Tuesday, August 6, 2013

Can Republicans Get Real About Repealing Obamacare?

"Can Republicans finally get real about repealing Obamacare?" was the headline of an op-ed column by Barbara Shelly that appeared in the Kingsport Times-News last week. Here's my reaction:

"Dear Barbara Shelly,
Having no idea whether you're a Republican (I'm not, though I can pass for one most of the time) I share the frustration expressed in "Can Republicans finally get real about repealing Obamacare?"
My Congressman, Morgan Griffith, is very clear about wanting to repeal Obamacare. I give him full marks for that. His e-newsletters have not, however, discussed what fiscal conservatives can offer by way of an improvement...and somehow I don't think trying to channel Grover Cleveland will get any points these days.
As a lowly blogger with no special professional experience in medical care plans, I wouldn't have made Obamacare a running theme if I hadn't had an improvement in mind. I've used very little medical care and no insurance--think some past employers may have taken out insurance policies on me but never used them--in my life. What I've observed is what has and has not worked for geriatric patients who've been my friends and employers. What's worked best for these people is, hands down, the Veterans Administration system that existed in the 1990s (don't know whether it's the same now). Specifically:
1. Patients are always encouraged to pay cash for medical treatment if they can. (Providers who aren't dependent on insurance are able to charge lower rates, so this is often feasible.) This can be done anonymously, so that nobody ever has to know that an individual has received treatment for something gross and embarrassing like psoriasis...which is vital to communities that want to keep gross-out diseases from reaching epidemic proportions.
2. If, after a year, patients have not been able to pay for medical treatment they've received, they appeal to the fund for payment assistance, documenting their expenses, their income, and other pertinent data, and the fund pays any outstanding balance due.
3. If patients have been able to pay for medical treatment they've received, but this has left them with an unacceptably low disposable income, they have the option of appealing to the fund for reimbursement.
4. Only legitimate medical expenses are paid. No funds are allocated for paying insurance agents to play with numbers and money. This keeps the cost of medical care and the burden on the medical care fund minimal, and the system sustainable. (The V.A. allowed veterans to use Medicare/Medicaid and/or private insurance if they so chose, but didn't require it.)
I think this could work for the nation as a whole. I even think Ben Carson would agree on that, although the plan outlined in his book is less simple (and proven) than the plan outlined here.
Those who identify intensely with the Republican Party may be using Obamacare only as a game strategy, but those who oppose Obamacare because (a) it's unnecessarily intrusive and/or (b) it's unnecessarily expensive and/or (c) it's unsustainable and likely to bankrupt the nation do have some ideas about alternatives. Any help you can provide toward publicizing this alternative would be appreciated.

Feel free to discuss and debate these ideas, Gentle Readers. If the comment section doesn't work for you, and/or your comments are long enough to be a separate post, e-mail Saloli (pop-up e-mail links never work for me either; that's salolianigodagewi @ Yahoo). I'll post your unpublished comments here if you like, or post links to the sites where they've been published. At this stage what I want is for everyone to know that fiscal conservatives do not want to cut off financial aid to our disabled relatives, telling them they should've saved up more money before they went out and got cancer or stepped on a landmine or whatever. We do care; we do want to help. We merely see that Obamacare isn't going to help, because it's unsustainable--a bankrupt nation can't offer financial aid to anybody.