Here’s my radical plan: If the Obamacare exchanges are going to result in, at best, people being able to buy Medicaid-style plans with limited choices and benefits, then why not just eliminate the middleman and give them … Medicaid?
Here’s a suggestion: nationalise (or more accurately federalise) Medicaid. Currently a joint venture of the states and the Feds, making it an entirely Federal program would have many possibilities:
- It would relieve the states of their largest running budget headache. That would insure the support of all fifty governors, Republican and Democrat alike.
- It would enable the Feds to set a uniform standard for eligibility, etc. That problem has bedevilled the current process, and led to the more egregious payoffs (LA, NE, etc.) we saw in the Senate process.
- It’s already a government program, so this (in principle) doesn’t “expand the role of government.” That would put the small-government Republicans in a box.
- It addresses the medical insurance issues of the portion of the population least able to afford it. Isn’t that what social welfare is all about?
- It would end the “health insurance shopping” that helped turn TennCare into the disaster it became before the state pared down the eligibility requirements.
Obamacare is the result of a political system–really, a life system in the U.S.–that puts “leadership” and “doing good” ahead of common sense and doing things that actually work.