Covering the Uninsured Without Obamacare

I have to laugh when I hear people say that we need government run health care. Really? Has the government ever done anything better than the private sector? Well it works in Canada they say. It's working for Canada huh? I guess that's why their elected officals come here for heart surgery. From Big Government:

What everyone needs to recognize before the Health Care Summit later today is that the uninsured can be covered at modest additional net cost without the government takeover of health care, government health care rationing, 100 new health control bureaucracies and programs, and trillion dollars in new taxes and spending (woefully underestimated) involved in Obamacare.

The lack of a clear safety net for the uninsured is what gives Democrats the political lift to keep coming back for socialized medicine. Republicans should advance the modest reforms necessary to establish a true safety net that will ensure that no one will be denied essential health care. Only that will permanently protect the health care of the American people from government takeover and control. Republicans should trumpet this point at the health care summit tomorrow.

Reform should start with Medicaid, which already spends over $400 billion a year providing substandard coverage for 50 million poor Americans. Congress should transform Medicaid to provide assistance to purchase private health insurance for all who otherwise could not afford coverage, ideally with health insurance vouchers.

This one step would enormously benefit the poor already on Medicaid. The program today pays doctors and hospitals only 60% of costs for their health care services for the poor. As a result, 40% of doctors and hospitals won't take Medicaid patients. This is already a form of rationing, as Medicaid patients find obtaining health care increasingly difficult, and studies show they suffer worse health outcomes as a result. Health insurance vouchers would free the poor from this Medicaid ghetto, enabling them to obtain the same health care as the middle class, because they would be able to buy the same health insurance in the market.

Ideally this would be done by changing Medicaid financing to provide the federal assistance to the states for the program through finite block grants, which would not vary to match increased state Medicaid spending as today. States that innovate to reduce costs can then keep the savings. States that operate programs with continued runaway costs would pay those additional costs themselves. Such reforms worked spectacularly in stopping the runaway costs of the old AFDC program when Congress adopted welfare reform in 1996.

The block grants should provide states with increased federal funding sufficient, counting state Medicaid funds, to give assistance to all who truly cannot afford health insurance. The voters of each state can then decide how much assistance for the purchase of health insurance to provide families at different income levels. This would rightly vary with the different income and cost levels of each state.

Done right, this would ensure that no one would lack health insurance because they can't afford it. But to ensure a complete safety net, federal funding should also be provided for each state to set up an uninsurable risk pool. Those uninsured who become too sick to purchase health insurance in the market for the first time, perhaps because they have cancer or heart disease, would be assured of guaranteed coverage through the risk pool. They would be charged a premium based on their ability to pay. Federal and state funding would cover remaining costs.


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