Saturday, September 05, 2009

Republican Congresspeople briefly outline a Republican vision for healthcare

I recently said that the Republicans had not helped their health reform case by a) not stating precisely what they support and what they oppose and b) by opposing reforms that no person with any reasonable knowledge of health policy would oppose. In a Wall Street Journal op-ed, two Republican Congresspeople, Reps. John Shadegg and Pete Hoekstra, outline a bit more of the party's philosophy.

They agree with the problem of the uninsured (phew!). Basically, they would offer subsidies through the tax system to purchase insurance, would require insurers to disregard pre-existing conditions, and would expand the existing state high risk pools. Briefly, some states operate insurance pools for people who are denied health insurance due to pre-existing conditions. These pools are expensive even after state subsidies, and often offer poor coverage (numerous exclusions, high deductibles and copays). As such, they're not a good solution. Any state subsidies would be vulnerable during budget cuts. It would be far better to place the sick folks in pools with everybody else.

Reps Hoekstra and Shadegg also accuse the Democrats of trying to take over the entire system. That's implausible. Even if a public plan were offered, insurers would adapt to it and care would continue to be delivered by mostly independent doctors. The drug and device industries would be independent of the government. Government action is required to fix many of the flaws that have been developed; Hoekstra and Shadegg will not help their case if they continue to say that the market can take care of everything.

I should perhaps have clarified my previous suggestion: the Republicans need to offer a sensible package of reforms they endorse.

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