Republicans offer only detrimental tweaking to our health care system

A Better Way to Fix Health Care

By Speaker Paul Ryan, June 22, 2016

Our Principle

In a confident America, everyone has access to quality, affordable health care.

Our Challenge

Obamacare is making things worse by the day. It drives up premiums and deductible costs for individuals, families, and businesses. It forces people off the plans they like. It fuels waste, fraud, and abuse. And it cannot be fixed. Its knot of regulations, taxes, and mandates cannot be untangled. Obamacare must be fully repealed so we can start over and take a new approach.

Our Vision

Over the years, House Republicans have put forward hundreds of ideas to improve health care, ranging from targeted proposals to full alternatives to Obamacare. This is the first time we are unifying these efforts into a single health care plan.

This isn’t a return to the pre-Obamacare status quo. And it isn’t just an attempt to replace Obamacare and leave it at that. This is a new approach. It’s a step-by-step plan to give every American access to quality, affordable health care.

Our plan recognizes that people deserve more patient-centered care, not more bureaucracy. That means more choices, not more mandates. You should have the freedom and the flexibility to choose the care that’s best for you. Insurers should compete for your business, and treat you fairly—no matter what. You and your family should have access to the best life-saving treatments in the world. And as you get older, Medicare should give you more choices too. At every step, you should be in the driver’s seat. This is a better way.

A Better Way to Fix Health Care - Snapshot (3 pages):

A Better Way: Health Care - Policy Paper (37 pages):



By Don McCanne, M.D.

As their vision states, the House Republicans have organized their previous concepts on health care reform into a single policy paper. It is heavy on rhetoric that is deceptive and bordering on dishonesty in that their proposals are cloaked in language suggesting that these are beneficial policies when many of them are actually detrimental.

The report includes a rehash of familiar proposals: health savings accounts, selling insurance across state lines, association health plans, medical liability, Medicaid block grants, and converting Medicare to a premium support program. There is really not much new here.

But what is missing are the details that would allow for an objective analysis of the impact were these polices converted into legislation. However, it is easy to translate their rhetoric into what they are really proposing: they would reduce the role of the federal government in financing health care, shifting responsibilities to the states and especially to the the markets, while sharply increasing the financial burden on patients.  Since more of the responsibility for paying for health care would shift to the individual, it is likely that the greatest impact would be to significantly impair access to health care due to financial barriers, especially the lack of cash on hand.

Just one example of their rhetoric:

“Currently under Medicare, for example, beneficiaries and physicians (and other providers) are not allowed to agree to a different treatment regimen for a Medicare covered service. Our plan would develop a personalized care demonstration program that would give beneficiaries and health care professionals the ability to voluntarily enter into an arrangement for items and services outside of the Medicare system. While participating in this voluntary demonstration project, Medicare beneficiaries would still retain their Medicare benefits. With the proper oversight, this is a common-sense approach to giving our seniors the opportunity to make medical financing decisions with their physicians without direct interference from Washington. These freedoms can also help to ensure that Medicare beneficiaries maintain the access to health care professionals they deserve by increasing flexibility and thus the number of physicians who participate in Medicare.”

Sounds great - freedom to purchase the care you want instead of that dictated by the federal government. No, that isn’t the point. The policy they advocate for here is to allow physicians to charge Medicare patients full fees for authorized services. That currently is not allowed unless a physician totally opts out of the Medicare program - not a practical consideration for most physicians. Why do they have this rule? Without it a two-tiered Medicare program would be created - a concierge tier for the wealthy, and an underfunded welfare program for the rest of us.

But how about a little perspective here? The Republicans propose repealing the Affordable Care Act and then replacing it with slight variants of many of the policies contained in the act. They leave in place most of the health care financing infrastructure: Medicare, Medicaid, employer-sponsored plans, individual plans with public and private exchanges, and private payment. They merely tweak the existing system. The tweaks cause private insurance to become even less effective in providing financial security; the profound administrative waste is perpetuated, and oversight of the outrageous pricing in health care is reduced.

We’ve already had enough of this. It’s time - past time - to demand reform that works, that would make health care affordable for everyone who needs it. It’s time for a single payer national health program - an improved Medicare for all.

PNHP note: Physicians for a National Health Program is a nonpartisan educational organization. It neither supports nor opposes any candidate for public office.