So after years of talking about “repeal and replace” while only focusing on repeal, a group of Republicans in Congress have come up with a replace plan. You can find a summary of the plan here. As expected, it 1) relies on a number of feel good ideas that will have limited if any impact, 2) includes cheap shots and unsupported assertions, and 3) attempts to preserve some of the popular parts of Obamacare while stripping away the foundations that make those aspects of the Affordable Care Act work.
Here’s just a sample of what you can find mixed in with tired ideas about tax credits and selling plans across state lines:
#1 Feel good ideas with limited or no impact
- “Improve Americans’ lives through effective prevention, wellness, and disease management programs, while developing new treatments and cures for life-threatening diseases.” Prevention and wellness are nice ideas but as Al Lewis and Tom Emerick demonstrate they drive costs up not down. And what exactly are these Republican leaders going to do about developing new treatments in a health reform bill?
- “Comprehensive medical liability reform that will reduce costly, unnecessary defensive medicine practiced by doctors trying to protect themselves from overzealous trial lawyers.” This is a hot button issue but its impact on overall medical costs has proven to be small.
#2 Cheap shots and unsupported assertions
- “Protect Americans from being forced into a new government-run health care planthat would: a) eliminate the health care coverage that more than 100 million
Americans currently receive through their job; b) limit your choice of doctors and
medical treatment options; and c) result in the federal government taking control
of your health care.” This is a caricature of the Affordable Care Act and not supported by what’s in the law.
- “It’s no secret that patients in other countries are often denied care or die waiting to get access to the top treatments.” Which country do we want to compare ourselves to in terms of access to care and outcomes?
#3 Attempts to preserve popular parts of Obamacare while stripping away the foundations that make those aspects work
- “Make quality health care coverage affordable and accessible for every American,regardless of pre-existing health conditions” Without a coverage mandate to get healthy people in the pool, how are insurance costs going to be held down?
- “Ensure that medical decisions are made by patients and their doctors, not government bureaucrats.” What about insurance company “bureaucrats?” Are they allowed to do any cost containment or do we just leave everything up to the doctor and patient and pray that it’s kept affordable?
There’s much more to write on the topic, but suffice it to say that this plan isn’t going to win anybody over.
By David E. Williams of the Health Business Group.
September 19, 2013