Republican Health Care Reform Ideas

Newt Gingrich and John C. Goodman list Ten GOP Health Ideas for Obama.  There's really too much to excerpt, so you'll have to read the whole thing for yourself.

My initial take: Some of these are very good ideas, some are less appealing.  But whatever their individual merits, it's hard to see an overarching "vision thing" in the proposals. It is tinkering.  Perhaps good tinkering, but it lacks a structural narrative that makes it easier to sell these as a package.

The GOP needs a much more comprehensive approach to entitlements in general, not just health care.  At this point, I think we need to do one of two things: Either....

  • Government as a Last Resort - Government can insure everybody for any yearly expenses over 20% of annual income, which completely eliminates the problem of unbearable costs, both for consumers and for insurers (and which ought to dramatically lower insurance costs, since the potential risk is far smaller).   That shouldn't have a major distortive effect on the market, either, because most catastrophic costs tend to be things about which we can't/don't often make good cost/benefit calculations.  This would also eliminate the need for Medicare/Medicaid, since this would automatically cover people who have little/no income. While there are undoubtedly problems with this, it seems on the whole better than a system that gets government involved at much lower decision and cost levels.  Or...
  • Government as a Safety Net - Restructure our entitlement system along the lines of what (if I recall correctly) Milton Friedman and Charles Murray have recommended: expand the EITC to cover basic costs of living on a means-tested basis, so we can predicate entitlements upon actual need, rather than blanket distribution.

In either case, I think you have a pretty strong, compelling message: Government should provide a safety net, not a straitjacket.  We are not going to let people fail completely, but safety nets should not catch people who do not fall.

These options would allow Republicans to strengthen the safety net for people who genuinely need it, while making the program more sustainable by removing the "safety net" for people who don't actually need one.  Importantly, this would also eliminate the "third rail" problem of entitlements, and we could actually begin making better cost/benefit decisions about them.

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... anybody? Anybody?

I think this sounds like an excellent idea and I'm a little annoyed that nobody's seen fit to comment.

I'm not really capable of evaluating it, so I don't *know* if it's a good or workable idea, but it hits the right notes.

There are so many NON Government options

The Question is why are we discussing "reform" of healthcare  ?   How did the Free Market fail  ?  The Free Market was fixing GM and Chrysler, until the Big Government Bailout fixed nothing.

America has the best Healthcare in the World........probably the Solar System too.   Lets take the subject of COST, reduce it by "Tort Reform".....Pass a law that LAWYERS only get 5% of any Mal Practice lawsuit payoff, and LOSER pays COURT COSTS and the Lawyer Fees of the Winner.

Bam, wham, you just brought down Mal Practice Inusrance cost from $80,000 a Doctor to .....What ?   I don't know, but it would definitely lower cost of Insurance for Doctors, and the associated Doctor rates for patients.

Ask the Doctors why their 8 yrs in Medical schools cost so much, ask the Doctors about cost.

  How about "Do NOT VOTE for any political candidate that is a Lawyer".........thats going to be a tough one, isn't it ?   Lets start with Lawyers and lawsuits, and see what happens to Medical Costs.

I live in Texas, dude.

My insurance went up ten bucks a month this month. Co-pay stayed the same, this time, which was nice. My payroll deduction has never gone down. My co-payment has never gone down.

Don't know who tort reform was supposed to save money for. Wasn't me. Tort reform is the tiger-repelling rock of the health care debate.

And where does your Health Insurance Co. live ?

Texas Law isn't Federal Law, nor is it Blue Cross Blue Shield law in Minnesota.   National Insurance Companies are NOT going to Give Texans a break, because of their Local law, if the lawsuits payouts in Michigan get way out of hand.

Doctors with a reduced cost for Mal Practice Insurance in Texas, may or may not pass it on to the Texas patient, but its a start.

Remember the small Airplane industry (Kansas)  ?   Lawsuits/Lawyers drove most of the Manufacturers out of Business years ago.   How did Dem. Candidate John Edwards make his Millions ?   He wasn't helping you pay your medical insurance, he was sucking the Insurance business dry and driving up your Insurance rates.

Maybe you want to pay for those new 100+ Federal Agencies created by the Health care Bill languising in Congress  ?   Right now you don't have to pay for those "Agencies" and their Federal employees, with their Cadillac Medical Insurance.........Right now, we still have options to fix things without growing government. 




You don't have a clue about how the Medical Cartel in this country colludes to fix prices and levels of care in this country.

