Another approach to health care reform that might work for both sides.
1/ Second look at this for healthcare? nationalaffairs.com/publications/d…
2/ The basics, we get rid of Obamacare, and replace it with catastrophic insurance for everyone not on Medicaid or Medicare already.
3/ The cost of this is about half of Obamacare. And with other changes outlined, would likely pay for itself completely.
4/ The downside for conservatives — you’re creating a government entitlement (though getting rid of another one.)
5/ The upside for conservatives, you save money, and make insurance into insurance again.
6/ You protect people from devastating worst case scenarios, but don’t prepay their basic medical expenses.
7/ For liberals, you are getting rid of almost all medical bankruptcy. And the plan is based on income,
8/ so that people with lower income would largely be covered for everything, middle class and up would lose the risk of catastrophe.
9/ Basic expenses could be insured outside of this program if the person chose to do so.
10/ For Trump, he would be able to claim he covered everyone, consistent with his campaign promises.
11/ I’m not completely comfortable with the idea- I’m nervous what this turns into later.
12/ I definitely would not design the system from scratch like this.
13/ However, it’s better than what we have and it might have some political ability to get through the process.
14/ The cost for upper middle and high incomes would be a tax of about 2K per person.
15/ But it’s a big tax cut from what they’re paying today, and it would lower general insurance costs,
16/ because your general insurance would no longer need to cover catastrophic benefits.
17/ Here’s a column by @bdomenech on the idea nytimes.com/2017/03/21/opi…
18/ Or here from @DouthatNYTnytimes.com/2009/10/19/opi…
19/ I think if you could combine this with encouraging longer term life insurance style purchases and the ability to form large groups
20/ As outlined by Rand Paul here foxnews.com/opinion/2017/0……
21/ And I would also argue to further means test Medicare, you could really improve things and save money.
22/ If we’re going to spend government money on health care, it should a) provide that money to the most vulnerable,
23/ b) be limited to eliminating worst case scenarios rather than everyday expenses
24/ and c) provide people with the opportunity to opt out and make their own decisions.
25/ Politically, this provides something new that would change the debate from how to slightly alter Obamacare,
26/ into one that ends with everyone having a shield against the worst, except for perhaps a few higher income people who opt out.
27/ Again, it’s not my ideal, but it’s an improvement, should get votes from both sides, and allow Trump to claim a victory.
28/ It’s worth a look.
