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My fellow Republicans, let's use Medicare to cover pre-existing conditions

7/26/2017

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My old boss, Ronald Reagan, used to advise us speechwriters that our advocacy should be easily understood by the guy pumping our gas while listening to his radio.
Most Americans now pump their own gas. Still, Reagan’s commonsense guidance holds. People in the communications business from ad writers to journalists understand when they’re told to KISS — the old “Keep It Simple, Stupid” rule. Of course, their job is describing policy, not making it.
These days, how you describe policy can be as significant as what you believe your policy should be. That is especially true when it comes to health care reform.

Senate Republican leaders don’t seem to agree on a replacement of Obamacare. The bill passed by the House, for which I voted, lacks what we might call promotability. For average voters, that means a lack of understandability.
The Democrats are ready to convince our supporters that our attempted reform will worsen their plight.
Here’s a simple prediction: If my Republican colleagues can’t come up with and pass an understandable reform package, we lose. If the public is presented with complicated funding models that make sense on Capitol Hill but not on Main Street, we lose. So it is time to get back to basics and keep it simple.
We should not lose sight of the fundamental premise driving health care reform: the unwillingness of the American people to accept that people with pre-existing conditions will go untreated because they have been priced out of the insurance market.
Sick and infirm Americans with pre-existing conditions will not be left to fend for themselves because of denied insurance coverage, period. However we meet this challenge, the reality is that the American people will pay for this benefit one way or the other. Neither the insurance companies nor state governments — many of them already near bankruptcy — will pick up the tab for the American people. It ain’t gonna happen. It’s going to be taken out of the pockets of all of us.
So if we the people are going to pay for it, the plan needs America’s confidence. They need a KISS solution, and they need it quickly. Here’s mine:
  1. The federal government would establish procedures to verify all our fellow Americans’ pre-existing conditions.
  2. The cost of treating those pre-existing conditions — and only those conditions — will be borne by Medicare.
  3. Those who receive Medicare coverage for their pre-existing conditions would be required to maintain private insurance to cover the cost of their remaining health care needs.
Obviously, any reform package will contain more elements than this one, but this could be the centerpiece of a broader piece of legislation. If Republicans can think beyond standard legislative guidelines for spending commitments, we can get something done as we promised to do. We might even be able to get some Democrats to come along with us.

Of course, my KISS proposal would increase the Medicare budget, which would be covered by direct replenishment from general revenues. But once pre-existing conditions are taken care of, millions of people now frozen out of the insurance market will take care of all their other health needs through private insurance — from which they are now excluded. These millions of new insurance customers will dramatically pull down the costs for everyone.
Medicare already enjoys the trust of the American people. They will understand this and support it.
They might even KISS us back.
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    U.S. Congressman representing CA-48. Former speechwriter for President Reagan. Surfer and father of 14 year old triplets.

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