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This 4th of July, let’s make a Grand American Bargain on health care

June 30, 2017

Perhaps the federal government shouldn’t be in the health care business.  But it is, as the direct provider of military and VA health care.

Perhaps it shouldn’t be in the health insurance business.  But it is, with Medicare and Medicaid.

Obamacare made health insurance a national entitlement, and there’s no way to backtrack once an entitlement has been given. We can’t go back to pre-Obama free health insurance markets because those markets no longer exist.  Insurance companies and many healthcare providers have been turned into government-controlled bureaucracies.  There is no competition except to lobby the government.

No matter what Republicans in Congress try to do to fix the mess that Obamacare has created, they’ll be blamed.  Not just by Democrats, but the 77% of people who (according to believe that pre-existing conditions should be covered for everyone.  77%!  That’s about as close as a democracy can come to a national consensus.

So where do we go from here?  Perhaps there’s a Grand Bargain just waiting to be made:  Republicans accept the reality that health insurance is now a government entitlement.  Instead of trying to fix Obamacare, they extend Medicare to everybody.

In exchange, the Democrats agree to limit the federal government to a few well-defined roles in addition to health insurance: national defense, immigration, foreign policy, protection of individual liberties, and the assurance of equal protection under the law.

The feds could concentrate on doing a few things well — a refreshing change because the federal government currently does almost everything poorly.

Everything else would be left to state and local governments — or to the people themselves — just as our founders intended.  Even with the added cost of Medicare for all, this would allow us to finally reform federal taxes, fix deficit spending and pay off the national debt.

No longer would state and local governments have to beg for federal funds for state and local projects. No longer would they be burdened by federal regulations.  No longer would citizens be powerless in the face of the massive federal bureaucracy and taxation; they would have more control because they are so much closer to their state and local governments.

So, how about it, Congress?

This 4th of July weekend, negotiate the Grand American Bargain that will:

  1. Give every citizen access to health insurance
  2. Focus the federal government on the few responsibilities that were laid out by our Constitution, plus health insurance
  3. Return all other responsibilities to the people and their state and local governments
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