As I've mentioned before, and everyone who looks at this problem in any kind of depth knows, tort reform would have very little influence on total national health care spending.  The last CBO score in late 2009 from Doug Elmendorf, who has been a thorn in the Democrats' and Obama's side, increased the CBO assessment of the impact of tort reform by a surprising factor of TEN, and yet the CBO still says the impact of tort reform on overall costs will be a piddling 1/2 of ONE PERCENT.

 The fellow from Texas above here knows this for a fact, but you keep pushing this bogus GOP talking point as though it were not, in fact, a gross, deliberate lie, like most all the GOP "ideas" set forth.


As a Hemophiliac, I know a lot about the Medical Establishment

I've gone from Vitamn K treatments for my condition, to fresh frozen plasma treatment, to the the current and final treatment solution of infusion of clotting factor replacement using gamma-carboxylated factor IX synthesized in Chinese hamster ovary cells.

And there hasn't ever been a Lawyer needed at any time in my Treatment, and Lawyers don't Create or invent Medical treatments (recombinant DNA).

I've seen medical Costs skyrocket, and I have observed Hospital treatment firsthand, from Emergency rooms to John Hopkins.  And I have noticed the infusion of Governement Regulations grow by leaps and bounds over the Decades.     

I got an X-ray every day I was in John hopkins.....from a portable x-ray machine and technician.....and i didn't need an X-ray at all.  It was extra cautionary treatment. Why did that Happen ?

A friggin Lawsuit prevention Mechanism, that's why.   Government Regulation in Hospital Treatment, Extra Treatments/Tests to prevent lawsuits....just go and ask a Hospital or medical practitioner.

Now to your comment....What is the NAME of the Medical Cartel that you are referring to ?   Are you wearing a Tinfoil hat ?

I've met, conversed with, known more Doctors and nurses, than you have members in your supposed Cartel, which probably ain't many. 


..your contention is you "know" the Economics of the Amerrican healthcare complex because you are sick?? My sympathies for your condition, but since you defend our current dysfunctional system, I would be interested to see what would happen should you need to get a new policy to cover you if, God forbid, your current carrier drops you.

In America today, there are well over 1000 separate companies that sell medical insurance, yet well over half the total nationwide policies are written by just five:  WellPoint, UnitedHealth Group, Cigna, Aetna and Humana.  United Health alone underwrites over 52 million people.

This group saw their profits increase by OVER 56% from 2008.

This is Webster's dictionary definition of a cartel:


Organization of a few independent producers for the purpose of improving the profitability of the firms involved (see oligopoly). This usually involves some restriction of output, control of price, and allocation of market shares. Members of a cartel generally maintain their separate identities and financial independence while engaging in cooperative policies.

   I repeat:  When it comes to the Economics of healthcare, you have no clue what you're talking about.


I don't do Class warfare, or Corporate hate

Especially the Corps. who offers their Consumers what the Aetna's of the World offer.  

I am not a Victim, and I will let you happily Join Obama in his Class Warfare against the Evil Corporations, the Corporations that Employ thousands and Reward even more.  

Buy a copy of Ayn Rand's "Atlas Shrugged" and you might learn this:

Politicians invariably respond to crises -- that in most cases they themselves created -- by spawning new government programs, laws and regulations. These, in turn, generate more havoc and poverty, which inspires the politicians to create more programs . . . and the downward spiral repeats itself until the productive sectors of the economy collapse under the collective weight of taxes and other burdens imposed in the name of fairness, equality and do-goodism. 

I know Healthcare as a Consumer

I am not Sick, I have a rare genetic disorder.
As a Consumer of Medical treatment at a frequency that goes beyond what 99 % of normal people experience, yes, I presume to know about Medical Economics, big time.
If it was a Dysfunctional System, I would not be Alive. Its a system that works mostly in spite of Government intervention and a medical system that covers the 1 in 10,000 rare diseases. Its fantastic and it works.
I have gone without Insurance for years at a time......I was Self Employed, too expensive, my choice, I gambled and won, I took the risk.
I've also seen the "Billed amounts" vs. the Real cost of Hospitilization, I've seen 50 dollar a day hospital rates go to 16,000 a day over the years.....same Room, different high tech engineered bed, different points in time.
I do have a clue......about Govt. regulations and HC costs.
Why does a 3 dollar item at a drugstore, suddenly appear as a 20 dollar Item on your hospital bill.....then become a 4 dollar item if Insurance pays for it ?
Interesting, isn't it.
Why is a one day emergency room visit, resulting in an Overnight stay, get billed as $143,000 if you have no Insurance ? 24 hrs, @ $143,000 ....Wow, is that possible ? In one phone call the bill is reduced to $105,000....3 months later, and some paperwork, and a "Charity" pays all $ 105,000 and you have no Bill anymore. Its the good old USA and a medical system that functions in a free market at a very high level of customer oriented service.
Yes, I know about the Medical System and its inner workings...The Best Medical system in the world, by far.
Its better than a Govt. run postal system, you betcha.
Its a working Capitalist system.....for the 1 in 10,000 sick person. No treatment left behind as a not worth the 1 in 10,000 effort.

