Bill Graham’s Health Plan: Do you believe in magic?

Republican gubernatorial candidate Bill Graham’s health plan is a bewildering mixture of mostly old-guard ideas delivered at a shotgun pace as part of a slickly named – and no doubt poll-tested – “We Care” package. 

Borrowing liberally (sorry) from the Massachusetts health plan developed under Mitt Romney, Graham proposes a similar mechanism for the state to encourage private insurers to offer health plans to those currently uninsured.  One problem – the coalition of conservative and liberal groups that enabled the compromise reform in Massachusetts was able to draw on around $400 million in state dollars.  This includes hundreds of millions the state was already spending on uncompensated care (money North Carolina simply doesn’t spend now), as well as taxes and fees on hospitals, employers and insurers.  In addition, much of the cost in Massachusetts is due to the subsidies for even the lowest-rate plans that must be provided to lower-income workers to make coverage at all affordable.

Graham’s answer to finding new money to finance his similar proposals?  Answer – he doesn’t have one.  In fact, he spends money like water on at least five separate proposals for new tax credits and tax deductions.  Where the money will come from to finance the cost of these new tax deductions and credits is not specified.  It’s magic!

Graham’s magic wand waves once again over NC’s Medicaid program.  He starts by rejecting NC Medicaid’s proven community-based doctor-driven health care management system that has saved North Carolina taxpayers hundreds of millions of dollars and won national awards.  Graham would rather invite the private insurance industry in to “save” Medicaid, supposedly expanding services and covering more people.  No word on where the new profits for private health insurers come from under this scheme however.  Graham’s master plan to somehow cover more people without more money is apparently at work here too.  More evidence of the supernatural.

Probably the most insulting part of Graham’s plan is his notion to make multi-thousand dollar high-deductible health plans more palatable for the public.   These sorts of plans are the darling of the ultra-right largely because of their favorable tax treatment of health dollars, but not much use for the uninsured – most of whom are lower-income workers without much tax liability to begin with.  To address the problem of how regular folks who get sick are to pay that first thousand dollars or so in bills will Graham limit deductibles?  Provide subsidies for those who can’t afford $1,000 hospital bills before their insurance kicks in?  No.  He’ll get banks to offer loans to pay the deductibles – at, no doubt, a great interest rate.  The only loan I can think of that would be more subject to abuse than a subprime mortgage would be trying to get someone to sign papers so they can get past the ER for necessary surgery.  No doubt this could be a profitable replacement for the late payday loan industry, but moral it’s not.

So there you have Graham’s health plan – millions in unfunded tax credits and deductions galore, no guarantee of any more coverage for anyone, dismantling our successful Medicaid program, and a windfall for banks and lenders to bolster unpopular high-deductible health insurance policies.  Not only do you have to believe in magic to support this plan, but you also have to believe in hot air and bad ideas.