“How do you tell a Communist? Well, it’s someone who reads
Marx and Lenin. And how do you tell an anti-Communist? It’s someone who
understands Marx and Lenin.” – Ronald Reagan.
If people were
machines, Communism would be the answer. Given the goal of producing
the best and most equitable society for a like-minded people, what
algorithm wouldn’t suggest people jointly owning everything and working
together for the common good? Except that people aren’t like-minded.
Mostly, they aren’t even similarly-minded on the issue of what is the
one true and common good. The Communist then has to decide that issue
and force everyone else to the same conclusion, which is why every
attempt at Communism in history has devolved into a dictatorship and
Obamacare failed for the same reason. (Yes,
gratefully, it is fair to begin talking about it in the past tense.)
Like Communism, the premise was noble in spirit: health insurance for
everyone and everyone to contribute according to their ability to pay.
Then came the kickbacks to get politicians to sign on and the exemptions
for special interests. Once passage was secured, the “ability to pay”
concept was modified steeply downward so that it all became northing
more than a wealth redistribution scheme hidden in a nightmare of
bureaucracy. Mao couldn’t have arranged it better.
In the end,
Obamacare accomplished precious little. Providing health insurance for
those that didn’t have it is only an accomplishment if it is paid for by
someone other than our grandchildren. It actually would have been much
less disruptive to simply raise taxes substantially and give away yet
more freebies but that all would have been too blatant amidst a
skyrocketing national debt. In pretending to solve a problem, Obamacare
created more unaffordable government spending that no one will ever have
the political will to eliminate.
But there was a problem that
needed fixed. If you don’t think so, you likely weren’t self-employed or
you didn’t have a family member with a pre-existing condition. Despite
the conservative mantra, there are some societal ills for which hard
work is not the remedy. Oddly, the very poor had some of the best
coverage even prior to Obamacare – they could walk into a hospital
emergency room, get treatment and walk out. They couldn’t be collected
on, so everyone who could afford care would just pay higher rates to
The one good in Obamacare was that it guaranteed that
health insurance could be purchased by everyone. Republicans will never
be able to entirely repeal it, but they can build off this one
achievement. What if they started not by financially enabling every
American to buy a health insurance policy of their choice? And not just
the poor. Every single American.
Last week, I covered the Prebate
element of the Fair Tax. The Prebate would refund the tax on necessities
up to the poverty line. All items would be taxed, including food and
medicine, but Americans would get the tax on those items back in the
form of a monthly payment.
The amount of the Prebate is in the
range of what a simple high-deductible insurance policy might cost -
$226 for one person, $690 for a family of five. What if the Prebate,
instead of paid directly to the recipient monthly, was deposited into a
Health Savings Account from which the recipient could purchase his or
her own insurance and pay other health costs? If the luxury tax
discussed last week was also dedicated to the Prebate, decent policies
and additional money for out-of-pocket expenses are well within range.
dig this: If a person seeking health care hadn’t bothered to purchase
insurance with his or her Prebate funds, that’s when the government
could step in – not to protect the person but to protect the health care
providers and other consumers who would heretofore have had to make up
the difference. If an American shows up at a doctor or hospital without
insurance, he or she would automatically be covered by a government
policy. That person’s Health Savings Account, which could only be
accessed for personal withdrawal once a year, would be deducted for all
months that a person couldn’t provide proof of private insurance and an
apportioned amount of money sent back to pay for the default government
In this system, you are always covered and with your
own money. You are encouraged to be a good steward of your Prebate
because you can cash out what you don’t spend. If that happens once a
year, why not on a person’s birthday? This is just for Americans by the
way – illegals, you can buy insurance with your own money but no Prebate
or government default insurance for you. Rather, illegals and foreign
visitors would be supplementing our health care when they buy
necessities here and pay our tax.
Just as good, this system would
free Americans from the employer-based health care system we currently
have. How many small businesses have not been started because a person
could not afford to leave their employment’s health insurance? Your
employer could still provide bonus coverage, but it would indeed be a
fringe benefit. More likely, your employer would discontinue health
coverage and be able to give you a substantial raise.
Oh, and I
almost forgot to mention, with health insurance being universally
provided in this way, much of Medicaid could be eliminated right along
with the income tax, payroll taxes, estate taxes and corporate taxes.
This means your state taxes would substantially decrease. Our country,
and our lives, would begin to be affordable again. Then to Marx and
Lenin’s horror, outside of national defense, we would start to wonder
what any of us need a big government for?