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Real health care reform: Give states the tools, and let them do the job

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Governor Bobby Jindal (R-LA). (Reuters)

They’re practically the first words out of one’s mouth the second a Washington reporter hears about a new health reform proposal: "How many people does your plan cover?"

The basic premise of the America Next health plan I’m endorsing today is simple: “I believe the problem is not that folks are trying to avoid getting health care. The problem is they can’t afford it.”

First, we need to focus like a laser beam on the health care issue Americans care most about: Rising costs.

In short, I agree with Barack Obama.

Of course, Barack Obama circa January 2008—when he uttered those words in opposition to a health insurance mandate -- represents a far cry from the Barack Obama who signed ObamaCare into law in March 2010. 

The president backtracked on nearly every single promise he made: on an individual mandate, keeping your plan, cutting premiums by $2,500 per year, and even on taxing health benefits -- all in the name of achieving the left’s utopia of “universal coverage.” And in return, America has been left with shredded promises, cancelled insurance plans, and a major-league case of buyer’s remorse.

So no, I won’t endorse a plan that sees tens of millions of Americans forced to buy health insurance under pain of taxation. 

I won’t endorse a plan that sees millions of other Americans forced out of the insurance they like, simply because it doesn’t meet some Washington bureaucrat’s standards. And I won’t endorse a plan that sees Americans extended the promise of insurance, only to find out that the “coverage” provided doesn’t guarantee they’ll receive the care they need. 

We already have all that -- it’s called ObamaCare, and it needs to be fully repealed, because it’s the problem.

Here’s the solution.

First, we need to focus like a laser beam on the health care issue Americans care most about:rising costs. 

The plan I’m endorsing includes an innovative $100 billion grant program that incentivizes our “laboratories of democracy”—the states—to come up with insurance reforms and other solutions that can stem the rising tide of health costs. States’ eligibility for the grants would be tied to their ability to lower insurance premiums for their citizens.

We include other reforms in our plan too -- tax equity between employer and individually-purchased health plans, lawsuit reform, wellness incentives, and new incentives for Health Savings Accounts. 

These reforms have proven track records of success -- and analysis from top economists to back them up. 

In fact, the Congressional Budget Office, analyzing a similar state-based approach in 2009, concluded that the kinds of ideas included in our plan would lower premiums on the individual health insurance market by $5,000 per year when compared to current projections. That, and not ObamaCare “rate shock,” is true change America can believe in.

Second, we need to protect the safety net for the most vulnerable. As someone whose mother arrived on these shores pregnant with me, I’m well aware of the plight of Americans with pre-existing conditions. I was one -- from birth. 

My son Shaan’s desperate fight for survival from a childhood heart defect reinforced my belief in making sure those with major illnesses don’t get left out in the cold. But we didn’t need to give up all the good things in the system to fix the bad. Extending coverage to Americans with pre-existing conditions didn’t require throwing millions of Americans off their current plans, or turning the IRS into the health insurance police.

Here’s a better solution. Our plan’s state grant program requires states applying for grants to guarantee access for individuals with pre-existing conditions. A state could guarantee access through a high-risk pool, through reinsurance, or through some other mechanism. But our plan ensures that the most vulnerable won’t fall through the cracks, and provides $100 billion in resources that states can use to subsidize that coverage.

Third, we should make insurance more portable, to enhance personal choice. Rather than taking away choices by regulatory fiat, we should give Americans more insurance options, so they can purchase plans they will own, hold, and keep. But if people like their existing plan, they won’t have to worry about it getting taken away by some government bureaucrat saying it doesn’t comply with a new mandate.

As someone who studied public policy in college, and worked in health policy all my adult life, I know ObamaCare is bad policy. 

The law may have been sold as a solution to the problem of pre-existing conditions. But it solidifies government -- through taxes, mandates, regulations, and your friendly bureaucrats at the IRS -- as a pre-existing condition in our health care system, and in the lives of all Americans.

That’s not reform.

As a governor, I know states can do better. We need solutions, but not Washington-centric bureaucracy disguised as “reform”—we’ve done that already, and it hasn’t worked. 

By contrast, conservative governors throughout the country have implemented successful health reforms -- from the Hoosier State’s Healthy Indiana Plan, to Rhode Island’s innovative Medicaid waiver, to the Bayou Health program we’ve created right here in Louisiana. These reforms have lowered costs -- in some cases dramatically -- improved the quality of care, and received widespread public support.

But in many states, including Louisiana, we would go further with our reforms, if only Washington bureaucrats would get out of the way. At the risk of echoing Churchill, that’s the better way forward on health care -- give states the tools, and let them do the job.

Republican Bobby Jindal is Governor of Louisiana and Honorary Chairman of America Next, a conservative policy group that focuses on winning the war of ideas.