The Republican Healthcare Alternatives

As the Republicans edge toward participation in the White House’s Healthcare Summit on February 25^th, the GOP (= the Grand Old Party, for my international readers) has been huddling closely to hash out their respective proposals which can be brought forward during the televised meeting.  Since the stated purpose of the summit is for both parties to present their views on directions for American healthcare reform, we can be sure that the Republicans and Democrats will be leaving little to chance.  While the Democrats have dominated the healthcare reform debate up until last month, Republican proposals have not been widely discussed or debated.

In essence, the Republican proposals will focus primarily on market-based solutions as opposed to relying on the government. Opposing both an employer mandate which requires them to provide healthcare insurance and the Democrat call for expansion of Medicaid, the GOP believes both proposals would burden states and create enormous long-term liabilities.  They believe that such a large expansion of fiscal requirements for small business and the states would be very difficult for these constituencies due to the severity of the economic recession.

Though the Congressional Budget Office and other independent analysts have not yet had a chance to weigh in on the Republican proposals, one certain item is that the GOP’s alternatives will not vastly increase the number of insured by the more than 30 million people which the Democrats have put forward.  The Republicans are advocating a smaller, more incremental change that will not impose such a large infusion of money during the worst economic crisis since the Great Depression.

So, we should expect that one idea which the GOP will likely propose as an incremental change is a plan to allow insurance companies the opportunity to sell policies across state lines.   Furthermore, Republicans are also likely to propose alternatives associated with monetary incentives for states to expand the insurance pools of high-risk patients with chronic illness.  A third incremental change will be changes in medical malpractice laws that would lower costs and decrease premiums because physicians hold the “power of the pen” and caution in today’s litigious world reins among the docs.  Fourth, Republicans are likely to propose the establishment of health savings accounts to cover regular expenses for those who purchase high-deductible plans.  It would not surprise me if they also proposed an expansion on the role of private insurance in Medicare as has already been done within the program’s prescription drug system.  At the same time, the GOP wants to assure that the growth of Medicare is tempered so, we should anticipate that if such a model is put forward the accrued savings from switching to this approach will be used to fix the program rather than creating yet another entitlement program.

The Republicans; however, remain deeply divided on the crucial issue of taxation.  Some, including Representative Paul Ryan (R-WI) – a hugely popular, rising star in the party – would establish a refundable tax credit for people to purchase insurance to replace the current tax-free treatment of health coverage.  Others claim that eliminating the current tax break for employer provided coverage would be the same as a tax increase.  But, all sides of the party are beginning to weigh in on the issue.  Former Speaker of the House, Newt Gingrich (R-GA), penned an opinion piece this week in the Wall Street Journal outlining his beliefs on what the GOP should represent in the negotiations.

Though the GOP clearly has a laundry list of alternative proposals, Republicans and Democrats hold the potential for agreeing on a number of issues.  For example, both parties believe in making it easier for small business to purchase healthcare and allowing children to stay on their parent’s policies.  The Republican approach; however, would help small businesses band together for purposes of purchasing health insurance.  As both parties begin to focus on the upcoming Healthcare Summit at the Blair House, we can be sure that Republicans and Democrats will be bringing their best arguments to the table in the hope that their policy proposals can make it into a healthcare bill which actually gets to the President’s desk.

Kevin Fickenscher, MD

The views and opinions expressed herein are my own and do not necessarily represent the views and opinions of Dell Services or its affiliates.