Thomas Donlan of Barron’s explains in his latest editorial commentary that President-elect Donald Trump has an opportunity to make major positive changes in health care.
As a form of insurance, Obamacare is a fraud: About 60% of its beneficiaries are on Medicaid, a welfare program, and the rest are in a tangled mess of exchanges that provides an illusion of good insurance.
If Trumpcare is to be any better, the new president and the Republican majority in Congress should think bigger, and also think more slowly.
They are talking about a quick legislative repeal of the misnamed Patient Protection and Affordable Care Act, but wise heads want to postpone the effective date for two or three years. It may not take that long to create a simple health-insurance plan that covers all Americans, but whatever Congress does probably will not be simple, and it will require a lengthy period of adjustment and adaptation.
It would be even better if they repeal and replace all of the other federal programs that take the place of real health insurance for a third of Americans. Their names are legion, but the six big ones are Medicare, Medicaid, Veterans Health Administration, Children’s Health Insurance, Tricare (for military families), and the Indian Health Service.
A seventh program, the Federal Employees Health Benefits Program, needs no serious adjustment. It relies on private insurance and gives beneficiaries a wide variety of plans to choose from. It should be expanded to serve the beneficiaries of the other six.
Trump said in 2000, in a book called The America We Deserve, “We must have universal health care. Our objective [should be to] find an equivalent of the single-payer plan that is affordable, well administered, and provides freedom of choice….The Federal Employees Health Benefits Program can act as a guide for all health-care reform. It operates through a centralized agency that offers considerable range of choice. While this is a government program, it is also very much market-based. It allows private insurance companies to compete for this market. Once a year, participants can choose from plans which vary in benefits and costs.”
Trump and his co-author went further in the right direction: The book proposed that groups and individuals receive the same kind of tax breaks for health insurance that employers now receive.
“This would allow ordinary citizens to buy coverage that complements their company policy and gives them more of what they need. It would also give them the option to jettison the company policy altogether and just buy their own insurance.”
