Health-care debacle a chance to hit reset button

Published 8:14 am Wednesday, July 26, 2017


Guest columnist

Shoemaker Marcelin Dumoulin and his wife Francine, a teacher, were 40 and 37 years old, respectively, when they left home one day in 1942 to feed their cows in the meadow above the village of Chandolin in the Swiss Alps.

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They had not been seen since, until their perfectly preserved bodies were revealed by the shrinking Tsanfleuron Glacier 75 years later on July 18 in a crevasse into which they had fallen at an altitude of 8,600 feet.

Marceline Udry-Dumoulin, the couple’s youngest daughter, now 79 years old, told reporters she never stopped looking for them, saying the discovery gives her “a deep sense of calm” and fulfills a lifelong desire to give them “the funeral they deserved one day.”

But she’ll be wearing white, not black, to that funeral because it “represents hope, which I never lost.”

Recent principled stands by some policymakers, including Sen. Rand Paul, R-Ky., also give us hope for a return to government of, by and for the people.

Paul was pressured to “take one for the team” and vote for a repeal-and-replace health-care bill which does neither.

But, as Kentucky’s junior senator writes, he “didn’t swear an oath to my ‘team’” but to “uphold the constitution, and I’m pretty positive bailing out insurance companies wasn’t envisioned in that document.”

Plus, you can be sure that sacred document never meant to force all Americans to swallow a pill as bitter as Obamacare.

But let us now turn our focus to replacement ideas, allowing the law’s failures to serve as our own health-care policy’s “receding glacier.”   

• Rediscovering federalism.

The federal government’s important role in fixing the health-care fiasco is to repeal it, while states — the “laboratories of democracy,” as Louisville native and Supreme Court Justice Louis Brandeis called them – should provide their own replacements.

Give states the money they now send to Washington and let them determine their spending priorities.

Kentucky, for example, along with having one in three of its citizens on Medicaid, also has high lung-cancer rates and severe drug problems.

Other states have their own priorities.

The federal government’s role is one of oversight — ensuring states have a realistic, reasonable plan — and safeguarding — making sure states don’t infringe on each other.

For example, California can implement a single-payer system but cannot force taxpayers in other states to bail it out if it doesn’t work.

• Re-implementing competition.

Right now, insurance companies hold all the cards, determining every matter from providers to price.

What if, instead, we allowed individuals to have more options, including buying access to provider networks without purchasing a traditional plan and paying monthly premiums?

What if they could insure themselves by opening a Health Savings Account to cover everyday expenses combined with a catastrophic plan for big-ticket items like surgeries and hospital stays?

This would force companies to compete for that business and might even attract financial institutions into the marketplace.

• Reforming incentives

Having an HSA combined with a catastrophic plan along with the potential for getting direct cash payments for responsible use of the system creates promising incentives.

What if individuals were incentivized to spend $10 on cough syrup versus $300 in the emergency room?

What if they were expected to spend, say, $5,000 in a year but spent only $1,000 and they were eligible for a cash payment of 20 percent of the difference, or $800 in this case?

Offering such meaningful incentives over an extended period could free up resources needed for those who truly need them.

Wouldn’t such an approach at least be worth a pilot program?

Obamacare’s glaciers are receding to the point where we can see common-sense reforms clearly again.

Let’s not miss our opportunity.

Jim Waters is president and CEO of the Bluegrass Institute for Public Policy Solutions, Kentucky’s free-market think tank. He can be reached at and @bipps on Twitter.