Monday, May 19, 2014

ObamaCare Is Something, and You Can’t Beat Something with Nothing

Preach not because you have to say something but because you have something to say.

Richard Whately  (1787-1863), English theologian and economist, Apothegems

Republicans are fond of preaching that ObamaCare is bad and must be replaced or repealed.

But with what?   

ObamaCare, after all,  is something.  It is something that 55% in the latest Pew poll dislike.  It is something that voters want fixed.  But it is something  that voters don’t want repealed unless it is replaced with something.

Simply stated,   you don’t beat something with nothing.  Time and time again,  I hear the plaintive refrain that Republicans offer nothing  to replace something.   

What would that something be?  

My suggestions for an alternative plan are:

1)       A guarantee that your present plan cannot be cancelled.  That would remove a lot of uncertainty among middle class self-employed workers and voters.

2)      Universal health care tax credits for the individual and small group markets as well as the corporate markets.  That would strike voters as fair and would remove much of the stigma that Republicans favor only businesses.

3)      Allow  health plan competition across state lines.   That would reduce premium variation, particularly in those states in which a few health plans dominate and can charge high premiums because they can.

4)      Expand health saving accounts (HSAs).    HSAs have already proven to be a potent mechanism for reducing premiums and as a means of giving workers more choice and more responsibility.  Furthermore,  HSAs are popular among employers and workers alike.

5)      Move quickly to create high-risk pools for those with pre-existing conditions.   Coverage for those with these conditions is popular,  as it should be, and should be retained.

6)      Retain coverage for young adults under their parents’ plans.   This ObamaCare feature is popular and takes the edge of soaring student debt.

7)       Cancel the one-size-fits-all requirement that all health plans must contain 10 essential benefits regardless of your age, sex, health  or demographics.    This requirement is silly, and voters know it.

8)      Institute and lobby for malpractice reform in all states, in the manner of which states like California and Texas have done.  Frivolous law suits unnecessarily drive up costs of care,  encourage distrust among patients , and demoralize doctors.   Encourage special health courts so voters can get a square and fair deal if malpractice has occurred.

 9)   End Individual and Employer Mandates. 

10)     Promote free market principles, including direct pay independent practices and independent outpatient surgical and diagnostic outpatient centers can get insurance-free care if they so choose.

Tweet:   To modify, replace, and repeal ObamaCare, which is something, Republicans will need a reasonable alternative plan voters can vote for.

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