In remarks he made in March 2019 from Capitol Hill, with the Obamacare constitutional challenge as a backdrop, President Trump told Americans the Republican Party was soon to take up the mantle of health care once again.
"Let me tell you exactly what my message is: The Republican party will soon be known as the party of health care," the president told reporters before meeting with Senate Republicans. "You watch.”
Given Democrats’ recently blatant inability to come together on a version of socialized medicine that they all agree on — and Medicare For All promising to make the purchase of private insurance all-but illegal since no plan could be sold that duplicates any coverage offered under the Medicare For All scheme — legislative committees and small business advocacy groups have begun releasing months-worth of research in the form of “ideas lists” they say will ultimately form a framework for future GOP-led health care policy.
The Republican Study Committee (RSC), for example, released 66 pages of ideas gleaned from months of work in which they reached out to think tank and health care leaders across the U.S. for ideas about what Republican health care legislation should include.
The 66-page framework seeks to "transform the individual marketplace's current regulatory structure, unwind the ACA's Washington-centric approach and largely return regulatory authority to individual states."
This includes provisions to increase the portability of health insurance within the individual marketplace, provide federal funding for state-designed "guaranteed coverage pools" which would help cover individuals with pre-existing conditions -- though it does not require states to run such pools -- put a moratorium on Medicaid expansions so it can be "sustainable ... for generations to come" and promotes "innovative care" such as telemedicine.
But there are other groups, such as the small-business advocacy group Job Creators Network Foundation (JCNF), that arguably started the same task sooner and released the results a week prior.
JCNF’s market research, which includes the opinions of 25,000 American voters representing all political affiliations according to President Elaine Parker, looks a bit more like the beginnings of a plan the organization hopes the Senate will use to bring legislation forward.
The comprehensive list of ideas is called “Heath Care For You” and it includes many of the same things the RSC study promotes: protection of patients with pre-existing conditions, more “direct access” to providers through telemedicine and direct primary care, and an emphasis on personalized health care such as portable health insurance. Parker says this is what the Americans her group say they want, despite reports that Medicare For All enjoys a 51percent approval rating from adults.
“This isn’t your traditional polling,” Parker said. “This is the largest ever market research health care study. “This provides a message for the Republicans to run on as far as what the American people want. And they were very clear: they do not want one size fits all health care. They want personalized health care. They want choice.”
JCNF’s framework, like the RSC’s, also offers ideas to lower the cost of drugs and insurance premiums. But its main — and arguably most important — focus is on increasing choice in health care.
“Imagine ordering your computer online, you decide the options on it you want and you order exactly what you want based on your needs,” Parker said. “The research came back with three clearly-defined desires: repair, restore, and improve the doctor-patient relationship, remove bureaucrats from the health care process for patients, and increase choice so costs will come down.”
Proponents of Medicare For All might say that Parker’s market research got it wrong — that Americans actually do favor Medicare For All or some sort of government-run health care. But there’s evidence to suggest that this may be because most people don’t understand what Medicare For All would do — and how much it would cost.
The latest survey by the Kaiser Family Foundation asked adults about Medicare for All and found 51 percent support it, 46 percent oppose it. At first glance, that looks like a just-big-enough majority to be a winner in November 2020, although it’s worth noting this sample is of adults, not registered voters or likely voters.
But the same survey also revealed that a majority of Americans are still seriously misinformed about how Medicare for All would work. 55 percent of respondents believed that people who get insurance through their jobs would keep those plans, and the same percentage believed that people who bought their own insurance would keep those plans. A separate question found that 40 percent said they thought private insurance would still be the primary way that Americans would get coverage under Medicare for All. 54 percent said that individuals and employers would continue to pay health insurance premiums.
Katarina Lindley, a direct primary care physician in Texas, originally from Croatia, remembers well the socialized medicine she grew up under in Yugoslavia and says when attempts to treat everyone under a government-run health care scheme means higher costs and lower quality. She’s seen it first hand, she says.
Lindley is very supportive of any idea that restores the doctor-patient relationship, she says, both on behalf of doctors who will be unburdened by the hours of billing related to bureaucratic requirements and patients who have better and quicker access to physicians.
“One of the first building blocks is restoring the patient/physician relationship,” Lindley said. “And i think once you do that everything else will fall into place. There’s no easy fix in medicine, but I still believe the free market will adjust and allow for different ways for medicine to be practiced and patients and physicians will both be happy.”
If Republicans in Congress begin to take the ideas of both the RSC study in the house and JCNF’s market research in the Senate, put them together into sister bills that move health care away from one-size-fits-all, then Trump’s prophecy that the GOP will become the party of health care will surely come to pass. And the American people will own a stake in the process.
Sarah Lee is a freelance writer and policy wonk living and working in Washington, DC.