Polls indicate that there are two issues at the top of Americans’ list of concerns: (1) healthcare coverage and costs; and (2) college costs and student debt. Both are being addressed by some of the prospective Democratic candidates (not at all by President Trump or Republicans) — but not in a way that addresses the realities any good policy must to be acceptable to the majority of citizens.
What follows are two practical, non-ideological proposals that could serve as the basis for rational, executable solutions:
Healthcare. It is long past the time when healthcare should be considered a right and not a privilege reserved for those who can pay for it. The Affordable Care Act was a beginning, but a meek one that needs fixing. Its triumphs are coverage of pre-existing conditions (which Republicans vigorously campaigned against and still, incredulously, oppose despite their false protestations), and allowing children to remain on their parents’ plans until age 26. However, it costs way too much.
Democratic presidential candidates have jumped aboard the “Medicare for All” bandwagon, dismissing legitimate concerns about the enormous cost that would attach to a Medicare expansion. Their glib solution is “tax the rich,” a response that will never succeed in a country where the idea of raising taxes is political suicide. Republicans, in contrast, have no healthcare plan despite hysterically railing against Obamacare for a decade.
A much more pragmatic and affordable approach would be to: (1) expand the federal government’s employee healthcare system — which is jointly funded by both individual/family premium payments and government contributions — to all Americans who want to participate. The beauty of this proposal is several-fold:
— The monopsony power of government negotiating premium rates with hundreds of private insurers eager to serve a huge population results in low costs for great coverage.
— It preserves the private insurance market while also providing a partial public option.
— The cost to government of expanding its employee plan to all interested Americans is a fraction of the cost of Medicare for All.
— Anyone who preferred to retain their current health plan could.
*This plan is “ideologically neutral.” It satisfies both Republican concerns about the continued viability of private insurers and Democratic concerns for universal coverage and cost control.
Tuition and Student Debt. All of the Democratic plans to date (Republicans have not addressed the issue) call for more of the same: (1) billions more in student loan and grant money and loan guarantees, which history shows only serve to incentivize colleges to keep raising tuition (at three times the inflation rate over the past 35 years). This approach throws money at academia without demanding any reciprocity.
The presidential hopefuls also want to provide free college education for all. Even if such a pipedream only applied to public colleges, its costs would be prohibitive. Democrats again offer no realistic solutions to the key question: How do we pay for this? Moreover, why should families who can afford to contribute to college expenses get a free pass?
The Democratic approach is a retread of all carrot and no stick despite the government wielding a very big stick indeed. The federal government doles out more than $35 billion each year in research and development funds to hundreds of universities, plus billions more in government contracts. Federal funds pay for the vast majority of university research. In return for this generosity, the government should mandate tuition reductions. Lower tuition means greater access to college and less student debt upon graduation.
These are winning ideas that would resonate with every voter who worries about his or her family’s health, finances and future. Relying on H.L. Mencken’s observation that “Nobody ever went broke underestimating the intelligence of the American public” is not a winning strategy … at least not for Democrats.
Canandaigua Academy graduate Richard Hermann is a law professor, legal blogger, author of seven books and part-time resident of the Finger Lakes.