Like the rest of President Obama's economic policies, the Affordable Care Act is a throwback to the 1930s, an unworkable clunker from a time when President Roosevelt's Depression-era experiments prolonged the misery for eight long years before World War II intervened.
The Affordable Care Act most notably resembles the 1933 National Recovery Act (NRA), which created a central-planning system designed to promote "fair competition" through all manner of codes and quotas on business and industry. The system was junked by the Supreme Court two years later for giving unconstitutional power to the executive branch.
But with judicial remedies to ObamaCare unsuccessful to date, a fundamental transformation of the health care law is in order.
Forbes columnist Avik Roy writes that ObamaCare presents Republicans with
... a counter-intuitive opportunity: to use Obamacare's subsidized exchanges as a vehicle for entitlement reform[.] ...
... Republicans ... could consider migrating Americans from single-payer programs like Medicare and Medicaid into subsidized exchanges. Believe it or not, this would actually result in a Medicare reform [that] is to the right of anything Paul Ryan has ever proposed.
Mr. Roy calls this turnabout "Obamacare jiu-jitsu."
Roy's first step would be to fix the exchanges by reducing the mandates and regulations, scaling back the subsidies, and making the whole thing market-oriented, as Utah has done already.
Next would be gradually raising the Medicare eligibility age, and migrating patients on to the exchanges. An exchange with a subsidy closely resembles the Ryan premium-support plan for Medicare.
Step three would be to reduce or eliminate employer mandates, while also improving the market for individual insurance.
And step four would be to start moving the Medicaid population on to the exchanges, which Roy says would lift "the disincentive that Medicaid recipients have to find work."
Along with structural changes, the Independent Payment Advisory Board (IPAB) is ripe for repeal, and there is already strong pressure from the medical device industry to repeal the 2.3% medical-device excise tax that starts next month.
Townhall columnist Chuck Norris expands on "Obamacare jiu-jitsu": "the art of jiu-jitsu is to use an opponent's weight and strength to your advantage[.]" He adds that "[c]onservatives can still suffocate the federal monstrosity by supporting individual-to-state efforts to impede its funding and implementation."
Norris cautions, however, that "state resistance also provides another manipulative chess move by the Obama administration to bully, coerce and cast blame on the states and Republican governors in particular who refuse Obamacare."
The Norris countermove is to offer more "fiscally responsible and freedom-loving alternatives," such as Avik Roy's four-step plan, which would allow Republicans to propose real solutions to entitlements that are buckling under their own weight.
As Mr. Roy points out, conservative opposition to ObamaCare and its "blizzard of mandates, regulations and taxes ... shouldn't prevent us from salvaging the least bad aspects of the law to reform our entitlements and make insurance cheaper."
In other words, since we are stuck with this clunker, let's try to make it work for us instead of against us.
And get some political mileage out of it in the process.