Election could turn on Affordable Care Act

Obamacare is now past its first enrollment period. San Francisco’s Nancy Pelosi said we have to wait to see what's in it. We now know. We know it took 600 million dollars to produce a federal exchange website that didn’t work. It was not a total disaster for enrollments, but bad enough that insurance companies will likely get a bailout.

Nevada’s state-run health exchange is down, at least for the next enrollment year. So is Oregon’s, Maryland’s and others. Obama said using the exchanges would be as easy as booking a flight on Travelocity. Admittedly, he didn’t realize insurance was so complicated.

Like all major government interventions in the markets, Obamacare produced initial winners and losers. Some like their plans, and think it better than what was available before. Many were not so lucky. They discovered they had no plan because the insurance company didn’t offer the full range of mandatory coverage required so they were switched to a much more expensive plan with higher deductibles. Others complain they lost their favorite doctor or access to the hospital they had.

Proponents said public approval would grow once they experienced the benefits. Instead it has declined. The Republicans can just bash it to win big in November. The House will probably not vote on an alternative but will talk about piecemeal reforms. The Republicans have never really put forth a clear alternative program for health reform, but maybe that is just as well. Sure, the Heritage Foundation proposed an individual mandate, and Romneycare utilized it in the most liberal state of all, Taxachusetts. It was never a big policy push for Republicans. If anything, the party has beaten the tort reform drum but that only reinforces their image as the party of rich people.

Just a couple of years ago, the Democrats and their pundit machine were praising the Veterans Administration as an example of how well government run (socialized) medicine was. How quickly the worm turns! It has instead been revealed to be just the government bureaucracy it always was. Long waits for care, resulting in unnecessary pain and death, are now shown to be systemic. Not only that, but documents were falsified or destroyed so that many VA facilities could be nominally in compliance with the goal of two weeks maximum wait time for care. Just like in the Soviet Union! And Canada!

Only a small number of politicians will talk of a radically different approach to public policy and health care. Some Republicans, like U.S. Rep. Joe Heck of Nevada, even want to keep some of the law. Ted Cruz was right—it was worth a government shutdown to try to stop Obamacare.

Nevada would seem to be the place for a real debate on health care. The state has thought outside the health care box before. It is a haven for alternative medical practitioners. Government involvement in health care goes back to the Progressive Era when it made the American Medical Association the gatekeeper for medical orthodoxy. Government payments have dictated a hospital-centered crazy quilt of subsidies and red ink. No one wants to be a primary care physician any more. Health care, like any service, is a meeting of supply and demand. The consumer in a free market is the ultimate employer of all who work to meet their needs. It is the big government regulation game itself that has distorted medical care. Life is not so simple that if you pass a law, or 12,000 laws, everything will just fall right into line. We need to put the consumer, not the state, back in the saddle.