Most Americans, about 180 million strong, get their healthcare insurance from their employer. Most like it that way and aren’t looking for a change.

Democrats support single-payer healthcare, or socialized medicine, which means government control of all healthcare. To get to that end they have proposed Medicare for All, which promises universal access to healthcare. About two thirds of Americans support this idea – until they realize it means eliminating their private health insurance.

Joe Biden doesn’t support Medicare for All because he realizes this won’t be supported when people understand they will lose their private insurance. Instead, he has proposed a “Public Option” be added to the current ObamaCare system. Polls show about two-thirds of Americans support this idea – because they don’t understand this will also eliminate their private insurance – just more gradually over time. In other words, it is a better marketing tool for the eventual government takeover of healthcare.

Republicans have been slow to offer an alternative. They ran hard on repealing and replacing ObamaCare in 2016. They might have succeeded if not for a few renegade senators like the late John McCain of Arizona and Senators Susan Collins of Maine and Lisa Murkowski of Alaska. This failure led to mid-term losses in 2018 and may have contributed to losing the White House in 2020.

There is no lack of good ideas from conservative healthcare analysts. There is only a lack of unity on the part of Republican lawmakers.

The Wall Street Journal  editorial board says what Americans really want is protection from the risk that they or someone they love needs help paying for cancer immunotherapy or surgery. There is a political opening for a healthcare policy that covers costs for the sick without compromising medical innovation or prompt access to care, and favors choice and competition over mandates and political control.

What’s wrong with ObamaCare?

Most Americans are satisfied with their healthcare now – but they shouldn’t be. Those who are satisfied are mostly the 180 million on employer-provided plans. Since their employer pays the premiums, they don’t realize how expensive they are. What they don’t realize is that the rising costs of these plans negatively impacts their own paychecks. When employers must pay more for health insurance benefits, there is less money available for wage increases.

ObamaCare costs more than necessary to provide good healthcare coverage. The law requires every qualified plan to provide “essential benefits” to every individual, regardless of their need for these benefits. In practice, this means men pay for mammogram screening and women pay for prostate exams. There is no allowance for variations in healthcare needs. It is a “one size fits all” system.

A better system would make allowances for specialized plans for, say, diabetics or cancer patients. Women beyond child-bearing age could eliminate obstetrical services. Tailor-made healthcare policies would lower costs and improve healthcare outcomes.

ObamaCare also unnecessarily raises Medicaid costs. The federal government pays states more to enroll prime-aged men above the poverty line than to cover the truly needy – even as Democrats claim to be the party of compassion. When state budgets are strained to pick up these higher Medicaid costs, other budget items, particularly education, suffer and children are the losers.

Medical costs could be lowered by enhancing Health Savings Accounts (HSAs). When I got my healthcare insurance through my business, I established an HSA account which I used to pay medical and drug expenses. This money was put aside before taxes and it incentivized me to be a good steward of these funds since they were controlled by me. But I had to give up my HSA account when I became eligible for Medicare. This needs to be changed. Expanded use of HSAs has been shown to lower medical costs in numerous studies.

Many of these ideas have been promoted by healthcare economist John C. Goodman and other healthcare analysts like Grace-Marie Turner and Brian Blasé. Goodman helped write the Sessions-Cassidy healthcare bill promoted by Representative Pete Sessions (R- TX) and Senator Bill Cassidy (R – LA). For more on this subject, I refer you to previous posts. (The GOP Solution to ObamaCare) (Sessions-Cassidy Healthcare Plan Solves Problems – I and II)

If Republicans want to avoid government-controlled healthcare, they need to promote their better ideas – and do so with unity. They need to stop Democrats from continuing to promote lies such as Republicans want to eliminate coverage of pre-existing conditions. That may be the one improvement ObamaCare has brought to our system that everyone can agree upon.