Obamacare has become such a humiliating debacle that the last line of defense for its dwindling band of true believers is to mechanically repeat the mantra, “There is no conservative alternative.” They do this because they can’t sell their product on its merits and want to convince Americans that, hey, as awful as this is, you’ve got no other option.
The Obamacare bitter-enders also want to set a trap—one conservatives had best avoid.
The proper answer to the charge obviously is: If by “alternative” you mean another one-size-fits-all, centralized, collectivist substitute for Obamacare—then no, we’re not interested in that. The reason Obamacare has become an embarrassment for its architects—and does not work—is that it is all those things. Who on earth would want to recreate that?
But do conservatives have solutions to such issues as providing health care for those in our society who can’t afford it and making sure that Americans with pre-existing conditions can get insurance? Yes, of course we do.
It was therefore gratifying to hear a potential 2016 presidential hopeful, Governor Scott Walker (R) of Wisconsin, mention Heritage’s ideas about health care on MSMBC’s “Morning Joe” yesterday.
Answering former Obama car czar Steve Rattner’s snide question, “Do you have some specifics for us today and what a better plan would be?” Walker said, “I think there are some options…you look at The Heritage Foundation, the American Enterprise Institute. Both of those are pretty good hybrids.”
Governor Walker was referring to our analysis of three weeks ago, “After Repeal of Obamacare: Moving to Patient-Centered, Market-Based Health Care.”
In it you would find, for example, that true reform “would subsidize private health insurance for low-income Medicaid beneficiaries…Congress should take steps to encourage states to provide premium assistance. Such programs would promote health care ownership and provide beneficiaries with better access to care than the traditional Medicaid program does.”
In fact, Heritage advises that states should move ahead now, even in the midst of the Obamacare wreckage, and “continue wherever possible to seek opportunities to reform their Medicaid programs, moving toward more personalized care and including strong incentives for personal responsibility. States can also seek additional flexibility from Washington to modernize care; many governors have already made such requests.”
For pre-existing conditions, Heritage observes that “the problem of providing access to individuals with pre-existing conditions, while very real, did not necessitate the massive changes in America’s health care system included in Obamacare.”
Rather than overhaul fully one-sixth of the economy and put the government in charge, “states could use a variety of approaches to provide coverage to individuals who are unable to purchase insurance. For instance, 35 states already operate high-risk pools with a collective current enrollment of 227,000 individuals to ensure access to coverage for individuals with pre-existing conditions.”
As our paper says, “Alternatively, states could establish reinsurance or risk transfer mechanisms under which insurance companies would reimburse each other for the cost of treating individuals with high medical expenses without added funding from state or federal taxpayers. Either approach would be far preferable to the massive amounts of regulation, taxation, and government spending under Obamacare.”
You can find our whole paper here, and we recommend you read it.
Governor Walker is right to look there for thought leadership on patient-centered alternatives to Obamacare. We advise the Obamacare bitter-enders to follow his lead.