Guest MINDSETTER™ Gardiner: Republicans Would Ride a Trojan Horse to Repeal Obamacare

Sunday, July 09, 2017
Guest MINDSETTER™ Michael J. Gardiner

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. 

Healthcare 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 Gardner
Michael J. Gardiner is an attorney residing in Providence. He was a Republican candidate for office in 2010 and 2012.

  • Gina Raimondo 

    RI Governor 

    "Rhode Island is making strong progress to provide our people with the education and job training they need to be successful and to expand access to affordable, quality health care to virtually everyone in our state. 

    President Trump's budget betrays Rhode Islanders by giving huge tax cuts to corporations and the wealthiest Americans while drastically reducing federal funding for vital programs that create jobs, raise wages, and protect low-income Americans. 

    Even as we analyze President Trump's budget in the coming days to determine its specific impacts on Rhode Island, I appreciate the members of Rhode Island's Congressional Delegation for their leadership and advocacy, and I join them in calling on their colleagues in Washington, D.C. to stop the Trump administration from making massive cuts to health care, public schools, affordable housing, and other programs that Rhode Islanders rely upon."

     
  • Jim Langevin 

    U.S. Congressman

    “In March, President Trump released a budget outline that I strongly condemned for its drastic cuts to programs that help everyday Americans. Unfortunately, the President’s full budget proposal continues these harmful policies by gutting programs that invest in our economy, create jobs and provide crucial assistance to families across the country. 

    This proposal slashes funding for education, food assistance and health care for low-income seniors, children and people with disabilities. It makes cuts to worker training, environmental protection, and investments in medical research and advanced manufacturing. These are not mere luxuries, but programs that make meaningful differences in the lives of Rhode Islanders. 

    Congress must reject this cynical and misguided budget. Instead, we should work together in a bipartisan manner, as we did on the recently passed 2017 funding bill, to find a balanced approach to funding priorities that will support families, promote economic growth and provide for our national security.”  

     
  • David Cicilline

    U.S. Congressman

    “If a budget is a statement of your priorities and values, then Donald Trump’s budget shows he doesn’t understand the challenges facing honest, hardworking Rhode Islanders. This is a budget written by the wealthiest Americans for the benefit of the wealthiest Americans. But it’s a setback for the middle class. It makes life harder for anyone who’s trying to punch a ticket to the middle class.”

    Donald Trump has already proposed a huge tax cut for billionaires. But the budget he released today says everyone else is on their own. This budget eliminates hundreds of millions of dollars for job creation. It zeroes out funding for workforce training and good-paying manufacturing jobs in Rhode Island. And it makes it even harder for young people to succeed by cutting teacher training, eliminating afterschool funding, and making it harder to pay off student loans.”

    This budget does nothing to address Rhode Island’s crumbling infrastructure. It eliminates the TIGER grant program, which is critical to supporting local infrastructure projects like the new commuter rail station in Pawtucket. And it cuts funding for public transit by $928 million.”

    And most worrisome of all, this budget makes our towns and cities less safe. It actually cuts funding for firefighters. It cuts billions from the EPA and other resources to protect the water we drink and the air we breathe. And it slashes $978 million from the Army Corps of Engineers – meaning Rhode Island will be less prepared for hurricanes and have fewer resources to protect the quality of our waterways.”

    Plain and simple, this is not a budget that any Member of Congress should be comfortable supporting. Along with my colleagues in the House Democratic Leadership, I will do everything I can to reverse these devastating cuts and shape a budget that invests in the future of our country and puts honest, hardworking families first.”

     
  • Sheldon Whitehouse 

    U.S. Senator

    “This budget is reckless, plain and simple. The President proposes massive cuts to Medicaid, breaking yet another campaign promise. He seeks to decimate the federal government’s central command in the battle against the opioid crisis affecting communities from Burrillville to Westerly. He pursues tens of billions of dollars in cuts to student loans and loan forgiveness programs.

    His plan would slash funding for research into life-saving cures; lay waste to endowments that support Rhode Island’s world-class cultural institutions; hamstring the EPA so big polluters can poison our air and water; and weaken NOAA, sapping critical resources for coastal economies like Rhode Island’s. The list goes on.

    These senseless, irresponsible choices serve one purpose: to pave the way for tax cuts for the very wealthiest.  The good news is that this extremist proposal will go nowhere in the Senate. I look forward to moving past this political stunt of a budget and working on one the American people will support.”

     
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