Redstate

run with it? They just about had a baby when Pelosi made them look like "old meanies" with the SCHIP program.....I really thought they were going to fold there and was grateful when they did not.

Freedom of Religion not Freedom from Religion

Should we just let them die on the curb ?

Aren't we a wealthy enough nation to provide for our least fortunate ?

The government is already paying for most healthcare if it took over the rest would there be such a difference ? We have the best healthcare system in the world.

Having just one payer would simplify things.

Insurance companies let people die.

This list brought to you by decades of muddle headed thinking. Its also what I go through every day I have to speak to my customers customers. Its a very high thick wall and if you try to approach them with anything less than a guarantee (Yes I know just what kind of a guarantee the dems offer) they shut down on you.
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"Those who expect to reap the blessings of freedom must, like men, undergo the fatigue of supporting it."
-Thomas Paine: The American Crisis, No. 4, 1777

Conservative and Republican politicians won't make any headway I think. What tips the scales for the Dems is their media lapdogs. Not just news, it's the celebrities, it's the yakkity shows, it's the propaganda films.

We need some Ben Stein style movies about Health Care, produced and entered at film festivals, funded by conservative groups for limited release. Maybe we need celebrity spokespeople.

Healthcare is a public relations issue. We are pretty sucky at public relations, all things considered. I think this is too important of an issue to let the elected take the lead.

absentee

As the entitlement programs are CURRENTLY structured, they are projecting that a 70% or higher tax rate will be required down the road. What level of taxation/borrowing will be required for socialized healthcare? It's completely ridiculous to even suggest that our country can afford something like that.

“.....women and minorities hardest hit”

it just won't work, and absentee has identified the primary reason: PR. You say the GOP needs to go on an extended public relations offensive. The problem is that the Republicans' "offensives" usually look, well, offensive. We're dealing with an American public that is more and more sympathetic to the nanny state. The prescription drug program that W passed was and is overwhelmingly positively received. So just resisting further governmental intervention is unlikely to get a good hearing. Most of your ideas will get a good hearing, except perhaps "Restricting Medicare, Medicaid, and SCHIP to individuals who are actually needy" - that one will get the lefties howling and will be a bulls-eye for bad PR.

I fear the American populace is so intoxicated on government handouts now, and as absentee points out, so under the spell of the MSM, that just about anything the GOP proposes short of full, single-payer, government-subsidized health coverage (Medicare++) is unlikely to fly, no matter how much of a full-court press the GOP exerts.

Sorry about the pessimism, but I can't visualize a scenario where we win on this one.

(I just read David Frum's new book "Comeback: Conservatism That Can Win Again", and he addresses health care, and proposes a couple of the same points as you. Unfortunately I turned it back in to the library, or I'd quote his strategy...when I read it, it made pretty good sense, though.)

the "required healthcare" approach.

Perhaps you can't complete your tax form without your health care information and if you don't provide it then you are enrolled in the government health care plan at a substantial cost.

Frankly, multiple choices including high deductibles coupled with REQUIRING insurance companies to accept everyone (that's gonna leave a mark) and at the same time assisting low income people leaves us with :

Mitt-Care

But then I didn't think Mitt-Care was all that bad of an idea even if it hasn't worked out perfectly.

... UNIVERSAL HEALTH CARE SYSTEM. They mandated that insurance companies provide insurance to all that apply (no exclusions for pre existing, and all accepted at that company's published price), with some incentives for healthy lifestyle.

The insurance companies are responsible for managing costs, and since they can not exclude and manipulate the pool, they actually have to minimize costs and maximize efficiency. Also, customers can leave (I believe once per year) for another plan.

The government provided tax breaks for insurers that had a percentage of certain types of high cost patients in their pool, which insures that the companies provide good service, as opposed to drive them out with bad care.

The WSJ had an article about it several months ago. I'm not a suscriber, but perhaps someone here can copy and past a few of the pertinent points in a post.

I've been saying this same thing (although much less eloquently) for a while. If R's don't come up with a better strategy than just calling Dem's plans socialized then we lose and they look like the experts.

I'm afraid this issue has become much like many others - the Dem's plans are seen as giving out freebies, while Republican ideas like MSA's are seen as hard-work. It's going to be hard to win when so many, well I'll just call it like it is, stupid, new voters are there who just want the handouts that are being promised by Obama and Clinton.

