June 28, 2017

I must be naïve. After decades of observing American politics, it still amazes me that many of those elected by the people to do the people’s business go to such lengths to harm them. The Senate "health care" bill, following a similar effort by the House, was designed to do just that. It was, however, not bad enough for some.

One of those is Ron Johnson, whose election in 2010 and re-election last year add to the puzzlement over what has happened to Wisconsin. During the 2010 campaign, George Will, in an approving column, quoted Johnson’s philosophy: "First of all, freedom." Like many conservatives, freedom to Johnson means property and the right to keep it, especially the right to avoid having it taxed: "The most basic right is the right to keep your property." Once that was possible: "For a brief moment" (when, under Reagan, the top income tax rate was 28 percent), "we were 72 percent free."

Senator Johnson wrote a column for The New York Times on June 26 setting forth his views on the ACA (Obamacare), which levied some taxes, and the Senate’s proposal to terminate its evil effects. His argument consisted of a string of conservative clichés, along with some inconsistencies.

"Washington believes that the solution to every problem is more money." Apparently he is, after six years, not part of Washington, which consists only of irresponsible liberals. Do conservatives not throw money at the Pentagon? Never mind.

"Like Obamacare, [the Senate bill] relies too heavily on government spending, and ignores the role that the private sector can and should play." Ah, yes, the private sector, in which no waste occurs, and every action results in the public good.

"[P]ursuing continuous improvement and root-cause analysis are core ideas in private-sector problem-solving. From what I’ve seen in six years in office, these concepts are foreign to government." This is nonsense; the core concept, the principle aim, of private business is making a profit. Medicare, not burdened with shareholders, overpaid executives or lobbyists, applies a far greater percentage of its revenue to patient care than do insurance companies.

The health care system has "virtually eliminated the power of consumer-driven, free-market discipline from one-sixth of our economy." How, pray, would that discipline work out in health care? Does he think that patients will be inclined, or able, to shop for care, comparing fees (if disclosed) between providers? Would insurance companies, with their network model, even allow that? The Senator really can’t make up his mind as to the system he wants. He complains that our health care system results in "separating patients from direct payment for health care," but contemplates reliance on private insurance, which largely accomplishes that separation.

Apparently, though, I’m making this too complex: "[A] simple solution is obvious. Loosen up regulations and mandates, so that Americans can choose to purchase insurance that suits their needs and that they can afford." The Senate Republican bill, to Senator Johnson isn’t drastic enough: it "turns its back on this simple solution and goes with something far too familiar: throwing money at the problem."

These are not unique beliefs, nor are they new for Johnson. When he decided in 2010 to run for the Senate, he claimed: "The Health Care Bill is the greatest assault on our freedom in my lifetime. It will do great harm to the finest health care system in the world."[30]  Our health care system is more accurately described as an embarrassment, a term used in one review of international results. Every study in recent years has shown that we spend more for poorer results than other developed countries. The ACA has reduced the number of uninsured, but our system is far from the finest, measured before or after that law’s enactment.

Would the Senator’s solution, removing government help, make health insurance affordable for all? Hardly, and that isn’t his aim. The result would be, he says, that people "can choose to purchase insurance that suits their needs and that they can afford." For many people, what they can afford won’t be much, if anything, and therefore won’t suit their needs.

His philosophy is aptly summarized in an article in The Nation: "The [Senate] bill makes an equivalence between affording care and deserving care." In other words, according to the foes of government, everyone deserves the level of care he can afford, and no more: health care is a privilege, not a right.

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30. https://www.nytimes.com/2017/06/26/opinion/senate-health-care-bill.html?_ r=0