ConservativeHome's The Republican

What do Republican GOP candidates think about America's frightfully large health care sector? Not enough that's good. Here's a guide to what they think

Ryan Streeter
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In last night’s GOP presidential debate Mitt Romney said it wasn’t enough to repeal ObamaCare; we need to replace it.

Hear, hear.

But, unfortunately, there was no real debate about that issue or any questioning of him about what he would do to replace the terrible health care law.

When it comes to health care, which is consuming scarily larger portions of the U.S. economy each year, no one really knows what the candidates would do. Given health care’s growing role in the U.S. economy, and given how much government interference and policy fuels that growth, we should have a debate devoted entirely to health care. But we won’t see that anytime soon.

So how to tell what the candidates think?

Kaiser Health News has compiled a helpful chart laying out the views of the 2012 GOP candidates on several health care issues.

What surprises me the most is that when it comes to reforming the health care marketplace, the candidates as a whole seem to lack unity on perhaps the most important reform idea of the past decade: getting rid of the preference for employer-provided care in the tax code, and replacing it with a universal credit for purchasing insurance. This was central to George W. Bush’s health care reform ideas, which never gained enough support to pass Congress, and became a theme of McCain’s in 2008.

But, strangely, none of the candidates take it up despite all the evidence that it’s the most effective tool for infusing market-based cost controls on the rapidly rising prices in health care.

Romney says he supports a deduction for people who buy insurance on their own. That gets us part of the way there, but it’s just not good enough.

What’s doubly weird about this is that there is no new thinking needed. Most of the thought has been done. We just need to promote the idea, which will do more bring much-needed competition into this incredibly uncompetitive sector. We can make the idea more politically feasible by ensuring that people who have employer-based plans that they like continue to receive that benefit, and Yuval Levin and Ramesh Ponnuru have proposed.

Given the size of the health care sector, its dysfunction, and Obama’s role in making it worse, it’s pretty shocking that no GOP candidate has chosen to lead the way in explaining the way out of this mess to the American public.

And the bad news just keeps building for President Obama as support for the health care law hits an all time low

Natalie Gonnella
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Despite a family vacation in Massachusetts and a whirlwind tour of the Midwest it's been a pretty rough month for President Obama. On top of tanking approval numbers, an unprecedented credit downgrade, and consumer confidence at a two year low, according to the latest opinion update from The Kaiser Family Foundation, just 39% of Americans hold a favorable opinion of the Affordable Care Act, the lowest number ever reported in the law's 18 month history:

As GOP governors reluctantly weigh their options on upcoming Obamacare grants, and with 57% of Americans pushing for repeal (the highest level in recent months), the full analysis from The Kaiser Foundations latest tracking poll is available to view here.

Sticking up for states' rights: Majority of voters believe governors should have the right to opt out of federal programs

Natalie Gonnella
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As GOP governors weighs their options on what to do about Obamacare funds, a new opinion survey shows that when it comes to states' rights, a majority of voters side with the states.

According to the latest telephone poll from Rasmussen Reports, 54% of Americans believe that states should have the right to opt out of federal programs. And on initiatives imposed without federal compensation, support for states’ rights soars even higher, with nearly two-thirds of voters insisting that states should be able to ignore the mandates. With this in mind, unsurprisingly, when it comes to the Affordable Care Act:

Fifty-four percent (54%) think states should have the right to opt out of the new national health care law or any portion of it that they disagree with, [while] fifty-six percent (56%) of voters say letting states compete to determine the most effective standards and guidelines would do more to reduce health care costs than having the federal government calling the shots. Most voters also continue to favorrepeal of the health care law as they have every week but one since its passage by Congress in March 2010.

As the debate continues to escalate over the constitutionality of Obamacare, the full analysis from Rasmussen's latest poll is available to view here.

Appeals court rules against Obamacare mandate

Natalie Gonnella
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In the latest triumph in the fight against Obamacare, a US appeals court has ruled that the provision in the Affordable Care Act requiring Americans to buy health care cover is unconstitutional. The Washington Post reports:

A federal appeals court panel on Friday struck down the requirement in President Barack Obama’s health care overhaul package that virtually all Americans must carry health insurance or face penalties.

The divided three-judge panel of the 11th Circuit Court of Appeals struck down the so-called individual mandate, which is considered the centerpiece of the law, siding with 26 states that had sued to block the law. But the panel didn’t go as far as a lower court that had invalidated the entire overhaul as unconstitutional...

The decision, penned by Chief Judge Joel Dubina and Circuit Judge Frank Hull, found that “the individual mandate contained in the Act exceeds Congress’s enumerated commerce power.”

