Or: Why it doesn’t matter who you vote for in November

Republican presidential challenger Mitt Romney says if you don’t want President Obama’s sweeping health care reforms, then he’s your man in November. There are several big problems with that (see below), but he is right about one thing: people say they don’t like ‘Obamacare’, according to polls.

They object to one of the two big provisions in the law: the one which requires them to have health insurance. Yet 85 percent of those same people approve of the other one, which tells health insurance companies they can no longer refuse, restrict or hike the monthly premiums for people with pre-existing medical conditions.

Requiring insurers to pay for the health care of people who already have medical conditions requires more money, of course. That’s where the ‘individual mandate’ comes in. The legislation pays for the extra cost by requiring all Americans who can afford it to buy health insurance (or pay a tax premium*). This adds enough money to the insurance pools to spread the risk more widely and theoretically make it possible for everybody to be covered – including those with pre-existing conditions – for affordable rates.

So, in case there’s any confusion: one major part of Obamacare (forcing companies to accept people with pre-existing conditions) is funded by the other (the individual mandate). That’s the foundation of the entire legislation; the necessary components that make it work.

According to the polls I mentioned above, then, the American people want the impossible: they want to be accepted by insurance companies when they have pre-existing conditions, but they don’t want to be forced to buy health insurance. This is understandable. We all want the impossible. I want a rocket-powered ejector seat to be standard equipment on my next car. It’s just a fact of life that ‘the people’ may not always think things through completely.

Mitt Romney, on the other hand, is the man who wants to be president. So you’d think his position would be more coherent. Yet, in his response to the news that the court upheld Obama’s law, he said that Americans should elect him so he can get rid of the legislation and replace it. With what? Well, as Romney said yesterday, “Gotta make sure that those people who have pre-existing conditions know that they will be insured.”

What? So, Romney wants to replace Obamacare with something that also ensures people with pre-existing conditions are covered, but doesn’t coerce people into buying insurance? Anybody see a very familiar problem with that? If Romney will not introduce any tax / insurance mandate, how will he pay for his legislation, let alone make health care more affordable?†

This is not, you may remember, Romney’s first foray into the health care debate. He’s the Republican who came under fire from fellow Republicans for enacting a health care law as governor of Massachusetts which – you guessed it – required people to buy health insurance, or taxed them more if they didn’t; in other words, which did exactly the same thing that Obamacare does! This is some mighty fine irony. Since Romney’s legislation was enacted at a state rather than a federal level, Romney can now claim that he was simply upholding the Constitution’s role for the states while opposing it for the Feds. But at the time, he had a rather different view of it. In one interview, he said his state legislation “could inform Washington on ways to improve health care for all Americans.”

If this uranium-grade hypocrisy isn’t rich enough for you yet, then you need simply listen to Republicans crying ‘Socialism!’ and ‘Big-Government Liberalism!’ about Obamacare. This is the same party that proposed two of its own health care initiatives in 1993: both included an individual mandate requiring people to have health insurance! One of them forced insurers to cover those with pre-existing conditions, subsidized health costs of the poor and originated in 1989 at a conservative think tank called the Heritage Foundation. At the time, it was hailed by Republicans as a solid free-market solution to the health care problem in America. Now it’s derided as ‘Socialism!’ and ‘Big-Government Liberalism!’

Political posturing aside, for me, the idea makes some sense, or at least it makes a little more sense than the status quo, despite Obamacare being far from a solid free market solution. Unfortunately, libertarian ideas for fixing health care are not on the menu, and are not likely to be anytime soon. Had Ron Paul been capable of winning the Republican primary this year, we may have been in a different position. But trying to get government-free health care reform now would be like walking into a McDonald’s, sitting down at a table and trying to order lobster: we simply don’t live in that world.

Will Obamacare really make health care more affordable, cover more people and improve the dismal record of the U.S. health care system; a system which currently charges us the highest health care prices in the world while giving us a quality of care that’s worse than 36 other countries, according to the World Health Organization? I don’t know. But even its most ardent opponents must acknowledge the possibility that it is capable of doing so.

Whatever you think of the legislation or its chances of improving the access and costs of health care for average Americans, one thing is certain: it doesn’t matter which party you vote for, on this as on so many issues.

The kicker: Five years ago, Obama opposed the individual mandate.

John Wright

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* A word about Obama’s individual mandate being a tax. Essentially, the court found that the government can’t force you to buy anything, but they can tax you if you don’t. People are up in arms about this. And yet the legislation simply says that, under Condition A, you will owe a certain amount of tax, and under Condition B, you will owe a greater amount of tax (Condition A = you buy health insurance, Condition B = you fail to). Sound familiar? My friends, if the United States Supreme Court found the individual mandate unconstitutional, they would have to find the entire IRS tax code unconstitutional! And that would be much too wonderful a finding to be true.

† This is not the only problem with Romney’s response to Obamacare. He also claims the legislation will be a “jobs-killer” and will increase the federal budget deficit, despite the non-partisan Congressional Budget Office’s official conclusion that the legislation will actually reduce the deficit. Is Romney just speculating?