Gov. John Kasich said, "We cannot turn our backs on the most vulnerable. We can give them the coverage ... and make sure that we live in a country where people are going to say, 'At least somebody is looking out for me.'"

Actually, Gov. Kasich, your congressmen, the CEO of UnitedHeath Group, CareSource in Ohio (probably the chief beneficiary of Ohio's Medicaid expansion), and the AMA are not looking out for your voters--but do not mind using you to promote their own interests. The Medicaid expansion brought in far more new enrollees than the 5,500,000 predicted, including 11,500,000 able-bodied adults. Since resources for providing care were not expanded, funds are being diverted from the disabled and needy.

AHCA did not get rid of the basic flawed premises of PPACA. Arguably, it would have cemented them further--but would it have been a step in the right direction? The answer to that question ultimately depends on whether it would have permitted a free market to...