Obamacare repeal, practically speaking

It was an important issue for Richard Nixon’s administration in the 1970s. It was a major policy initiative for the Democratic majority in the 111th Congress. And now it remains this week’s salient issue as the Republican-controlled House of Representatives moves closer to the repeal of what has been labeled Obamacare . 

Like it or not, the president’s health care reform package was a major issue in the 2010 midterm elections. The results were a Republican sweep of the U.S. House with the largest shift in more than 60 years and the Democrats retaining their majority in the Senate by only a few seats. However we interpret this result, it was a backlash against the party in power and provided a wake-up call for Republicans to get back to basics.

Now that the election dust has had time to settle, political junkies on both sides of the aisle are trying to figure out what the Republican majority in the House is actually going to do.

Total repeal of Obamacare seems to be the Republican leadership’s ambition. But in practical terms, an actual repeal of the entire legislation would require majorities in both chambers of Congress and a signature from the president.

The numbers show that Americans disapprove of the president’s health care reform package even almost a year after its passage. According to a CNN poll released Tuesday, five in 10 favored repeal while four in 10 did not.

Newly elected Speaker of the House John Boehner had it right in his closing arguments before the bill was voted on in March. Boehner said voting for the bill was a “breaking of trust with America.”

His witty “Hell no, you haven’t” self-responses to his own questions like “Have you read the bill?”  were somewhat comically illustrated by one of former Speaker Nancy Pelosi’s remarks about the bill.

In a widely circulated clip, Pelosi was quoted as saying that “We (as the Congress) have to pass the bill so that we can find out what is in it.”  

Many of my friends on the left like to characterize health care as a right, which it may or may not be according to whatever version of the Constitution you read. But what bothers me more is that I sometimes hear liberals charge conservatives with being against health care reform completely, which is untrue.

Political puns aside, Americans can agree unanimously that health care is too expensive. Examining the causes of what seems like exponential cost growth requires action to stem. And reforming 16 percent of the American economy is no easy task ; to do so is sure to upset someone, somewhere.

Real reform starts with addressing the practical causes of increasing health care costs, something the current law does not do.

This is evidenced in a letter from the nonpartisan Congressional Budget Office in November to Congressman Paul Ryan, who is now chair of the House Budget Committee, about prescription drugs covered by Medicare. The letter states that just next year, the bill could result in a medical premium hike of as much as 4 percent on average for new prescriptions that enter the market.

Medical malpractice, high insurance premiums and the overhead of hospital administration are but a few of the leading contributors to health care costs. The conservative package would include proposals addressing these things, none of which the current law does.

For example, medical malpractice reform was not addressed in the president’s health care package. Republicans favor medical malpractice reform because it would cut out large costs incurred by physicians.

According to an article in the Wall Street Journal dated October 2009, medical malpractice reform could result in savings of as much as $240 billion per year. 

Whatever the course of action, the current bill does very little to address the rising costs of health care. It does provide some good policy changes such as banning denial of medical coverage to children with pre-existing conditions.

The best course of action at this point seems to be to take some of the mutually agreed good things (like pre-existing conditions) and start over with a new set of health care reforms that make sense in a bipartisan fashion.


E-mail: cjcaudil@indiana.edu