Rand Paul Is Right: Replace Obamacare with Group Insurance for All

The GOP is back at it. Their DOA replacement for the Affordable Care Act is being spiffed up with even more egregious attacks on low-income and chronically ill Americans. But there is hope from one of their own: Sen. Rand Paul of Kentucky.

Sen. Paul would disagree, but he has become the loudest and most credible voice endorsing universal health care – albeit under a different name. On his website and in multiple interviews, Sen. Paul advocates the establishment of nontraditional groups called Independent Health Pools (IHPs) “in order to allow individuals to pool together for the purposes of purchasing insurance…These can include…entities formed strictly for establishing an IHP.” In essence, Sen. Paul believes any American who wants to buy group medical insurance should be able to do so.

If enacted, IHPs could eliminate the most absurd peculiarity of the American healthcare system: employer-supplied medical insurance. Employer involvement with healthcare began during World War II as a way for corporations to skirt federal wage controls. Health insurance was a valuable perk that attracted job candidates while allowing employers to comply with the letter of the law. Plus, because companies could deduct the cost of the benefit as a business expense, the bottom line effect was negligible.

Employer-provided medical insurance is still widely popular. It covers the large-majority of non-elderly middle- and upper-class Americans and is rarely criticized from either side of the aisle. That’s the good news. The bad news is employer involvement with medical insurance represents ground zero in the battle to fix our dysfunctional American healthcare system. It’s the primary reason displaced workers can’t afford private insurance and why individuals with pre-existing conditions can’t find insurance companies willing to offer coverage.

My personal experience provides a textbook example. I left the corporate world in 2007 to start a business. I was covered under COBRA for about a year after leaving my former company. During that time I was billed for the same amount the company paid when I was an employee: about $17,000 per year for our family of four. When COBRA ended, we had to buy private insurance with an annual premium of $25,000 for less coverage, higher co-pays, and astronomical deductibles. We were the exact same family of four, but our out-of-pocket expenses more than doubled because I was no longer a member of a “group” and no longer qualified for group insurance rates.

Group medical insurance is a highly competitive business. Industry giants like Aetna, Cigna, and Humana bid aggressively for corporate accounts. The larger the company, the more competitive the bidding and the lower the premium. The IBMs and Walmarts of the world pay lower premiums for better coverage than their smaller competitors or mom-and-pop suppliers. That’s fine for big-company employees until they leave for a start-up or niche company. Assuming the new employer contributes the same amount as the former (typically 72% of the total premium) the employee will likely see an increase in paycheck deductions and a reduction in coverage benefits. That’s insane by any definition of the word.

That’s why I love Sen. Paul’s IHP proposal. If fully implemented, every American would come together in a true melting pot of quality healthcare services and delivery. Every working American covered by an employer-sponsored plan would receive a pay raise equal in value to their firm’s contribution towards medical insurance. The company would still be able to deduct the extra wages so there’d be no effect on corporate profits, and the employee would have the means to pay the premium negotiated by his IHP.

The more cynical observer might point out that this approach does not address the cost of health insurance which remains beyond the means of minimum-wage workers, the unemployed, and the disabled. As a nation of historically compassionate leaders, the federal government could increase the withholding tax for Medicare by a percentage or two in order to help provide or subsidize coverage for the less fortunate.

The key thing to remember is that this proposed system is nothing like the socialist abomination known as single-payer or universal health care. The Independent Health Pools epitomize the individualistic character of our nation. For the sake of efficiency, I’d personally recommend combining all the IHPs into a single entity. We could call this IHP “The United Citizens of America.” Membership would be automatic for every U.S. citizen, begin at birth, and end at death. It’s an idea whose time has come, and I’m sure Sen. Paul would agree.

The GOP’s Bastardization of FDR

Scream editEvery school child can recite this exhortation from Franklin Delano Roosevelt’s first inaugural address: “The only thing we have to fear is fear itself.” Fewer Americans, however, remember how FDR revisited this theme in his 1941 State of the Union address to Congress:

In the future days, which we seek to make secure, we look forward to a world founded upon four essential human freedoms. The first is freedom of speech and expression…The second is freedom of every person to worship God in his own way…The third is freedom from want…The fourth is freedom from fear.

Roosevelt understood that fear is an insidious form of oppression. It holds us back and severely limits what we can aspire to or accomplish. Indeed, Roosevelt further defined fear as a “nameless, unreasoning, unjustified terror which paralyzes.” Our Founding Fathers incorporated a similar sentiment in the Declaration of Independence when they identified “the pursuit of happiness” as an unalienable right. No one can truly be happy if he or she is afraid. Fear is debilitating, and it’s all for naught. Fear saps our strength and wastes both time and energy. It’s like the concept of “wasted calories” in reverse. We expend a great amount of energy without reaping any benefit.

Fear is an affect. It’s a powerful emotion that bubbles up from deep inside. When you combine that understanding with the fact that the word courage derives from the Latin word for heart, it’s an easy extrapolation to the concept that most of the fears that hold us back are internal rather than external. Fear is based on feelings not logic. It is a hard-wired response to every threat – real or imagined. But even if the threat is only imagined, it doesn’t make the fear any less real or painful. Unless addressed, fear can be a constant tormentor. Our deepest fears do not come and go. They are always present in the back of the mind – at least until a catalyst propels them front and center.

In a very real sense, fear is a choice. Abraham Maslow, the American psychologist who is best known for his “hierarchy of needs,” believed that every single day, in most every thing we do, we have the choice to move forward and grow or step backward into our safety net. In his classic Toward a Psychology of Being, Maslow explains:

Every human has both sets of forces within him. One set clings to safety and defensiveness out of fear, tending to regress backward, hanging on to the past…afraid to take chances, afraid to jeopardize what he already has, afraid of independence, freedom and separateness. The other set of forces impels him forward toward wholeness of Self and uniqueness of Self, toward full functioning of all his capacities, toward confidence in the face of the external world.

When you combine FDR’s words with Maslow’s you get a vivid picture of what’s happening to the national psyche, and the calculating strategy the GOP has embraced to strike terror into the hearts of every American. Whereas FDR endorsed a freedom from fear, the GOP presidential candidates have taken a diametrically opposite approach. They want to win an election by instilling fear. They want to regress and hang onto the past, using Maslow’s words. They utilize fear to bully and shackle voters rather than grant them the freedom to think for themselves. By casting our military as weak and woefully underfunded, our borders as sieve-like expressways for marauding jihadists and rapists, and our economy a huge disaster, the GOP candidates promote a horrific worldview that can only be righted by arming every single American man and woman, carpet-bombing cities and nations, burning more coal and oil, restricting immigration to northern Europeans, and closing every Planned Parenthood facility. And who better to accomplish all this than a Republican president?

I’m certain that FDR is rolling over in his grave along with the Republican patron saint Ronald Reagan.