Real Healthcare Reform
The past week has proven, if proof was needed, that the federal government is incapable of even handing out free money. Conservatives in Congress, if there are any left, need to capitalize on the Cash for Clunkers debacle and push for real healthcare reform. The attack ads should write themselves: “Democrats can’t be trusted to give you a ride to work, much less the hospital. And now they want to be in charge of the healthcare system? Don’t let Pelosi, Reid and Obama in the operating room.”
Democrats can’t be trusted to give you a ride to work, much less the hospital.
First, Obama’s scurrilous claims should be but have not yet been rejected:
- Horror Stories. Obama loves the sad story: Mother’s with cancer refused treatment or forced into bankruptcy. This never happens in a government plan? Mr. President, are you ignorant or just criminally naive?
- 45 Million Rational Americans. Obama loves to point to the 45 million Americans without healthcare. Let’s break that down:
- Anytime Obama uses a number, even if it’s 1600 Pennsylvania Avenue, be suspicious. Have you seen any of those 150,000 jobs he said that have been saved or created? What about the 8.5% maximum unemployment rate he promised? How about the $1 billion in cash for clunkers he said would last 3 month and only lasted a week. Twain said there are three types of lies: lies, damn lies and statistics. He didn’t know about the fourth, any statement by Barack Obama.
- There are a number of reasons why people elect not to purchase healthcare. Americans have always been given the right to choose. The only way to get 100% of a free people insured is to give it away for free.
- Finally, the notion that Obama can cover 45 million more people and pay less money is utterly ridiculous.
- Spiraling Costs. Costs are spiraling out of control: this is true, but he gets the right answer for the wrong reason, it has nothing to do with the tonsil vultures. It’s my fellow lawyers, like Jonathan Edwards, swooping in and administering jackpot justice. Obama trumpets (falsely) a claim that hospitals have agreed to cut costs by 1.5% over 10 years. Defensive medicine, tests and procedures doctors perform not because they are medically necessary, but legally prudent, cost the system nearly 6x that!
But the system is indeed in need of repair. Republicans and Blue Dogs should spend the recess pushing hard against the current plan and forming a coalition platform that should include the following 5 fixes:
- End the Employer-Provided Tax Exemption. Because of how historical accident, your health insurance is tied to your employment. Is your car insurance? Your homeowners? That’s absurd you say? Well so is the fact that your health insurance is tied to employment. Tying it to the government doesn’t make it any better. Ending the tax break for insurance plans provided by employers is the best way to do that. This will, technically, be a tax increase, but it can and should be offset by rebates to all Americans (not just employees) to defray the cost. The rebates can sunset as the system normalizes.
- Allow Insurers to Cross State Lines. Allow insurers to sell insurance across state lines. This will open the risk pool and allow people to move across state lines and keep the same policy. Rules created in the 1950’s don’t make sense in a world where people commute from Pennsylvania to NYC to work.
- Medical Malpractice Tort Reform. Limit the amount a plaintiff can receive in a medical malpractice claim except in egregious circumstances (gross negligence and willful misconduct). Provide an absolute safe harbor for good Samaritan care. If Obama thinks he can set the cost for medical procedures, why not set the cost medical malpractice?
- End-of-Life Care Accounts. Establish a voluntary tax-free savings account, similar to a 401(k) where people can save for their end-of-life care. Money that is unused gets placed into a pool to offset the cost of end-of-life care of others.
- Tax Credits. Provide tax credits to promote healthier behavior and for people under 35 who purchase health insurance. Although complicating the tax code is anathema to conservatives, this is the proper incentive to drive universal coverage and healthier behavior. Younger, healthier people are less likely to use health insurance, so this will provide two benefits. First, when someone in this age group has an unexpected illness, rather than becoming an uninsured burden on the system, they are insured. Second, the large number of younger, healthier insured will skew the risk pool and make insurance more efficient. As for the credit, just as you certify now whether you are blind or over 65, you would certify whether you are under 35, have diabetes, hypertension, etc and whether you purchased a plan. If you meet the requirements and have purchased healthcare, you would receive a tax credit. Those who fear government bureaucrats nosing into their health records are free to opt out of the credit.