“What Congress cannot do under the Commerce Clause is mandate that individuals enter into contracts with private insurance companies for the purchase of an expensive product from the time they are born until the time they die,” the opinion said.

The latest Obamacare 'oops': $50 billion a year in understated costs

Natalie Gonnella
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Nancy Pelosi famously said 'we have to pass the (health care) bill so that you can find out what is in it,' and according to the latest analysis on Obamacare costs, unfortunately the surprises just keep coming.

As Neil Munro notes in the Daily Caller today:

Federal payments required by President Barack Obama’s health care law are being understated by as much as $50 billion per year because official budget forecasts ignore the cost of insuring many employees’ spouses and children, according to a new analysis. The result could cost the U.S. Treasury hundreds of billions of dollars during the first ten years of the new health care law’s implementation.

“The Congressional Budget Office has never done a cost-estimate of this [because] they were expressly told to do their modeling on single [person] coverage,” said Richard Burkhauser in a telephone interview Monday...

Employees and employers can use the rules to their own advantage, he said.  “A very large number of workers” will be able to apply for federal subsidies, “dramatically increasing the cost” of the law, he said.

Richard V. Burkhauser, Sean Lyons and Kosali I. Simon, who worked on the analysis, recently published a working paper on the topic at the National Bureau of Economic Research (available to view here).

WIth an unprecedented credit downgrade, soaring economic pessimism, and the latest news of $50 billion a year in ACA hidden costs, it's shaping up to be quite the week for the Obama Administration (and it's only Tuesday!) 

More bad news for Obama: Americans really - no, REALLY - don't like his health care law

Ryan Streeter
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President Obama's got a lot to worry about, especially when you look at underlying trends that will likely affect voter turnout and preference in 2012.

The Kaiser Family Foundation released poll results today showing that Americans continue to give ObamaCare a thumbs-down.

Only 28% of Americans think the law will help health care costs get better, while 49% think costs will get worse. And a plurality, 41%, think health care quality will decline under the law, compared to just 26% who think quality will improve. On the cost front, a new study by economists who work for the Centers for Medicare and Medicaid Services justifies respondents' concerns: they predict health care spending will spike up to 8.4% in 2014 when ObamaCare's main provisions all kick into gear.

The only positive point for Obama is that 49% of respondents think access to health care for the uninsured will improve. But that's hardly saying much since the law makes it illegal to be uninsured.

The poll report's authors point out that Americans don't necessarily understand what drives up the costs of health care (I'm not sure a lot of left-leaning health care "experts" do either), almost as if to suggest we should discount the public's dissatisfaction with the law.

But the poll also asked about cutting entitlements such as Medicare and Social Security to address the deficit and found majorities opposed. While this is a problem (we can't get out deficit under control if we don't reform these programs), I wonder if Obama's team finds it at all worrying that Americans seem wedded to Medicare and Social Security but are ready to ditch ObamaCare?

Aspiration Nation: What’s it going to take to make America’s economy something we can be proud of again?

Ryan Streeter
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It’s hard to believe, but the debt ceiling isn’t America’s biggest problem right now. Our biggest challenge is job creation.

Arnold Kling and Nick Schulz are writing some of the most important articles on this topic right now. All of us – investors, business owners, lawmakers, educators, bloggers, you name it – should think about what they're saying.

Why? Because they are uncovering what is necessary to fix America’s economy. Our nation’s future depends not on getting the debt ceiling negotiations perfect (though that would sure help!), but on figuring out how to increase productivity and create jobs at the same time. It's not just going back to Reagan-esque tax cuts, though that would be nice. We need newer, more creative solutions.

Their writing comes at a good time. Both the Fed and the Commerce Department released reports yesterday showing our economy struggling this summer under declining manufacturing and durable goods orders. It’s tough sledding these days.

Building on their important recent essay in National Affairs, Kling and Schulz published an article yesterday at the American on what jump-starting a long-term recovery requires.

First, we need to understand that our problem is long term, while most solutions we employ are terribly short term.

The stimulus has failed because America’s problems are long term and stimulus measures are short term. How do we know our problems are long term? Kling and Schulz write, “For starters, the downward trend in the proportion of the working-age population with jobs predates the financial crisis and recession.”

They have a few useful charts that drive the point home, and then they say:

Government stimulus can sometimes be effective at returning people to their old jobs, but the market is telling investors and entrepreneurs that those jobs are not needed anymore. And so the stimulus fails to stimulate very much. It may sound cold to say this, but those old jobs are not coming back.

