While it appears almost everyone is in agreement that Obamacare’s roll out has been negative, at best, the Republican alternative has been anything from disjointed to just attempts to de-fund it.
This is a shame because for nearly a half century, we had a leader who fought for national healthcare. As a child, this man lost two brothers to tuberculosis and watched his family nearly financially destroyed. As President, he produced a plan that covered mental health, preexisting conditions, kept young adults covered, and provided for economic incentives for preventive care, all without busting the Federal budget. That Republican was Richard Nixon.
The health care plan which he introduced in February, 1974, stands as a blueprint to fix the issues with Obamacare. First, let's face facts: Obamacare is the law: the Republicans don't have the votes to defund it or repeal it. If we did, it would never have passed. So the problem we must face is finding a way to fix it. We must move away from the party of “just say no.” The answer may begin in this old Republican alternative.
Nixoncare and Obamacare have something in common: They share a requirement for employers to provide health insurance, but Nixon’s plan does not undo the current system, it plays to its strengths. In fact, Ben Stein, a former Nixon advisor and healthcare speechwriter, wrote that Nixon’s approach was relatively simple. Figure out who cannot afford health care and help them. It leaves those who are happy with the plans they have alone, which was the central promise Obama made. Remember “if you like your current plan, you can keep it. “
Nixon’s plan had four basic priorities:
• Assure equal access
• Balance supply and demand
• Organize a more efficient system
• Build on the strength of the current system
The plan was based on the formation of HMOs (Health Maintenance Organizations). Its framework did not introduce a huge bureaucracy and new government controls. It was, in fact, a plan endorsed by both the Washington Business Group and the National Chamber of Commerce.
President Nixon saw the pluralistic medical insurance system as a strong component to how our system functions. He encouraged more competition amongst insurance providers and physicians to create both more efficiency and to keep patients engaged in the cost-savings process. The plan, according to the Nixon Foundation's Chris Barber, went after the real problems he saw in the system:
1. Delivery of service -- Nixon required plans to purchase memberships in HMOs, put $23 billion into grants and loan guarantees to sponsor HMOs and allowed Medical Group Practices, which allowed doctors to use medical assistants for certain tasks.
2. Scarcity areas -- Nixon put money into off-setting risks for HMOs to go into scarcity areas, funds for Health Education and funds for doctors and nurses to practice in those areas.
3. Personnel needs -- He doubled money for low-income students to study medicine and promoted the use of allied health personnel
4. Addressed lawsuits and malpractice insurance - He proposed serious tort reform and formed a commission to address the issue and keep the costs down
President Nixon also looked to incentivize the prevention of illness, focusing on bio medical research, health education and the prevention of needless accidents.
The Nixon plan was not perfect and it was written in 1973, but it had bi-partisan support and was only derailed due to the fascination with Watergate. Sen. Ted Kennedy lamented, later in life, that his failure to support President Nixon on this plan was his biggest regret. While many have tried to cast it as the father of both Romneycare and Obamacare, it never attempted to consolidate power in the government’s hands.
I would suggest that as Republicans in Congress look to address huge issues related to the current Obama care plan at their retreat this week that it has a foundation to start within the leadership provided by the life’s work of our 37th president.