As the fall presidential election comes nearer, the need grows for clarity on the part of Republicans about health care and the uninsured.
“Repeal and replace” the new health-care law is a good pithy slogan, but it raises the question: Replace it with what?
That’s not to say that Democrats have all the answers, but they do have in the new health-care law a slew of specific ways that health care should be managed, and with some exceptions there have been changes for the better. No one liked the old system in which people were denied insurance coverage because of pre-existing conditions, for example.
But if that is repealed, how does one put into law protections against the old system coming back? That new provision on pre-existing conditions costs insurers money, and without a mandate to buy insurance, it could seriously erode the finances of every private insurer in the country.
Some GOP bills are floating around on this subject, but few of them have gained any prominence in election-year debate.
Republican candidate Mitt Romney has a checkered history on the issue, having fathered the Massachusetts law that was the inspiration for the new law backed by President Barack Obama.
One of his chief spokesmen on this issue is, not surprisingly, a former state and national health official from Louisiana named Bobby Jindal. The governor said Romney “has focused on creating voluntary purchasing pools, on free-market reforms to make health care more affordable, more portable, more accessible without undermining the private sector delivery system.” Phew. Unpacking this, though, doesn’t seem to us to come up with a bill.
Whatever the outcome of the fall elections — and particularly in the House, most of the betting is that the GOP will remain in control — revisiting health care cries out for a GOP alternative that is more specific.
In a meeting with Advocate editors and reporters, U.S. Rep. Charles Boustany, R-Lafayette, said discussions are going on about fleshing out a GOP alternative to the Affordable Care Act, or what some refer to as Obamacare.
Another doctor in the Louisiana delegation, U.S. Rep. Bill Cassidy, R-Baton Rouge, has proposed specific legislation to deal with the financial structure of Medicaid, the big health care program for the poor.
The Cassidy bill is focused on reimbursing states on the basis of conditions treated and managed, rather than today’s broad national formula for Medicaid aid. It is a significant issue, and Cassidy’s bill seems to be a promising start about how to make day-to-day decisions in hospitals and doctors’ offices more cost-effective.
Still, all this doesn’t add up, yet, to a comprehensive approach to a big national problem. We believe that the issue of the uninsured has not received sufficient attention from the GOP. Those with insurance pay a substantial hidden tax when costs of the care of the uninsured are shifted onto those with private-pay or Medicare.
One of the strengths of the ACA is that it aims to tackle that issue, instead of avoiding it — and that’s why, in several ways, the new law seeks to find a combination of savings and new taxes to pay for what is today a hidden tax.
When the new Congress meets, will there be a GOP alternative? And when the American people cast their votes in November, will there be a Romney alternative?
The opposition has the liberty of opposing, but should it not on health care make some specific promises?