Tuesday, January 26, 2016

Health Reform and  Heart-Head  Rhetoric
If you are not liberal at twenty, you have no heart; if you are not conservative at forty, you have no brain.
Winston Churchill

I often think it’s comical
How nature does contrive
That’s every boy and every gal,
Is either a little Liberal,
Or else a little Conservative!
W.S. Gilbert Iolanthe II

I see by the various polls  that  roughly 60%% of Democrat  millenials are  voting for Sanders  and about 60% of  the middle class, 45 and older,  are voting for Clinton.   Similar percentage align themselves for retention or repeal of ObamaCare.
What’s going on here is dualism.  The young are idealistic.   The middle class and older folks are realistic.  Or, to put it a little differently.   The young are all heart, the older  are all head.
Young millenials find themselves in a bind.   They may be idealistic,  but many cannot find a job.   Why not, then,  vote for a Democratic socialist?   He promises a free college education and free health care, both largely at someone else’s expense, and maybe,  just maybe, a job at rebuilding the nation’s infrastructure.   Besides,  Medicare-for-all has a nice ring to it.
Somewhere in between are 75% of voters,  namely, the non-millenials, split between liberals, independents, and conservatives.   These non-millenials  have been around the block, and they have seen the consequences of liberalism – the worse recovery from a recession since World War II with a sluggish 2% GDP growth, a 10% drop in wages and personal wealth, and a increase in health premiums of 20% to 40% in some states.
On the other hand, they have witnessed a  decline in the uninsured from 15%  to 1o%, from 48 million to 30 million, of the population  in round numbers.  As a fair-minded people,  they know this decline is not inconsequential.
Which brings me to the  nub of the health-heart-head problem – whether to retain or repeal ObamaCare?   The answer, it’s fair to say,  is still very much up in the air. 
If you retain the law,  the 10 million who have been subsidized  and the 10 million who have taken refuge in  Medicaid are safe from those hard-hearted conservatives.
If you repeal the law, you may return to a more prosperous economy, with smaller government, less taxes and less regulations,  more choice of doctors with lower premiums, and a more hard-headed approach to the limitations of government and its excessive spending and budget deficits.
But what about those 10 million souls who the government has subsidized to give them access to health insurance?   Surely you can’t throw them overboard 
In this setting,  the conservatives  have began to formulate their alternative to ObamaCare. In general,  conservatives and Republicans have a six-point plan:
 1) Retain employer coverage for Americans, half the population.
 2) Offer tax credits for all who qualify.
3) Assure continuous coverage protection regardless of place of employment.
4) Reform Medicaid by allowing states to handle their distinct problems. 
5) Reform Medicare for new members, by allowing them to join the old Medicare or enter the new managed Medicare ranks.
6) Expand  health savings accounts to allow workers to pick and choose and negotiate their choice of plans and set aside unspent health dollars for a rainy day.  (Lanhee Chen and James Capretta; “Instead of ObamaCare; Giving Health-Care Power to the People,: WSJ,  January 25. 2015).
This plan and other plans  rely on hard-headed approaches to health reform.   The plans promise to cover just as many people as ObamaCare, but it is still not clear specifally  how they would handle those already  subsidized by government.
Therein lies the political rub, the choice between heart and  head.

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