The Democratic Healthcare Plan

 

What is the Democratic healthcare plan? Democrats retook control of the House of Representatives in the recent mid-term elections largely based on their promises to improve your healthcare. They spent over $90 million on healthcare advertising alone. So what is their plan?

That’s the question John C. Goodman, healthcare economist writing in Forbes, asks in a recent post. What exactly do the Democrats plan to do?

Senate Democrats maintain a website called A Better Deal which purports to outline their plans. But here is what Goodman found when reviewing the site:

  • They have no plan to insure the 28 million Americans currently uninsured.
  • They have no plan to address the ObamaCare premiums that are 2 – 3 times higher than they used to be.
  • They have no plan to reduce the sky-high deductibles that cause people to avoid seeing their doctors.
  • They have no plan to address the narrow networks that exclude the best doctors and hospitals from these networks.
  • They have no plan to address the problem that half the counties in this country offer only on insurance provider.
  • They have no plan to address pre-existing conditions protections though most of their ads focused on this issue.
  • They do have a promise to stand up to pharmaceutical companies – whatever that means.

 

We have all heard that about half the Democrats in the House of Representatives, and many Democratic senators preening for a presidential run, have advocated “single-payer” healthcare, often referred to as Medicare For All. But the Democratic leadership in both chambers are avoiding this discussion and it is not mentioned on their website.

Goodman also examined the writing of economist Paul Krugman, a reliable apologist for Democratic thinking. He found an editorial entitled How Democrats Can Deliver on Health Care, which proposed two ideas the federal government should implement:

  • Allow individuals under age 65 to buy into Medicare
  • Allow Medicaid to be a public option competing in the exchanges

 

Goodman thinks Krugman, and most Democrats, believe Medicare and Medicaid are government programs that are fundamentally different from private insurance. In fact, both programs have been so extensively privatized that these “reforms” might not involve much change at all. Here’s why:

Conventional Medicare today is less attractive than most people think. Although the government pays for Part A (hospital coverage), the individual must purchase Part B (doctor coverage), Part D (drug coverage) and Medigap insurance (supplemental to cover what Medicare doesn’t cover). It is hardly a government give-away. Even after all that there is no catastrophic coverage.

As a result of all that, Medicare Advantage is growing in popularity. More than one-third of all seniors choose Medicare Advantage plans which are offered by private companies such as Humana, Cigna, and United Healthcare. These plans are less expensive and offer broader coverage. Their only real drawback is a limited choice of primary care physicians.

If Medicare were offered to younger people, it is likely most would choose a Medicare Advantage plan. But private plans like these are already available. The difference is seniors are heavily subsidized. They pay only about 20 percent of the cost of their insurance out of their own pocket. But if we’re going to subsidize young people we don’t need Medicare. We could just subsidize private insurance directly.

Goodman says no one in Congress is advocating spending more money to subsidize insurance that people already have access to. Yet a Medicare buy-in would amount to little more than that.

The same problems exist in extending Medicaid availability. About two-thirds of Medicaid enrollees nationwide are in private-sector health plans. The private insurance providers who operate these plans have been more successful than others in the ObamaCare exchanges. Centene, one of these, covers about one-fifth of all ObamaCare enrollees in the country.

However, quality has been a problem. The plan Centene offers in the exchanges is little more than Medicaid with a high deductible. There have been numerous complaints of patient abuse in the Texas Medicaid program and Centene was the contractor with the most complaints.

Goodman says these cheap, low-quality plans on the exchanges essentially are already a “public option.” But they don’t solve real healthcare problems. Democrats may be making promises to solve your healthcare issues but they don’t have any meaningful plans yet to do so.

 

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