Healthcare: If At First You Don’t Succeed…

I watched with great concern as the proposed repeal and replacement of Obamacare went down in flames last week.  It was a sad day for all Americans. An imploding, top-heavy healthcare system still hangs around our individual necks like a surgical noose.

I went back and forth about the merits of the Ryan bill. On one hand, I thought it might be a good first step forward (though not great) and give President Trump a win and some momentum. On the other hand, I knew there was a better way that many were championing with their “no” votes.

Then the bill was pulled and we careened back to this truth:  

If at first you don’t succeed, try, try again.

Here are my thoughts and gradebook on the most recent healthcare debacle.

It’s easy for me to think of grades right now because of teaching at Faith International University. Besides my YWAM projects and responsibilities, this Spring Quarter I will be teaching fourteen courses at FIU (most on-line) and grading papers most days.

Right now I live in the land of A through F–so let’s apply those letters to the various players in the healthcare saga. Before we go there and suggest the way ahead, I’d like to analyze why the American healthcare system debate is important. I will do it in question and answer form to make the ideas clearer.

1. Why is healthcare such an important issue in today’s world?

The main answer is the cost due to advances in modern medicine. MM keeps us alive with antibiotics, prolongs our lifespan through major surgeries, and even extends quality of life via cancer treatments and the like. All of the these medicines and procedures cost large sums of money to research, develop and provide.

The benefits and costs of medical care were not an issue prior to 1900. Before the 20th century you simply lived, fought various diseases in natural or primitive ways, and died. Today there are vast (and often expensive) ways to extend both quantity and quality of life.

My wife recently had major female surgery from which she has received a great outcome. Even with the bloated costs of care that exist in today’s system, her surgery cost thousands of dollars that we wouldn’t have been able to pay without insurance.

One more reason for healthcare’s importance: It amounts to nearly one-fifth of the American economy. Getting it right or wrong affects literally trillions of dollars.

2. Why is there such a rift between Democrats and Republicans on healthcare?

It’s the great American divide–between the secular view of life and the biblical one. The secular Democrats believe that government is the answer to most problems (a God substitute). They don’t care about people’s behavior or the cost of things. In the name of compassion (whether honest or pretended), they want all citizens to be taken care of–with the government in charge.

Republicans hold to the traditional Judeo-Christian view that individual responsibility (under God), free markets, and church-centered compassion make for the best combination of health care in society. They believe this view retards bad behavior, gives everyone a sense of stewardship, encourages good works and philanthropy and lowers costs through competition.

3. Why did Obamacare (ACA) pass eight years ago and the AHCA fail?

Obamacare wasn’t easy to ram through Congress (it was a 2700 page bill), but at the time, the Dems controlled all branches of government including the critical 60 votes needed in the Senate. Democrats are also more united in their secular philosophy (liberalism/progressivism) than the Republicans. They are a small tent party–either be Far Left or get out! Do you know of many national Democrats who are moderates or conservatives?

Republicans are the Big Tent party of the 21st century. Their roots are in conservative (biblical) philosophy of government (Freedom Caucus and others), but they possess a strong moderate faction (Paul Ryan, John McCain, Lindsey Graham etc.) and even some liberals (e.g. Susan Collins and Linda Murkowski). In 2017, they don’t hold a 60 vote margin in the Senate. This makes their task much more difficult–a harder needle to thread.

Plus, they’re not used to governing (they have a lot to learn) and, as mentioned above, aren’t as united as the Dems.

4. Why did the Republicans keep many governmental aspects in the AHCA bill and not vote on a free market solution?

This is one of the “dirty little secrets” of the health care debate. Republicans know (and Dems depend on the fact) that a sizable portion of 21st century Americans like free stuff.  The American populace is so addicted to government hand-outs and re-distribution of wealth that it is very difficult for the Republicans to rescind Obamacare. That’s why the moderates clung to Medicaid expansion and defected. They knew some of their constituents have Democrat appetites for government aid.

5. Did this dependency make Obamacare easier to pass?

Yes. Another dirty little secret is that Obamacare was really a 10 million person expansion of Medicaid— expanding the definition of poverty to anybody with an irresponsible lifestyle including drug users and indigent folks–while making everybody else pay for them. It was a step toward fully socialized medicine or single payer insurance (government controlled).

I learned about single payer when I had hip surgery a few years ago. One of my fellow patients, from Canada, had been a chain smoker. The government paid $250,000 for lung transplant surgery (which was his fault), which then impacted his hips (his body reacting to anti-rejection drugs). They paid for that too ($30,000). Quite a gravy train with no personal responsibility.

Single payer takes from the responsible and gives to the irresponsible. I believe in caring for the truly needy, but not subsidizing poor choices.

So what are the grades for last week? (from good to worst):

1. Freedom loving, responsible Americans = A for praying and caring about their health.

2. President Trump = A- (half a grade off for naively trusting House leaders). Beyond that, he did a yeoman’s job of listening and negoiating with everybody. In fact, it was refreshing to see our government at work again.

3. Freedom Caucus = A on first two weeks (holding out for a good bill) and a C in the last week (loyalty to the party). Average = B. These House members must learn to be principled team players.

4. Paul Ryan & Allies = B for effort but D for delivery (should have gotten consensus beforehand). This reverts to a C.

5. Barack Obama and Dem Party = D- (will give half a grade for “compassion” but terrible policy). Plus, not one of them would have voted for this better bill.

6. Justice John Roberts = D- for horrible Supreme Court verdict (he should have stopped this mess).

7. And “F” to the demonic forces who are behind destroying America though inspiring irresponsible behavior, economic collapse, and bad leadership. Don’t forget the unseen realm. They are our true enemy.

