Lighting a Candle Instead of Just Cursing the Darkness

by Gordon Cooper

From Broader View Weekly, November 6, 2009

It is easy to find fault with what we have seen so far of the Democrat Party’s proposed Health Care Reform Bill. As our loyal readers know, I have spent several columns pointing out the dangers of increased federal regulations and increased deficit spending surrounding the idea of a government-run and taxpayer-funded universal health plan. I feel that I must do more than just sit in the balcony and throw insults toward the stage. That is not conducive to constructive debate and only serves to polarize and anger those who disagree with my assessments.

Therefore, I am hereby lighting a few small candles and offering some alternative plans. I wish I could truthfully say that the plans below were all original thoughts by me, but I have to admit that (as if you need to be told this) I am not the brightest bulb on the Christmas tree, and it was only after reading the thoughts of many others who are pretty bright that I came up with the following suggestions.

One dangerous dark point in the House version that I have mentioned previously is the expanded role of the federal bureaucracy in our healthcare decision making. This would come in the form of a Federal Health Care Committee that would have unprecedented powers and no accountability to the electorate. This would mean that compensation rates to providers and tests and procedures available to patients would all have to be filtered through a distant and disconnected bureaucrat’s desktop.

One possible alternative to that darkness would be to hearken back to the words of our founders who saw the danger of a large, overreaching centralized government that was out of reach of the common citizen by both geographical distance and political accountability. They understood that increasing the power of the individual states was the best insurance against tyranny.

Therefore, I propose that we shift the responsibility of providing health care back to the states. We could essentially have 50 laboratories performing experiments rather than having one monopolistic laboratory trying to impose a one-size-fits-all solution to an issue that has proven to be so complex that it has already consumed tons of paper and months of negotiation and is still miles away from being solved.

I believe this could work because it has been tried on a small scale already. Massachusetts, Tennessee and Utah have each taken on this issue and while Tennessee and Massachusetts have not been glowing successes, they have at least provided the other states with valuable lessons. In the case of TennCare, the state of Tennessee offered a scaled-down version of the plan the Democrats are proposing, i.e. highly subsidized health care and restricted reimbursements for providers. As you might guess, that solution has since been abandoned.

Utah, on the other hand, is experimenting with a plan based upon defined-contribution and citizen-owned and citizen-controlled health insurance that increases portability as employees retain their policy as they move from job to job while it also increases patient responsibility for making healthy choices by offering incentives.

Another candle I would light would be to illuminate the proposal offered by four Republicans in Congress (and you thought they were only the ‘Party of NO’, right?); Senators Tom Coburn (R-OK) and Richard Burr (R-NC), along with Representatives Paul Ryan (R-WI) and Devin Nunes (R-CA). They have authored a bill called the Patients’ Choice Act. The nutshell version of this bill is to re-direct a $300 billion tax subsidy – already being used to subsidize employment-based health insurance – back to individuals and families in the form of a $2,300 and $5,700 (respectively) tax credit or debit card (if they do not pay income tax due to low income). This would empower the individual to purchase her/his best plan and would set the insurance companies against each other in increased competition for those consumer dollars. This would automatically lead to lower prices.

Another candle would be to encourage employers to offer defined-contribution plans as opposed to defined-benefit plans. These would take the form of offering a set contribution from the employer to the employees who would then shop for the best plan. Rather than having the insurance company negotiate with one buyer, they would have to offer packages to multiple buyers. This again would foster true competition and choice. It would also encourage the employee to make healthy choices and give them true ownership of their policy.

One more candle has been lit by the Improving Health Care for All Americans Act (IHCAA) sponsored by John Shadegg (R-AZ). One proposal within this bill would allow group insurance to be offered through membership associations such as churches, civic groups and even alumni associations and trade associations. This would greatly increase competition and enable individuals who were self-employed, underemployed, unemployed or retired to get the benefit of group plans.

In conclusion, these are all candles that could be lit, but the sad fact is that the current political leadership in Washington has shut the door – both figuratively and literally – on any constructive debate from the opposition, hence the darkness continues to reign.