It has been bandied about that Republicans have offered no alternatives to the Affordable Care Act even while they've been vehemently opposed it. This is patently false. I recall hearing, prior to it's 2009 passage, that as many as 30 alternatives were offered by Republicans and rejected. It seemed that every other day leading up to the passage of the AHCA I heard about a Republican alternative being shot down. Now, it's difficult to find anything out about these plans...the focus is mainly on a single bill introduced in 2009 that was quickly shot down by Democrats. You can read about that plan and others that were introduced as far back as 1995 here.
Myself, being but a lowly electrician, apparently shouldn't have anything to say on the issue....but I do. In fact, the following outline would go a long way toward fixing our overly burdensome and intrusive tax code, immigration, and our healthcare system. Mind you, it's just an outline.....you'd need far more.....umm......educated minds than mine to work out the details. Plus, it has the inherent problem of bumping into lots of special interests. Big ones. And bumping into them hard. Oops.
Step 1: FairTax. Why, you ask, should we begin healthcare reform with tax reform? The answer is actually pretty simple and has to do with increasing the tax base to include those who are using the system and not paying for it and increasing the amount of take home pay each person receives. Extra take home pay means more flexibility of choice in medical insurers and providers. This one change, while the simplest to implement, may run into some of the strongest opposition due to several facts: first, it would be the single biggest shift of power from the government to the American people possibly in its' history. Imagine the government's spending being constrained by what you decide to spend and be taxed on...it would force fiscal responsibility. Second, thousands of K Street lobbyists would be out of work...with no loopholes to find and no special interests to fight for, they'd have to retrain, wouldn't they? Third...no more IRS. Somewhere in the neighborhood of 90-95,000 IRS employees would find themselves in the same line as those K Street lobbyists I mentioned. No more audits, I'm sure, would just ruin some of their ideas of fun. Again....oops.
Add to that the expected repatriation of approximately $11 trillion dollars being held in offshore tax shelters to contribute to business investment, an approximately 22% decrease in the cost of consumer goods, and taking home 100% of your pay....that equals a lot of extra money in your pockets to spend on things like medical insurance, which could also be cheaper, were the proper reforms implemented.
Which brings me to....Step 2: Health care reform. A little more complicated, as it would require revamping our healthcare system from the ground up. To do this, one must consider why healthcare costs are as high as they are to begin with. One of the biggest contributing factors is coverage of the uninsured and under insured. Add to that the cost of education of doctors and nurses, malpractice insurance, facility maintenance, administration, material and equipment costs, pharmaceuticals....just to name a few. Getting these costs under control in a rational way that still leaves some room for profit and expansion of services while maintaining affordable private insurance is paramount in solving the healthcare dilemma....and the AHCA completely misses it.
The fatal flaw in the Affordable Healthcare Act is that is does absolutely nothing to address the underlying issues...it merely shifts the burden of payment onto already overburdened taxpayers and places the government in control of who receives what coverage and the amount that will be paid for it. I don't know about you, but that places entirely too much control of my life into the hands of people that don't really give a shit if I live or die....only whether or not my treatment will be cost effective.
To begin to address these issues would require increasing the tax base, thereby increasing revenues to jumpstart programs nearing insolvency such as Medicare and Medicaid. Next on the list would be deregulation of insurance companies to allow policy purchases across state lines, increasing competition and decreasing consumer cost. After that....tort reform. A major contributing factor in the high cost of medical malpractice insurance is the sheer number of false insurance claims, many of which are settled simply to avoid the costs associated with going to court. Premiums on these policies can run as high as $1 million a year or more for a surgeon or private practitioner. Pharmaceuticals are next....contrary to popular belief, pharmaceutical companies are not entirely to blame for the high cost of their medications, though they're not entirely innocent either. It's not unheard of for big pharma, with collusion from health care professionals(especially in areas of mental health), to invent an illness just to provide a drug for it. And if a highly sought after drug is in the hands of a single provider, you can bet on paying a premium no matter how much it actually costs to produce. Regardless, a great deal of money goes into research and development of new drugs, which then undergo a lengthy and expensive approval process with the FDA. These drugs are marketed not only here in the States, but globally. Many countries simply refuse to shoulder a fair portion of the burden of developing, approving, and marketing these drugs, paying well under market value. Pharmaceutical companies are then left with a choice....either market their drugs in countries who refuse to pay market value and retain their market share in those countries, or refuse to sell in these countries and risk tarnishing a relationship with a customer. Either way, it increases the cost to patients in the US.
This is by no means an all inclusive outline and it's sure to run into some pretty heavy opposition from vested interests. But if you value freedom from government intrusion, the ability to make your own choices concerning affordable healthcare, and a reduction of the tax burden on the American public, it's certainly a viable option.