Nor do you.

   I repeat:  When it comes to the Economics of healthcare, you have no clue what you're talking about.


Nor do you.  Where are your economic studies on the health insurance sector?  Where are your peer-reviewed publications?  You post unsourced evidence that begs the question.  Not exactly scholarly.

You are just talking out of your ass, like you always do.

UnSourced Evidence ? I am the Evidence and I gave you sources

Example of Evidence I gave you, Sourced by Any Google Search...try the Highlited words in Google..........pretty Scholarly stuff, try and keep up, will ya ?

I've gone from Vitamn K treatments for my condition, to fresh frozen plasma treatment, to the the current and final treatment solution of infusion of clotting factor replacement using gamma-carboxylated factor IX synthesized in Chinese hamster ovary cells.

I gave you 1 in 10,000 have Hemophilia, and being alive is my Evidence.   I have the American Medical system to thank for Reasearch and Treatment.  

I have worked for the Federal Center for Medicaid and Medicare Services (CMS), I am researched beyond your capabilities whether you can accept it or not.

I'm sure the Single payer Death Panels in the Health Care bills would NOT approve of treating the 1 in 10,000, just as soon as a Budget crunch appeared, I'm Dead thru Federal Bureacrat inactivity.  Sorta like the waiting lines in UK and some research on that, will ya ?  I have.




4speed, I am responding to Jim Dandy, not to you.  Believe me, I am no fan of the current health bill monstrosity.

@chemjeffsonian sorry, fer tha confusion

Unsourced evidence

Sure, sure, chemjeff.  If anyone here has an ass vocabulary, it' s always been you, you asshat.

The numbers I posted, first of all, I sourced via the link to the Washington Post;s reporting,  The additonal numbers come out fo a cursory GOOGLE.


The other numbers are conservative, and have been part of the Healthcare discussion for months.  I don't know anyone other than you who would dispute them.

1.  Number of companies offering Medical coverage in the US: Over 1300 are members of the Association of Health Insurance Plans, the trade organization.


2.  I posted the list of the five top Insurance companies.  Public knowledge, and listed here as well:

Insurers' profits soar in 2009"


3.. Individual Insurance Rates soar in some sttes:



Chemjeff, you are a partisan know-nothing.  I know you are some kind of small-town college instructor or something, but Thank God I was never in any of your classes, otherwise I would be the same kind of fool and Conservative tool you are.  Or I would have exposed you for the kind of fool and Conservative tool you are.

The Master plan hits a speed bump on the Right

What's your Point on 1300 Insurance companies making profits ? Is this a hit list of Corporations for Obama's takeover plan ? Obama wants those profits for sure, how else can Obama Finance his SEIU friend's union benefits and pay back the 60,000,000 in Campaign donations to his Union buddies. Then there are those new 100 Federal Bureaucracies Obama and friends want to create from their current healthcare bills sitting at odds on the legislative shelfs. Is there any profit in these new Bureau crazies ?
Go sign on with the other losers on DAILY KOS or MOVEON dot Ugh and express your frustration over'll find more friends.
Drink some Tea, and light a candle at your Obama alter of Hoax and Chains. The Republicans are taking over from the Lame Duck TOTUS.


Where's your evidence that the insurance industry is some sort of eeeeeeeeeeevil cartel?  You post reports prepared by left-wing advocacy groups and THAT'S your evidence?  Not even they claim that the insurance industry is a cartel.   Gee, why don't you call up Howard Dean while you're at it, I'm sure he'd provide some unbiased advice, after all he's a DOCTOR.

Hell, the own article you cite even says that the liberal group's study is flawed.  Wellpoint had the highest profit margin of 7.1%.  SEVEN POINT ONE PERCENT.  And that's supposed to represent raping the sick?  The insurance industry's profit margins are completely in line with every other normal industry.

