Patterson: Latest move puts Obamacare on thin ice; now it’s time for an alternative - East Valley Tribune: Opinion

Patterson: Latest move puts Obamacare on thin ice; now it’s time for an alternative

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East Valley resident Tom Patterson ( is a retired physician and former state senator.

Posted: Monday, July 15, 2013 11:29 am | Updated: 7:06 pm, Tue Jul 23, 2013.

Obamacare is all but dead in the water. The latest evidence this program is in deep trouble was supplied — as usual — by the Obama administration itself. This time it was the administration’s decision to unilaterally postpone the employer mandate until after the next election.

The Obama minions gamely tried to depict the delay as necessary to develop sound policy. Over three years after the legislation was passed, White House senior adviser Valerie Jarrett claimed “you need the time to get this right.” Media analysts called it politically brilliant.

It’s obvious that lack of time is not the problem. The problem is that Obamacare is based on a bad idea, combining the worst features of government-controlled medicine with a cumbersome, expensive private bureaucracy. Worse, the 2,000-plus-page bill that nobody read turns out to be poorly thought out and incompetently written.

For example, the employer mandate is having unintended, but predicted, consequences before it is even implemented. Because the law imposes a fine up to $3,000 per full-time worker who is not offered appropriate insurance, it provides a powerful incentive for employees to not hire or to higher only part time. 41 percent of business owners told Gallup recently that they are in a hiring freeze mode and 20 percent have actually cut jobs. America is becoming a nation of underemployed part-time workers.

In another year, Obamacare won’t be less of a job killer. It won’t be easier to implement or more popular. It’s all just political.

Meanwhile, eliminating the employer mandate unhinges the entire private sector side of Obamacare. Under the law, employees are entitled to certain benefits and subsidies through the state exchanges if they don’t receive coverage from their employer. Without employer reporting, it will be impossible to determine eligibility for employees, who are still required by the individual mandate to either buy insurance or pay a fine.

But wait, there is a solution! The Obama administration has proposed that benefits be awarded without proof of eligibility, simply based on whatever the beneficiary avers about income and employee benefits provided. Let’s see, handing out billions of dollars without verification. What could go wrong with that? Estimates range up to $250 billion, assuming fraud rates similar to those for the Earned Income Tax Credit.

This is just the latest Obamacare fiasco. Right out of the box, businesses clamored for waivers, many of which were illegally granted to those with friends in high places. Congress demanded to be exempted from its provisions, so of course it was. Most states declined to operate insurance exchanges.

The Supreme Court ruled that the forced Medicaid expansion was unconstitutional (although the feds successfully bribed most states, like Arizona, into going along with it anyway). Insurance costs are going up, not down. The law remains massively unpopular.

This isn’t the first time the administration has ignored its own prize law. The IRS announced that federally administered insurance exchanges would apply tax credits, subsidies and taxes that are clearly not authorized under the law. It goes on and on for this law that desperately needs to be repealed and replaced.

Still, opponents should not be overconfident. Repealing a social program of this magnitude is unprecedented. Moreover, an important element is lacking in the public debate: a viable alternative.

There is a wealth of ideas that would create a health delivery system more efficient and free than Obamacare. Yet for the general public, the choice appears to be between Obamacare and the status quo, which wasn’t so hot either. Republicans have been unable to coalesce around a free-market alternative that could fill the void left by Obamacare’s failure.

They should advance a plan based on patient choice and freedom. We would pay routine medical expenses through something like a deductible Health Savings Account, with public subsidies for those in need. Catastrophic insurance would cover unusual expenses. Insurance markets would be opened up across state lines. Price information and outcome data would be available to patients. The tax preference for employers would be eliminated. Liability cost would be reduced to the levels of other developed nations.

Now that would be dynamic reform. Obamacare is almost certainly doomed. It’s time for leaders to create its replacement.

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