President Donald Trump should be applauded for courageously tackling the "disaster” — as he calls Obamacare — in his first major legislative effort.
The House Republican healthcare plan has come under fierce criticism from almost every quarter, with some justification.
Now, our new president could inherit the bad political baggage of both Obamacare and the House Republicans.
Unfortunately, such a scenario is unfolding before our very eyes.
Remember that Obama and Trump agreed on the key, positive premise that every American should have access to medical care.
But both Obamacare and the new GOP plan (let's call it Ryan Plan II), have a serious flaw: an onerous demand that almost every American should buy health insurance from the private market.
This demand, done mainly to please the insurance industry, has made the cure of simply expanding the less expensive Medicaid program a nonstarter.
As a conservative, I have a real problem with the so-called "private health market.”
Healthcare is regulated by states, and many states have allowed private insurance companies to operate like a racket.
In many states there is no free, competitive market for health insurance since they limit the number of operators, creating near monopolies.
Trump became a fierce critic of this fact, wisely grasping that a truly nationwide market for health insurance would create real competition and reduce costs.
This is one of the primary reasons Obamacare failed. It mandated that every adult citizen purchase private insurance in these uncompetitive state markets.
Under Obamacare, if individuals can't afford private insurance, they have two options. First, the truly poor could get Medicaid. And other low-income individuals were provided with "subsidies” to help them buy private insurance.
You don't need to be Warren Buffett to figure out the biggest financial beneficiary of Obamacare has been insurance companies.
Everyone was mandated to buy private health insurance. The legislation provided no caps on profits or cost controls. Insurance company stock prices soared as Obamacare became law.
Other, big derivative winners of Obamacare were pharmaceutical companies and physicians.
No surprise, then, that the insurance industry, big pharma, and the American Medical Association all strongly backed the passage of Obamacare. (The insurance industry is once again strongly backing Ryan Plan II.)
But, the flaws in Obamacare soon became apparent as the law's draconian mandates and taxes hit. Premiums for working Americans and businesses soared.
Obamacare also targeted Medicare with cuts, to pay for the millions added to Medicaid.
The newly insured under the Obamacare umbrella discovered that their basic care was never actually covered, because deductibles for their private insurance were raised. The sick ended up having to pay more in out of pocket expenses than before Obamacare.
What a nightmare!
Voters rebelled, and in 2010 the Republicans unexpectedly gained control of the House.
The 2010 election exit polls were very clear: Seniors concerned about Obamacare and Medicare voted in record numbers for the Republicans.
The Republican response to this election gift was rather strange.
Instead of moving to protect Medicare and fix some of the inherent problems in Obamacare, in 2011 the House proposed the Ryan Plan (Ryan Plan I).
Ryan Plan I essentially turned Medicare from a federal entitlement program into a private voucher program.
Under this first proposed Ryan Plan, Medicare was to be phased out in a decade and the voucher program would be administered by the states for the benefit of private insurance companies.
The Republicans had clearly forgotten who had just voted them into office. (Though it should be noted that Donald Trump strongly criticized Ryan Plan I, one of the few Republicans to do so.)
In 2012, Democrats all over the country ran against Ryan Plan I. Though deeply unpopular, Obama won an easy re-election over Romney-Ryan, carrying key swing states Florida, Ohio, Virginia, and Pennsylvania.
Ryan Plan I played a key role in helping the Democrats keep the Senate that year, with the GOP not gaining a single seat.
Today, I am amazed that House Republicans haven't given up on their political death wish.
Interestingly, Ryan Plan II accepts key parts of the Obamacare law that benefit the insurance industry. But it ends the Medicaid expansion program that benefits the poor and keeps costs down.
Instead, Ryan II forces poor individuals back into the private health insurance market with the help of tax credits. I wonder who that benefits?
According to the AARP, Ryan Plan II also cuts Medicare, a program Trump voters clearly want protected.
The CBO is estimating 14 million Americans will lose coverage compared to Obamacare.
This number may be inflated, but limiting Medicaid coverage for the poorest will most certainly leave millions without coverage.
The most significant problem is that Ryan Plan II doesn't fulfill Trump's own vision of universal healthcare while removing the onerous requirements of Obamacare.
Clearly, Trump has been acting in good faith, but he shouldn't trust House Republicans.
The president should be sticking to his guns on healthcare reform. He did so in the campaign, helping him win Democratic states like Wisconsin, Michigan, and Pennsylvania.
Here is a game plan for Trump to regain the initiative:
- 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.
- Find a few parts of Ryan Care II that can win passage in the House and Senate with either GOP support or bipartisan support. Declare victory.
- Rekindle the bipartisanship in Congress that Obama destroyed. Empanel a bipartisan committee to report back by year's end with a feasible plan to fix Obamacare.
- 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.
- Tie Medicaid funding to states with the requirement each pass legislation to allow for a truly nationwide healthcare market.
- Get Democrats to agree to modest tort reform to help lower medical costs.
- 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 healthcare and even profit from it.
The clock is ticking for Trump's first 100 days.
It's difficult to imagine the House and Senate will soon pass a full Obamacare fix that controls costs while keeping universal coverage.
Trump won the presidency by trusting his own instincts and ignoring the GOP establishment, including its views on healthcare.
Donald Trump staked out the high moral ground by calling for a feasible system of universal healthcare to replace Obamacare.
He shouldn't retreat from that no matter how much the establishment GOP dislikes it.
Christopher Ruddy is CEO and editor of Newsmax Media Inc. Read more Christopher Ruddy Insider articles — Click Here Now.
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