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The Conservative Alternative to Obamacare
Patients need to be the main decisionmakers.


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It’s not a secret that Obamacare is wreaking havoc on the health-care sector, and this is prompting many Americans to ask for an escape. However, we wouldn’t want to go back to the health system as it existed before the Affordable Care Act.

Recognizing this, the Heritage Foundation last week released a definitive compilation of health-care solutions that make patients the primary decisionmakers. Our commonsense solutions are based on five principles:

Let Americans have total choice and control with regard to their health insurance.

Allow free-market forces, with light regulation, to incentivize insurers and health-care providers to offer affordable and effective health coverage.

Encourage businesses to provide portable health-insurance benefits to their employees.

Help the most vulnerable Americans through the states, non-government organizations, and the free market.

Protect Americans’ right of conscience and unborn children.

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Guided by these principles, Heritage health experts outline solutions for dealing with preexisting conditions, helping Americans have continual coverage when they switch jobs, lowering health costs while increasing quality of care, and honoring people’s faith and right of conscience in health-care decisions. Our solutions include changing the tax treatment of health insurance so that all Americans, not just those getting coverage through work, can benefit from a tax credit to buy private insurance.

We also encourage states to use high-risk pools or reinsurance and risk-transfer mechanisms, so that insurance companies are able to insure patients with preexisting medical issues without risking insolvency. Other cross-state purchasing and pooling mechanisms could help states open up their insurance markets for more customers and increase competition, thereby driving down premiums.

These patient-centered reforms could be extended and enhanced in Medicare, which, under Obamacare, is facing an onslaught of provider cuts and serious threats to access to care. Heritage supports letting doctors and patients contract privately for services. We also encourage a fundamental financing reform that would allow seniors to direct Medicare funds to an approved plan of their choice, while enabling seniors to pocket the savings if they chose a less costly health plan. This would not only stimulate intense competition to control costs, but also spur innovation in the delivery of care and improve health-care quality.

And for poorer and vulnerable Americans, Heritage would transform Medicaid’s federal-state partnership into a new patient-centered system. States would have more freedom to experiment with programs that work better for helping sick and disabled populations. Low-income families that have been pushed into Medicaid by Obamacare would get assistance to buy private coverage, which offers better access to doctors and better health outcomes than Medicaid, as numerous studies have shown.

Finally, Heritage calls for Congress to permanently prohibit the taxpayer funding of abortion services, and for protecting the rights of workers, employers, insurers, health-care providers, and others to refrain from participating in or providing services that violate their consciences.

Taken together, these health-care alternatives would move America in a new direction — away from ever-increasing health-care costs, one-size-fits-all government mandates that force insurance cancellations, stifled economic growth, and suppressed job creation. Instead, the Heritage alternatives would enable Americans to once again have full control of their health-care dollars and decisions, promising a far more effective and dynamic health system.

— Nina Owcharenko is director of the Heritage Foundation’s Center for Health Policy Studies.



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