Tuesday, March 14, 2017

Is This Idea Too Crazy to Work?

Christopher Ruddy, a conservative ally of Trump, and CEO of Newsmax, has advanced this rather radical idea of Medicaid for all:
He offers the following seven-point game plan:
  1. "Ditch the Freedom Caucus and the handful of Senate Republicans who want a complete repeal of Obamacare. They don't agree with universal coverage and will never be placated.
  2. Find a few parts of Ryancare II [i.e., the AHCA; Ryancare I refers to Paul Ryan’s longstanding desire to privatize Medicare] that can win passage in the House and Senate with either GOP support or bipartisan support. Declare victory.
  3. Rekindle the bipartisanship in Congress that President Obama destroyed. Impanel a bipartisan committee to report back by year's end with a feasible plan to fix Obamacare.
  4. Reject the phony private health insurance market as the panacea. Look to an upgraded Medicaid system to become the country's blanket insurer for the uninsured.
  5. Tie Medicaid funding to states with the requirement that each pass legislation to allow for a truly nationwide health care market.
  6. Get Democrats to agree to modest tort reform to help lower medical costs.
  7. While bolstering Medicare and improving Medicaid, get Republicans and Democrats to back the long-term fix of health savings accounts. This allows individuals to fund their own health care and even profit from it."
My favorite parts of this plan are the first point "Ditch the Freedom Caucus", and the third one, try to rekindle bipartisanship. I don't  agree that Obama destroyed it; he had a lot of help.  But restoring it is key for trying to initiate a meaningful health plan.

Of course, as the author says, "...embracing this idea would be a huge break with the ideological orthodoxy of the Republican Party. But Trump really did campaign on a promise of universal coverage. And as he told CBS’s Scott Pelley back during the primary, “the government's gonna pay for it.”'
This "ideological break with orthodoxy" is such a rupture that it probably wouldn't be considered seriously.  But one could hope.


  1. Very interesting.

    Sometime after Nixon re-established relations with China, a phrase entered the American lexicon - "Only Nixon could go to China". Perhaps it is only Trump who can establish universal healthcare.

  2. Thanks for posting this, Katherine.

    I would support free basic Medicaid for all, though I think the fly in the ointment for both liberals and conservatives would be cost (an entitlement would go down hard with many conservatives; a sliding scale might be more palatable), how it's paid for (conservatives believe Obamacare costs too much), who administers it (states or feds), and what is included in in basic Medicaid coverage (Obamacare sets minimum standards for health care coverage, standards that probably need some tweaking).

    A plan like this would seriously erode the health insurance and pharma industries, and you can bet that their powerful lobbying bloc would have many objections.

    What bothers me about the continued re-engineering of Obamacare is how much ill-will has been spread between our two major parties over this issue, how much legislative time has been wasted trying to re-engineer something that mollify everybody (ha!), and how many people are at the mercy of powers beyond their control (politics and industry) in gaining access to their care.

  3. Jean, I think you're right about the pharma bloc fighting this kind of a plan. But I wonder about the health insurance companies. We're already seeing a lot of insurers bailing out of providing health insurance, because of higher than expected costs to them. Seems like they want to concentrate on the more predictable life, property, and casualty markets. I can envision us sort of backing into a medicaid/medicare for all plan because of too many carriers leaving the market.

  4. Katherine, you make a good point. There are some carriers that do health care only (Humana, BCBS), and this kind of system might put them out of business unless they could diversify in some way.

  5. Unagidon writes again with that combination of expertise and compassion we've grown to know.

  6. Unagidon writes: " ... we think the sick should get to see a doctor. And sooner or later they do. For the uninsured, this often comes far too late, and when it does come, it’s far more expensive than it could have been had they gotten health care sooner."

    Yes. The GOP is looking at Obamacare as a financial disaster because it is expensive for the government rather than in looking at health care savings down the road.

    On the other hand, Obamacare has disincentivized employers from hiring full-time workers whom they would have to pay health benefits, leaving many employees with less money to buy health care ... and higher subsidies that have to be paid. Employers and other "haves" in our nation have themselves caused many of the problems they impute to Obamacare.