I'm pleased to see that you seem to be taking a much more open approach to the idea of the misunderstood individual mandate.

"The time for honoring yourself will soon be at an end."
- Maximus

is try to intelligently structure some sort of system.

The Right, especially the business community, has slavishly backed HSAs; people don't really want or like them. They really are a work-around for the fact that employers can buy HI pre-tax and individuals can't. So fix the problem with the tax system and allow people to individually buy HI pre-tax.

The real need and the very real fear for responsible but not well-off people is the catastrophic medical situation. We need to devise a universally available catastrophic/major medical plan. As much as I don't like federalizing things, this is an area where state lines need to be crossed. This has a little in common with what I know of the Dutch system: if an insurance company is doing business in the US, it must offer a relatively high-deductible, say 80%-20% with maybe $5K deductible, major medical plan to ALL comers and with no pre-existing condition exception. We use the tax system to allow pre-tax payments and some graduated "credit" system for those who can't afford it.

What we MUST avoid is a government run "universal" health care system where you go to the Doc whenever you want and for whatever you want and the Fed picks up all or most of the bill. Politics being politics and politicians being politicians, before long we'll be paying for spiritual healing, tit tucks, sex changes, tattoo removal, behavior mod for brats, drug and alcohol spin drys, and on, and on until every dime in the economy is sucked into it.

The "prime directive" must be that the government cannot run it and cannot set benefit levels for anything other than the aforementioned catastrophic plan. No government will have any incentive for cost control and every pandering politician will have every incentive to mandate benefits for the condition du jour - especially if it is backed by some contributions.

I could go on, but it would start to feel like work and it's getting late.

In Vino Veritas

Why do they argue for government controlled healthcare but are ok about a private system for food? Isn't food at least as important than medical care, if not more so? Why does a capitalist system work for food but not for healthcare? We can and should make this type of argument about any necessity: food, clothing, shelter. I have always thought that this is the type of tactic we should have with the minimum wage too. When the Democrats threaten to increase the minimum wage, Republicans should introduce a bill to increase it to $100 or $200 an hour. Let the Democrats argue why the lowest worker shouldn't be enjoying a caviar lifestyle.

If the federal government is going to intervene, it should do it in ways that make economic sense.

Make a new requirement for medical schools to recieve federal grants: Enroll more students.

We don't mandate auto insurance to protect the driver. We mandate it to protect everyone else on the road. Drivers must be insured for Liability, not for their own personal or property damage. So the analogy only goes so far.

Another point: auto insurance laws are a matter for the states, and do in fact vary widely from state to state.

Perhaps that should be the core of our health care platform: let the states innovate with various approaches and programs, with the federal government playing a supporting role as it does in education. That has the merit of being ideologically consistent with other core Republican approaches and with McCain's own federalist philosophy.

"If all men were just, there would be no need of valor."
- Agesilaus

We had 6 years with a GOP president and Congress to put forward a plan and sell it to the public.

I doubt most Americans can name one single idea the GOP majority congress had to fix the health insurance issue.

So now we don't have credibility on the issue because we went to sleep on it.

Let this be a lesson - if you don't address an issue the voters believe is very important you wind up handing the issue to the other side regardless of how dumb their plan is - because to voters at least a plan is better then the status quo.

At my little Republican precinct meeting on Tuesday night, there were three resolutions:

1. Protect the unborn.

2. Preserve traditional marriage.

3. "Health care is a national problem." (The woman who proposed it told a very credible story of the difficulty she had in buying insurance when she was self-employed.)

We CANNOT afford to hand over this issue to the Democrats.

