Sen. Bill Cassidy got cheers on late-night television for calling for an Obamacare replacement plan that would pass what he calls “the Jimmy Kimmel test” — that is, cover children like the comedian’s son recently born with a congenital heart defect.
To hear him tell it, he’s the one in Congress fighting to keep President Donald Trump’s promises to his base. On the campaign trail, Cassidy argues that Trump consistently promised a health care plan that would reduce premiums, eliminate mandates, ensure continuous coverage and protect people with pre-existing conditions. Any GOP plan, he says, needs to meet that bar.
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President Trump’s recent 2018 budget proposal, which includes roughly $800 billion in cuts to Medicaid over the next decade, has led to howls of outrage from Democrats.
Senate Minority Leader Chuck Schumer, D-N.Y., said last week that the cuts would “carry a staggering human cost.” Sen. Bernie Sanders, I-Vt. has called them “just cruel.”
Medicaid’s defenders claim that it’s a bargain for patients and taxpayers alike. As Sen. Schumer put it, “Medicaid has always benefitted the poor. That’s a good thing.” A recent issue brief from the Kaiser Family Foundation, meanwhile, concludes, “Medicaid is cost-effective.”
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Republicans should be on the lookout. While the GOP tries to repeal and replace Obamacare, Democrats are sharpening their message on health care. In their race to the left, Democrats are increasingly calling for a full-fledged single-payer system. The momentum is shifting, and the stakes are getting higher for Republicans. As we all know, in politics, a bumper sticker beats an essay. With the “single-payer, universal health care” catchphrase, Democrats are beginning to use their simple “bumper stickers” more frequently.
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A new Lancet study adds to the growing mountain of evidence that market-oriented health care systems outperform the single-payer systems that have captivated the imagination of progressives for more than a century. Yet despite their claims of believing in evidence-based policy, far too many progressives persist in disparage efforts by Republicans to move the U.S. health system in a more market-oriented direction even while working feverishly on a misguided quest to put California on the path to single-payer health care.
The Lancet study focuses on the extent to which countries are able to avert “amenable mortality.” “Amenable mortality” refers to “unnecessary, untimely deaths,” i.e., deaths that hypothetically would not occur with timely and effective medical care. The idea is that it makes no sense to fault a country’s health system for deaths that never could have been averted even if the system was organized to be as efficient and effective as possible. Market-driven systems have shown to be superior at averting avoidable deaths.
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Senate Republicans may be all over the map on an Obamacare repeal plan, but on one fundamental point — reducing insurance premiums — they are in danger of overpromising and underdelivering.
The reality is they have only a few ways to reduce Americans’ premiums: Offer consumers bigger subsidies. Allow insurers to offer skimpier coverage. Or permit insurers to charge more — usually much more — to those with pre-existing illnesses and who are older and tend to rack up the biggest bills.
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