Do We Want More of the Same?

 

Most of the time on this blog I address what I consider to be our country’s two biggest fiscal and economic problems: 1) economic growth which, at 2% per year for the past seven years, is too slow to create enough new jobs and higher wages for middle- and lower-income workers and 2) massive and rapidly growing debt, now at 75% of GDP, the highest since the end of WWII.
But from time to time I take a broader look such as:

  • James Piereson’s contention that the New Deal liberal consensus has broken down and we are headed for America’s Fourth Revolution.
  • Yuval Levin’s argument that both progressives and conservatives are stuck with a mid-twentieth century nostalgia to which it is impossible to return.
  • Senator Mike Lee’s (R, Utah) belief that Congress is itself responsible for its shrinking powers vis-à-vis the President and the Supreme Court.

Along this line, Yuval Levin and Ramesh Ponnuru have a powerful essay in the latest issue of the National Review saying that “Mainstream liberals now advance a vision of American government that is increasingly contemptuous of our system’s democratic character and seeks to break through the restraints of the constitutional system in pursuit of their policy ends.”

capture64This vision is advanced in three key ways:

  • Executive unilateralism, for example, by President Obama with respect to status of illegal immigrants, various suspensions and waivers in the implementation of the Affordable Care Act, and net neutrality regulations.
  • The administrative state referring to the tangle of regulatory agencies that populate the executive branch. These agencies issue thousands of regulations per year which, given the vagueness of major legislation, means that the agencies legislate through their rules. Examples are the immense power of the Environmental Protection Agency and the implementation of the Dodd-Frank financial-regulatory reforms.
  • Liberal judicial philosophy understands the courts to be in the business of advancing what is properly understood as a legislative agenda. For example, two Supreme Court cases, a health-care related case (King vs Burwell) and a same-sex-marriage case (Obergefell vs Hodges) turned out this way.

Conclude Messrs. Levin and Ponnuru: “That the constitution makes the work of progressive ideologues frustrating is not an excuse for ignoring and subverting it. Arguments for doing so amount to unprincipled excuses for lawlessness.”

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Beyond ObamaCare: Where Do We Go From Here?

Last Sunday’s Washington Post has an Op Ed column by Jon Kingsdale, “Beyond Healthcare.gov, Obamacare’s Other Challenges” which describes the many challenges confronting ObamaCare besides just the website problems and the millions of individual policies which will be cancelled for not meeting the minimum requirements of the Affordable Care Act.  Based on his experience setting up the Massachusetts Health Insurance Exchange from 2006-2010, there will  be huge problems in getting enrollment, billing and premium collections working smoothly for such a large government program.  For example, an estimated 27% of those who will be eligible for tax credits under the ACA do not have checking accounts.  How will their monthly premiums be paid and tracked for these people if they’re late?
Considering all of the problems involved in the implementation of ObamaCare, and the fact that it does not really reform our current very costly healthcare system but rather just extends it to cover more people, it makes much sense to move toward real healthcare reform, which will control costs.
A column in today’s Wall Street Journal by Ramesh Ponnuru and Yuval Levin, “A Conservative Alternative to ObamaCare”, lays out several basic features which should be included in a sensible, market oriented approach to healthcare reform.   The principles are:

  • A flat and universal tax credit for coverage which applies to everyone and not just for employer provided healthcare.  The (refundable) credit would be roughly the amount necessary for catastrophic coverage.
  • Medicaid could be converted into a means-based addition to this tax credit.
  • Everyone with continuous coverage (which would be provided by the tax credit) would be protected from price spikes or cancellations if they get sick.  This provides a strong incentive to buy and retain coverage without the need for a mandate.

A market oriented healthcare system like this is not only preferable to all of the mandates and restrictions of Obamacare, it also improves our current system by both expanding coverage to more people as well as controlling costs by giving health consumers (all of us) a much bigger stake in purchasing healthcare.
The United States spends 18% of GDP on healthcare, twice as much as any other country in the world.  Our fiscal stability and future prosperity depend on getting this huge and growing cost under control.  The ObamaCare fiasco provides an excellent opportunity to get started on doing this.