As Congress prepares to vote on an Obamacare replacement bill that won’t actually do anything to lower the prices and increase access to medicine, conservatives are understandably frustrated. The lack of spine in the Republican Party, coupled with the significant numbers Democrats still hold in the Senate, makes passing a full-scale repeal of Obamacare impossible, and even the ”conservative” objectives that people like Sen. Rand Paul are trying to get inserted into the bill are minor tweaks that won’t salvage this disastrous piece of legislation.
But what else can be done? Anything more bold and market-focused will lose the support of Democrats and left-leaning Republicans, and the alternative is the status quo, in which Obamacare slowly collapses, leaving vulnerable people without access to health care and paving the way, almost assuredly, for a single-payer system, a system we all know would be a nightmare for the country.
In this situation, it is hard not to feel that the battle has been lost and there’s nothing we can do to recover. It’s all well and good to write white papers detailing what the ideal conservative health care reform would look like; political reality make such efforts works of fantasy, at least in the short run.
But all is not lost. There are, in fact, things that Congress could do right now that would, if not entirely undo the damage done by Obamacare, at least give people more options for dealing with medical issues.
Republicans should kill the current bill, which will not make things better but only create the perception that the GOP “owns” the health care issue, and instead focus on pushing forward a number of small, piecemeal bills that address one problem at a time. The desire for a comprehensive health care bill means that conservatives will never get what they want, but some of the components of market-based medical reform are so rooted in common sense that it would be hard for anyone to vote against them on the record.
The most obvious of these bills would allow insurance companies to sell policies across state lines, a prohibition that has been stifling competition for years. Another would be to allow people to form voluntary risk-sharing pools among private organizations, such as employers, gyms, or churches. We already see a little of this going on with health sharing ministries, but broadening the scope of these organizations would give people flexibility in their coverage options, and the smaller pools would allow more control over the kinds of risks that are being shared.
Other slightly more controversial bills could tackle issues like certificate-of-need laws, which prevent medical providers from getting the equipment they need to treat patients; scope-of-practice laws, which prevent nurse practitioners and technicians from doing work they are perfectly capable of doing; and telemedicine, which stands to dramatically reduce the cost of doctor’s visits by allowing them to be conducted remotely over the internet.
By advancing these bills one at a time, the GOP could force a national debate about why people are forbidden to do things that would improve their health and lower their expenses. The opposition would have to explain why insurance companies should be protected from competition while the American people suffer. Not every bill would pass, but the record would clearly show which legislators are legitimately trying to solve problems and which are merely catering to the special interests of the medical and insurance profession.
I don’t know where this idea came from that we have to pass one bill and only one bill to address all of the nation’s health care woes, but as long as we are stuck in that mindset, the opportunities to advance genuine market-based solutions will be minimal, and the country will continue to slide down the path towards fully government-run medicine. The end result will be higher costs and lower quality of care for everyone. By breaking the bill down into its component parts, we would not only present a clearer picture of what’s going on, but we also might make people a little bit better off. Imagine that!
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Logan Albright is a researcher for Conservative Review and director of research for Free the People. You can follow him on Twitter @loganalbright73.