Hamilton column: Health insurance: A 427-day countdown?
March 7, 2017
It took former President Obama 427 calendar days for his hallmark ObamaCare to be passed by the Democrat-controlled Congress and be signed into law by President Obama. Perhaps, a Republican-controlled Congress and President Trump should be allowed 427 calendar days to repeal and replace Obamacare. That would be by March 23, 2018.
Because Obamacare was enacted without a single Republican vote in Congress, there are those who, in a spirit of revenge, would like to repeal Obamacare immediately and then work out a better approach to health insurance for the masses. But humanitarian concerns demand that "replace" will occur before outright "repeal."
A major reason for the failure of Obamacare, in addition to its inherent flaws, is that Obamacare was enacted without a bi-partisan consensus. To be successful, whatever replaces Obamacare will require that both political parties and President Trump have a hand in its creation of a health-insurance system that is: Of the insured, by the insured, and for the insured.
While Obamacare, as enacted, was unworkable, the concept that everyone living under the protection of the U.S. Constitution should have some form of health insurance is now embedded in the American psyche. Obamacare's lasting legacy is that it created, in the minds of many, an "entitlement" to health-care insurance. Also, that pre-existing conditions do not preclude insurability and that adult "children" can stay on their parent's health insurance until age 26. Now, the question is how to make health-care insurance affordable for the many?
One way or another, the U.S. taxpayers are going to help each other pay their health-insurance premiums through tax credits. But what about those who pay zero federal income taxes? What about the truly indigent? Space constraints delay those issues for later columns.
Meanwhile, here are some often-discussed ideas on how health-care insurance can be funded: The Obamacare replacement should allow individual taxpayers a dollar-for-dollar tax credit for dollars spent on health-care insurance. Individuals should be allowed to establish tax-sheltered Health Savings Accounts, the money to be invested as a "rainy-day" fund for unexpected health emergencies. Individuals should be allowed to pick and choose what kind of coverage they can afford from a cafeteria of choices offered by insurance companies that are free to compete for business across state lines.
Employers should be allowed a tax credit for matching employee contributions into company-provided, health-insurance coverage. Moreover, employee contributions should be portable and movable to the health-insurance plans of other employers.
Companion legislation should rein in meritless medical malpractice suits by tort lawyers that cause health-care providers to practice needless and expensive defensive medicine. Moreover, legislation should make it easier for overly aggressive tort lawyers to be punished for engaging in barratry — the frequent incitement of nuisance lawsuits.
So far, the Trump Administration is not imposing a from-the-top-down Obamacare replacement. Instead, congressional committees are using a from-the-bottom-up approach which might consume 427 calendars days or even longer. But if there is ever a time when Democrats and Republicans should be working together for the common good, this is it. Failing that, the party perceived to have acted against the public interest will pay a painful price in the mid-term congressional elections on November 6, 2018.
Nationally syndicated columnist, William Hamilton, is a laureate of the Oklahoma Journalism Hall of Fame, the Nebraska Aviation Hall of Fame, the Colorado Aviation Hall of Fame, the Oklahoma University Army ROTC Wall of Fame, and is a recipient of the University of Nebraska 2015 Alumni Achievement Award. He was educated at the University of Oklahoma, the George Washington University, the U.S Naval War College, the University of Nebraska, and Harvard University.