"People will not look forward to posterity who never look backward to their ancestors." -Edmund Burke

How expensive will health care get? Way worse if you get free coverage to everyone. Universal health care will exacerbate the cause of rising health care expenses--what we call the "moral hazard" of health insurance.
Essentially it works like this. If you let people drink unlimited Pepsi for only a dollar a year, they will become Pepsi gluttons. In the US, medical costs rise because people want Doctors to "do everything" to help them. "Everything" entails many, many, many procedures incurring huge expenses. In the last few months of life people often rack up tens and even hundreds of thousands of dollars in medical expenses for little if any health benefit-because we have a moral hazard and will say "do everything" knowing it is not our expense, or feeling that we have already paid it to our insurance companies. We then die and pass along the cost to the next person who buys insurance (or to some poor taxpayer).
With universal health care this will only get worse unless the government tightly controls end of life care and other huge expenses such as dialysis, treatment for chronic diseases, bringing high risk pregnancies to term etc.-which would prove too unpopular for anyone in public office to actually do.
In the end taxpayers will bear the burden of the cost. Many tax payers will bear the burden twice, as cuts in doctor reimbursement will drive physicians to sub-specialize or go into boutique practices that won't (because it's not financially viable) take medicade/medicare. Many people who want quality treatment instead of an impersonal high throughput system with unreasonable waits for procedures and imaging will have to choose between the public system and paying out of pocket for the private system.
The obvious answer is not universal health care, but instead going to a market based system, perhaps giving tax credits or refunds for people to either find their own insurance or to pay for their care directly. People will then make more reasonable decisions regarding their health care and would also have economic incentive to take better care of themselves (helping combat the obesity epidemic and smoking). With this method, the current burden on employers would be reduced (a big reason there are so many uninsured), costs would be subject to market forces, and the cost and quality of private insurance would get better as insurance companies shifted their attention away from companies and big groups, and started focusing and competing for individuals.

So listen up America-pay for your health care once or twice.... Seeing that Social Security + Medicaid + Medicare = more than 40% of spending already, the answer seems obvious.

I favor your idea for high-deductible insurance. The thing that is most troubling to middle america, is not the prospect of having to pay $100 instead of a $20 co-pay, or even the threat of a bill fo $2000. No, it's the astronomical bills that come in for chronic or endurig illness. It's the bankruptcy-inducing bills.

We should eb very aggressive in seeking ways to provide that "safety net" in a way that encourages the free-enterprise system that will bring costs down.

Proposal:

1. Tax breaks and deregulation to allow the development of national insurance companies, with national risk pools, with direct contractual relationships with individuals--on a per-family basis of over 10K.

2. In exchange for the privileged position, these insruance companies (hopefully a minimum of 7 or of) will be subject to strict(er) antitrust regulations.

3. They will set standard per-person, and per-family rates. Need-blind.

4. Moreover, they will be forbidden from (1) dropping people or jacking up the premium on people once they get sick.

5. What about the uninsured showing up at emergency rooms? As a condition of being treated, they will be automatically enrolled at random among the several companies (and they will owe, say a year of back premiums)--and those companies will have extraordinary collection authority--security interest on any real property, or priority in bankruptcy, etc. But no--no debtor's prisons. :)

"People will not look forward to posterity who never look backward to their ancestors." -Edmund Burke

private payer, we won't have to re-invent the wheel, and it is working.

We know that whatever plan we put forward, the Dem's will say "that can't work because ________, Republicans just want health care for the rich". If we crib the Dutch system, we can say, "It is working, and in a European country, and for rich and poor alike"

Basically, when they attack it, we can say "Scoreboard."

Those who get "employer-funded" heath care think they're getting a freebie. The WSJ has an entry on their "Health Blog" on this topic today ("Employers Pick Workers' Pockets on Health Insurance"). The writer states:

Most people who get insurance at work believe that it’s the boss. But the notion that employers really pay for insurance for their employees simply isn’t true.

That misunderstanding is called the “myth of shared responsibility” by Ezekiel Emanuel, the ethics guy, and Victor Fuchs, the money guy, in a commentary in JAMA. They explain that the cost of health insurance comes not from employers’ profits but from employee wages. Employers adjust for rising health care costs by essentially docking pay, and “the increasing cost of health care has resulted in relatively flat real wages for 30 years,” they write.

Why does the myth matter? Emanuel says that people’s belief that they’re getting a free benefit is a big reason why they are resistant to a major overhaul of the health care system. But employer-based health care is economically inefficient, Emanuel tells the Health Blog. A substantial chunk of the money goes to pay for things that have nothing to do with health care, such as underwriting, sales and marketing.

So another thing we must convince the public (those who get insurance today via employers) is how much it's really costing them and how much a true choice-based system might benefit them. Unfortunately, that "convincing" must be done via 30-second soundbites and not via 30-page policy papers and spreadsheets.