(…because the rice-bowl syndrome got in the way)

President Trump’s strong-arm efforts notwithstanding the Republican led House could not deliver on his campaign promise to repeal Obama Care and replace it with something supposedly “better.”

While former President Obama, perhaps because of his more effective ways of manipulating things to get such a contentious issue maneuvered through Congress, was able to get a health care bill enacted, neither his, nor the previous Clinton efforts, really resolved the basic health care problem of…affordability. The reasons for that and why President Trump is now also coming up short is because the rice-bowl syndrome got in the way.

By “rice-bowl” syndrome we mean all the special interests which have a financial stake of one kind or another relating to providing health care for all, which any kind of meaningful reform of the existing system could jeopardize. Thus they keep getting in the way of such reform efforts because neither the Democrats nor the Republicans have ever dared or been willing to buck those interests in any way.

Yet, nearly thirty years ago we came across a barely noticed news report about how a former Congressman from Georgia who, after having had quit from politics, had come up with a very interesting way of getting around all that obstructionist BS about health care. How true that news report was is hard to say because we’ve never heard any more about it since that time. Nevertheless, here is what we recall about what he reportedly achieved with his idea. That is, by making a very creative use of the existing tax code to support it. One that solved the three critical aspects of health care…affordability…portability…and continuity… something everyone else in Washington continues to ignore.

Here’s what he did: First, he established a non-profit 501(c)(3) “Chartered Medical Center” in his former congressional district. Once the legal and tax-exempt process was completed for it he then went to several deep-pocket individuals who had previously contributed to his campaign funding, and asked them to purchase a surplus grade school property up for sale, then donate it to his non-profit tax-exempt entity, for which they would receive a deductible tax chit. Next, he then approached various local architectural and construction enterprises to donate their services…to convert and remodel the structure into a first class 25 bed medical center facility.  

Having accomplished all that he then completed similar arrangements with high-end medical specialists and facilities from around the country, pharmaceutical suppliers, etc., to provide consulting and other support for his chartered medical center.

By this time he had also recruited local medical, administrative, and other staff personnel to man it on a subsidized volunteer basis, everyone able and willing to donate a minimum of 4 hours per week so that the facility would be properly manned, with each individual receiving in exchange a tax deductible receipt for the value of those services.

Once all of these things had been arranged, he announced that any registered voter of that district could become a member of that facility, with initial nominal monthly membership fees of…$25/month for individuals…$20 per head for family members.

The point of all this is that once created this facility provided first-class primary and preventive care at an affordable rate for anyone who was a member. More importantly, having that medical service available, anyone who was a member was thus no longer tied to either an employer provided, or government provided plan, and thus no longer dependent upon these for medical coverage. They were therefore no longer “indentured” to have it, and free to move, change jobs, or unemployed or otherwise, but still able to maintain their basic coverage.

But the greater point to be made from all this is to ask the question: What if…the President, and the Congress, instead of continuing with their usual partisan nonsense, and otherwise ignored all the yapping from all those special interests concerned about losing their “rice bowls”,  simply enacted legislation to allow the formation of such “Chartered Medical Centers”, with special tax-exempt status allowing donations either with cash, materials, or services, at going market fee-for-service rates, in every congressional district of the country. And further, that these would allow anyone a member of one to transfer freely to another, as their needs might require?

What would happen then to the health care system in this country?

For one thing, the issues of…affordability…portability…and continuity…would have been accomplished. No one would be without access to medical care regardless of their condition. Government would no longer be directly involved in any way (thus no direct subsidies or budgetary impacts to argue about), thereby eliminating those never-ending arguments about its role or the costs related to that. The only medical insurance plan anyone might need would be one to cover either catastrophic illness, injury, or other hospitalization needs, and that could be had much like auto insurance. Even the cost of such insurance could be contained, if such Chartered Centers established regional pools for their members, much like AARP does for its members, allowing everyone to have some level of insurance for this kind of coverage depending on their means.

Let us hope that somewhere in this favored land of ours, someone in our government will realize this is a feasible and workable concept…and take the necessary action to make it a reality.