“The health care system in America is broken. Costs are rising at an unacceptable rate — more than doubling over the last 10 years, which is nearly four times the rate of wage growth. Too many patients feel trapped by healthcare decisions dictated by HMOs. Too many doctors are torn between practicing medicine and practicing insurance. And 47 million Americans worry what will happen to them or their children if they get sick.”
Who do you think said that? President Obama? Actually, those words were written by Republicans. They are part of the summary of the Patients’ Choice Act, introduced this May by Rep. Paul Ryan (R-Wis.) in the House and by Sen. Tom Coburn (R-Okla.) in the Senate.
To hear it from President Obama, the choice is simple: his plan or the status quo. He is wrong on both counts: he has no plan, and the Republicans do. In fact, Republicans have introduced meaningful health care reform for years.
In the 1990s, Republicans tried to change Medicare into a defined-contribution model, more along the lines of the plan that federal employees enjoy. The Republican-controlled Congress passed such legislation in 1995, but President Clinton vetoed it. Seeing that Medicare costs were out of control, Clinton set up a bipartisan Medicare Commission headed by John Breaux (D-La.). The Breaux Commission came up with a similar plan in 1999. Democrats killed that too.
When Republicans controlled Congress and the White House, from 2003-06, they provided Health Savings Accounts and prescription coverage under Medicare for the first time. With the Democrats regularly using Senate filibusters, those were significant achievements.
Republican introduced precursors to the Patients’ Choice Act in the House in July 2007, May 2008 and September 2008. All died in the Democrat-controlled House. There is also the Health Care Freedom, introduced in the Senate this June by Sen. Jim DeMint.
The Patients’ Choice Act addresses the concerns most of us have about health care. It will reduce costs. It will expand coverage. It will increase patient choice, moving decision-making away from government and corporations and toward individuals.
When this country wanted to fight a hunger problem, it did not turn over the entire food production industry, from farmer to grocer, to the federal government. The federal government simply provided food stamps — in effect, vouchers for food.
Under the Patients’ Choice Act, low-income Americans would receive vouchers for health care in the form of tax rebates to purchase health insurance: $2,300 for individuals and $5,700 for families. That is more than what a high-deductable, HSA-eligible plan costs today. Low-income families, those currently covered by Medicaid, would receive extra money to buy private insurance that best fits their needs.
Participating insurers would be required to offer coverage to any individual, regardless of age or health history. Health insurance would be portable and patient-based, not employer-based.
While PCA would not force individuals to have health insurance, it would incentivize participation financially and by providing enrollment opportunities through places of employment, emergency rooms, the DMV, etc.
The Heritage Foundation estimated that Jim DeMint’s plan, which, like the Patients’ Choice Act, is based on vouchers, would insure an extra 22.4 million people — more than the 16 million that the Congressional Budget Office estimates would be added to health insurance rolls by ObamaCare. The numbers for the PCA, which Heritage did not study, are likely similar.
The PCA promises “no tax increases or new government spending.” Generally, savings would be achieved by replacing byzantine rules and regulations with simpler incentive structures that foster patient choice and free-market competition.
Notably, the CBO estimated that simply allowing individuals to purchase non-group health insurance coverage in any state would reduce the 2010-19 deficit by $7.4 billion and insure an additional 400,000 people by 2014.
Instead of Medicare dictating reimbursement rates, the act would provide a mechanism for competitive bidding among insurance plans. CBO has estimated this could save $158 billion.
Rather than dictate national tort laws, PCA would provide incentives to the states to reform their tort systems. Potential solutions range from specialized courts to handle medical malpractice cases to caps on damages, as successfully instituted in California and other states now. Tort reform could save perhaps $200 billion per year, according to a Pacific Research Institute study. If it saves only half that, or $1 trillion dollars over 10 years, it would save as much as ObamaCare would cost.
Regarding President Obama’s plan: he doesn’t have one. What he insists on is a “public option,” a sort of Medicare for non-seniors. That is curious, since the current Medicare system has been held together with chewing gum for years, and will go broke in 2017. Even Obama paints the public vs. private option as a US Post Office vs. FedEx/UPS choice, and not in a good way for the public option.
The plan being debated in town halls across the country is the Affordable Health Choices Act, introduced in the House by Rep. John Dingell (D-Mich.). This is the “Obama plan” only in the sense that it has a “public option” in it.
The CBO did a cost analysis of ObamaCare and estimated it would cost $1 trillion over the next 10 years and insure an extra 16 million people (of 47 million estimated to be uninsured). Under ObamaCare, to insure an extra 5% of the population would cost more than $1 trillion dollars.
On its very face, Obamacare fails ignominiously. Its reason for being was to save money, but it will cost a trillion dollars! And even after 10 years, it will cover only a third of the uninsured. (The math works out to $6,250 per additional person insured, or six times more than an HSA-qualified plan today.)
Try this multiple-choice question:
(a) Do nothing, for zero extra cost and 85% of the population insured.
(b) ObamaCare, for a cost of $1 trillion and 90% insured in 2020.
(c) A Republican plan, for no tax increases or new government spending, lower overall costs, and near-universal coverage.
Don’t believe the Administration’s ultimatum. It’s not Obama’s way or nothing at all. There is an alternative, and the nation should rally behind it.
Randall Hoven blogs at kulak.worldbreak.com