The news is overloaded with talk of the ongoing struggle to find a healthcare plan that can be acceptable to Congress and the President without creating a new untenable situation in place of the current one. And we now know that Paul Ryan's calculated proposal, dubbed as repeal but really not, was voted down by the Republican controlled House, so what should we do now? The answer is relatively easy but the implementation is not.
First of all, since Ryancare was not a repeal, it was nothing more than a tweak of the existing law. Conservatives were right to oppose it. Had it passed, Obamacare would, in effect, now just go by another name, Trumpcare, which would morph as its name over time, and it would ultimately explode on its own in the not-t00-distant future just like Obamacare will. So what is needed, and what should have been done, is a complete revamping around two principles. These are reducing cost so that families can afford it and ensuring that the doctor-patient relationship is paramount as opposed to a bureaucratic administrator making the final call. Only a combination of a better product, tailored to the needs of the consumer, and a management process that eliminates waste and abuse while improving efficiency will drive costs down.
How do you reduce cost? Open up competition, let companies cross state lines in offering coverage, reduce regulations to the minimum critical requirements for safety and provide tort reform to a reasonable level so that doctors can practice the medicine needed, not defensive medicine with unneeded and expensive batteries of tests that likely wouldn't be needed otherwise. Then, offer cafeteria options to differing groups of people, allowing the patient to pick the package he or she wants, not a federally dictated requirement for everyone to cover everything even if we individually don't need it or want it.
Everyone needs a catastrophic plan, but depending on the circumstances there should be co-pays and premiums which allow those who can afford it to opt for high deductibles and accept more personal risk. Right now some of the poorest among us are paid for by having so many hard working, self employed small business people sidled with premiums so high and co-pays so exorbitant that short of a major life saving event they might not even get a penny of insurance payment during the entire calendar year. Just because you have an insurance policy doesn't mean you'll get healthcare.
And with the advent of so many concierge medical practices, where doctors group together, bring on a set volume of patients per doctor, they can offer full routine care services (excepting catastrophic and hospitalization events) for as low as fifty dollars per adult and significantly less for a child. How do they do it? By negotiating effectively with their vendors, not being at the whim of a government contract specialist who has likely never negotiated anything in their life. These are growing in favor and coupled with a good catastrophic plan bring affordable options to what today continues to be the the same-old, same-old pricey and less valuable options.
So why after nearly eight years has Congress, and here I'm referring to both parties, just allowed the albatross that is Obamacare to fester and grow to the point where it is near implosion? The answer is quite simple. For those in today's Democratic Party, they want it to fail as planned to usher in a single payer system. For the Republicans, they really don't want to give up central authority either and they seem to be very happy operating like a minority. Also, both sides of the Washington coin have their unique internal Cadillac plan which lets them avoid the pain that others suffer. And that is also why the phony repeal and replace bill failed? Because we, the people knew it was phony and we let them know in advance of the vote with both barrels.
Time for all of our leaders to quit spending us into bankruptcy and get to work and save the future for our kids and grand kids. What kind of world are they going to inherit anyway?