In the wake of the debacle known as the rollout of the Affordable Care Act (ACA aka Obamacare), everyone has a criticism but folks seem short on solutions. Time for me to write my own legislation. I won’t profess that these ideas are particularly original but they seem to be the right combination of things to cure what ails us, without the complicated big bang blow up of Obamacare. I hereby present the Lawson Insurance Act of 2014.
What should be our goals up front?
- Quality of health insurance
The first element of the plan is the establishment of the Health Insurance Oversight Commission, a government body modeled after the FDA and the FCC that audits and approves all insurance policies issued in the US. Most of us are thankful or take for granted that we have government entities that enforce minimum standards on the food we eat and the drugs we take and the publicly available communications that we consume. The HIOC would serve this purpose in the health insurance realm. Such popular provisions in Obamacare such as no disqualification due to pre-existing conditions would be enforced by the HIOC. The HIOC would also disapprove so-called junk insurance policies.
Some right wing zealots say we should be “free” to buy junk insurance policies if we so choose. This of course flies in the face of the widely accepted role of government in consumer protection. The only one who profits from a junk insurance policy is the insurance company. The folks who buy them, probably because they can’t afford better, don’t understand they are throwing their money away and are not protected from bankruptcy in the event of a serious illness. It is a proper role of government to keep these folks from being played for suckers.
Indeed Obamacare has attempted to do that with the horrific result that millions of folks are being summarily dropped from their substandard insurance policies and offered alternatives that are double or triple the premium. This is the very definition of the road to hell being paved with good intentions. So let’s move on to affordability.
Medicaid, not Medicare, For All
Medicaid is associated with the poor. I would submit the definition of poor in this country has changed. With so much wealth shifted to the top 1% of this country, we now have a whole new class of working poor who live paycheck to paycheck. I suggest that a needs based Medicaid expansion take place with the precise goal of bridging the gap between what people are charged for insurance premiums and what they can afford. With these supplements, we allow people to pay what they can truly afford for health insurance without placing downward pressure on the profit motive of the insurance companies. Call it a socialist buttress to capitalism. The supplements could be handled in either of two ways. We could pay these supplements to individuals who would file their insurance premium bills much as a businessman might file an expense report and then get reimbursed a certain amount based on need. The other method would be to pay insurance companies directly some sensibly calculated stipend which would allow them to pass reduced cost on to their customers. In this way the insurance company basically has two customers — the government who pays them to keep premiums affordable — and the policy holder who pays the affordable premium. Of course, insurance companies who not meet the minimum standards of the HIOC would not qualify for supplements at all.
Stop Protecting Insurance Companies From True Capitalism
Since health insurance is not a brick and mortar consumer item there is no reason for there to be a geographic constraint on its sale. All insurance companies should be required to accept policy holders from anywhere in the country. There should also be a push for a purely private insurance industry with employment-based insurance being completely phased out. There is no Earthly reason why affording health care should be attached to employment at any particular employer. Insurance companies should be exposed to the same risks and rewards of any other company competing in the capitalistic marketplace. We should be seeing health insurance commercials with Anthem battling it out with United Health Care to offer consumers the best quality for the most competitive price.
Did anyone notice I didn’t list universal coverage as a goal? It wasn’t an oversight on my part. I’m beginning to think that it is THAT goal that has sunk the ACA rollout. You can’t believe in capitalism and in the same breath say that EVERYONE can buy (or must buy) a particular product. Unless you go complete socialist on this and demand Medicare for all, then you must give up the universal coverage goal. The goal should be for government to put a bit of juice into the system so that the vast majority of people can afford quality health insurance. The goal should be to exploit the greatest virtues of capitalism (for example, competitive downward price pressure) to get as many folks insured as possible.
OK, the details are a bit fuzzy. I’ll admit that. I’m not a policy wonk or a legislator. I suggest that the above ideas are simpler and more understandable than Obamacare. Now it’s your turn to tweak this, tear it apart, reconstruct it. But there are two things you DON’T get to do.
You don’t get to trash it without your own solution.
You don’t get to settle for the status quo.