Republican Health Plan–Don’t get sick

Thaddeus McCotter (R) from Michigan in an op ed puts forth the republican view–perhaps the forthcoming health plan. He’s in favor of “patient-centered wellness.” Wellness, who can argue with that!

His argument is vague. He forgets that the current economic problems and deficits are legacies of his republican president. He overlooks the fact that his party which favors the dismantling of government programs including Medicare and Social security and argues that what we need for sick poor people is more “Federally Qualified Health Centers.” He talks of “rationing” forgetting that we currently ration care economically–etc., etc, etc.

His recommendation:

  • “Consequently, we understand health care reform must match — not resist — these economic and communications advances by decentralizing government to provide the sensible, affordable reforms that foster patient-centered wellness, which empowers American citizens to be consumers of health care through transparency and free market forces.”

    “The heart of patient-centered wellness for our people-powered world is prudent, targeted, multi-track reforms that reduces costs by leveraging the communications revolution and market forces to increase the supply of health care amid rising demand. Immediate, obvious measures include reforming medical liability laws; ending exclusions for pre-existing conditions; expanding health savings accounts; providing tax credits for purchasing private health insurance; allowing association health plans; permitting health insurance purchases across state lines; encouraging individuals to insure against changes in health status; incentivizing preventative health care; and applying information technology to enhance transparency and increase efficiencies.”

For those that get sick;

  • “For the less fortunate and most vulnerable amongst us, there must be an expansion of Federally Qualified Health Centers (FQHCs), which will provide patients with preventive and routine treatment; and end underserved people’s use of emergency rooms for primary health-care treatments. Doctors and other health care professionals can be incentivized to provide their services at these clinics for either immediate or future considerations; and a “Patient Navigator” program attached to each FQHC can assist the underserved in accessing the health care system.”

Medicynical Note: Lots of generalities and “incentivizations,” but few details. What’s missing is a commitment to community rating rather than individual rating and a mandate to cover those with illness. If I read it right insurers, under the republican “reform,” will be able to charge whatever they wish to those with high risk and illness. This will deny those people health insurance and force them into the “FQHC’s.” This is quite a resourceful approach, allowing insurers to cover those with the lowest risk (and protect their profits) while foisting off on government those who need care. I guess the drafters of the republican proposals have to protect their supporters’ interests.

Some ideas such as insuring against change in health status are very creative. Isn’t that what health insurance is supposed to do? Health Savings Accounts are an ineffective solution for the great majority with incomes near the median (down to about $50,000/year) who can’t afford even basic insurance much less have excess income to save. I wonder who high deductible Health Savings Accounts benefit?

On the positive side who can argue against preventive health care or better access to information–I guess the republicans can’t.

In the next few days the House GOP is set to release a healthcare bill. We may have more as it’s recommendations are made public. If this is a sample, don’t expect much.


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