As I get organized to enter the 2018 Nebraska Republican Primary for U.S. Senate, I want to make it clear why I would challenge the apparently popular incumbent Senator Deb Fischer who is running for reelection. The reason is very simple and clear cut. The new tax law which she voted for will raise our national debt by $1 trillion over the next ten years and likely overheat our already vigorously growing economy in the process. In other words:
- Our national debt, already sitting at 77% of GDP (for the public part on which we pay interest), is the highest it has been since right after WWII and already slated to get worse, even before the new tax law supported by Senator Fischer. When interest rates inevitably rise in the near future, interest payments on the debt will become a huge burden on our economy.
- Controlling the cost of healthcare, which already eats up 18% of our GDP (and is growing much faster than GDP), is the key to shrinking our annual deficits and therefore being able to shrink our debt as well.
But is it possible to control healthcare costs within the framework of a free market? I think it is and here is one way to do it:
- For private healthcare, repeal the employer mandate and replace the ACA income based tax credits with age based tax credits (which then apply to everyone). This will allow healthy employees to migrate away from employer provided health insurance towards individually underwritten health insurance (including Health Savings Accounts) at much lower cost. This saves money for employers and rewards healthy life styles. High risk pools for unhealthy people would receive federal and state subsidies.
- Medicaid recipients would also be able to migrate into this new private system.
- Medicare Advantage (Medicare Part C) would be required to offer Medical Savings Accounts which were authorized in 1997 but have not been widely utilized. This will make Medicare Advantage highly attractive to healthy people and encourage migration from regular Medicare (Part B) to Medicare Advantage.
Conclusion. The point here is not to try to insist on one particular way of controlling the cost of healthcare but to demonstrate that it can be done within a relatively free market framework.
It Does Not Add Up 
A clearly defined plan for universal health insurance would not change our nation’s ‘health spending’ levels without rationing. A strategy for improving Primary Healthcare with a nationally sanctioned and community managed process will be required to improve our nation’s HEALTH along with a 33% decrease in the portion of our GDP devoted to health spending. Without a means to manage Parkinson’s Law, our nation’s ‘health spending’ will continue to degrade our nation’s Social Capital.
I agree with you that any plan to control healthcare costs should put a strong emphasis on primary care. Better primary care is the key to a more healthy nation.
Ok, I get it. We need a larger venue to consider long-term change. How about renewing our progress toward a Constitutional Convention to pass a Balanced Budget Provision and a Congressional Term Limits Provision? Its likely that Congressional paralysis will never cease without it. Its my recollection that 30+ State Legislatures have already passed resolutions to convene the Constitutional Convention, just a few left to reach the 2/3 requirement.
28 states have called for a CC to propose a Balanced Budget Amendment: http://bba4usa.org/report/
I’m not sure about the so-called Convention of States project.