US Senator John Thune: It’s Time to Turn the Page on Obamacare

It’s Time to Turn the Page on Obamacare
By Sen. John Thune

I can’t think of a more personal aspect of someone’s life than that of his or her doctor-patient relationship and the decisions they make together. Whether it’s a routine exam or a serious surgery or treatment, each decision – however large or small – can have a lasting effect on an individual and his or her family. The most important and fundamental part of this, of course, is first having access to affordable health care so these relationships can be built and the care can be delivered.

It would be an understatement to say that America’s health care system has been on a bit of a rollercoaster ride over the last eight years. I’ll be the first to admit that health care in the United States wasn’t perfect before Obamacare was implemented, but it certainly didn’t make it better. For many Americans, it got worse.

Fixing our health care system is too important to get wrong, which is why I’m working with my colleagues in Congress on a plan that would correct some of Obamacare’s greatest shortcomings, like its high premiums and limited choices. The first step in this process, though, is ripping out the old law root and branch. Leaving it intact would be like treating a broken arm with a Band-Aid, two ibuprofen, and a pat on the back.

The American Health Care Act (AHCA), which was recently introduced in the House of Representatives, is a good foundation from which we can work to turn the page on Obamacare. According to the Congressional Budget Office, the AHCA would meet two of my top priorities: It would reduce premiums (by 10 percent) and increase choices. The AHCA would also cut taxes by $883 billion, reduce the federal deficit by $337 billion, and make major entitlement reforms that would save taxpayers another $880 billion. 

While this bill represents a great start, I’m working on a proposal that would make it even better. I believe that by making some common-sense adjustments to the bill’s tax credit, we can deliver more targeted relief to Americans who need it the most. My plan would simply apply an age and income test to the tax credit, ensuring low-income Americans and seniors receive more robust assistance. 

Reforming America’s health care system isn’t easy, nor should it be. But by focusing on the best policies that deliver the best results, we can finally help reduce the cost of premiums, increase access to affordable care, and create a system of which both doctors and patients can be proud. That’s what I’m fighting to achieve.   

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11 Replies to “US Senator John Thune: It’s Time to Turn the Page on Obamacare”

  1. Nonymouse

    U.S. Senator Thune is a great civil servant and a brilliant leader. We are very lucky to have him!

  2. Kelly Lieberg

    http://reason.com/archives/2017/03/19/the-failures-of-the-american-health-care#comment
    It’s the mandates that are the problem. A modified individual, guaranteed issue/community rating, maternity care, mental health care, chemical dependency rehab, and vision and dental care for children under 18.

    “The American Health Care Act effectively leaves all of the Obamacare mandates in place.”

    “If the Republicans are not up to the task, then, as cynical as it seems, it might be politically safer to just do nothing, avoid the blame for the crash, and then try to rebuild from the ashes”.

  3. jimmy james

    Senator Thune says that the: “The American Health Care Act (AHCA), which was recently introduced in the House of Representatives, is a good foundation…”

    If knocking 24 million poor and middle class folks off of their health insurance, partly to lower taxes on the wealthy, is a good “foundation” then your house is built on indifference. I know some of these people. It will be devastating.

    We need to do something about rising premiums but this is cruel.

    1. jimmy james

      I do, however, applaud Thune for at least wanting to make the House version more equitable for the poor and elderly. I do not understand some House members who say it doesn’t go far enough.

    2. Anonymous

      Did you have the same concern for the middle class who lost their health insurance through ObummberCare? Does having money and being successful mean that it’s open season to tax you into oblivion for those who aren’t as successful? The federal government isn’t the answer to everything, and they don’t spend money very wisely, so I don’t think it is a bad thing to take power out of the government’s hands and put it into the hands of those who pay the taxes.

      Is it cruel if someone abuses the free healthcare they receive or does that not qualify?

  4. MD

    If we as a country want a conservative, cost saving, market solution to the health care problem, the health care reform efforts would have to be much more comprehensive, and would be a fairly bitter pill to many conservative voters.
    Markets compete on three factors, price, quality, and quantity.

    We have almost no knowledge of price when we go into a health care encounter, aside from a very general idea based on previous experiences, and possibly a knowledge of our own out of pocket costs. In order to compete on cost, we would need to eliminate most of the items that conceal cost, Medicare, Medicaid, and (to a lesser extent) insurance company negotiation. That would allow price to become more transparent, as providers are not inflating their list prices to help maximize reimbursement.

    The other aspect of price is the cross-subsidization and charity care that is provided off the backs of the health care consumer today. Most health care organizations are effectively given an unfunded health care mandate through bills such as EMTALA which require medical screening exams for all that present to an emergency department and other entities such as Medicare which include a charity care component. Along with this, Medicaid care is often provided below cost. Therefore, we would have to strip those regulations and allow providers to only see patients willing and able to pay. Individuals that are unable to afford health care would have to negotiate with health care providers to receive care. The good part is, there would likely be a net decrease in the cost of health care, so paying out of pocket would be more affordable if you are unable to afford insurance.

    Quality in health care is a derived function as we ultimately seek health. Individuals would be more hard pressed to make health care decisions in the face of uncertain knowledge regarding quality. The burden would likely fall on health care providers to prove their worth to the health care consumer. Stripping the Medicare quality burden will reduce cost and might result more variation in quality, so the burden will fall towards the consumer to ensure their health care provider is of the quality they seek.

    Quantity would also be a challenge as quality and price challenges change the market landscape of health care, the change could result in more entities entering the market, seeking to provide care to the high income consumers, or more market consolidation among entities providing care to lower income consumers as they seek to lower their costs. In addition, most rural hospitals would face an extremely uncertain future as their current avenues for support evaporate (Medicare Critical Access Hospital cost reimbursement) although regionalization could help some entities survive.

    The changes to the health care market, US economy, and jobs would likely require a large adjustment as our economy is largely built on a bloated health care system. The number of people that would be removed from accessing the system would also be significant.

    In reality, the current arguments that AHCA is an ACA-lite are true. If we keep trying to put bandaids on a fundamentally broken system (As has been the case with ACA and what estimates of the AHCA look like), we will remain in our current state – serving special interests while the majority gets ripped off.

    That leaves us with an ultimatum.
    Instead, do we want to swallow the bitter pill and restart with a market solution that leaves many out, or do we want to take a different approach and take the money that we are all currently spending and devote it towards a more universal system? Consider the amount that we are spending on a federal level, state level, and individual level (Health insurance premiums are nearing 20% of our average real income according to the CMS). We could cut the fat, build an (effective, which does not necessarily mean single-payer) universal system, and still put a lot of money back in taxpayer pockets. As a moderate, I could see some utility in a purely conservative solution and some utility to an (effective) universal solution. What does not make any sense, is the continuing effort to slap lipstick on a pig and come up with ineffective solutions that continue to sustain this unsustainable health care system as each side continues to use health care as a political football.

    1. Kelly Lieberg

      Excellent summary. I find it hard for anyone to defend that more government will surely move us in the problem solving direction. Maximize the empowerment of the consumer. And when the consumer can’t speak for themselves, competitively maximize the charity. Malpractice needs more market legal reforms. And medical fraud needs more severe penalties. The extent of the ongoing dysfunction may yet give us another opportunity.