Referring to the Affordable Care Act, chairman of the Senate Finance Committee, Max Baucus (D-Mont.) stated earlier this year, “Unless we implement this properly, it’s going to be a train wreck.”
And indeed, from looking at the Obamacare implementation timeline alone, the law seems to have gotten off to a shaky start. The implementation of the so-called employer mandate, which would require businesses with more than 50 workers to offer insurance to all full-time employees, or else pay a fine of $2,000 per worker, has been delayed until after the 2014 midterm elections. And in late June, the Obama Administration announced another delay when it pushed back the August 1, 2013 deadline of requiring religiously-affiliated non-profits to comply with the mandate to provide coverage of contraceptives, to the beginning of next year.
Time can prove valuable and as the impending “train wreck” of Obamacare gathers momentum, more and more good, free-market alternatives are beginning to take shape.
One such approach will soon be discussed in the Michigan Senate. Last week, the Senate Government Operations committee voted to send two pieces of legislation, which would create a free-market alternative to Medicaid expansion, to the full Senate for consideration by the Chamber. “Senate Bills (SB) 459 and 460, introduced by Sen. Patrick Colbeck (R-Canton) and known as the Patient-Centered Care Act, would enact a patient-centered healthcare plan that expands access to quality care without expanding government,” according to a statement released last month.
SB 459 creates the necessary framework for development of a free-market health care environment, and SB 460 covers the logistics of moving individuals currently on Medicaid to Direct Primary Care Services and High Deductible Health Plans.
Sponsors say the Patient-Centered Care Act would:
- Make quality of patient care for all citizens the first priority
- Expand access to quality care without expanding government assistance
- Convert existing Medicaid population to commercial insurance featuring Direct Primary Care Services plus High-Deductible Health Plans within a Health Savings Account
- Return healthcare decision-making to doctors and patients
- Return insurance to risk management not benefit management
- Limit government role to determination of government assistance eligibility
- Protect patient health information from government
- Make it more affordable for employers to purchase healthcare for their employees
- Mitigate the reduction in employees’ hours due to the ramifications of the Affordable Care Act
- Use our free market healthcare system to accelerate the growth of our economy
Avik Roy, a senior fellow at the Manhattan Institute for Policy Research, was among those who testified alongside Sen. Colbeck in support of the legislation. Roy is hopeful that the Obamacare employer mandate delay will afford businesses the opportunity to choose from a broader array of private insurance plans. In a Forbes article, he states, “Even if the Obama administration’s delay lasts for only one year, that delay will give firms time to restructure their businesses to avoid offering costly coverage, leading to an expansion of the individual insurance market and a shrinkage of the employer-sponsored market.” This movement toward private health care solutions is evidenced by Sen. Colbeck’s legislation and H.R. 903, a bill proposed by U.S. House of Representative members, aimed at repealing the provisions of the employer mandate.
Approaches which advocate moving away from a government-centered healthcare approach are also being developed outside the legislative sphere. This week, the American Enterprise Institute launched the initiative, Best of Both Worlds: Uniting Universal Coverage and Personal Choice in Health Care. The program utilizes markets “to achieve universal coverage without coercive mandates. By restoring individual risk pricing to premiums, the plan allows markets to function properly and avoids the so-called health insurance death spiral, in which the young and healthy opt out, raising burdens on the old and sick.”
While recognizing the important dialogue and efforts to change an arguably flawed U.S. health care system, it is important to realize that a system’s utility is not the only piece of the puzzle. Health care is a deeply moral issue and respecting the inherent dignity of the human person is paramount. While the provision of health care is a central part of human dignity and Christian charity, so too is the recognition of people as creative and capable of individual decision making. In the event people are not able to meet their own needs, those around them may be able to step in and provide a solution, driven by personal commitment and knowledge and characterized by efficient means. This is what makes a decentralized health care system valuable: people are rendered more accountable to take care of each other.
Respect for human dignity is promoted by considering both a duty to care for the sick and personal responsibility for maintaining one’s health. The common good would be better served by market-oriented reforms, which compassionate subsidization for those without means, rather than expanding government or employer-based health care. A commitment to the poor and vulnerable follows from the principle of solidarity. Subsidiarity encourages assistance for those unable to access the health care market. It motivates care by those closer to the sick and needy rather than by government or employer. This prescription for health care reform provides for virtuous and economically sound improvement in American’s health care.