ten of the changes needed to make ObamaCare acceptable.

What’s the purpose of the health summit — bringing the president and Republican and Democratic Congressional leaders together? The Republicans hoped it meant we would start over. Toss out the highly defective legislation that has been working its way through the House and Senate and begin anew with a clean slate.
The White House is rejecting that idea. Apparently, all they want is to ascertain the minimum changes they have to accept in order to get a bill passed.
Okay. Here are ten of the changes needed to make ObamaCare acceptable.

1. Establish Equality Under the Law. That means everyone should be treated equally. Specifically: Treat every Medicare enrollee the same. There should be no special subsidy for Medicare Advantage members in Florida, while millions of seniors are losing their coverage in other states.
   Treat every Medicaid enrollee the same. There should be no federal bailout of Nebraska’s Medicaid expansion, while other states are forced to pay their own way.
   Treat every taxpayer the same. There should be no tax on some workers, while exempting others because they happen to be longshoremen or members of other unions.
   
   
2. Drop Individual and Employer Mandates. Remember Barack Obama’s admonition to Hillary Clinton: We should not require people to buy something they cannot afford and then fine them when they don’t buy it. Further, we should not have one set of rules for carpenters, plumbers and bricklayers, while a more generous set of rules applies to employees of every other small business. Accordingly, we should: Replace the mandates with a fair and efficient system of economic incentives. We should provide generous financial support through the federal tax system to make health insurance affordable for every American.
   Give all insurance the same subsidy — regardless of where it is purchased. We should treat all insurance the same — whether it is provided through an employer, purchased in the marketplace or acquired in a health insurance exchange.
   Give every individual the same subsidy — regardless of how insurance is obtained. We should treat all individuals at the same income level the same — regardless of where they obtain their insurance. (See details in my commentary, “Level the Playing Field for U.S. Health Insurance.”)
   
   
3. Encourage Comprehensive Coverage for Seniors. We should encourage rather than discourage Medicare Advantage plans, which give seniors access to the type of broad comprehensive coverage most nonseniors have. We should encourage, rather than tax, employers’ supplemental Medicare benefits.
4. Allow Health Insurance to be Sold Across State Lines. We should encourage a national market for health insurance, allowing the citizens of each state access to the types of products routinely sold in the other 49 states. (See details in the NCPA Brief Analysis, “How to Create a Competitive Insurance Market.”)
5. Encourage Personal and Portable Insurance. We should end the current practice of barring employers from purchasing the type of insurance employees most want and need: insurance they own and can take with them as they go from job to job and in and out of the labor market. (See details in the NCPA Brief Analysis, “Personal and Portable Health Insurance.”)
6. Allow Private Insurance Alternatives to Medicaid and S-CHIP. Instead of trapping more children and more families in public health plans that all too often ration care by waiting, we should make those dollars available to subsidize private coverage which gives patients access to the full range of medical providers and facilities. (See details in the NCPA Policy Report, “Opportunities for State Medicaid Reform.”)
7. Allow Special Health Savings Accounts for the Chronically Ill. One of the most successful Medicaid pilot programs is Cash and Counseling, under which the homebound and disabled manage their own budget and are free to hire and fire those who provide them with services. We should use this experience as a model to liberate the chronically ill and empower them in a newly-competitive medical marketplace. (See details in a previous Health Alert on chronic illness and Health Savings Accounts.)
8. Allow Health Insurance Plans to Specialize in Solving the Problems of the Chronically Ill. Instead of requiring health plans to treat all enrollees as though they were the same, we should encourage special needs plans that specialize in treating the health problems of the chronically ill. (See details in a previous Health Alert on chronic illness and Health Savings Accounts.)
9. Allow Employers and Their Employees to Prefund Post-Retirement Health Care. Although one-third of baby boomer workers have an employer promise of post-retirement health care, almost none of these promises have been funded. We should allow employers to help their retirees obtain personally-owned, portable insurance for their retirees and to build up funds in order to keep their promises. (See details in a previous Health Alert, “What to Do About Early Retirees.”)
10. Enact Sensible Malpractice Reform. Encourage a health care system in which victims of unexpected adverse events are promptly compensated by episode-specific insurance and in which providers and facilities have economic incentives to reduce medical errors — without the need of lawyers, judges, jurors and courthouses. (See details in the chapter, “Five Steps to Liability by Contract,” from the NCPA’s Handbook on State Health Care Reform.)