By F. H. Buckley in the NY Post.
NOTE: This article raises an important question that is often asked about national improved Medicare for All: whether private insurance should be a part of the system or not. We advocate for a universal and comprehensive healthcare system that covers all medically necessary care and that private insurance be banned from offering coverage that duplicates what is offered by the national plan. If we have a single system, it will be the most cost-efficient. Allowing private insurance in complicates and undermines the national system. Some countries do allow private plans to supplement coverage offered by the national system, but this is not necessary if the national system is comprehensive. – Margaret Flowers
With the collapse of RyanCare, the Trump administration is looking for a new plan. We’re going to need one, since health-care reform isn’t going away. At best, we just kicked the can down the road. We’re still living with the night of the living dead that is ObamaCare.
It’s slowly dying because too few people have signed up for coverage. For younger, healthier people, it’s cheaper to pay the penalty than to sign up. That’s why Aetna has announced it will drastically reduce participation in public exchanges, as did UnitedHealthcare and Humana. The collapse will accelerate with Trump’s executive order to waive enforcement of the penalty.
So fine, kick it down the road, but give some thought to what reform will look like when we have to revisit the issue in a year or two. At that point the status quo — ObamaCare — won’t be an option.
Better still, tackle the problem now.
A do-nothing strategy leaves in place the present system that has raised prices for the insured, and will raise them more until ObamaCare collapses under its own weight. That’s a callous way to treat Americans, and reminds people that the Republicans blew health-care reform.
So what would reform look like? Here’s one that’s off the table: Ryancare, a plan only an accountant or a right-wing ideologue could love. It left 20 million Americans without health care but cut expenses. Not to worry, said Ryan, we’re going to have a balanced budget.
I can’t imagine a plan better calculated to play to the stereotype of a heartless Republican Party.
That wasn’t what Trump promised, in any event. What he said he wanted was a plan that would leave no one uninsured.
The simplest way to do this is universal health care, on the Canadian model, with a right of individuals to purchase a Cadillac plan on top of this out of pocket. And there are things that might be added, like removing the ban on reimporting drugs from Canada.
Not only would this be close to what Trump promised, but it would be a responsible response to the problem — one, moreover, that would reach across the aisle to the Democrats. Take out all the killer amendments that would give them a plausible excuse to reject it, and ask them to put up or shut up.
Now let me tell you who’d support this. The people who elected Trump in 2016. They weren’t right-wing ideologues. They were people who had lost or who feared they’d lose their jobs. Many were but a few steps away from the diseases of despair, social isolation, drug and alcohol poisonings and suicide that Anne Case and her husband, Nobel laureate Sir Angus Deaton, tell us have lowered the life expectancy of white Americans.
The defeat of RyanCare is thus a victory for the Trump agenda, if used wisely as a means of reinventing the Republican Party as a party of working Americans of all races and ethnicities. Split the Republican Party, if need be. Send the Charles Koch Institute packing. The defeat of RyanCare shows the party needs splitting, if it’s not entirely split already.
Leave behind all the people who hated you, who curse when you succeed. Reach out to the people who voted for you. Challenge the Democrats by offering them what they’ve always said they wanted.
In “What’s the Matter with Kansas?” Thomas Frank asked how it was that the poor folks of his home state voted for a Republican Party that cared so little for their economic interests. Become the jobs and the health-care president, and you’ll have answered Frank’s question. And the answer will be — nothing, now.
Steve Bannon has said the Republicans will become a party of “economic nationalism.” No one has bothered to define this, but here’s one thing it must mean: We’re going to treat Americans better than non-Americans. We’re going to see that Americans have jobs, medical care and an enviable safety net.
The economic nationalist must be a nationalist with a sense of solidarity for his own people, whatever their race, whatever their circumstances. If he lacks this, if his nationalism is merely an excuse to turn his back on foreigners, he can be charged with cold-blooded hypocrisy.
F.H. Buckley teaches at Scalia Law School. His most recent book is “The Way Back: Restoring the Promise of America.”