For six years the Republicans have called for the repeal of the Affordable Care Act. Now that the Republicans have complete power here is one of the health care options that the very conservative Liberty-Republicans like.
Liberty-Republicans believe that government should get out of health care all together. Well over 40 percent of all health care is paid for by the government through government employee benefits, Veterans benefits, Medicare and Medicaid. Promises have been made–promises that conservative Republicans want to break.
What Paul Ryan advocates is unlinking coverage with government responsibility. Instead of the government providing you Medicare, you would receive a subsidy which, if the Liberty-Republicans have their way, would forever shrink to nothing. Their next job is to weaken the collective bargaining for employees and Vets. The first program to go would be Medicaid.
To replace government funded health care, patients would be completely responsible for their own care. We, the patients, would negotiate directly with the doctor and pay what the doctor wants or go without. For doctors, there are the savings from government paper work and regulations, but no consistent paycheck. To keep prices down doctors could give up centralized offices and staff, returning to house calls, if the price is right. The cost of treating the poor would fall completely on doctors and hospitals. Since there won’t be any government involvement health care access and quality would vary widely.
The losers in this system would be rural areas. Idaho has fewer doctors per capita than almost any other state. Republicans could open our boarders to more doctors from other countries, but without adequate pay would they come?
Doctors graduate from medical school with hundreds of thousands of dollars of debt. Yet in this new system they would take a huge pay cut if they take care of the poor. The government could forgive all medical school debt hoping doctors would take care of the poor, vets, and elderly. This wouldn’t ensure doctors in rural areas. So, the government would need to build medical schools and pay for doctor’s education hoping they would move to the small towns.
Maybe, in 10 years, if all health care education was government funded, this system would work. But expanding immigration, forgiving educational debt, and building medical schools isn’t in the Liberty-Republican’s plan. Without it hundreds of millions will not get health care.
Next let’s examine a single-payer system.