I am a candidate in the May 15 Nebraska Republican Primary for U.S. Senate. I have entered this contest because the incumbent, Deb Fischer, has done nothing to reduce our enormous and out-of-control national debt and, in fact, voted recently (with the new tax law) to increase our debt by $1 trillion over the next decade. And this is after new economic growth, stimulated by the tax changes, is taken into account.
One way to get the debt under control is with a more sensible budgeting process, but this is not enough by itself.
We also need a major effort to reduce the cost of healthcare. One problem here is that employer provided health insurance is very inefficient, especially because it insulates employees from the full price of their healthcare. The way to fix this is to make the employer mandate in the Affordable Care Act more flexible in the following ways:
- Replace income based tax credits in the ACA with aged-based tax credits (which then apply to everyone). See here for details.
- Allow individual employees to migrate away from the employer plan to individually underwritten personal insurance. This will often save money for the individual employee (and family), the employer (who has fewer employees to cover) and the government (which has a smaller tax exemption). The employees also gain more flexibility for future employment.
- Such a system, when fully implemented, will save $400 billion per year in government revenue, both state and federal.
Conclusion. I have outlined one way of moving from the defined benefit healthcare system we have now to a defined contribution system which will save hundreds of billions of taxpayer dollars every year by putting more responsibility on the individual health consumer.
My only concern is a further eroding of first dollar coverage for Primary Healthcare. This might be worth a lunch discussion for alternatives.