Compared to his energy initiatives with visions of a nation
going hydrogen in twenty years, the President’s health care
proposals seemed tame. Indeed, the President offered no new
initiatives on health care. Instead he proposed to continue
supporting the buildup of the health care equivalent of the Web —
a broadband-based system of sharing all sorts of information on
health care — and making incremental changes in existing programs
and tax regulations that will allow people to invest (tax free) in
their own health and increase the range of health plans they can
choose from. There was no defense of his health care proposals as
there was for other aspects of his agenda.
That was a shame. The President could have framed the health
care debate in powerful terms and reached out to those core voters
who would benefit most from being able to choose their own health
plans. There are 35 million Americans who either run small
businesses or are self-employed Americans and who pay the highest
price for health insurance. Democrats offer these people Medicaid.
The President offers them freedom and more.
Health savings accounts are a middle class tax cut and means for
providing continuous health care coverage for millions of Americans
who want to change jobs, start a new life, work from home, care for
a loved one, etc. The President is proposing to deduct expenditures
on insurance and out-of-pocket expenses as long as they purchase at
least insurance against medical catastrophes. This would give
individuals the same tax breaks that big corporations now have when
buying health care, which by the way is the Democrat approach to
making health care affordable. Many other small improvements can be
made to HSAs. One in particular the President should have mentioned
and recommended is allowing families to meet the individual
deductible requirement for HSAs ($1,000) instead of the family
contribution of $2,000.
Second, the President could have framed the choice debate in
starker terms: the private sector is quicker to adopt and use the
best technologies to extend life and reduce costs. Those who oppose
tax-free accounts are opposing not only freedom but better health.
He could have talked about the woman, on Medicaid because her
multiple sclerosis forced her to stop working, who was denied
access to a drug prescribed by her doctor that ironically would
have allowed her to return to work. The reason? Medicaid focused
only on the price of the drug, not the value of its benefit to the
woman. He could have compared that to the private health plans that
are using a combination of medical information technology and new
drugs to reduce total health spending. He could have talked about
the increased investment individuals with HSAs are making in
wellness and preventive care. Just as the American economy grows
when people are allowed to keep their own money through tax cuts,
so too will the health of the nation improve when people are free
to seek out the care that is right for them.
That’s about a paragraph and two minutes more on health care
than the President spent last night. But going on the offensive on
health care — while not the defining issue in 2006 — could have
helped solidify support for Republicans in key areas and given the
President a head start on an issue he cares deeply about. It’s
still not to late but there is little time to waste.
