Tuesday, July 18, 2017

Opuscula

Simple plan
To replace
“Obamacare”

FIXING “OBAMACARE” (the Affordable Care Act Congress passed without reading) should be bi-partisan and include the people who USE the program, but not insurance companies, medical professionals, hospitals and clinics, and “ethical” pharmaceuticals. (I’ll explain shortly.)

First of all, scrap everything that has transpired since President Trump took office,

While Obamacare was passed for a Democratic president when the Democrats controlled Congress, look at the push back by the people forced to use the program.

ASK THE USERS

It probably seems a novel idea to many in Congress, but ASK THE USERS what they like and what they don’t like about Obamacare. Use the franking privilege, use the internet, and send the office staffs to hold town meetings.

Send out a letter to every adult in the Congressional district with a two-column questionnaire:

What's good about ACAWhat's bad about ACA

Explain that “ACA” is “Obamacare” but do nothing to influence the thinking of the person filling out the questionnaire. “We want your opinion. Please take time to answer the questions and mail the questionnaire back, postage paid, when complete. Thank you.

    Having been in the “quiz” business I know that how a question is worded can pre-determine what the answer almost always will be. Are you still beating your spouse?

Take the same two-column questionnaire to the town hall meetings. Have an amanuensis record what the people at the meeting say, preferably in large letters on a white board or chalk board. (The ideal is to use a “smart” board that can capture the input to a computer or copy machine.)

    Just to give the constituents a “warm and fuzzy” feeling that their voices were heard, ask the local media to disseminate the results of the meeting. A notation that “n” comments were for ABA and “n” comments were against will not suffice; the recorded comments must be listed. Beside the “warm, fuzzy,” it will help keep the congressperson honest when a vote comes to the floor.

State by State

After a reasonable opinion-gathering period — say two months — have each state’s senators and representatives meet to compare notes and create a new, albeit similar table.

What's good about ACA%What's bad about ACA%

Look at the negative comments — for example requiring everyone to pay for pregnancy coverage; is it fair to the add additional cost to an octogenarian man’s coverage? It might be — the octogenarian also pays school taxes and he’s long past his school days.

Now the senators and representatives will know what their constituents consider the good and the bad about the ACA.

How does it compare to the “Romney plan?”

According to Wikipedia: The Commonwealth of Massachusetts passed a health care reform law in 2006 with the aim of providing health insurance to nearly all of its residents. The law mandated that nearly every resident of Massachusetts obtain a minimum level of insurance coverage, provided free health care insurance for residents earning less than 150% of the federal poverty level (FPL) and mandated employers with more than 10 "full-time" employees to provide healthcare insurance.

The senators and representatives from the other 49 states should send delegates to a meeting of Massachusetts senators and representatives to find out what they discovered from their constituents about the Massachusetts plan — a/k/a the Romneycare Plan — before the Massachusetts’ plan was massaged to conform to Obamacare.

Now, compare notes

Now that the politicians have input from the majority of their constituents, let them put all the acquired comments into a single and simple document — perhaps using a format such as the second table in this effort — so all politicians from all states can review the input. An outsider -- perhaps the Government Printing Office (GPO) could assemble the data since it has no direct interest in the plan's contents.

With the voters’ input in front of them, they should be able to reach an agreement on what the voters want. I suspect it will not be “clear cut,” and compromises will be necessary, but in the end, all parties and independents should be satisfied that they have met most constituent expectations.

This no longer is a “conservative” vs. “liberal” politician combat. It is the result of taking the matter to the citizens.

Disseminate the results of the joint senate and house exercise.

Bring in the lobbyists

Until this point, no one has asked the lobbyists from the healthcare, insurance, and “ethical” pharmaceuticals. (“Ethical” pharmaceuticals are prescription drugs vs. OTC (over-the-counter) medications. The word “ethical” may or may not apply to all such pharmaceutical companies; its use is solely to differentiate one from the other.)

Over the years I have found lobbyists — vendor representatives — to be a wealth of information, especially when they are competitors. That may not be the case with Washington (and state capital) lobbyists, but their insight should be sought. There is no rule that states their advice must be followed.

Build a plan

Even with all the inter-party meeting, disagreement is inevitable, but — hopefully, and assuming all parties are open-minded — compromises in line with constituents’ expectations can be reached. Extremists from all sides need to be banished from these compromise sessions; there is too much far left and far right in Congress now and the pendulum needs to swing in a small arc near the center.

Once a plan has been formulated, make it available to “the world.” Put it online so that the general public can read the entire plan, not just what a biased (liberal or conservative) media wants the public to know. Politicians in Congress should be prepared to send simplified — albeit honest — “Reader’s Digest” versions of the bi-partisan bill to their constituents … with reference to the complete bill’s location and availability.

One of the primary complaints with the Obama bill was the way it was presented to Congress: “Here is a 2,000-plus page bill; read it overnight and vote tomorrow” (or words to that effect). President Trump, to his credit, is demanding transparency. Unfortunately, it is abundantly transparent that there is zero bi-partisan cooperation on developing a replacement program.

If there are parts of the plan constituents might find objectionable — again, let’s use pregnancy coverage for an octogenarian male — the plan should offer a reasonable explanation that the octogenarian can understand, if not appreciate.

    When American was “young,” we used to take care of one another. Communities pulled together to raise barns, to care for the sick, and to provide loans for newcomers to get on their (financial) feet. We seem to have lost the feeling of “community” somewhere along the way that may account for the octogenarian male objecting to paying for pregnancy coverage. Then again, perhaps not.

Bottom line

If the liberal and conservative extremists will honor the will of the majority — once again, the “silent” majority” — rather than encouraging their followers to riot and commit mayhem against their own neighbors, then America can have affordable health care for all individuals.

Even the former president acknowledges that his plan can be improved upon. (Why he failed to improve upon the plan while he was in office is beyond my ken.)

President Trump promised to replace the ACA with a better plan; the ACA cannot be cancelled sans a replacement plan; that was the president’s promise.

Getting a replacement plan is the problem, and the problem is caused by political division and a total disregard of the citizens who will be blessed — or cursed — with the plan.

If Congress — and the president — really want Americans to support the plan, Congress (and its employees) and the president must be insured by the plan. Anything less and Americans will know the new plan is a farce as was the old plan.

Replacing ACA should have been simple

If the GOP had gone about the task differently, and had the Democrats been willing to work with the GOP, and had all Congresspeople had their constituents in mind, a replacement plan could already be on its way to implementation.

Congress must start with their citizen constituents. It failed us by ignoring us.

It’s time to start over.



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