Louisiana governor Bobby Jindal today proposed a replacement for Obamacare. It has a lot of parts, most of them familiar to conservatives who have been following health-care policy. He talks up medical-malpractice reform, for example, and would let people buy insurance policies across state lines.
Here I’m going to focus on two features of the plan. First, it includes something I haven’t seen other conservative elected officials embrace: a change to medical-licensing rules. From the plan:
Similarly, state licensing requirements can impose unnecessary burdens on medical practitioners, also limiting access to health care. Given that the supply of doctors is not expected to keep up with projected demand, policy-makers should allow other medical professionals to utilize more of their expertise to provide more affordable and convenient care for patients. In 2011, the Institute of Medicine recommended that all professionals should be empowered to practice to the full scope of their professional training. States should modify their licensing requirements to remove artificial barriers impeding the ability to provide high-quality care. States must also act prudently to protect patient quality and maintain high standards. Doing so would expand access to care, allowing Minute Clinics and other similar entities to treat patients quickly and at lower cost than hospital emergency rooms or other sources of care (footnotes omitted).
I think this is right, and Jindal deserves credit for it. I assume he knows what a heavy lift it would be politically.
Second, Jindal resurrects President Bush’s proposal for a standard deduction to create a level playing field between employer-provided and individually-purchased insurance. I think there are two problems with this approach. It is too disruptive to existing employer-provided insurance, and it does not help enough people get coverage. Replacing Obamacare with this plan would probably result in millions of people losing their coverage, and I think that would doom it. It would be better to go with a tax credit, not a deduction, and make it available on the individual market only when people have no access to employer coverage.
Update: I should note that the plan also includes a subsidy for people making up to 150 percent of the poverty line, which mitigates but I strongly suspect does not eliminate the coverage problem.