The House of Representatives passed the American Health Care Act. Though advertised as their repeal-and-replace bill, the AHCA amended and in some waysenhanced ObamaCare. In July, the Senate just said no to any action whatsoever on our failing healthcare system.
Congressional Republicans seem unable to envision a solution for healthcare that restores the proper relationship between doctors and patients where the payer is the patient.
The Obama administration promised byexpanding MedicaidAmericans would be freed from job lock and able towork less. This is another example of Washingtons attempt to orchestrate peoples behavior and its refusal to admit the purpose of any healthcare system is to improve access to quality care.
In a recent survey of businesses with fewer than 50 employees, economist Casey Mulligan found that ObamaCare contributed to killing at least250,000 jobs. These losses, whether direct fires or fewer hires, are driven by ObamaCares mandate that small businesses must guarantee workers health insurance.
If people cant find jobs, they either drop out of the labor force or apply for disability, which remains near record levels at8.8 millionAmericans.
Businesses higher cost from soaring insurance premiums for hiring that 50thworker explains more terminations and fewer new hires. But what is reducing current workers desire to work? Mulligan attributes this to theimplicit marginal income tax.
This implicit tax is not explicit like income tax, whereby raising your income to where you lose free government insurance reduces your incentive to work and earn more. A Medicaid recipient who works extra hard and increases his income could be rewarded by losing of thousands of dollars in welfare payments.
To pay the$2 trillion price tagfor ObamaCare,additional taxeswere levied on American workers. Many people decided to leave the workforce, collect benefits, and avoid paying income taxes. This promoted a vicious downward spiral with an ever-expanding Medicaid pool and an ever-shrinking taxpayer pool.
More ominous even than ObamaCare suppressing job growth, wage growth, and economic output, is the ACAs effect on care.
Healthcare discussions always seem to focus on the number of insured individuals with no proof that having insurance will lead to timely care.After paying the huge bureaucratic and administrative costs of ObamaCare, there is too little money remaining to pay for care. Already low doctor reimbursement schedules continue to fall.The hardest hit is theMedicaid population:only 53 percent of U.S. physicians acceptnew Medicaidpatients.
The experience of New Mexico Medicaid proves that ObamaCare reduces access to care. With expansion, New Mexico Medicaid added more than 300,000 new enrollees, causing a shortfall of $417 million. To balance the state budget, they had tocut low doctor reimbursementseven lower. The result is more insured people with fewer doctors to provide care.
Americans now experience the worst possible scenario. National spending is up, productivity is discouraged, and insurance premiums are more unaffordable. While more Americans have insurance, care is increasingly difficult to access.
Washington, D.C., should return healthcare to long-excluded free market principles instead of continuingfailed government controlslike ObamaCare.
There is no better example of an effective policy choice than the Texas model of limited government. Ranking as nearly the most economically free state according to theFraser Institute, Texas leads the nation ineconomic growthandjob creation, wherealmost 30 percentof all U.S. jobs were created in the last decade in a state with only 9 percent of the population.
Unleashing major economic activity comes from a host of pro-growth policies. However, the key decision is to limit the size and scope of government. Healthcare is a policy area that desperately needs the same key: less government.
Congressjust threw awayan opportunity to repeal oppressive ObamaCare. Eliminating its onerous mandates would have restored jobs, reduced bureaucratic waste in healthcare, and increased access to care.
America needs a system that puts patients back in the driver seat so they can shop for their health care and make their own health decisions. Healthcare should not be a system that de-incentivizes work, discourages risk-taking and innovation, keeps people dependent on federal handouts, and letsAmericans diewaiting inline for care. Its time for a market-based, patient-centered approach.
Dr. Deane Waldman, MDMBA, is Director of the Center for Health Care Policy at the nonprofit Texas Public Policy Foundation, Professor Emeritus of Pediatrics, Pathology and Decision Science, and the author of The Cancer in the American Healthcare System.VanceGinn,PhD, is senior economist in the Center for Fiscal Policy at the Texas Public Policy Foundation.
The views expressed by contributors are their own and are not the views of The Hill
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The Senate's healthcare double whammy: fewer jobs and less care - The Hill (blog)
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