When I first took a glance at businessman Andrew Yang, I immediately dismissed him as a hyper-leftist. He supported Medicare-for-All, the most radical healthcare plan being proposed by some of the Democratic candidates. But like others in the field, Yang has walked back his support for Medicare-for-All. His newly released healthcare plan is by far the most moderate being proposed by anyone polling over nil. Its more moderate than Pete Buttigiegs Medicare For All Who Wants It. Its more moderate than Joe Bidens Obamacare 2.0. In fact, its the only plan that, if proposed by Democrats and Republicans together, would likely pass with massive bipartisan support if one component was stripped from it.
Dont get me wrong. Im not a Yang supporter. I have issues with other policies hes proposing and would actually enjoy a conversation with him over a couple that make very little sense to me. But I can say this about the candidates proposals: Hes the only one in the field who could appeal to right-leaning Independents and moderate Republicans in the general election. Polls say that person is either Biden or Buttigieg, but heres the catch: When people start taking a closer look at the policy proposals theyve backed themselves into in an attempt to appease the far-left in their party, those policies wont hold up to scrutiny. They are to the left of President Obama and candidate Hillary Clinton. Theyre much further to the left than anything this country has ever seen in the White House.
Biden and Buttigieg only seem moderate because the scale has been so skewed by the Democratic Socialist wing that extreme views seem tame compared to the radicals. Yang, on the other hand, has as his branded position the Freedom Dividend, a concept that has been examined by many conservative economists. Milton Friedman proposed a variation of universal basic income in the form of negative tax rates. Others have said it could work if cuts were made to other avenues of spending. A current Republican lawmaker recently told me off the record that if it could be used to reduce the need for welfare, it could actually work well.
What Yang unveiled today as A New Way Forward for healthcare in America is a six-point plan that makes sense. Id strongly recommend Representative Kevin McCarthy and Senator Mitch McConnell give it a serious look.
Here are the bullet points to his six ideas with my commentary below.
The last two ideas are great. Theres a great risk with the others, at least in a vacuum, because healthcare innovation is driven by profits. This is good and bad, but Yangs proposal doesnt address either. Its good thatpharmaceutical research isprofit-driven because it allows for the generation of more funds that private companies can reinvest into more breakthroughs. The bad part is it puts an emphasis on treatments over cures. Treatments are profitable as theyre ongoing. Cures are inherently not profitable.
To truly address the prescription drug issue, incentives need to be established that take advantage of American ingenuity and resources while keeping DCs hands out of it. There have been a handful of proposals Ive read over the years that would drive innovation while also guiding it towards cures and prevention rather than super-profitable ongoing treatments.
These are no-brainers. The only nitpicking I could do would be to take out the broadband access component. It tastes too much like recently proposed Internet for All schemes that suggest spending huge infrastructure dollars to provide digital access to people who simply dont want it. Nobody moves to the boonies in Montana with the expectation of streaming Netflix. They did so for a reason. Those who have intense medical needs wont be hours from the nearest town. Its a pointless addition to the plan. Otherwise, spot-on.
Conservatives may be scared of the idea of federal regulations and licensing. But the plan does not call for the elimination of state medical requirements and licencing. As long as he allows states to regulate their doctors as they see fit but allows for separate telehealth-only licensing and regulations, it passes the federalism smell-test.
Theres a whole lot to unpack here. Capitation and salary plans can work on a small scale but have never been tested on larger scales. There are many risks, especially if it will be the federal government implementing these changes. Were talking about an ideal system in the long-term that could suffer cataclysm on the road to getting there. Its conspicuous that he uses the words work with and explore in the first two bullet points instead of mandate and implement. Such a move could be great if steady hands over a period of time longer than a president can be in the Oval Office were handling it. Thats a lot to ask of DC, but the spirit of the plan is acceptable.
Frivolous malpractice suits yep. No objections to protecting doctors in this regard.
Fix EHR yep. The system is flawed without any good reason other than nobody has addressed it.
There are several slippery slopes in the last three bullet points. Hes describing getting further involved in the way states handle healthcare for their residents. Its a populist concept that would need to be handled carefully. His last two bullet points would shift the job market tremendously. It would raise the costs of hiring specialists because of higher demand and could cause an imbalance of too many primary care physicians.Such programs would have to belimited and adjusted on the fly as needed.
The first bullet point isnt policy, nor should it be. Doctors will do as doctors will do and Ive never met one who didnt tell me to eat better and exercise.
Id want to learn more about the incentives he proposes in the second bullet point. It seems like a nothingburger (or nothingpomegranate, if you prefer) that could eventually lead back to Michelle Obamas school meal decadence plan.
More funding for food banks is good. Better management of charities to feed the needy would be better.
As for the end-of-life proposals, yes, were at a stage in society when all of these ideas make sense. We are better at keeping people alive than we are at maintaining an acceptable quality-of-life. As long as he doesnt get into assisted suicide, these are all positive changes.
The first seven bullet points on mental health and disabilities are good.
Breaking the TRUVADA patent is dangerous only because it sets a precedent. Yes, its important, but the last thing we need is for pharmaceutical companies to pull back the reins on treatments or prevention options because they believe theyre going to lose profits when the government decrees their patents are void.
Then, theres the abortion component. Remember when I said above that one component would have to be stripped? This is it. Yang needed to include it if he has any chance of winning the nomination, but its a non-starter for millions of Americans, including me.
Covering maternity costs is another populist view that would require a full cost analysis to see if its even possible.
Including vision and dental should not be mandated. Theres already a vibrant and affordable market for coverage. This isnt solving a problem. It just mandates convenience at unnecessary expense. It wont save anyone money and could end up costing more as theprices associated are hidden.
Selling a public option as reducing burden on employers is smart. I dont agree with it as the burden would be transferred to taxpayers, but since Republicans seem to no longer be in the business of repealing Obamacare, this really wouldnt be much of a change from the status quo.
So, the $100 Democracy Dollars incentive is odd, but only because I probably dont understand how it works. Call me obtuse. Everything else in his portion of his plan makes sense and should be extended outside of healthcare.
Lawmakers on both sides of the aisle should take a look at Andrew Yangs plan. Its the only healthcare proposal from a Democrat that isnt ludicrous. Considering what Capitol Hill has done with healthcare (nothing), this is worth a peek.
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Healthcare2 days ago Andrew Yang's healthcare plan could pass today with bipartisan support - NOQ Report
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