Being an in-principle laissez-fairist, I am of two minds about the new Speaker calling PPACA (“Obamacare”) a “monstrosity.” (Full disclosure: because of PPACA, my twenty year old son will have his private health insurance coverage, from which he was dropped, coverage paid for by me, restored in January.) First, the very sentence in which this word was used is at odds with itself: “I think it’s important for us to lay the groundwork before we begin to repeal this monstrosity.” In other words, we’re not going to repeal the monster, not right away, but we want to make it clear that we would like to. Now this is prudent because of course it is impossible for him to repeal it: such a bill would not get past a Democratic Senate and would certainly face presidential veto.
Our laws are already shot through with government-produced incentives and disincentives for participants in health care activity in countless ways. The principal effects of PPACA are to introduce a financial incentive to purchase health insurance from private parties, and to prohibit these same parties from dropping coverage. We already have things of a similar character. For example, your employer-provided health insurance has to be made available to you even after you get fired, or else the employer loses the tax break associated with having provided it in the first place. This has been true since 1985.
But what puzzles me is this: suppose that you deeply believed in freedom of contract. Suppose you passionately opposed government intervention in health care. Suppose you wanted to reduce taxes as much as possible, for liberty reasons and economic reasons. Suppose that you were especially concerned by government spending, and even moreso by deficit government spending. Your mission, should you decide to accept it, is to identify the single most important piece of legislation to repeal to accomplish as much as possible along as many of these dimensions as possible. What do you do?
That’s easy. Abolish Medicare. And if you know that it is politically impossible to do so, at least call it “monstrous.” In public, out loud.