On the one hand, personally, I’m a nice, patriotic, idealistic person.
I tear up at the sight of the U.S. Capitol and the White House, and I believe, deep down — possibly in the same part of me that still believes in the Tooth Fairy — that anyone who becomes president must feel a sincere sense of awe and terror.
I think that, if any of the major candidates who are still in the U.S. presidential race becomes president, he or she will appoint fine advisors, listen to them carefully and, in the end, make reasonable decisions, on health policy as well as in connection with other matters.
On the other hand, it’s hilarious to see that one of Donald Trump’s major proposals for replacing the Patient Protection and Affordable Care Act (PPACA) is to let people leave the assets in their health savings accounts (HSAs) to their heirs.
On the third hand, few of the people bashing Trump have tried to put out any PPACA replacer proposals of their own, and few of the proposals that are out there look serious to me.
So, what standards should a “serious PPACA replacer” meet, other than, “I should like it”?
Here are ideas for standard health policy literacy requirements, and ideas for questions that anyone who wants to change, replace or keep PPACA ought to answer.
Health policy literacy requirements:
Candidates who want to weigh in on health policy should show that they understand that the public exchange system, Medicaid expansion, the individual coverage mandate, and the birth control coverage mandate that the U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius bolted onto PPACA are just small parts of PPACA. Does the candidate really want to repeal the parts of PPACA that don’t affect commercial health insurance, and, if so, why?
Candidates who are trying to change the system should talk a little about their own health coverage and show they have a basic understanding of how it works or doesn’t work.
Some questions that anyone making the proposal should ask themselves:
1. What role, if any, do you think the federal government (or state governments acting at the direction of Congress) should play in paying for health care for civilians?