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Explore our coverage of government and politics.

Vogel: Healthcare Advice

House Speaker Paul Ryan has unveiled his plan to repeal and replace the Affordable Care Act. One early headline from the New York Times sums it up this way: “Republican Health Proposal Would Direct Money from Poor to Rich.” A dramatic example, as reported by Business Insider, concludes that under the new plan the 400 wealthiest households in America get a tax cut of seven million dollars per household per year. Lots of other provisions in the American Health Care Act are getting more attention than these tax cuts for the wealthy, but I believe that what really drives this legislation is this seven million dollar windfall for each of the nation’s richest families.  

Perhaps naïvely, I expect this legislation will not only die but end up embarrassing Ryan, Trump and anyone else who endorses it. And if that happens, I have a suggestion for Republicans looking for ways to salvage their reputations and fulfill their longtime pledge to get rid of the Affordable Care Act - also known as Obamacare. I think they ought to take a page from the Democratic Party playbook.

The Affordable Care Act is essentially a plan that owes most of its best ideas to the Republican Party - and specifically to Republican Governor Mitt Romney. It’s ironic that the Democrats co-opted the idea and now get all the credit – and the blame. So when the American Health Care Act fails, President Trump might follow the same script and co-opt one of the Democratic Party’s best ideas - the public option.

By making every American eligible for Medicare or a similar public option, he could fulfill his promise of “insurance for everyone” and probably end up with a system that fulfills his other promise to create a “far less expensive and far better” healthcare system. Furthermore, if carefully constructed, a public option like Medicare for All would also do wonders for U.S. businesses by relieving them of the burden of providing health coverage for their employees - at a cost significantly lower than what they now pay.

Many of us have forgotten that President Nixon created the Environmental Protection Agency and Legal Aid; perhaps President Trump can create Healthcare for All.

John Vogel is a retired professor from the Tuck School of Business. His tenure at Dartmouth began in 1992, where he taught Real Estate and Entrepreneurship in the Social Sector, among other subjects. He was named by the “Business Week Guide” to Business Schools as one of Tuck’s “Outstanding Faculty” members.
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