All errors should be reported to

Friday, January 06, 2017

National Review supports President Trump on Obamacare repeal

A reader requested my comment on National Review's editorial, "How to Repeal Obamacare: The Core conservative replacement should be ending Federal Government's role."


Let the free market handle hospitalization insurance with the states regulating it.

You know, what we had before the Democrats shoved the Patient Protection and Affordable Act down the throats of the American people without seeking a single Republican vote.

Despite the corner the Oldest Conservative Magazine in Washington painted itself (throwing away its influence in the process) this editorial makes sense.

From National Review:
On health care, congressional Republicans should listen to Donald Trump. The president-elect may not be chock-full of ideas about health-care policy, but he has the right political instincts. He has said that Obamacare should be replaced, that its beneficiaries should not simply be stripped of coverage, and that people with pre-existing conditions should be protected.
It is possible and desirable to devise legislation that meets these objectives. Trump has also warned congressional Republicans to be careful — and he is right about that, too, because their current course does not look likely to accomplish the repeal of Obamacare or its replacement by something better.
Senate Republicans want to pass a bill that repeals the taxes and spending in Obamacare, but not its regulations. That’s because they think that they can use a legislative process to avoid Democratic filibusters only if they leave the regulations alone. They think that this partial repeal of Obamacare will set the stage for later legislation that repeals the rest of the law and creates a replacement.
This seems highly unlikely. Leaving Obamacare’s regulations in place while getting rid of its individual mandate — a tax measure, which Republicans would eliminate in their first bill — would further destabilize health-insurance markets. No one would cheer the Republicans for producing that outcome: not conservatives, who would know that Republican boasts of having repealed the law were false; not the many voters of all kinds who would see their insurance disappear or grow still more expensive; not the Democrats, who would be happy to blame Republicans for this mistake and everything else that goes wrong with health care afterward.
Precisely. You break it, you own it.

Unless you are an incompetent Democratic president, but I repeat myself.

The editorial ended:
Too many congressional Republicans think that conservatives will take a quick but phony win on health care. We disagree. A real win is worth the time and effort.
If conservatives are going to complain about liberal tantrums over President Trump's overwhelming victory, then they first must accept it.

And if we are willing to work with Chuck Schumer on key issues -- which we should -- let us work with the PC Conservatives in Washington and Manhattan.

We beat them on November 8. Now is the time to work together.

And yes, please, keep the good things in the act, allowing states to opt out of them if their legislatures and governors want to.


Please read "Trump the Press," in which I skewer media experts who wrongly predicted Trump would lose the Republican nomination. "Trump the Press" is available as a paperback, and on Kindle.

It covers the nomination process only. The general election will be covered in a sequel.

For an autographed copy, email me at

Be deplorable. Follow me on Twitter.


  1. Health care is NOT, I repeat, NOT equivalent to health insurance.
    One can easily have health insurance, but health care can still be easily unaffordable.

    (I am pretty certain the readers here at the kind Mr Surber's blog are well aware of this, but nonetheless this is a major issue the fakeasream media prefer to obfuscate).

    1. That always bears repeating, and should be stated plainly and directly whenever someone tries to conflate the two: Care is not the same as insurance.

      Similarly, immigration is one thing. Illegal immigration is quite something else.

      Both truisms should be shouted from the mountaintops.

  2. Obamacare to be shot to death with arrows at dawn on St Valentines Day.

    Mr D. Surber, in charge of the firing squad, will be carrying a dart in a side-holster in case a coup de grĂ¢ce is required.

  3. Deleting the mandate and keeping the regulations is a recipe for disaster.

  4. I thought the idea of treating the repeal by reconciliation (which is the way the enabling Obamacare legislation was passed in the first place) was to keep anyone from using the filibuster against the repeal bill. Am I wrong? If I'm right, why are Republican Senators raising their canard? Are they using it for cover because they really DON'T WANT to repeal Obamacare?

  5. From Reason: "The Republican plan to repeal and replace Obamacare will do neither."

    Rand Paul gets it right:

    What should we replace Obamacare with? Perhaps we should try freedom:

    1. The freedom to choose inexpensive insurance free of government dictates.

    2. The freedom to save unlimited amounts in a health savings account.

    3. The freedom to buy insurance across state lines.

    4. The freedom for all individuals to join together in voluntary associations to gain the leverage of being part of a large insurance pool.

    1. All four points are points Trump made. End mandate (No. 1), health savings accounts, cross state borders, and pool coverage independent of employment are things Republicans wanted before Obamacare. I'm pretty sure Dr. Price will include them

  6. What is wrong with Ryan? I didn't like him before, didn't like him as a VP candidate, and don't particularly like him as Speaker.

    How does he keep on keeping on?

  7. This article was written by a real thinking writer. I agree many of the with the solid points made by the writer. I’ll be back.

  8. I wrote a huge response to this and it somehow got erased while trying to get it posted. Most people know my opinion about licensing and accreditation. The post roused on some of the things that inhibit distribution such as a thirty percent premium on payments to urban facilities and physicians for the same work that rurals do, and how the ACO and EMR mandates of Obamacare have lowered access to care. I also discussed the ramifications of trying to allow cross border insurance sales while leaving states in charge of regulation. All you need to do is think about it.

  9. They must identify and fix the costs issues first. Health care costs are out of control for several reasons.

    From an economic markets perspective, there are several issues, starting with the unworkable incentives with a three party (provider, consumer, payor) system. Then there are the burdensome regulations of health care in general. E.g. silly limits on selling insurance across state lines (which sounds like rent-seeking crony capitalism, it surely does not help consumers in any way).

    They need to address the fundamental issues with the market to reduce costs without also limiting access and/or quality. And if you don't reduce the costs, you can't make the insurance market better for consumers, since insurance is just a financial instrument built on top of the fundamental cost structure of health care providers and consumers.

    1. The one thing to remember about health care is that no market actually exists. There is no price competition at any level other than insurance. The only leverage that insurance companies really have in cost control is what they are willing to cover. When there were small medical systems and independent doctors they had some leverage, but with consolidation of systems deals both ways become take it or leave it, resulting in diminishing options for the consumer. All of this is a result of the initial market distortion caused by a legalized cartel produced by licensing and accreditation. Unless these are done away with all talk about a market is make believe.

    2. Read the ninth chapter and all the verses of Capitalism and freedom by Milton Friedman. I was going to say something about Hail Mary's and such but decided that was going too far.

  10. "Let the free market handle hospitalization insurance with the states regulating it."

    Slight disagreement, Don. We need competition across state lines, and state regulators won't allow it.