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Sunday, February 23, 2014

A Program For the Future - Getting America Working Again! - 4

An obvious plank in the GOP platform for 2014 is bringing and end to Obamacare.  Clearly, this will be a major issue in the campaign.  Nevertheless, it would be better if the Republicans were to offer their own program for healthcare moving forward. 

The key to a Republican health care platform ought to be that it focus on something different than Obamacare.  The Democrats' plan puts the emphasis on getting everyone insured and mandating insurance policies filled with all sorts of items whether or not the person buying the insurance wants them.  This has driven the cost of insurance for everyone way up, disrupted the healthcare coverage of something like half of all Americans, forced deductibles way up and generally priced healthcare out of the reach of many folks.  Even for those who have been moved into Medicaid, the coverage is not meaningful because so few doctors will now treat patients in that program.

The Republican plan ought to focus on bringing down the cost of healthcare for everyone while still finding a way so that families can avoid disaster if a truly serious health crisis hits.  So how does this translate into specifics?

1.  All of the limitations on health insurance policies should be eliminated except for the following:  after a family has spent $10,000 on healthcare during a year, the insurance policy has to kick in and provide coverage.  This would allow the sale of catastrophic coverage for many people at a greatly reduced price.  All the extras like health club dues, birth control pills, and the like which are not really required for good health need not be included in the policies.  Obviously, policies that include these items can and will still be sold, but the minimum basic policy will just be there to cover catastrophes.  Obama's constant refrain that Americans ought not to be one illness away from bankruptcy should be adequately dealt with by these basic policies.  This structure will also allow the insurance companies to use their clout to negotiate lower rates from doctors which will help keep medical costs down.

2.  Medicaid should be transformed into a designated clinic system.  People on Medicaid who now go to emergency rooms for normal treatments should be directed instead to clinics set up in each county specifically for those in the program.  Moving people into these clinics as patients will allow for massive cost cutting.

3.  All of the massive tax increases designed to fund the Obamacare bureaucracy and subsidies ought to be eliminated to the extent possible.  This should provide a major boost to the economy.

4.  The federal government should provide grants to states to be used to help subsidize those who cannot afford the cost of the catastrophic coverage.  The states can decide if this fund will go to insurance premiums only, deductible coverage or both.  This will let the states experiment to find the best system which can then be copied by the others.

There are, of course, many other pieces that have to go into this system.  Those should be put in place separately.  We have all had enough of "comprehensive" health care reform.  We all know now that "comprehensive" actually means (a) unread by Congress, (b) not fully considered, and (c) the product of some academics with strong opinions who do not understand the real world impact of their ideas.




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