Like it or not the President, to the delight of Schumer & Pelosi, now owns Obamacare. Despite our recommendations, Ryan, McConnell & Price have persuaded the Administration to take a different course. Instead of coming out with a plan that directly reconstructs the entire system they’ve decided to run a leveraged approach. Leveraged in the sense that will phase-in their ascent of Mount Obamacare by first presenting a “working” plan in the form of proposed legislation, followed by 3-4 concurrent Bills, principally with the intent of engaging both parties into the consensus-by-amendment process.
Unfortunately, in my opinion, this approach inevitably degrades into a ping-pong like process and though, theoretically, the notion might ease the approval process by distributing political-risk/incentive to both Democrats & Republicans, I believe that legislation by lowest possible common denominator relies on a system unaccustomed to working toward rational, disciplined and functional legislation.
We’ve contributed extensively to the repeal & replace effort and I can tell you, without reservation, the illusion driving the current motive force is that somehow Congress can return the system to a pre-Obama footprint and that is simply not possible. Obamacare (and the Democrats) has pushed the country into an entitlement corner with a massive and growing cost structure that no Democrat or Governor of any State, particularly those that happily bought into Obama’s Medicaid Expansion Giveaway, will ever be willing to confess or to acknowledge that their having accepted this bribe ignored the glaring truth that there was no funding mechanism in place, other than the Federal Government (a.k.a., the Taxpayer), to pay for it.
Unless the Federal Government and its feudal-like crop of dependent States, neither of which have any motive to be managerially effective or fiscally prudent, stop the financial inducement there will be no fiscal sustainability no matter what they do. The Government has told the Public that free health care was their entitled right and few are prepared to take the political risk that accompanies telling the Public what they don’t want to hear.
Because this is now an Entitlement Nation most Americans now believe that the solution to every Individuals personal financial mismanagement is to simply expand or create another entitlement program never realizing that the problem they seek to resolve thru government intervention creates, at the minimum, at least 3 problems that previously didn’t exist:
(1) Expands Government
(2) Removes/alters functional market-based facilities from the economic cycle
(3) Causes an exponential growth in Government funding demands
The extent to which government, at least in this Country, should be involved in any economic cycle is the extent permitted by the “Commerce Clause” of the Constitution which states that Congress shall have (only) the power “to regulate commerce with foreign nations, and among the several States and with the Indian tribes.”
It is important to know that at the time of its writing the term “regulate” meant to “make regular or to normalize” and not to impose, restrict or restrain on behalf of the Government apparatus or its Special Interests. What should have been done, and can still occur, is simply this: Congress & The Administration commands the healthcare insurance industry to perform the following task:
(1) Design a basic major medical/catastrophic-coverage plan with a range of deductibles from zero to twenty-percent.
(2) Provide a range of care options including, but not limited to (providing a premium cost for each) the following options: A no lifetime-cap option, a no pre-existing condition option, prenatal and postnatal care, geriatric care, terminal care, pregnancy care, cosmetic care, birth control, eye care, dental care, extended ER coverage, military/service related care and so on.
(3) Calculate Premium Costs (for item “1.” & “2” above) based on the following parameters:
(a) With and without participation of VA, Medicare/Medicaid beneficiaries
(b) Indigent & Illegal Immigration (only)
(4) National Household at 80, 90 & 95 percent levels of participation including all Self-Employed and all Government Employed. In other words, everyone not included in “a.” and “b.”
Do this and here is what you will discover: VA, Medicare & Medicaid are grotesquely inefficient and approximately 35-40 cents per dollar spent is somehow associated with waste, fraud or abuse and that 51-54% of Medicaid dollars, net of the waste and fraud, is being spent on Individuals here illegally.
Yes, legal reforms and predatory pricing controls will be required, but think of this: This Country could dissolve the black hole of the VA, Medicaid and Medicare programs and provide a means-tested replacement for a fraction (approximately 34%) of what is presently being spent on these programs and at the same time eliminate all of the Medicare/Medicaid unfunded mandates.
The key to solving the explosive cost and degradation in medical care is to expand the risk-pool and stop government-induced failure. As well as focus on getting the market back to competing for patient care and not government/insurance reimbursements from a system who singular purpose is political survivability within a structure built on cross-purposes.
If all the stars remain in alignment it is possible for Trump/Ryan/McConnell to pull-off their multi-phase approach but for the life of me I can’t imagine why when so simple an alternative is available.
Curtis C. Greco, Founder
