Fools rush in where angels fear to tread

I know I enter dangerous territory when my wife, Carol, tells me not to write on a particular topic.  So, it is today as I let my opinion be known about the current healthcare debate.  You see, her advice is really sound.  The country is about equally divided on this topic and my giving my two cents worth will only irritate one segment of my reader base, if not a large majority.  But I have been observing this healthcare debate debacle now for eight years and I can no longer keep quiet.

Before I get started, those of you who read my commercial real estate commentary on a regular basis and expect me to somehow tie my thoughts on healthcare back to commercial real estate are going to be sorely disappointed.  So, if you expect that to happen, now is the time to stop reading this article.  Yes, you have my permission.  STOP READING NOW.  For the rest of you, I hope my thoughts can help crystallize your thinking on this very important subject.

My thoughts on healthcare

Is healthcare a fundamental right?

There are some who believe that healthcare is a fundamental right. I respectfully disagree.  Our rights as U.S. citizens come from our Constitution and the Bill of Rights.  Nowhere in the U.S. Constitution or Bill of Rights does it state that healthcare is a right.  Now some will say that the clause “promote the general welfare” found in the U.S. Constitution implies that healthcare would fall under this purview.  You can’t convince me that the founding fathers were thinking at all about healthcare when they wrote this clause into our Constitution.  Ain’t going to happen.

A moral obligation, not a fundamental right

I do believe as the richest nation on earth and a nation that believes in Abraham Lincoln’s view of “malice toward none and charity for all” that we have a moral obligation to help our fellow man with the absolute basics of life and that includes healthcare. There needs to be a healthcare “safety net” that provides a minimum standard for all our citizens regardless of wealth.

The difference between a fundamental right and a moral obligation

In my view healthcare is not a fundamental right; rather it is a moral obligation. This is an important distinction.  If you believe it is a right then everyone should have equal access to all medical procedures regardless of cost.  If you believe it is a moral obligation then those who can afford to pay for top notch healthcare should be allowed to do so and those who cannot should be thankful that the government is covering the basics.

I was against Obamacare

Eight years ago, I was against Obamacare. Not the concept, but how it came to be.  When the Democrats controlled the House, the Senate and the White House they forced their will on the American people and passed the Affordable Care Act.  Some will say that the Republicans were the ones who were uncooperative.  And that was likely true.  The point I’m trying to make is this: No political party should pass comprehensive legislation of this magnitude by forcing it down the throats of the minority party.  If the majority party cannot get bipartisan support for their legislation they should wait until they can.

I’m against repeal and replace

Likewise, I am against the repealing and replacing of Obamacare by President Trump and the Republicans in the Senate and the House for the exact same reason. I repeat, no political party should pass comprehensive legislation of this magnitude by forcing it down the throats of the minority party. If the majority party cannot get bipartisan support for their legislation they should wait until they can.

Crafting legislation requires compromise

Neither political party has a monopoly on good ideas. Both parties, if they worked together and learned to compromise, could come up with a healthcare bill that would be far superior to what we currently have.  But for that to happen, there needs to be less finger pointing and demonizing of our political opponents, and more humility and conciliatory reaching out to the other side.  The real question is this: Are there enough adults in the House and the Senate that can swallow their pride and for the good of the American people pass bipartisan healthcare legislation?

Incremental legislation is the best approach

Over the years I’ve come to the conclusion that Congress is not particularly good at passing comprehensive legislation. This is not their strength.  But they are good at passing incremental legislation.  By that I mean, it becomes readily apparent that there is a flaw in a piece of legislation they passed previously.  A congressperson realizes their legislation is not working as intended and promotes a new piece of legislation that fixes the problem.  That is an example of incremental legislation.  And this is how they should fix Obamacare.  Quit attempting to pass a comprehensive bill to replace Obamacare.  Let’s face it. Your track record of passing well written comprehensive legislation is not particularly good.  Instead fix some of its broken parts.  To begin, I suggest the following incremental changes:

  • Allow the federal government to negotiate lower drug prices for Medicaid and Medicare. Right now, they aren’t allowed to negotiate.  How silly is that?  A 15 percent reduction in drug costs would produce a $600 billion savings in healthcare costs over 10 years (Democrat party idea).
  • Tort reform should be considered. The abuse of malpractice suits results in hospitals over-treating and over-testing. If tort reform shaved just two percent off of health-care costs, that would yield about $800 billion over a decade (Republican party idea).
  • Repeal the individual mandate forcing everyone to either get insurance or pay a penalty. Instead treat everyone as adults and give everyone this option: Your pre-existing conditions are covered as long as you have insurance.  If you decide not to have insurance that’s your decision.  But if you then get cancer, etc. prior to getting coverage the cost is on you.  No longer can you wait to get insurance until after you need it (my idea).

What are your thoughts?

These are three common sense proposals that would help improve healthcare and significantly reduce costs.  These are just the beginning.  There are many, many more good ideas that should be debated and passed in a bi-partisan way.  There you have my thinking on healthcare.  Now it’s your turn.  How would you make it better if you could waive a magic wand?

Sources:  Nine Ways to Really Fix Obamacare, by Steven Brill, The Washington Post, June 30, 2017