A Better Republican Health Care Strategy: Play Ball

Left as is, the Obamacare legislation will be disastrous for our healthcare system.  But I don’t see a way that the Republicans, given only control of the house, can repeal it.  Attempts to de-fund it will lead to confusion and uncertainty which is not something we need right now.

The best chance of getting rid of it is in the courts.  I believe that it is unconstitutional, but if I were a republican legislator, I would have to admit that that wasn’t my call to make.  No, ultimately we’ll need proceed to the Supreme Court, pull the lever, and wait until the spinning stops and count the number of thumbs-down.

So, as a legislator, I would have to prepare for the contingency that the high court does not strike it down.

What the Republicans can do is try to ensure that if the mandated purchase of health insurance survives, that it will be a workable plan.  The insurance companies are for this.  They’ll sell more insurance to more people - Especially to young healthy people who would offset the risks.

But as it is, the new legislation will damage the industry greatly.  The $900 penalty for not having insurance does not induce one to buy coverage costing a minimum of around $3500 – especially when you can buy it after you become sick.  So the healthy will pay the penalty and save their money and the sick will buy coverage.  To support this, premiums will skyrocket to unsustainable levels.  Once this happens, the president will declare that private insurance companies have failed and introduce the single payer – government – plan.

The cries of “Socialism!” may or may not be true, depending on where you’re willing to draw the line.  But it’s not a particularly successful message for those who don’t cringe at the very thought.  Discussions regarding the constitutionality are pointless.  In the end, the opinions of only nine people matter in this regard.

Republican legislators should focus on amending the law in order to make sure that consumer choice and competition are retained.  The largest threat to those favoring government controlled healthcare would be a working private sector solution that meets all of the social goals.

To achieve this, there will have to be some give and take.  We will have to subsidize coverage for the poor – But not in the form of so called ‘Cadillac Plans’.  The proportion of this burden shared among income class ranges will be debatable.  There will be no opt-out for wealthy individuals who have the resources to ‘self-insure’.  We will have 100% coverage.

We must retain high deductible health plans - which reduce premiums significantly.  The insurance plans must be just that – policies to help individuals manage their risks.  Those that can take their family out to a restaurant can pay for an office visit.  For the poor we can debate lower deductibles, deductible susidies, or other solutions such as low, or no cost clinics.  If we are to mandate coverage, we must ensure that individuals have the widest degree of choice.

All individuals in a geographic area could buy into any plan at the same premium level.  Some might argue that the young and healthy would be bearing an unfair portion of the premium burdens.  However, the young and healthy have a not-so-curious habit of becoming older and increasingly infirm.

Since employers would be buying insurance for their employees would be paying the same rates as individuals, they could just give that money directly to their employees to purchase for themselves.  The employee gains choice and the employer rids itself of a large administrative function that is not related to its mission.

The individual state insurance commissions should be eliminated in favor of one national one to produce consistent regulations.  This part, at least, seems reasonable under the interstate commerce clause.

This framework should be offered to the president in a sincere attempt to secure his legacy and perhaps even guarantee him a second term in office.  We would all like to look back on our first black American president as a success.  I think most everyone, from Wellpoint CEO Angela Braly, to Daily Show host Jon Stewart would approve.

And if the Dems don't go along, the GOP would have a compelling argument.  "Hey, we tried to fix it but they stopped us.  Those premium increases are all on them."

Oh, and did I mention that with a working private industry solution that covers 100% of Americans in place, Medicare and Medicaid wouldn’t have a job to do?  We could shut them down.

Then we could sit down and figure out the potential impact to the FairTax rate.