In light of this week’s submission of the GOP alternative to a nationalized plan, I wanted to put together a quick follow-up to the health-care column that I wrote on Tuesday.  I asked for a tangible alternative that utilizes tax credits and outdoes Medicare in expanse of coverage and I got it.  The proposal, explained here by its authors, was more generous to the safety net aspect than I expected, while also maintaining its strict limits on federal intervention.  Chiefly, it contains the following:

• As expected, it relies on tax credits being given more heavily from employer-based programs to refundable credits for families.  This allows individuals to make their own decisions about health care, without limiting them to their company’s low-bid selection.
• States set up their own competitive pools, where companies offer a minimum of services (based on federal employees’ standards) and meet state inspection requirements.  However, for people who want to save and buy much less comprehensive coverage, companies are allowed to operate outside of the exchange in a much less regulated fashion.
• States can link their pools into regional exchanges, allowing consumers to buy across state lines if they find a plan close by that has the specific coverage they want at a lower price.  I was hoping for a national open-borders policy, but the lawmakers apparently weighed insurers’ ability to negotiate with officials they know locally as crucial to competitive pricing – fair enough.
• Non-profit boards, selected at the state level, make sure that the extremely sick are not charged exorbitant rates and that all coverages within the exchanges meet the minimum requirements for acceptance and compliance.  This is where I was surprised with the concessions to the safety net, especially in pooling of risk among approved companies.  I guess the private insurers come out ahead in terms of market freedoms with the plan, but this seems like a pretty heavy-handed regulation.  That said, it will help a large proportion of the few people who would have been better off under the nationalized plan.
• Current Medicare recipients can opt for the private plans with their public funds, like a private school voucher says the American Spectator, helping the poor to get better coverage than they would under a national plan at the same small personal cost.
• There are several other reform-oriented aspects to the bill and ways in which HMOs and the like are regulated that you can find in the full text on Sen. Coburn’s site.

Excepting possible qualms with the state regulations on standards, the proposed alternative does everything we could have asked of it – except sell itself.  Going into the summer debates over revamping the system, that will become the primary challenge to GOP lawmakers.  But at least that’s a step up from having to come up with an entirely new alternative.

Last 5 posts by Gideon D'Assandro

• The Reality of Racial Politics - August 17th, 2009
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• Health Care Coverup - July 23rd, 2009
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• Social Conservatism Going Forward - July 5th, 2009