A Simple Healthcare Proposal

July 24, 2012 04:15

If you want to drive down price, and coincidentally increase availability and ease of access, increase supply. If you want to increase supply, reward the production of it. One reward that always works – and which is the complete opposite of what happens in Obamacare – decrease or eliminate taxes on companies and individuals that produce health care.


By Bob Fierro at Center for a Just Society


“When you tax something you get less of it, and when you reward something you get more of it.”  -Jack Kemp

Pretty much everyone agreed with the ostensible reasons that Barrack Obama undertook health care reform – prices rising too fast, too many uninsured, and too many people excluded from access to the most sophisticated health care system in the world. The fact that it is now amply clear that Obamacare won’t correct these problems need not keep conservatives from agreeing that real solutions to them are goals worth pursuing. The question is how best to achieve them?

This is a relevant question not only for the nation but also for Obama’s chief competitor for President, Mitt Romney. Fairly or not, reasonably or not, like the terrier with his teeth on the postman’s leg Obama’s campaign is trying desperately to clamp Obamacare to Romney’s health reform activities when he was Governor of Massachusetts.

Can the Governor shake the terrier, demonstrate that he is prepared to take on the major issues facing America, and help improve the lives of average Americans ?

Yes, but to do this he must focus on the future. Forget about what happened or didn’t happen in Massachusetts. He must do what the President didn’t when Obama allowed Harry Reid and Nancy Pelosi to frame a bill so damaged, it took the shabbiest of parliamentary maneuvers to ram it through Congress using the “Louisiana Purchase,” “Cornhusker Kickback,” and votes from numerous career politicians who had just been defeated at the polls.

In other words, lead.

Propose a bold, new, national approach to solving the real problems in health care – access, affordability, and availability. But what approach should he propose?

Enter Jack Kemp and Economics 101. If you want to drive down price, and coincidentally increase availability and ease of access, increase supply. If you want to increase supply, reward the production of it. One reward that always works – and which is the complete opposite of what happens in Obamacare – decrease or eliminate taxes on companies and individuals that produce health care.

Here is a specific strategy to consider.

Recognizing that there will be a greater need for family physicians and medical professionals of all stripes in the future, promote investment in new schools and educational institutions that can produce the needed professionals. Promote this investment by creating enterprise zones around any newly created medical schools, nursing colleges, schools of chiropractic, etc., and drastically reduce or even eliminate corporate or personal income taxes within the zones.

Imagine how much investment attention would be attracted to an area where all the profits on the return on investment were tax free. How many drug companies or medical device manufacturers would build facilities in a region where all the profits generated stayed in the company? Visualize how much construction would occur if the architects, contractors, and building owners knew whatever they earned working on a project was theirs to keep. How many jobs would be generated by a single economic empowerment zone of that type?

How many jobs would be created if there was at least one zone like that in every state?

Properly sited and situated the educational institutions that form the centers for such zones would become the raison d’etre of entirely new prosperity engines that could rejuvenate moribund communities, increase the productive employment of capital, and swell the ranks of health care professionals that will be invaluable to the Boomer nation as it ages.

Naturally, sensible geographic, operational, and regulatory boundaries should accompany the implementation of such zones. They must be voluntary, not mandatory. They should be under the control of the states, not the federal government. Strong, consumer-enabled disclosure and feedback should be available for all facilities, practitioners, and services in the zones. They must add to the nation’s health care armory, not just replace or supplant existing resources. They should receive no federal revenues other than ordinary payments for Medicaid or Medicare service delivery. They should be open to all entrepreneurial comers, large or small.

These kinds of issues are important, but they are details that should not be allowed to strangle the life out of the big idea. The big idea is that the nation’s health care needs can be satisfied through the application of the great free enterprise principle of reward for productivity, not the confiscatory extraction of gains that come from it.

In the end these kinds of implementation matters will always be worked out among the players as the necessary legislation moves along. What is important is to redirect how Americans view big problems and solutions. Obama and Obamacare see government as the only entity capable of addressing issues. This approach sees innovation, creativity, and entrepreneurial action as a better source for national, structural action.

It is likely that if, or when, this enterprise-zone approach is ever undertaken it will be subject to many attacks, but we can dispense with two of them here and now.

First, we know this proposal meets constitutional muster because the Supreme Court has just told us that just about anything Congress does using its taxing power is constitutionally acceptable.

Second, the states will implement this idea with varying degrees of success, meaning some states will have better health care systems than others. This will annoy considerably those who think that the uniform distribution of mediocrity is better than the uneven presence of excellence, even where excellence is frequent or widespread. This is known as equal opportunity which is also constitutional.

Note that even the sitting President could propose this idea to Congress as a way to further press “forward” on solving health care problems. It’s just that he won’t.

This opens the possibility for Governor Romney to draw a clear line of demarcation between himself and his opponent on a major issue, make the Massachusetts health care system irrelevant in the national debate, and demonstrate that his vision transcends his past and sees forward into the nation’s future.

Finally, this, or a similar approach, might just elevate the standard of health care delivery for the Boomers and their heirs to the nation. In doing so it would fulfill the promise of “hope and change” which has become so mockingly hollow in recent years.

Bob Fierro has been a Florida resident since leaving the Army over thirty years ago.  He is a graduate of the United States Military Academy, a board member of the local West Point society, and has been active in political and social issues for over 25 years.  Please email your comments to forum@ajustsociety.org.


The CJS Forum seeks to promote an open exchange of ideas about the relationship between faith, culture, law and public policy. While all the articles are original and written especially for the CJS Forum, they do not necessarily reflect the views of the Center for a Just Society.

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