The GOP hates Obamacare, that is certain. However, repeated attempts to repeal have failed to make even the slightest dent, in particular because people do not want to suddenly lose their healthcare or be denied for pre-existing conditions. In response, one GOP pundit has decided on taking a radically different tactic to get rid of Obamacare.
Robert W. Patterson, editor of The Family in America: A Journal of Public Policy, released a new article last week, titled “Grand Strategy on Health Care” in which he proposes a new policy by which the Republicans can manage to get Obamacare repealed. This is his proposal:
It’s time for Republicans to dump their policy advisers, start thinking about the anxieties of ordinary Americans, and construct a viable health system that beats Obama at his game.
First, congressionally charter Blue Cross-Blue Shield as a monopoly to provide basic coverage to all Americans, except retirees. And grant the regulated nonprofit authority to impose payer-fee schedules on providers of routine care and services, much as Medicare does.
A utility-style Blue Cross-Blue Shield covering all working-age Americans and their dependents would offer enormous administrative economies of scale and an insurance pool of unprecedented size. By trumping state regulations, the plan would be relieved from paying for luxuries like aromatherapy, Viagra, sex-change operations, hair implants, birth control, or elective abortion. Nothing would preclude other carriers from selling supplemental insurance for medical non-necessities, purchased by individuals at after-tax rates.
Jointly funded by a modest payroll tax and shale-oil severance fees, this utility would not only replace all nonsupplemental health-care plans, but also Obamacare, state exchanges, much of Medicaid, and the State Children’s Health Insurance Plan.
This is, ultimately, a single payer healthcare system, much like you would find in the United Kingdom. By utilizing an existing non-profit, in a government sanctioned monopoly role, it could be implemented rapidly, and affordably, in short order. This would eliminate much of the various state programs, greatly simplifying the administrative overhead needed. But by not being a government agency, but a private non-profit agency, it plays to the Republican “small government” cries without falling victim to the “profit driven healthcare” trap which could sink the plan. It is politically brilliant. By embracing such a position, the GOP would change the entire rhetoric, and for the first time in years put the Democratic party on the defensive for domestic policy.
But this is not all rainbows and roses either. Part of the plan would also enable the GOP to drop birth control coverage, regulate abortions, and generally continue their war against women. This would win over arch-conservatives within their own party and, combined with the private management of the plan, could get the support it needs on the Hill to pass through the otherwise deadlocked congress. But it would still allow for third party insurance coverage of these services, so it is not an absolute ban.
If the Republican Party were to embrace Bob Patterson’s proposal, they would restore their relevance to the debate for the first time since the 2010 election. By being the party of “NO,” the GOP has abandoned ideas. Obama, through his healthcare proposal, stole the Republican proposal for healthcare reform, which put them in a bind when it came to the health insurance debate. This single move would give them a new position, a new argument, without abandoning their core values in the process. It is, in a word, brilliant.
Will the mainstream party come out in support of a single payer plan, even one which is handled by a private organization operating under a government monopoly? Only time will tell. If they do, however, then perhaps, just perhaps, the Republican Party may yet survive its current crisis.
Nathaniel Downes is the son of a former state representative of New Hampshire, now living in Seattle Washington.
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