An Alternative to Obamacare

The mainstream media, pundits, and the political elite criticize others, mostly Republicans, by saying the opposition never offers alternatives. This isn’t so. The opposition offers alternatives, but the alternatives are ignored. The rule of ruling class is: if it isn't my idea, it doesn't count and is off the table.

The truth is the political, think tank, and political elite shut out news of alternatives. The NYT, ABC, NBC, CNN, CBS editorial filters are powerful. One of the unspoken rules of political partisanship and elite mediaship is: never give your opponents the time of day or prime time exposure.

One function of this blog, which is respectful but skeptical of Obamacare, is to highlight reasonable health reform proposals. The proposal put forth by Shawn Tully, editor at large of Fortune is such a proposal and consists of four parts (“Don’t Like Obamacare” Here’s an Alternative," Fortune, August 20, 2009)

1. End tax breaks for employer health plans.

As an employee, your take home pay will go up, and you will own individual plan. Your premiums will go down. You will have a high deductible, but your will be motivated to shop for the best deal, and if you have cash left over, you will have a retirement nest egg.

2. End the three big inflators of health costs.

One. End the “standard benefits packages,” which too often contain costly special benefits like hearing aids, wigs for cancer victims, chiropractic care, autism care, drug abuse treatment.

Two. End “community ratings” – the same rate for everybody, whether sick, young, old, or healthy. This punishes the young and pushes them out of the market.

Three. End “guaranteed issues” requiring plans to accept anyone who applies. Again this punishes the young and healthy and drives up the number of uninsured.


3.Protect people with pre-existing illness.

Place them in high risk pools of those with such illnesses, and cap their premiums at 150% of average premiums. Subsidize them if necessary them with state-based income subsidies and sales tax revenues.

4.Expand the supply side.

Give consumes control over their own money through HSAs. Protect them with castatrophic insurance. Allow nurse practitioners, physician assistants, and other qualified professionals to provide basic care. Promote retail clinics, worksite clinics, cash-only clinics, concierge practices, and urgicenters.