Guest MINDSETTER™ Gardiner: Republicans Would Ride a Trojan Horse to Repeal Obamacare
Sunday, July 09, 2017
As the repeal of Obamacare looms, it’s easy to worry about what comes next. Going back to double digit inflation in health care and lots of uninsured people doesn’t make much sense.
But Obamacare has us heading toward spending 20% of GDP on healthcare by 2025. That’s going backwards too. We should be heading to maybe 12% of GDP like other nations. What’s wrong? And what should we do about it?
What’s wrong is Obamacare left intact an insurance market place that was unlikely to produce savings and more likely to produce inflation. The well employed with employer subsidized plans don’t pay the full cost and don’t care much what individuals are paying. The uninsured got free care at emergency rooms and other ways. The independent contractor types, here in Rhode Island, they had to pay through the nose at full price.
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTHealthcare reform here in the 90’s made me lose my $1200 per year with a two million dollar lifetime cap policy and replace it with BlueCross RI and a one million dollar lifetime cap, a two thousand dollar deductible that may as well have been five thousand, and a price of $2880 per year. My friends in the RI General Assembly engineered a 240% increase for me.
You see, here in Rhode Island, Obamacare actually did cut some premiums a little bit, because, we were unaffordable already, premium wise. But for much of the rest of the country, they experience Obamacare the way I experienced Rhode Island’s reforms in the 1990’s. Americans don’t want that.
What We Want - And How To Get It
What we do want is affordable insurance, and I think we even want a basic guarantee that we will all receive care, and we want to do it efficiently. So here’s how we might do that.
First let’s create one nationwide market place. It is possible to get the states all on one uniform code of law in the field of healthcare. Our uniform commercial code caused nationwide franchises to explode across the country. It’s not hard or arcane. We have many uniform codes in probate, child custody, on and on. We can do it. One nationwide market would be a huge opportunity for competition and innovation. Let give capitalism, the invisible hand and all that, the best opportunity to solve this crisis.
With the same urgency, let’s resurrect the public option; oh I know it’s a Trojan horse but it’s a pretty horse. It would give Rhode Island individuals another choice for affordable health insurance and the government a chance to influence the market. That’s okay, it’s our government and we can change course if we needed too. Let’s not pretend that the state sized low choice markets we have are so perfect they must be protected on Libertarian principle.
Let’s automatically give the public option to those who do not have other coverage charging them an appropriate premium. Let’s not threaten with jail and act too much like the IRS about it. We can recover delayed payments in a variety of fair methods. This will be good news for hospitals and states if those people show up needing care without “workers comp”, auto carrier or other health insurance. Let’s keep the public option a major medical plan. We don’t need a basic guaranty looking like blue chip coverage.
“Why should I want that?” “ I am well employed!” you say? Because small employers or large, won’t have to worry that their workers have no health insurance and worry about trying to afford it. Workers who lose their jobs won’t be paying COBRA continuation payments they can’t possibly afford on unemployment benefits
Employing the Private Sector
Let’s keep fully alive the private sector. With a nationwide market, we want carriers offering supplemental polices. We want insurance carriers luring people off the public option with great plans. Why would insurers do that? They would, I think, because a lot of premiums coming in means you have a lot of money to leverage. It’s a lot of clout. I want my cell phone provider to offer its subscribers a discount it negotiated with a partnering health insurer. I want to see what comes of the opportunity a nationwide market represents.
We should encourage medical savings accounts that will meet future needs the basic guarantee would not meet, like, for instance, the middle aged refresh therapies that help people look and feel competitive in the work place, or, better therapies and equipment as we age. The basic guarantee should be like a gateway drug to buying better insurance in a better marketplace.
Progressives who want single payer are wisely arguing for a basic guarantee that is humane and if it is not to costly, liberating. But conservatives wisely trust in the power of consumer choice and capitalism to produce the best value and quality at the best price. Let’s acknowledge that most Americans do want a basic guarantee, that the “earners” absolutely deserve the benefit of it, since they are paying for it, as should employers small and large.
And, giving capitalism the full opportunity to produce better ways, let’s remember that the basic guarantee should be just a reliable stable pediment of a choice and value rich high quality health care marketplace. Now imagine that Trojan horse riding across a nationwide marketplace. Oh, it’s a pretty sight.
Michael J. Gardiner is an attorney residing in Providence. He was a Republican candidate for office in 2010 and 2012.
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