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OPINION - Obamacare: what comes next?

by Chris Conley

NEWS BLOG (WSAU)  Canada has single payer health care. They're totally committed to the policy, so much so that private health insurance is illegal in Canada. There are two unlikable things about it. Canadians pay a 15-percent sales tax on everything to fund it. And there are waiting lists for painful but non-life-threatening medical procedures (i.e. hip replacements; which many Canadians go across the border and pay cash for.)

If ObamaCare implodes, single payer will be offered as the alternative in the U.S. I’ve already pointed out the likely intermediate step  – states or the feds will offer their own subsidized health insurance plans on the exchanges alongside private plans. This could start in the very near future, perhaps as a demonstration project in a high-insurance-cost blue state that wins a federal waiver. The private plans won’t be able to compete and will either be starved out or drop out of the system.

Now that healthcare.gov shows the prices before people enroll, more people will experience sticker shock. I browsed the plans and prices today. For me, the cheapest bronze plan is 40% more than what I pay now through my employer. But the plan I’m on now is the equivalent of a gold plan – and my premiums would triple for comparable coverage. And I don’t qualify for any tax subsidies. If I was forced into the exchanges, Obamacare would be a financial disaster for me. I’d probably drop my insurance and pay the fine – hoping like hell the system crashes or gets fixed before the penalties go up a year later.

So, hypothetically, let’s imagine that even the most-stubborn true believer in the Obama administration concedes the current system is a failure. ObamaCare supporters already have their back-up plans in place – first, try to get Congress to pour more money into the system to fix it. Second, onward to single payer.

And here’s where Republicans are falling down on the job. Where’s their after-Obamacare-fails plan? If they don’t have an alternative, and if they aren’t talking about it now, single-payer will be the only game in town. This is critically important. In truth, a one year ObamaCare delay is impractical. Private insurance companies have already notified hundreds of thousands of policy holders that they’re being cancelled. Wisconsin and other states have made changes to their Medicaid programs after being promised that the exchanges would be up-and-running on-time. Those people will have no insurance if there’s a one year delay. That many people can't be left out in the cold. And President Obama knows that he’ll be harpooned if the number of uninsured skyrockets during the first year that his healthcare plan is in full effect.

So here’s where we stand right now. ObamaCare is here and cannot be stopped. The only issue is what the nation’s health insurance system looks like in its aftermath. Democrats have answers for that. And, as of this moment, the Republicans don’t. If one party has a plan and the other doesn’t, more bad ideas will win out over no ideas at all.

Chris Conley
10.23.13