Reforming Obamacare

The president addressed a rare joint session of Congress Wednesday night and rather eloquently laid out his "wish list" for healthcare reform (“Obamacare”), this time with specific talking points about who and how Americans will benefit. As far as program details or how it will be financed, the president either isn't saying or doesn't yet know.

The president's lack of transparency and detail coupled with the government's long history of profligate entitlement spending makes it easy to understand why Americans are reluctant to buy into the president’s program, especially when the reform narrative keeps changing. The original priority was to insure the 47 million uninsured, but quickly turned to overhauling our entire healthcare system, one that according to polls satisfactorily serves 75 percent of the 250 million insured. Called out by protesters at the prospect that taxpayer money would subsidize healthcare for illegals, the president changed his tune and referred to 30+ million uninsured and assured us that illegal aliens will not be insured under his program.

Originally, healthcare reform was going to be substantially paid for with cuts in Medicare and new taxes on the wealthy. Seeing backlash from seniors probably led the president to rethink that approach and definitively say that there will be no Medicare cuts to pay for Obamacare. The president is now saying that half the costs of Obamacare can be paid for by eliminating the waste, fraud and inefficiency from the existing system. That's a difficult one to swallow especially knowing that one of the House proposals calls for 53 new government bureaucracies to be created under Obamacare!

President Obama is urging us to “trust him,” but has not earned that trust. Critics of Obamacare point to language in the various proposals that refute many of the assertions made by the president in his speech. The president hasn't backed up any of his statements with any details or actual documentation. In addition, he "sold" us Obamacare by hyping the positives, without acknowledging even the possibility that there will be unintended and potentially negative repercussions from such comprehensive and complicated changes to our system. Finally, his stimulus plan early this year showed us that he has neither the experience, expertise nor the inclination to add value to his own programs.

Notwithstanding all the evidence to the contrary, the president says that he is seeking incremental reform that fixes the problems with our system. If he truly means what he says, his “incremental” reform should consider the following common sense suggestions:

Enable interstate competition among insurance companies. Greater competition among insurance providers should lead to cheaper insurance for consumers. We buy our home, auto and life insurance in a national marketplace, why shouldn’t we buy our health insurance there too? Instead, Obamacare proposes to create some type of national exchange for insurance companies. Apparently, no one knows how it will work, including the president.

Eliminate mandates for minimum insurance coverage. One reason health insurance is so expensive is that we’re forced to buy insurance for every conceivable health condition and situation. Again, Americans select their home, auto and life insurance by making choices among coverage alternatives, why should health insurance be any different? Let consumers select from a menu according to their own needs, once their basic needs are met. Healthy young people, for example, who otherwise would not seek any insurance, should be encouraged to purchase “catastrophe insurance” to insure against major events that can potentially strike at any time.

Reform medical malpractice law (tort reform). The president mentioned tort reform last night, but his comments clearly indicate that he has no intention of taking decisive action in the time frame contemplated for his reform package. Many believe tort reform is critically needed in order to contain future healthcare costs. If the president is serious about reforming healthcare, he needs to put aside the long-standing allegiance of the democrats to the civil trial lawyers of America.

Tort reform refers to making changes to our civil justice system that would limit the incidence and monetary awards arising from litigation. Should victims of medical malpractice be compensated for their misfortune? Absolutely, but does the average settlement need to exceed a million dollars, and should that practice be allowed to paralyze and potentially bankrupt our healthcare system? Approximately one third of our healthcare costs are driven by “defensive” medicine and more than 80 percent of U.S. doctors admit they require unnecessary tests for their patients just to avoid potential patient lawsuits arising from alleged negligence on their part. Tort reform has the potential to save $100 billion annually in healthcare costs and any proposed reform of healthcare should address the cost, waste and inefficiency created by the current law.

Provide tax incentives to individuals who purchase health insurance. Employers and businesses pay for employee insurance premiums with after tax dollars, why shouldn’t all of us be able to do the same?

These ideas have the advantage of being straightforward and can be implemented incrementally. I hope the president will keep his promise and seriously consider them for his healthcare reform program.