When we talk about health care in America, there is one figure that is more important than any other.
That is the cost of all health care in the US divided by all the people in the US. Obamacare attempted to funnel that much money to health insurance companies with subsidies or Medicare. Instead, people on the exchanges paid $7,500 with up to $7,500 in deductibles. Obamacare sucks, but a “replacement” plan is going to fix this. A strategy is required, something that is hard to come by for Republicans.
Redstate has a piece about the lack of defining principles that is making it impossible for the party to pass a repeal or replacement. The problem with repealing Obamacare is that it requires the same 60 votes it did to pass Obamacare (in the Senate) back in 2009. What can happen is a budget reconciliation bill that requires only 51 votes. That would de-fund Obamacare. Ted Cruz helped kill Obamacare years ago by ending the slush fund the Democrats were using to bribe insurance companies into staying in exchanges even though the math wasn’t working.
This idea we can burn down the government and start over is popular in the Trump era, but it started with Libertarians. They want to blow shit up because the “free market” will solve everything. Many supported Trump because they didn’t want someone to govern, they wanted someone to un-govern.
The Libertarian non-plan for health care goes like this. Everyone pays their medical bill in cash or credit. If they can’t pay, it’s the same as if they won’t pay and they don’t get any care. People may die, but doctors will also go out of business. Eventually, the health care industry will need to lower their prices and more people can go to a doctor. That is why Gary Johnson isn’t president. That, and agreeing with Bernie Sanders.
The key is to lower that $7,000 figure down to less than $5,000. Then it would be 10% of the median income. One thing we could do is cap lawsuits, but start imposing other punishments, like taking licenses from bad doctors. It would also help to get away from insurance. Insurance is a gamble where everyone pays more to the company than it pays out because of overhead costs. This is why conservatives talk about health savings accounts. It’s a way to pay insurance premiums and keep all the money.
Regardless of the plan, there are people who won’t like it. In fact, a lot of people won’t. That’s too bad. Republicans, more than anything else, need to relearn that the perfect is the enemy of the good. Also, Donald Trump isn’t perfect.