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Call Rand Paul: 202-224- 4343

Rand Paul fantasizes that he can stand on principle by voting against the Graham-Cassidy Obamacare repeal/replace bill, and there will be no consequences. The bill would replace Obamacare by repealing its most odious mandates and giving the money it costs the Fed to the states as block grants.

But in one week, when the fiscal year ends, the window will close on passing a bill with a simple majority under Reconciliation rules. After that time, we’ll need 8 Dems to help pass a repeal—an impossibility that only a modern-day Don Quixote could believe in.

Sen. Paul keeps babbling in interviews about a national group plan—which also won’t be achievable under strict Reconciliation rules and surely won’t get 60 votes, after September 30th.

The obvious result is, we’ll be stuck with Obamacare forevermore. The GOP will be blamed, and rightly so. This is obvious to anyone but Rand.

But that’s not all. As Obamacare fails, the GOP will be forced to help the Democrats shore up the flawed plan. That is going to cost more and more money until the idea will be floated that eliminating insurance companies will save money—something one-third of Democrats already favor. There’s a name for that: single payer.

That’s been the plan from the start; Harry Reid admitted as much in a 2013 Las Vegas Sun interview:

“What we’ve done with Obamacare is have a step in the right direction, but we’re far from having something that’s going to work forever,” Reid said. When then asked by panelist Steve Sebelius whether he meant ultimately the country would have to have a health care system that abandoned insurance as the means of accessing it, Reid said: “Yes, yes. Absolutely, yes.”

What will be the effect on the Republican Party if it fails to repeal Obamacare? Next year they could even lose the House.

But in the Senate—which has accomplished absolute zero since the GOP took over in January 2015—they need lose only 3 seats to lose the control they have squandered. This is very likely, given their arrogant ignoring of their base, on issue after issue. Given that there’s no discernible difference between the McConnell Senate and the Reid Senate, Republican voters will have little incentive to come out on election day to save the GOP.

Now let’s look at the scenario, if Rand votes for the bill. It’s possible that Alaska’s Murkowski can be persuaded to vote for it also. Kim Strassel, writing in The Wall Street Journal on the 21st, said Alaska has suffered under Obamacare:

[It] has hit Alaska harder than any other state. Health-insurance premiums have soared more than 200% and are now the highest in the country. All but one insurer has fled the state’s individual market. People are dropping policies. Doctors are refusing to take the flood of new Medicaid patients.

Ms. Strassel describes the price Alaska and its senator will pay for another no vote:

She would get the fury of a White House and a GOP Congress with far more power over Alaska than just its healthcare.… Alaska lives or dies on federal largess. It routinely tops the list of federal funding per capita. It receives billions in annual federal grants and billions more in defense spending. Federal money supports an estimated one-third of all the jobs and household income in the state.

The money that really matters is discretionary. It’s the Denali Commission. It’s the Essential Air Service, which subsidizes flights in rural Alaska. It grants for weatherization, and village water projects, and salmon recovery. It’s wildlife refuge payments and bridges to nowhere. Its upgrades for military bases.

Kim also reveals that “Interior Secretary Ryan Zinke called Ms. Murkowski after her July health-care defection to let her know President Trump would be turning off the tap and ending Alaska’s enormous opportunity to cash in on energy deregulation.”

If Graham-Cassidy passes, the GOP has a chance to pick up 8 more seats (especially if it can show other achievements).

With those new votes, Graham-Cassidy can be tweaked without a single Dem vote. A national group plan could be passed. Apparently, this advanced reasoning is beyond Rand Paul, whose judgment is clouded by his impossible dream of always being able to vote conservative in a largely RINO party. Rand once seemed aware of this, The Wall Street Journal reports in today’s editorial:

“In July on Fox News, he said he’d vote for the Senate’s ‘skinny repeal,’ which would have nixed discrete features such as the individual mandate, because it was ‘the best I can get, given the colleagues that I have. You send me some better colleagues, and I will repeal more of it.’”

Of course, we’d have more time if McConnell would give up his precious legislative filibuster (which he won’t). But, too busy jousting with windmills, Rand hasn’t even mentioned that.

Americans should be fully aware what life will be like under single payer, which Rand Paul, John McCain, et al. are condemning us to. Suffice it to say: under that system, the only way to control costs is through rationing. That’s why Canadians have had to cultivate extreme patience in getting their health care. The Fraser Institute has been cataloging treatment wait times in Canada for over twenty years. Here are some highlights from its 2016 “Waiting Your Turn” report:

Specialist physicians surveyed report a median waiting time of 20.0 weeks between referral from a general practitioner and receipt of treatment… the longest ever recorded.

Among the various specialties, the shortest total waits exist for medical oncology (3.7 weeks), radiation oncology (4.1 weeks), and elective cardiovascular surgery (8.4 weeks).

Patients wait longest between a referral by a GP and neurosurgery (46.9 weeks), orthopedic surgery (38.0 weeks), and ophthalmology (28.5 weeks).

Photo credit: Gage Skidmore