They say that wherever government gets involved, there are unintended consequences — results that most people who had initially cheered on government action hadn’t considered. But the cynic in me believes there are few truly unintended consequences — that most proposals are not goals, but only a stop along the way toward a larger objective.
As a former health policy analyst at the Heritage Foundation, and as someone whose mother’s life was extended and improved by prescription drugs, I still follow the issue. I can assure you there are no unintended consequences here — only consequences that politicians hope no one outside their intimate circle thinks of.
One example came roughly 10 years ago, when key parts of ObamaCare began affecting the insurance market. The sudden increase in health insurance premiums was a feature of the bill, not a bug. The ultimate goal, I continue to believe, is a complete government takeover of the system, which the ballooning prices help facilitate.
The only “problem,” from the perspective of progressive takeover advocates, was that costs exploded too quickly and at a politically inopportune time. The public connected the dots between the new law and the cancellation notices. They saw that their bills were going up, despite the $2,500 in savings that President Barack Obama had falsely promised them. That helped Republicans gain nine seats and take over the Senate in 2014. If Obama and the Democrats could do it again, I’m guessing they would have boiled the frog more slowly.
Still, the law was always meant to make the situation worse. It was sold as a way to get more people into private health insurance. More than a decade later, the drop in the number of uninsured (about 20 million) is considerably smaller than the number who have gone on Medicaid since then (about 30 million). So we could have gotten the same result without blowing up the market for private health insurance, making the experience even more unpleasant for patients.
In response to the ever-greater discontent with the system that ObamaCare negatively disrupted, the same people who promised to fix the problem last time are now grumbling about their next step to “fix” it — a “public option” to address the problems they’ve created or exacerbated.
So here’s the real question: Would you let the same mechanic who poured syrup into your gas tank fix your engine afterward?
ObamaCare has been extremely successful as a study in incrementalism — in slowing working toward an ultimate goal without letting anything stand in the way. Republicans talked for years about repealing ObamaCare. They won elections on it, took a lot of votes in the House on it (when the Senate was controlled by Democrats), then ultimately came within one vote of repeal. When Arizona Senator John McCain voted “no” on his campaign promise, the issue died.
There has been no serious push for repeal since then. Republicans have simply walked away.
I know, having briefed many elected Republicans on the issue years ago, that they want nothing to do with health care. They view it as a Democratic issue. They want to know enough to talk about it on the surface for a few minutes, but none of them care to be close to anything that would be considered an expert. They want Democrats to act, so that they can react and appear to be involved. They will block, but they will never repeal, because then they’d own the problems. They would have to defend their actions, and they are ill-equipped for that.
Republicans’ avoidant behavior on such issues helps Democrats make any case for bigger government. And if you don’t know what the “unintended” or perhaps just unmentioned consequences are, then maybe their case will sound like a good one.
A favorite one currently is, as they would put it, to “let Medicare negotiate the cost of prescription drugs.” That sounds reasonable. But the problem is that, with Medicare now the monopoly insurance provider for 65 million senior citizens, there is no negotiating with it. You either give them what they want, or you’re out.
In “The Godfather,” Don Corleone, perfectly played by Marlon Brando, tells a young singer (allegedly based on Frank Sinatra) that he’s going to make sure he gets a part in a movie he’s desperate to have. When the singer asks how, the Don replies, “I’m gonna make him an offer he can’t refuse.” The producer ends up agreeing after waking up with the head of a prized horse in his bed.
That’s what the Biden administration is trying to do with prescription drugs now, minus the horse head. The offer the drugmakers can’t refuse is to take what Medicare offers, or face not only exclusion but also reprisals.
The Biden administration, thanks to a provision in the “Inflation Reduction Act,” can impose a 95 percent excise tax on any drug if the manufacturer won’t accept the price that the federal government deems “fair.” Yes, a 95 percent tax, just like in the Beatles’ song. Accept what we’re offering, or you’ll be punished. That’s not what most people would consider to be a “negotiation.” In most cases, it would be extortion. Because it’s government doing it, it’s perfectly legal.
Unfortunately, it is patients who would pay the price. It could come in the form of higher prices, or else in a more deadly form — an inability to obtain what their doctor believes they need. Such are the rippling consequences when government acts with its heavy hand.
Earlier in “The Godfather,” Michael Corleone had warned his girlfriend about his family, explaining to her another “deal” someone couldn’t refuse. This one involved a gun to the head of a band leader, who was told very clearly that “either his brains or his signature would be on the contract.”
Government, of course, doesn’t have to use a gun. It can destroy businesses and industries with a bureaucrat’s pen.
Fortunately, horses’ heads are safe. Unfortunately, Medicare recipients aren’t.
Derek Hunter is host of the Derek Hunter Podcast and a former staffer for the late Sen. Conrad Burns (R-Mont.).