As a voting drudge, I must be unusually interested in healthcare policy—when it comes up in these candidate debates my attention is out of all proportion to the journalistic commentary afterwards. I wrote, here, that Trump’s “concepts of a plan” for replacing Obamacare, eight years after running on rescinding it and giving us “something better,” showed how bankrupt he and his party are on this matter.
Smooth-talking J D Vance did nothing to change my mind the other night.
When Walz brought up “concepts of a plan” and said that really there was no plan, unless you count throwing sick people off their affordable insurance, Vance parried with a flow of words that included: “We currently have laws and regulations in place, in place right now, that protect people with pre-existing conditions. We want to keep those regulations in place, but we also want to make the health insurance marketplace function a little better.”
I think a better debater than Walz would then have said something like:
Well, I’m happy to say I agree with one thing the senator said there. It’s true that there’s a law right now protecting people with pre-existing conditions. The name of that law is Obamacare. It’s the law Trump says he wants to repeal. And in fact, when he was president, he came within one Senate vote of succeeding. I doubt anything could show better than what you just heard how vacant Republicans are on this question of vital importance to millions of Americans. These guys tout the provisions of a law they hate and want to scrap in order to argue that everything would be just fine if that very law was repealed!
I don’t know how Vance would have responded—some anodyne nonsense, no doubt—but any talk of “the healthcare marketplace” or “market solutions” would have given Walz a chance to explain that, actually, the vaunted market is the problem. Insurers figure out how much you’re apt to cost them before deciding what policy to offer, at what price. If for example it’s auto insurance, they want to know about your car, how far you drive it, your age and gender, the number of moving violations you’ve had, etc. The analogous questions, transferred to the realm of health insurance, cause unhealthy people not to be able to afford it.
As a society we’ve decided it’s okay if people with poor driving records pay more for auto insurance. But we haven’t decided it’s okay if people with poor health prospects can’t afford medical insurance. Only Republicans have decided that.