Memo to GOP: Don't replace Obamacare with another octopus

You have to feel sorry for Republicans in Congress as they ride into the Big Muddy.

After whaling on Obamacare for seven-plus years, they’re now duty-bound to build a better octopus.

“They’re basically going to fix the flaws (of the Affordable Care Act) and put a more conservative box around it,” former House Speaker John Boehner predicted recently.

Judging from the House’s opening bid, rolled out Monday, Boehner has it about right.

Following the partisan playbook, Democrats, who blew their chance to go long on health care in 2009 when they controlled Congress, are railing at the re-boxing of Obama’s legacy legislation.

Cue up progressive talking points pitying the “victims” of GOP heartlessness in the form of tax credits and block Medicaid grants.

There is, however, one grand new solution the GOP could champion that would leave the Democrats speechless — and helplessly compliant.

What if Republicans went against the grain and replaced Obamacare with Medicare for All?

Could never happen, right?

Under normal circumstances, Medicare for All would be as unthinkable to Republicans as raising taxes on corporations or declaring Planned Parenthood Day.

But if President Trump wants that bust on Mount Rushmore, he might want to listen to a former mayor of Encinitas.

Jerome Stocks, it should be noted, is a dyed-in-the-wool Republican who, in the partisan world of Encinitas, was often criticized for being too pro-business, insufficiently green.

Now far from the madding world of politics, Stocks has for 36 years counseled clients on insurance in general and medical insurance in particular.

To Stocks, a professional who actually had to school himself in the Byzantine complexity of the ACA, the best Republican play is breathtakingly simple.

Here’s how he breaks it down.

“Every type of insurance,” Stocks tells me, “allows the consumer to choose complete coverage or minimal coverage. Except health coverage that has levels dictated by federal law and an IRS penalty for not obtaining it.”

OK, so far he’s espousing GOP boilerplate rejecting government control over what kind of health coverage one must buy, if any.

But here’s the kicker.

“The obvious fix to this ridiculous Obamacare octopus,” Stocks says, “is simply Medicare for all. Eliminate the age and disability qualifications and give all Americans Medicare Part A, which is hospitalization. Make Part B, outpatient coverage, available for a price, which would be income adjusted, as it is now. Prescription coverage? That’s Part D, which is purchased through the insurance companies. Prefer HMO? That’s Medicare Part C, also known as Medicare Advantage and like Part D is also acquired through an insurance company such as Kaiser, Blue Shield or Pacificare, to name a few.

“This makes sense because it allows the American consumers to decide what level of coverage they want rather than Congress dictating coverage as it now does. If I get one more call from a 60-year-old woman asking why there’s a $10 charge for juvenile insurance on her bill, I may go crazy.”

Stocks advocates a tried-and-true hybrid founded on automatic hospitalization for everyone. (Think of it as government-issued liability auto insurance.)

“This solution to a vexing, failing Obamacare problem,” Stocks goes on, “is much more American than our current morass. Choose your desired level of coverage. No need for IRS involvement, and the insurance companies can focus on selling Medi-Gap and Medicare Advantage plans to all Americans not covered by their employers.”

Medicare, it should be noted, is not free beyond Part A. Payroll taxes, premiums and copays cover a significant part of the program.

What Medicare for All would mean, in stripped-down terms, is that the United States would guarantee basic urgent care to everyone, but not the same comprehensive coverage offered in, say, Canada.

In other words, Medicare for All ain’t utopia. In the U.S., enhanced care would remain a privilege for which one must pay in taxes and out of pocket.

If you don’t want to fly third-class, and you have income and/or savings, you have to open up the checkbook to get first-class treatment.

To be sure, given ideologues in both parties, actually passing Medicare for All would require a right-left coalition. (What a concept.)

But here’s the killer selling point: Explaining Medicare for All is easy. You could spell it out on a post card.

Everyone knows someone, or is someone, who loves Medicare as a business proposition. It’s a good, simple, fair and humane deal.

How rich would it be if Republicans replaced the so-called “conservative” plan Democrats fashioned in ‘09 with a progressive rallying cry, Medicare for All.

What a superb Machiavellian twist if the Republicans were to rebrand Medicare for All as rock-ribbed Trumpcare that preserves freedom of choice.

At this early stage of the game, Republican leaders appear committed to their knock-off octopus, which Stocks charitably calls “convoluted.”

Meanwhile, there’s a lot of crazy going on in the White House, some of it scary.

When it comes to health care, however, America could use a little wild and crazy.

Trump, you’ll recall, has made sweeping populist promises about covering everyone with “beautiful” plans.

If Stocks is right, Medicare for All can make America, which has struggled on the health insurance front, pretty darn good, maybe even great.

It could happen but only if Trump, the most impulsive president of anyone’s lifetime, sees the light through the partisan pettifogging over health care that promises to envelop Washington this year.

Hope for that illumination is one healthy reason, maybe the only one, to stay tuned to Trump’s Twitter account.

logan.jenkins@sduniontribune.com

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