While I have never been a Trump supporter, I have also managed to avoid being afflicted by the so-called Trump Derangement Syndrome. Symptoms of this fast-moving affliction on the Left range from babbling incoherently to rioting. However, it appears that when congressional Republicans come down with Trump Derangement Syndrome it leads to populism and maybe a dash of desperation.
On the Right, Trump Derangement Syndrome doesn’t always mean opposing President Trump — sometimes the derangement is merely the percolation of envy because of his popularity and successes.
We have seen examples of this from Republicans in Missouri Sen. Josh Hawley’s attacks on social media companies. We have seen examples of this in Texas Sen. John Cornyn’s attacks on intellectual property. And we are now seeing it from Tennessee Sen. Lamar Alexander dealing with healthcare prices.
Each of these members are addressing real issues (OK, not Hawley) but Trump Derangement Syndrome has led them to solve issues in the most top-down, big government way possible. Historically, Republicans have been the party of limited government. They have been about removing restrictions and lifting the boot of the government off the necks of entrepreneurs. The idea is to let the productive sector be productive. Let them innovate and build and they create more jobs and grow the economy. This isn’t trickle-down economics, this is “Big Bang” economics.
Alexander, in his role as chairman of the Senate Health, Education, Labor, and Pensions Committee, is attempting to solve the problem of surprise medical bills. These bills primarily come from out-of-network doctors that take part in an emergency, and these visits currently represent 5% of all emergency department visits. The problem is real.
However, the current proposal from Alexander sets fire to the whole healthcare market to get at the problem. His solution calls for out-of-network doctors to limit how much they can charge not just the patient, but the insurance company covering the patient. While some are calling this “rate setting,” it is simply a price control — a government price control being implemented by a Republican.
That is a fairly obvious symptom. Diagnosis? Derangement.
If you set prices like Alexander’s current proposal, all of the power is in the pockets of big insurance companies. The senator has effectively taken your doctor out of the equation in deciding his pay. So, now, the patient doesn’t decide. The doctor doesn’t decide. The employer doesn’t decide. The insurance companies get to decide how much your care is worth and they will have the backing of the government in this decision. Worse, like all government price-setting breaks markets, this breaks the markets too.
If a doctor is out of network the proposal says they should be paid the median in-network rate for the region. While this isn’t a good policy even at implementation, it gets worse as contracts start running out. The insurance companies won’t have an incentive to renew any contracts above the median. Therefore, the median will begin to drop, and insurance companies will renew fewer and fewer contracts. Where the spiral will stop nobody knows, but there is no reason for the spiral to stop until it hits bottom and the government steps in to solve their self-induced mess.
The question is how many would be hurt by the downward spiral before government would step back in? Would the market still be functional? Derangement Syndrome will have long-run circumstances.
While it is fairly easy to diagnose derangement, the cure is going to be more illusive. President Trump has his issues, and they are real, but he has also had big wins. Congressional Republicans haven’t figured out whether he is with them or against them, if he is one of them or not, or if imitating him in the short-run is good for their long-run political career.
I don’t think that we will ever find a solution for the type of Trump Derangement Syndrome the Left suffers from — they are lost. However, on the Right, I hope that these longtime leaders and stalwarts of limited government return to their senses on their own and then we can really pursue public policy solutions that deal with real problems.
Charles Sauer (@CharlesSauer) is a contributor to the Washington Examiner’s Beltway Confidential blog. He is president of the Market Institute and previously worked on Capitol Hill, for a governor, and for an academic think tank.