What’s a solution going forward?

Here’s the simplest idea.

Rescind Obamacare with one sentence, then immediately replace with the free market.  Just like every other industry where prices have gone down, create more quality, competition and lower prices. (Here’s a good freedom-oriented proposal from the Heritage Foundation.)

  • Make the 90% of able-bodied Americans buy anything they want or can afford. Let all policies be sold nation-wide and let all manner of associations pool their resources (to drive down costs).
  • Make the poor and indigent have some skin in the game (small co-pays etc.) If you don’t pay, you won’t care about how you live.
  • Let Medicaid be a state-based safety net solely for the diligent poor.

Bryan Fischer agrees:

“The solution to Obamacare is not to make it worse and grant it the government equivalent of eternal life. No, it is to get government out the health insurance business altogether and let insurance companies develop whatever plans Americans want and compete with each other for their insurance dollars. This will instantly lower costs and increase accessibility, which is the goal.”

“Overnight, policies will be crafted that will make health insurance accessible to everyone and affordable for every budget. Folks with limited incomes will be able to buy low-premium, high deductible plans that will protect them in cases of unforeseen but expensive health incidents like cancer.”

“What about those who still wind up with a stiff deductible and a large health care bill even with insurance? Well, that’s what families, friends, churches and charities are for. Christian America is the most spectacularly generous nation on earth and they will step up.”

I agree.

So, Congressional leaders, get back to work with perseverance and wisdom. We’re praying for and standing with you.

If at first you don’t succeed, then try, try again.


  1. Ron Boehme on March 29, 2017 at 5:22 pm

    Thanks for your great and honest post, Shane. I totally understand where you're coming from. In fact, minus the debilitating disease that you have, I'm in the same situation. I've been in Medicaid for a few years and it has certainly benefited me, and next year I'll be shoved onto Medicare. But I've also paid many of my own personal expenses (including two hip re-surfacing surgeries totally about $25,000).

    Here are my quick thoughts:

    1. You deserve to be a part of the 10% I mentioned in the article that need high risk pool government help. You have a debilitating disease that you cannot pay for on your own. It's not a result of your lifestyle choices. I believe that both government and charity can be a part of that safety net.

    2. I realized years ago that despite my feelings and desires, what's good for me is not necessarily good for the country. And I must always put the greater good over by own personal circumstances.

    3. That means when I choose to do what's right or good for all, then I truly need to trust God to take care of me as He sees fit. Health is not a right. It is a privilege–nothing more.

    4. And remember this about European, Canadian and US Obamacare: A day of reckoning is coming. Because they are based on a false premise (healthcare is the domain of government), they will collapse one day–hurting ALL. it's just a matter of time. Those enjoying it now just got into the Ponzi Scheme at the right time. But collapse is inevitable without major change.

    Thus I'm all in taking America back to a free market system with the caveats above. It will create the most blessing for the greatest amount of people.

    Thanks for your great thoughts. Will help me pray for you.

  2. Shane Kuester on March 29, 2017 at 6:37 am

    Hello Ron,

    I'm trying to figure out what I think about all this, and I'd love your input in doing so. I watched the healthcare bill debate with great interest myself, but for very different reasons. I'm very happy that the bill failed because I would possibly be one of the people losing my insurance based on how the bill was written, but based on your proposed remedy, I would certainly lose my insurance. It was not a sad day for this American when the bill failed.

    Here is my story. At 25 I was diagnosed with Chron's Disease. I don't think I caused it by anything I did, but they don't know the cause, so its hard to say. You know where I work, but please don't mention it because I'm overseas now; but because of that I didn't have health insurance available through work. So, since that time, I was essentially uninsurable. The only policy I could purchase at any price carried a rider that stated it wouldn't cover the one thing I really needed covered, Chron's Disease.

    I know this has skewed my view of insurance companies, but I see them as the problem, not the solution.

    Then, to further push my thinking leftward, Obamacare saved my life, or at least kept me from declaring bankruptcy and abandoning my medical debts. When Obamacare was passed, it was the first time in 20 years that health insurance was available to me. I avoided it at first, because I agree with you, in theory anyway, and there are many things in Obamacare to be disgusted with. But, when it became cheaper to buy a policy than to pay the penalty, I did it.

    Less than a year later, I had a flare up that ended up with abdominal surgery. Without the Obamacare policy I would have either died of the disease or gotten as much treatment as I could string out before declaring bankruptcy.

    Further influencing my thinking is seeing all the like minded Europeans that I work with not have healthcare be an issue for them. I know their systems have serious problems too, but everyone has access to a basic level of healthcare, and the rich can always find a way to get immediate care for anything.

    The biggest problem as I see it, is that I don't believe the America church can be trusted to pick up the slack. I think that in the same way that the failure of the church led to Social Security, its time for the failure of church and insurance companies to give way to social healthcare.

    That is the big dichotomy I struggle with. On paper, I completely agree with you, but in real life I'm completely opposed. I don't see how a Christian gets around the lack of compassion for people in situations similar to mine that are inherent in the system that you (and many of my friends) propose. It seems like there are a lot of us out there, at least according to the CBO, that said as many as 24 million of us would lose our coverage over the next few years based on the wording of the AHCA.

    All this has pushed my thinking on healthcare so far left that it is the one thing I agree with Bernie Sanders on; given the opportunity, I'd vote for a single payer system.

    I really am open to your input on this because as I said, on paper I really do agree with you, I just don't believe it will work in real life. Also, Obamacare is not something I'm fond of and I disagree with on many points, its just that it ended up saving me from disaster.

    Thanks for your time and thanks for your updates, I try to learn from them even when I can't bring myself to agree with them.

    -Shane Kuester

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