…and see how they work. If you need to go further, then do it.
First, open up health insurance so it can be sold across state lines and let the market define the parameters of what gets covered. That will allow consumers a maximum amount of coverage options and it will make for far more customized insurance policies to fit the countless individual situations which make up the health insurance market.
Second, get out of the way and let any financial institution offer health savings accounts. Banks should be able to compete with insurance companies and investment firms in providing those. At some point there might need to be some form of federal subsidy in order to fill HSA’s for Americans who don’t have enough income to build an HSA (the key is to do it for children, who are unlikely to need to tap into it, and that way it can be done at a low cost) – that would be a lot cheaper than Medicaid or having to pay to treat indigent patients. But we’ll let that come later. For now, get out of the way and let’s see how people do on their own.
Third, stop punishing people who are in the individual market by giving favorable tax treatment to employer-based health insurance. Apply those tax breaks to all health insurance costs. Yes, this probably costs the federal government money, but on the other hand it isn’t Uncle Sam’s money in the first place – it’s our money that he’s taking. Let us keep it, and perhaps less of us will find it necessary to suckle upon the federal teat with freebies like Medicaid.
Fourth, remove the obstacles which prevent people from buying health insurance through associations which don’t have to do with employment. In other words, the University of Tennessee Alumni Association ought to be able to offer a group health insurance plan if they want, and so should AAA or the National Association for Gun Rights, or even the Sierra Club. We have a cultural problem in this country in that people don’t join groups as much as they used to; well, this would be one way to incentivize a change in that trend while at the same time provide a mechanism by which more people could find affordable health insurance. As it happens, it used to be quite common for people to get health insurance or something which functioned quite like it through organizations like the Odd Fellows or Moose Lodge or other fraternal organizations; the FDR administration destroyed that with stupid tax policies in the 1930’s and 1940’s which created employer-based health insurance. Let’s bring back what worked.
Repealing Obamacare lock, stock and barrel is what I want, but I’m pretty sure it’s going to collapse on its own even if it’s not repealed. This business of trying to draft a comprehensive, utopian health care system to replace it is a fool’s errand.
Just do the four things above. Do them now, and let the market expand to replace Obamacare as it goes down the tubes. If you want to repeal it from there, great – almost nobody will notice.