Washington is currently aghast at the chutzpah of Congressional Republicans advancing various strategies to restrict or eliminate Obamacare. The Republican initiatives run from the Cruz/Lee defunding gambit, to the efforts to get rid of some of the more obnoxious aspects of the law like the medical device tax, to other efforts to delay for a year or perhaps more the so-called "individual mandate." I think that anything and everything that can be done to get rid of this disastrous government power grab should be encouraged, so I don't mean to be too critical. But as usual, nobody is advancing what I think is the best idea. Although I generally don't offer strategic advice to the Congressional Republicans, I'm going to make an exception this time.
The Republicans should be always and everywhere, and as loudly as possible, screaming from the rooftops to all young people that this is a fraud and a scam directed at them, intended to take their hard-earned money away at the least-wealthy point in their lives, for nothing in return, and transfer the money to people wealthier than they are. No young person should sign up for health insurance through the exchanges. Actually, if the Republicans had any sense they should be organizing a boycott.
But instead the Republicans seem to be completely pussyfooting around this one, and I don't get it. There hasn't been one word of actual sense spoken about healthcare in this country for several decades, and this is a fantastic opportunity to get that conversation going. Why? Because the only way that healthcare or any other industry works is that consumers bear the costs and risks of their decisions. That has not existed in healthcare in this country for a long time, but suddenly Obamacare makes it so greatly to the financial advantage of a large swath of the population to take on a big piece of the risk themselves that they will be crazy not to do it. Why is that not a good thing? Given the ridiculous financial burdens that Obamacare seeks to load onto low-earning young people, if they behave rationally we could shortly see the number of uninsured in the country shoot up. That would mean that Obamacare would promptly be revealed as failing in its principal stated goal of getting "insurance" for everyone. Meanwhile, there would suddenly be a huge cohort of massively price conscious shoppers for medical care. Imagine: you might even be able to get a hospital to tell you how much a treatment will cost before they perform it!
I have previously characterized the government's promotion of Obamacare to the young as "the most massive organized fraud in world history." How could it possibly be wrong to point that out? And remember, the government is gearing up to spend unbelievably huge amounts of money on obviously false and fraudulent advertising to get the young to sign up -- the AP has identified at least $684 million in state and federal budgets for the project. There would be no need to spend a dime if this was to people's financial advantage.
What are the possible objections to my proposal?
From the Progressive/Democrat side, the main idea seems to be that it is immoral for the government to allow people to take on any material risk in their lives. Even if you believe that a world where all risk is socialized can actually work, I don't see that as any justification for this kind of huge fraud. Sorry.
Another justification I have seen is that the "individual mandate" is now the law and so Republicans should not be seen as undermining a duly enacted law or advocating civil disobedience. Here's the problem with that: the "individual mandate" is not the law. The Supreme Court struck it down. Here's a link to the Supreme Court opinion. I don't think I am misreading it. The only part of the individual mandate that is still the law is the tax penalty for failure to obtain the insurance. Oh, and the law disables the IRS from actually enforcing that penalty. So I don't see why anybody should be deterred from advocating a boycott by the supposed "individual mandate." If anything, the Republicans should be loudly pointing out that the individual mandate has been struck down and that the tax penalty is far less than the amount you will save by not signing up.
Looking for an actual intelligent objection to my proposal, the best I can find is from the usually thoughtful Megan McArdle at Bloomberg. Megan says that "Republicans have been skating a thin line" between predicting that "people can game the system by going without insurance and then buying it when they get sick" and "encouraging it." Megan says that Republicans are "wrong" to even get close to this line. Why?
After March 2014, this is going to be a pretty dangerous game to play. You will only be able to enroll in an exchange policy during open enrollment at the beginning of each year. Now, this would actually work for a lot of conditions- -- even necessary surgery can often wait nine months, and while I really wouldn’t recommend it, it probably wouldn’t actually kill you to wait six months to get into a diabetes treatment program. But if you get into a car accident in April, the next 10 months of expensive treatment will be on your dime.
Sorry Megan, but I strongly disagree. I don't see it as at all a fair characterization of what young people may do as "gaming the system" when the government is trying to strong-arm them into paying double or triple the fair price for health insurance, and also has a stupid rule that allows you to buy so-called "insurance" after you get sick. The whole idea behind free-market capitalism is that people are allowed to behave rationally and are rewarded for it. That's what distinguishes a functioning economic system from a Cuba or a North Korea.
So how big is the risk for a young person that you take a pass on the insurance and then you have a bad accident or medical problem and go many months before you can sign up? The answer is, no worse than things are today for the supposed 47 million uninsured. If the accident happens, you show up at the hospital, get treated, and then don't pay. Go bankrupt if necessary. If you have no meaningful amount of assets, it's their problem, not yours. I'm not saying this will be pleasant, but the tradeoff is a one or two percent chance of going through an assetless bankruptcy versus overpaying by thousands per year for medical insurance for a decade or two. It's time to embrace a little risk!
Here's the most important part of my proposal: When you find yourself in an unsustainable Ponzi scheme, you want it to collapse as soon as possible. With Obamacare, the essential question is, is it going to be a painfully slow Ponzi scheme like Medicare/Medicaid that is taking at least 70 and maybe as much as 100 years to get to collapse, or can we get it to collapse in just a few years? We want the death spiral absolutely as fast as possible! If only young people will boycott it, that could happen.