Just about every Republican candidate for office in the country is an unabashed opponent of ObamaCare. But if they get rid of the Democrat's health reform law, what would they replace it with?
Some critics claim that the GOP only knows what it's against when it comes to health policy. They have no positive agenda for solving the problems of rising costs, inadequate quality and, for many, lack of access to care.
But the critics are wrong. There is a Republican health plan. And it's even more radical and more progressive than ObamaCare! What is it? It's the health reform John McCain proposed during the last presidential election.
If you don't live in a battle ground state, you probably never heard about the McCain health plan. During the election the national media completely ignored it — even though it was far more innovative than the health ideas Barack Obama was proposing.
If you do live in a battle ground state, you probably did hear about it. But odds are what you heard was a completely distorted version. In fact, the Obama campaign spent more money attacking and mischaracterizing the McCain health plan than has ever been spent for or against a public policy idea in the history of the republic.
Perhaps for that reason, Republicans today are a bit skittish about even discussing the idea. Just as most Democratic candidates don't want to talk about ObamaCare, Republicans don't want to talk about the McCain plan either. And that's too bad.
The McCain vision was based on a bill, sponsored by Sens. Tom Coburn (R-OK) and Richard Burr (R-NC), along with Reps. Paul Ryan (R-WI) and Devin Nunes (R-CA). That bill, in turn, was based on an idea which Mark Pauly and I proposed in a Health Affairs article more than a decade ago.
What makes this Republican approach so radical is that it would replace all government tax and spending subsidies for the purchase of private health insurance with a fixed-sum tax credit — essentially giving every American the same number of dollars to apply to their health insurance, regardless of where they obtain it.
Under the current system, federal state and local tax subsidies for private health insurance approach $300 billion a year. The distribution of these dollars is arbitrary, unfair and wasteful.
How much help a family gets from government depends on such factors as its tax bracket, the type of health plan the employer chooses, and state and local tax rates.
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