A Better Idea for Congressional Republicans

Here’s an essay by David Frum in The Atlantic about how the GOP should handle the Affordable Care Act now that they’ve gained the White House.

Frum, a conservative thinker and generally smart fellow, wrote this over a year before the 2016 election. There are some very good ideas within. First, the obvious:

“No illusions please: This bill will not be repealed.”

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Since 2010, the ACA has survived dozens of repeal votes in Congress, three national elections, and two Supreme Court challenges, the most recent of them only last week.

Second, some suggestions for improving the law:

Republicans should accept the Affordable Care Act as a permanent new fact of American society. They should accept universal healthcare coverage as a welcome aspect of any advanced democracy. Instead of fruitlessly seeking to repeal a law now that will in 2016 enter into its fourth year of operation, they should specify the law’s most obnoxious flaws and seek a mandate to reform them.

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1) Fix the funding mechanism.

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2) Let states run their Medicaid programs their way.

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3) End the employer mandate.

Give it a ten-minute read for the details and see what you think.

The ACA is a distinctly American take on mass health insurance for its population. Unlike other western nations, where health care has been nationalized, the ACA incorporates private enterprise into the law. That goes a long way to explain why it’s so messy.

Another alternative is to expand Medicare to cover everyone, cradle to grave, and increase that portion of the FICA tax to cover it. This is basically what most Americans age 65 and over have right now. I’ve seen it up close with my mom. It works. It could use a tweak to the tax rate to cover the bulk of the retiring Baby Boomers, but it does work.

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