Real healthcare reform means putting patients, families and doctors at the heart of health care
The Affordable Care Act (Obamacare)
Obamacare has failed American families, driving up costs and reducing access to quality healthcare. With costs running into the trillions, Obamacare is also sinking America further into debt while imposing hundreds of billions of dollars of new taxes. By emphasizing competition and innovation instead of government controls, we can build a modern health care system that delivers accessible, affordable, and high-quality care. We can also protect vulnerable populations, including patients with preexisting conditions. Real healthcare reform means putting patients, families, and doctors first.
Obamacare has proven incapable of controlling the growth of healthcare costs, which take an increasing cut out of workers’ paychecks or even force them to give up insurance. Major insurers are pulling out of Obamacare exchanges because the program is so poorly designed and so full of complex regulations that the insurance companies are losing money despite vast federal subsidies. The cost of those subsidies will be $1.2 trillion over the next 10 years, or an average of $120 billion per year. The program will also impose more than $200 billion in penalties on workers and employers – and still 33 million Americans won’t have health insurance.
We must repeal Obamacare as soon as possible, replacing it with a more streamlined, pro-market approach to insurance. The few positive elements of Obamacare, such as guaranteed coverage for pre-existing conditions, could easily be incorporated into a new program in a much more efficient manner.
The heart of any Obamacare replacement should be a tax credit for every household that does not have insurance through an employer. Instead of the government defining a long list of benefits every insurance plan must have, customers should be able to tell insurance companies what they want. This will spur competition and ensure that the tax credit is sufficient to purchase any number of different plans. Allowing the purchase of insurance across state lines would also increase competition and bring down costs. Finally, encouraging the use of Health Savings Accounts (HSAs) will help create more educated consumers who seek treatment from efficient and high quality providers.
Medicare plays an indispensable role in providing health care for America’s senior citizens; it must be put on a sound financial footing so that all Americans have access to high-quality care in their retirement years. The only way to preserve Medicare for the next generation is to get hold of the runaway costs that threaten the program’s viability while spurring massive growth of the federal debt and deficit.
Established 50 years ago, Medicare hasn’t adapted to an aging population with a rising life expectancy. Instead of covering 1 in 10 Americans, the program now covers 1 in every 6—or 50 million men and women—who spend close to 20 years as Medicare patients, up from just 15. At the same time, relentless inflation in medical costs has led the cost of coverage to triple. Whereas payroll taxes and premiums once covered 70 percent of costs, the government now spends $700 billion per year while collecting only $100 billion from Medicare payroll taxes.
Without reform, Medicare and other entitlements will push our government to the edge of bankruptcy. Donald Trump and Hillary Clinton have made clear they have no appetite for reform, only for more spending. However, Evan McMullin is not afraid to challenge the status quo in order to put Medicare on a sound footing for the future.
The way to reform Medicare is encourage competition and innovation by putting patients, families, and doctors for first. The key to reform is premium support, a system in which all beneficiaries would receive a uniform subsidy toward the purchase of coverage from competing health plans, including the option of traditional Medicare. This approach would give seniors greater freedom to choose the plan that best suits their needs, while spurring competition among plans to provide the best quality care at the most efficient price.
To promote informed decision-making by beneficiaries, the federal government must develop and distribute user-friendly publications that enable beneficiaries to compare plans, estimate out-of-pocket costs, and assess the quality of competing providers. By making informed-decisions, beneficiaries can encourage a cycle of competition and innovation that leads to better outcomes for all.
Medicaid’s purpose is to provide lower-income Americans with the health care they need but can rarely afford. Despite its tremendous cost, there is little evidence that Medicaid is actually improving the overall health of the citizens it insures. The program should be reformed substantially, so that it continues to fulfill its critical mission without pushing our national debt past the breaking point.
When first established in 1966, Medicaid covered just 2 percent of the population. Today it covers more than 20 percent—almost 70 million men, women, and children. Obamacare alone has pushed 12 million individuals onto Medicaid. The annual cost of the program has risen to $550 billion, an increase of $200 billion under President Obama. The cost per beneficiary has also risen sharply to more than $7,000 per year.
Along with other entitlements, Medicaid is pushing our government to the edge of bankruptcy. Nonetheless, Donald Trump and Hillary Clinton have no appetite for reform. Yet voters have a choice, because Evan McMullin is prepared to demand accountability from Medicaid, in order to bring costs under control while delivering better health outcomes for Medicaid patients.
Despite having a different purpose than Medicare, Medicaid would also benefit from reforms that emphasize competition and innovation while putting patients, families, and doctors first. Currently, individual states rely on federal matching funds for Medicaid. This leads to inefficiency because the system rewards states for spending more instead of spending more wisely.
Instead, there should be a cap on federal support. This can be accomplished by giving states block grants instead of federal matching funds, or by giving states a fixed dollar amount for each individual enrolled in Medicaid. The advantage of the latter is that in the event of an unexpected increase in enrollment—because of a recession, for example—states will be able to handle the change.
This would be complemented by paring back the extensive restrictions that Washington places on state Medicaid programs, which discourage innovation and prevent states from taking full responsibility for outcomes. Medicaid could also become far more responsive to patient needs by creating a separate program for disabled and elderly recipients, whose needs are far different from able-bodied adults and their children.
Together, these changes provide a promising way to increase the accessibility of healthcare to Medicaid participants. Right now, many doctors refuse to accept Medicaid patients because reimbursements rates are so low. These reforms point the way toward ensuring that Medicaid patients become valued customers, not second-class citizens.