Newt Gingrich has proposed the most cutting-edge solution to our fiscal crisis.
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Gingrich proposes to control health costs by expanding HSAs throughout the health care system. Workers would be empowered with the freedom to choose them in place of employer provided coverage, the poor would be empowered to choose them for their Medicaid coverage, seniors would be empowered to choose them for Medicare.
Gingrich supports extending similar Patient Power to the poor in Medicaid with designated sums for the purchase of private insurance coverage in competitive markets, resulting in incentives for cost saving choices among competing health insurance alternatives. That would greatly benefit the poor because Medicaid today is structurally an institution serving to deny the poor essential health care just when they are the sickest and most in need of such care. That is because Medicaid does not pay the doctors and hospitals enough to assure such care. But with the above reform, the poor would enjoy the same health care as the middle class because they would have the same private insurance as the middle class, paying market rates for care.
Gingrich supports doing the same for Medicare, with retirees free to choose premium support through the program for the purchase of the private health insurance of their choice, similar to Ryan’s proposal. The same approach for the drug coverage of Medicare Part D has proved quite successful in controlling costs. A personal savings and investment account for the Medicare payroll tax during working years would provide additional funds that can be used in retirement for the purchase of private health insurance of the workers’ choice, which would result from Gingrich’s proposed ultimate expansion of personal accounts.
Gingrich further supports replacing Obamacare with a complete health care safety net assuring essential health care for all, achieved with no individual mandate and no employer mandate. That safety net focused on the truly needy would cost just a fraction of the cost of Obamacare, actually sharply reducing government in the process.
That starts with the provision already in federal law, stemming from the Kennedy-Kassebaum legislation of the 1990s also enacted when Gingrich was Speaker, providing for guaranteed renewability. That means if you already have health insurance, you cannot be terminated because you become sick. That is what health insurance insures against after all, so such termination would actually be fraud, as state law across the country recognized even before Kennedy-Kassebaum. Under this regulation, insurers also cannot discriminatorily raise rates for those who become sick while insured. This law ensures that if you have health insurance, you will be able to keep it as long as you continue to pay the premiums.
The next component involves block granting and reforming Medicaid as discussed above, assuring that no one would suffer without essential health care because they were too poor to buy insurance. The final component would be a high risk pool in each state for the uninsured who never get coverage and then become too sick with costly illnesses like cancer or heart disease to buy it. The uninsured in this case would be able to get coverage as a last resort from the high risk pool, paying what they can based on their income, with taxes subsidizing the pool to keep it afloat. Because only 1-2 percent ever become actually uninsurable like this, this is the most inexpensive option for assuring an essential safety net.
What Gingrich has now proposed is the most cutting edge, advanced, sweeping, entitlement reform, sufficient to solve America’s long term fiscal crisis, while better providing for those in need, which is what makes it politically viable and so exciting.
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