Policy wonks will soon be hyperventilating about all the changes the Senate supposedly must make to turn the House-passed healthcare bill into “acceptable” legislation. But they should save their breath. The most important hurdle facing the Senate is not the substance — it’s the sales pitch.
No bill is ever going to be perfect. No bill needs to be perfect. Our Madisonian system is not meant for that which is perfect, but instead for law that is “plenty good enough” for a free people to understand, test out, learn from, and modestly tweak (but not radically change) in coming years.
But as Madison said in Federalist No. 62, “It will be of little avail to the people, that the laws are made by men of their own choice, if the laws be so voluminous that they cannot be read, or so incoherent that they cannot be understood.”
Any new law which substantially improves upon the current system for a substantial majority of the public while not unfairly burdening others, even if it might fall short of some platonic ideal, is a law worth passing, as long as the citizenry understands and accepts it.
The poorly named American Health Care Act does the first part: It substantially improves upon Obamacare. Its elimination of a trillion dollars in taxes will help individuals, businesses, job creation and overall economic growth. Its elimination of the individual and employer mandates will increase freedom and, for many, reduce costs. Its encouragement of the states to experiment with better Medicaid provisions (including work requirements for the able-bodied), different coverage options, and different ways of providing for higher-risk patients will effectively create laboratories in which policymakers can actually discover what does and doesn’t work.
Its vast expansion of health savings accounts will continue an ongoing revolution in health insurance that promotes individual choice, market-based cost controls, and a continued phase-down of the pernicious third-party-payer system.
The combination of these and other provisions (including better-funded “high-risk pools”) will, for the vast majority of Americans, drive down (or seriously slow the cost growth in) premiums and deductibles. Individuals will have more options to choose the coverage that best fits their personal needs, and to avoid overpaying for coverage they don’t need. Unlike with Obamacare, most people really will be able to “choose their own plans” and “keep their chosen doctors.”
Right now, though, the American people don’t know these things.
One reason they don’t know them is because we don’t have a president who can explain things, or who even tries to do so. President Trump doesn’t explain; he just mouths slogans or declarative sentences.
Those declarative sentences work for him, though. They can be a helpful part of a sales pitch, but they do no good for those not already inclined to believe him…..
[The full column is worth reading, here.]