Gov. Scott Walker and the Heritage Foundation propose Obamacare replacement that is hardly patient centered

Excuse me, Governor Scott Walker, (R of Wisconsin) . I heard you    on Cindy  Crowley’s show on  CNN today.  You say you want  to repeal Obamacare and replace it  with something that is more” patient centered.” You did not go into detail, so I tried to fill in the blanks.

If I read your other  recent public statements correctly, what I suspect you mean is that anything Federal is less “patient centered”  than anything state funded and run.  A comprehensive reform mandated from Washington is ideologically repulsive to you and any solution short of that  is better any time  than some big federal program, even if it costs more.  

Surely, if you had a chance,  you would not  remove the  Affordable Care Act benefits  of patients who already have finally acquire  insurance to cover  pre-existing conditions or allow  young adults to say  on their parents’ insurance, or would you favor  reinstating lifetime caps on the amount of coverage, or removing the gender and  mental health parity standards, among others. Removing co-pay free  cancer screenings, or annual checkups would not make health care more  affordable to anyone or make  any of us  likely to care for their own health. How much more “patient centered”  do you want to get?

However, in reading between your lines, I saw no indication you would continue with those benefits and protections  if you had the ability to  repeal and replace Obamacare, except you would replace it with  proven unworkable approaches to help those with pre-existing conditions and let consumers choose the details of their coverage from the free market.

At least I give you credit for trying to come up with a way to cover the uninsured but it still relies on some government entity subsidizing premiums or care.   It is just what you are doing in Wisconsin that   seems contradictory, inadequate, and needlessly expensive.

That you believe in state run health insurance over some big government federal plan, is obvious.  However, you already  gave up some state control, anyway.    Even when your state was given the power and funding  by Obamacare to set up your state run exchanges  , you sent your citizens  to Uncle Sam’s   exchanges.  You refused federal money to expand Medicaid to the near poor, used your own state money to expand similar Medicaid programs a little, and are proposing  to spend more  state funds to send more of the near poor into the federal exchanges upon which you have frowned.

 You say you  are embracing the Heritage Foundation’s newest plan.  The Heritage Foundation was the one promoting the Massachusetts plan once upon a time as an alternative to a single payer system that would have cut out private insurers and smacked of Canada. On second thought, horrified their proposal became a model for Romneycare and Obamacare,  they now propose plan B:  just subsidizing the poor’s health insurance premiums and funding high risk pools for those with pre-existing conditions, excluding requiring any  consumer benefits and protections  or any cost savings measures imposed  on hospitals and physicians now  included in the ACA. 

Yours and the Heritage Foundation’s new alternative would let consumers pick and choose their benefits on a free market.  What free market?  The free market in health insurance does not exist; it is exempt from anti trust laws, free to collude with fellow providers, and incentivized by profit motives  to limit in small print  and prejudice  their  coverage in a way  that  results in the fewest losses. Been there,  done most of that, already, and the ACA was constructed  to deal with their excesses in the first place. The Heritage Foundation approach, if anything,  is insurance company centered, not patient centered.     

 States have had high  risk pools for some time too, but the costs of premiums were so high that they only reduced the insurance premiums to the levels of those who could afford non high risk catastrophic insurance premiums…never made affordable to those who  never could  afford even those premiums,   anyway. It was just too darn expensive to do otherwise and it never worked well anywhere. It was only marginally “patient oriented” since coverage was so limited with such high deductibles, contained no consumer protections or preventative care,  and was  unaffordable for  so many.   Let us see  a list of benefits and a  price tag attached to that one, Governor, before we   swallow that idea as a viable alternative.

Likewise, your  proposal of  subsidizing the near poor  to buy insurance on the federal exchange and expanding Badger Care a little has come under intense fire by Democrats for being  more expensive than accepting 100% of  federal dollars for Medicaid expansion, even if the state had to pick up 10% of the costs after 3 years. .

 Ideology has  trumped your fiscal conservatism and you simply have come up with a way to use tax payer money to keep on underwriting the ever soaring health care costs in the country and allowing substandard coverage to continue unabated for everyone else. Yours is an expensive band  aid still partially dependent on federal exchanges  that covers only a small part of the patient centered wound .