And about those rates "soaring" in some states... gee that's too bad, if only there were regulations at the state level designed to prevent huge rate increases for insurance... oh wait, THERE ARE regulations!  The insurance companies must ASK PERMISSION to raise their rates with state insurance regulators.  This is exactly what liberals demand government do to business - regulate, regulate, and then regulate some more.  Well congratulations, they're regulated, and yet you still complain about the rates.

Again, I ask to see your impressive economic studies on the health care industry.  Make sure they're peer-reviewed, because that's apparently quite important or something.

Oh, and you wouldn't even meet the prerequisites to take any of my classes.

 It is all hard to evaluate.

 It is all hard to evaluate. One problem we have is that we all want the best healthcare when we need it. It is like we all want a cadillac.

PBS had a documentary on healthcare and they went to different countries. Bottom line, each healthcare system has its problems, but the citizens of that country would not want what we have. 

FRONTLINE: sick around the world: watch the full program | PBS

This is more magical thinking

 This isn't a serious proposal.  It is ends without the means to reach them.  This is why the GOP has never substantially addressed the issue.

The "Vision Thing"

Jon -

What do you think of what appears to be the overarching "vision thing" of many reasonable Rightward commentators? I'm thinking something along the Kling/Cannon model - break the employment-insurance nexus, move toward an individual market, incentivize a catastrophic coverage model for most and an expanded safety net. 

My concerns with the "government insurance for the over-20% income category" is that this may prove more out of control in the face of rising costs. Admittedly I don't have on hand what percentage of Americans' health bills at the moment do go over 20%, but the number is surely rising and will continue to for the near future no matter what reforms are enacted. And this will have a feedback effect as more and more go over that 20% barrier.



The Kling/Cannon model sounds quite similar to what I've described above.

Sickness Care

The current proposed Congressional Health Care Plans do a great deal to help keep the status quo while favoring the government and union employees.  The proposals spend to much, are all about politics, and long term do nothing to solve our most important issues.

We need to start from scratch.  I agree that having a government safety net is the only place the government should be involved.  We need portability, in other words, a decoupling of heath care (or sickness care insurance) from employers.  We need to reform medical malpractice law and cap awards for pain and suffering.

My post at has more complete ideas as to how we should reform our current and proposed system of health/medical care.

It all comes down to too much government involvement and too little personal responsibility.


We need portability, in other words, a decoupling of heath care (or sickness care insurance) from employers.

Yes, yes, a thousand times YES.  I don't understand why liberals don't recognize how keeping health insurance tied to employers only empowers large insurance companies.  Liberals who are motivated primarily by hatred of insurance companies (which, I think, constitutes most of them) would do well to support ways to stimulate vigorous competition with insurance companies, thereby bringing them down to size.

Yes, Liberals are motivated by hate....

And after hatre, comes a long list of words.   Solvency, Tea Party, America, etc......

I love it how Liberals talk about the worlds best Helth care/Insurance, while ignoring how we got there, and it was through "Employers" and "Insurance Companies", along with the Free Enterprise system of Doctors, Hospitals, etc...Hell, the Health Care bill stopped construction of Private Doctor owned Hospitals.

Wow, how exciting ....lets regulate hospital construction by doctors out of existance.  And I have to wait 3 more years to find out what's in the future of Government run Healthcare  ?   Wow, I might be dead if I have to wait 3 yrs for any Health treatment, and that's is what the future of Government run healthcare holds.  

A majority of Americans are going with what got us where we are today, on healthcare..........Private Employers......Private Insurance......not Pelosi (she got fired, ya know ?).

Liberal "hate" isn't going to stop that, there are not enough haters in America, and the majority rules, just look at Wisconsin, hate lost, Americans won.


One Democratic talking point

One Democratic talking point is that the Republicans accept been sitting on the sidelines and complaining, instead of alms account of their own to break the accepted problems. This abstraction was arresting in the Sunday allocution shows. Watch for it in the President's abode to Congress tonight. The Democrats, like Congresswoman Maxine Waters D-Nutsville on This Week With George Stephanopoulos, who said "You've had your opportunity. You don't accept a bill. Where's your bill? What accept you appear up with? What are you alms as an alternative? This President has accomplished beyond the aisle. He's done everything. He's stroked. He's cajoled. He's begged. But the Republicans are not acknowledging him. It's bigger than healthcare. This is about President Obama, and the Republicans accept absitively to use this by which to accompany him down."



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