The individual mandate to buy health insurance looks likely to be struck down by the Supreme Court, given the argument on Tuesday (27 March 2012). Today, we hear a discussion about whether the rest of the reform act can stand if a part is ruled unconstitutional. Let’s acknowledge that Obama’s healthcare reform was wimpy from the start. It tried to accomplish too much, while putting too little into the effort. Here’s my solution:
1. Eliminate Medicaid, and open Medicare to anyone who wants it. The copay will be based on a person’s income. I already pay into the Medicare system–a big chunk of my paycheck gets taken for that–so I ought to be able to get the benefits from it.
2. Require medical providers to accept Medicare. Medicare will be able to negotiate the fee rates in the same manner that private insurance does.
3. Allow anyone who wishes to do so and can afford to do so to buy private insurance.
This solution allows choice and preserves competition. I doubt that it would be any worse than what we have now with regard to cost. Could it pass? Let’s see: Intelligent? Yes. Consistent with American values? Yes.
It has no chance.