GOP Wealthcare

When Obamacare became the elephant in the room.
03/15/2017 02:26 am ET Updated Mar 15, 2017

The GOP/Trump health care plan is off to a rocky start. Everyone is familiar with the superlatives that President Trump used to describe his replacement for Obama care: ― more choice, less cost, higher-quality, etc. Etc.

Well sir it’s delivery time. This chicken is home to roost; and unless you want to lay an egg Mr. President you can’t ignore the needs that are so obviously present.

Congressman Ryan and you are on the right track to differentiate coverage from care. Patients want care, not coverage. The reason is quite simple: coverage is often qualified by very high deductibles and other fine print that makes the actual receipt of care substandard or impossible. This was the sad empty core of Obama care. President Obama deserves a great deal of credit for succeeding as far as he did with implanting the understanding that health care is a human right and not an option. It is a cruel hoax however when that right is not observed but only papered over with a not very helpful health card.

Obama of course could not foresee that the states would not all participate; nor could he recognize that insurance companies gaining a regulatory monopoly under Obama care would use their privileged position to gouge her fellow Americans with exorbitant premium increases, ridiculous bonuses paid to themselves, and other price controls that kept care needlessly expensive. So President Trump and Congressman Ryan and the GOP get credit for demonstrating that unless the working poor and other uninsured families actually get help when they are sick, pretending that 24 million or 14 million or some other number of the quote unquote covered is well just to pretend. Sen. Schumer and Nancy Pelosi you can start caring now and stop pretending, too.

But Sen. Schumer and Congresswoman Pelosi have a point – and the pointy end of it is now your responsibility Mr. President and Mr. Speaker: you don’t get off the hook by just describing what you hope will be competitive markets or deregulated savings are a host of other economic theories that may or may not actually bring down premium prices. You bear the risk of your economic experiment; it goes with the job. It’s great that you’re offering choice, but the choices must be realistic and they must provide real care.

Mr. President, you said health care was complex. It’s not; it’s really quite easy, but it’s not so simple that you can just say to the working poor trust us – the market will ultimately produce lower prices – tax credits will cover part of your cost – you’ll have a choice of plans so you won’t be buying things you don’t want – every single working poor person understands all that and also understands that in the end if none of that works, they, not you, will be left paying far too much for what is a human right.

The solution is obvious: and it was the backbone of Obama care, and Messrs. Trump and Ryan here’s where you get a chance to say something nice about Mr. Obama. Mr. President, you in particular would be interested in this opportunity since you know and everyone else knows that you indulged the absurd in calling your predecessor “sick” when you should really be attending to the needs of the sick and not making false accusations. Anyways, here’s an opportunity to be nice; don’t overlook it.

The thing that will differentiate Trump care from Obama care is just this: the rich get the privilege of paying for the health care of the working poor and the middle class and those disabled or with previous existing conditions. When one half of 1 percent owns half of the nation’s wealth, it is not too much to ask that they chip in to pay for something as important as the health of their neighbor.

So there’s no need for everyone’s underwear to get tied into knots over this #what is needed is a very simple and in fact long overdue direct opportunity for the extreme wealth in the country to give back in a meaningful way.

Here’s how it would work:

Step one:

The tax benefits that the wealthy are currently scheduled to receive under the GOP proposal are removed from the legislation. You’ll have to find some other way to cut back on the deficit. Don’t place the reduction of the deficit on the working poor; that is just plain inexcusable. You also know its bad politics. So strike out the rich people tax benefits before it is certain those efficient improvements in the market actually work. Wealthy of this nation need to be the guarantors of that care and fill the gap which does and will exist ―- at least for a time before your market efficiencies kick into gear.

Step two:

Authorize people above a certain income – you wealthy people know you are – as eligible to form health care foundations; these charitable foundations would identify people and families by name and need. A wealthy person will have to give, but if they do – and the more that they do, it will be entitled to tax benefits for that positive act of helping. Note to my libertarian friends no one is forced to do this. I know libertarians view taxation as theft; and I’ll grant you given exorbitant rates and when the government doesn’t provide real value for its projects, it can be, However, what is being proposed here is anything but theft; it is an opportunity to be generous. Moreover, by having Mr. and Mrs. wealthy identify hundreds or thousands or more that they wish to help by name, it modestly takes advantage of abundant research that suggests that when names and faces are attached to need those needs are more likely to be met and more likely to be met effectively.

Step three

Having formed the foundation to provide health care to one’s working poor and middle income and impoverished neighbors, having listed their names and addresses and amounts, it would then be possible – but only then – to write off those contributions against positive income.

Step four:

Happy ending no one with a pre-existing condition or a child under 26 or families that are struggling will be left without adequate care. Instead, all then will be blessed with the choice of insurance plans, and if the GOP hypothetical economic consequences are correct, it will be abundant and affordable choice. Providing insurance in this way will also meet the well-considered goal of Obama care: to avoid the highest priced medical treatments in emergency rooms.

Importantly, matching the wealthy with the poor by name will start rebuilding the idea that we are one nation, and that what makes us great, is truly looking after the needs of another.

CONVERSATIONS