Second, we need to understand where the jobs are.

Washington wants to think we can re-start a new manufacturing push, and we all think of finance as an opportunity sector. But the jobs are, and have been, in education and health care. Demand is rising in both sectors, and yet government policy is more interwoven – and destructive – in both than in other sectors.

What to do?

To revitalize these sectors and revive the American job market, we must open up these industries to competition and entrepreneurial reform. This will require tolerating a certain degree of messy experimentation. But entrepreneurial growth in these sectors is what will get the American economy back to work.

They point out that both parties have had a hand in creating the government interference that is costing us jobs rather than producing them.

On education, they write:

Imagine what might happen if government involvement in education were restricted to giving school vouchers to households below the median income. Entrepreneurs would be free to redesign education completely. Perhaps the very concept of a school would ultimately be replaced by different educational components with entirely different business models.

They have plenty more to say about higher education. Read the article in full.

They encourage experimental thinking in health care, too:

Imagine if state governments experimented by setting up healthcare enterprise zones. These would be areas where entrepreneurs could set up healthcare delivery systems without any rules concerning what license would be required to engage in any particular activity. Perhaps medical services could be delivered by workers with fewer credentials but more rigorous on-the job training.

If these services rate at the same level as standard hospitals and clinics, they should be allowed to continue.

Again, read the whole article for their other ideas.

Here’s the main takeaway from their article: in the past, innovation in education and healthcare has been driven by ideology, but today it’s driven by necessity.

We are used to having fights, rooted in conservative or liberal worldviews, about education and healthcare. The conclusion we should take from Kling and Schulz is that our desperate economy won’t turn around unless we reform these two sectors, and doing so means opening them up to entrepreneurial endeavor. The solutions for both are not a right-left thing. They are the right (as in correct) thing.

If we care about making America an aspiration nation once again, we’ll follow their line of thought. Despite the need for everyone across the ideological spectrum to think this way, it won’t happen if conservatives don’t lead.

Sen. Barrasso says all Americans should be given waivers from ObamaCare: Sign me up!

Ryan Streeter
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I like this:

I am introducing a bill that will allow every American to apply for a waiver from the health care law. Under my bill, any American can submit a waiver application seeking relief from any — or all — of the health care law’s mandates. Waivers will be granted to individuals who show that the health care law is either increasing their premiums or decreasing their access to benefits.

It's from Sen. Barrasso in a Roll Call op-ed today.

Where do I sign up?

Of course, left on my own to purchase insurance (as I already do) without a universal credit and the ability to shop nationally, this wouldn't be a total fix. But still....

Read the whole thing here.

Ten ways that Obama has made healthcare worse - facts and figures from Sen. Barrasso

Some good facts and figures that Senator Barrasso distributed at today's Senate Republican Policy Lunch.

ObamaCare fact of the day: If you work 40 hours a week, you'll pay more for your insurance than if you choose not to work

Ryan Streeter
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The AP reports on one of ObamaCare's "let's expand the welfare state in every way imaginable" provisions. The provision is summed up by health care consultant Robert Laszewski:

If you get a job for 40 hours a week, you're going to pay more for your health insurance than if you don't get a job.

At issues is the provision that allows Social Security recipients who are too young for Medicare to deduct their Social Security income when purchasing (the mandatory under the law) health insurance on the exchange the law establishes.

The article provides this helpful hypothetical:

To see how the Social Security wrinkle would work, consider a hypothetical example of two neighbors on the same block.

They are both 62 and have the same income of $39,500 a year. But one gets all his income from working, while the other gets $20,000 from part-time work and $19,500 from Social Security.

Neither of them gets health insurance on the job. Instead, they purchase it individually.

Starting in 2014, they would get their coverage through a new online health insurance market called an exchange. Millions of people in the exchanges would get federal tax credits to make their premiums more affordable. Less-healthy consumers could not be charged more because of their medical problems.

The neighbor who is getting Social Security would pay an estimated $206 a month in premiums.

Half of his income from Social Security, or $9,750, would not be counted in figuring his federal health insurance tax credit. On paper, he would look poorer. So he would get a bigger tax credit to offset his premiums.

But the neighbor who makes all his income from work would not be able to deduct any of it. He would pay $313 for health insurance, or about 50 percent more.

The Obama administration response: "We are monitoring this issue and exploring options that would take into account the needs of Social Security beneficiaries."

For those unfamiliar with inside-the-beltway speak, "monitoring" and "exploring options" are expressions meaning "we are actually focusing on other things we care about more."