Wednesday, February 9, 2011

Health Care Reform: What’s the Alternative?

The Kaiser/Harvard poll discussed in the last post shows us that about one American in four wants the Affordable Care Act — the health care reform law passed last year — repealed and replaced with a Republican alternative. So, what’s the alternative?

Officially, there isn’t one.  Last spring, when the Affordable Care Act was being debated in Congress, Republican legislators introduced a number of alternative bills and complained their ideas were being ignored. Well, apparently they didn’t think much of their ideas, either, because all of those bills have been abandoned. House Speaker John Boehner said the Republicans have no deadline for drafting an alternative to the Affordable Care Act, but he expects House committees to begin generating ideas.

If affordable health care were a brand-new issue, this all-the-time-in-the-world attitude would be understandable. But rising health care costs, and increasing numbers of uninsured, have been problems for a long time.  Access to affordable health care is a huge worry to Americans, including Americans with the deadly lung cancer mesothelioma. The issue of health care reform has been discussed in every national election going back at least 20 years.

And Republicans don’t have a plan?

Actually, one Republican has a plan. Rep. Paul Ryan of Wisconsin, the new chairman of the House Budget Committee, is considered one of his party’s leading experts in fiscal policy. You might remember that he delivered the Republican rebuttal to the State of the Union speech recently.

Rep. Paul Ryan’s ideas for fixing the health care crisis include putting an end to the Medicare program and replacing it with vouchers. Seniors could apply the vouchers toward purchasing private health insurance policies on the open market, assuming private insurers are willing to insure them. And Ryan’s plan for holding down the cost of his program is to be sure the value of the vouchers lags behind growth in actual health care costs. Seriously.

Rep. Ryan also wants to put an end to the tax exemption for employee benefits. This idea also was floated by Sen. John McCain, when he ran for President in 2008, and several other prominent Republicans. The purpose of ending the exemption — some Republicans will even admit this — is to encourage employee benefit insurance to be phased out, forcing everyone into the private market for health insurance.  And the point of that is to force Americans to confront how much their insurance, and health care, actually cost, so they won’t use it so much. Seriously.

Republicans refer to this as “skin in the game,” meaning that if more of the costs of health care came directly out of people’s pockets, they would make better choices as health care consumers. But purchasing health care is not the same thing as shopping for a toaster, and when people postpone seeing a doctor because of cost it often means their conditions are far more expensive to treat when they finally do seek care.

These ideas are included in what Rep. Ryan calls his “Roadmap for America’s Future.” The “roadmap” goes far beyond just overhauling health care; it also overhauls Social Security and taxes and lots of other stuff in ways that are more “fiscally conservative.” And the Congressional Budget Office says that the “roadmap” will indeed balance the budget — in 2062.  But it would add more than $62 trillion to the national debt before then. Such a deal.

This entry was posted on Sunday, January 30th, 2011 at 3:53 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.


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