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Herman Cain’s (Mostly) Conventional Plan for Health Care Reform

It’s easy to forget, but Herman Cain first became famous in political circles for his wonky takedown of President Bill Clinton at a town hall meeting where the President was touting his universal health-care plan. (Herman Cain walked President Clinton through the math of why Clinton’s plan would drive Godfather’s Pizza out of business.) Today, Republican Presidential candidate Herman Cain spent half an hour with the GOP Congressional Health Care Caucus, where he outlined his proposals for health reform.

As Newsweek put it at the time, Cain was “the real saboteur” of the Clinton plan:

An articulate black entrepreneur, Cain transformed the debate when he challenged Clinton at a town meeting in Kansas City, Mo., last April. Cain asked the president what he was supposed to say to the workers he would have to lay off because of the cost of the “employer mandate.” Clinton responded that there would be plenty of subsidies for small businessmen, but Cain persisted. “Quite honestly, your calculation is inaccurate,” he told the president. “In the competitive marketplace it simply doesn’t work that way.”

The switchboard at Godfather’s was lit up with supportive calls. It was as if the small business community — a very large and politically powerful group — had been told to march on Washington. Cain, said Larry Neal, an aide to Sen. Phil Gramm, “was the lightning rod.”

For better or worse, Cain’s platform effectively represents consensus Republican thinking on health care. This is good, insofar as Cain endorsed repealing Obamacare, Medicaid block grants, etc. But it’s unclear if he proposed anything that would move beyond the meat-and-potatoes of Republican consensus. And there’s a lot more to do with health-care reform than simply repealing Obamacare.

Jason Millman of Politico was at today’s GOP confab for Cain’s address. “Cain said if he had the right numbers in Congress, he would sign legislation repealing health care reform on March 23, 2013 — three years after it was signed into law. A bill by Rep. Tom Price (R-Ga.), H.R. 3400, would be the starting point for replacement legislation, he said.”

According to Millman, Cain also endorsed block-granting Medicaid. He also voiced his support for purchasing insurance across state lines along with tort reform. Cain criticized the employer-based insurance system, something his 9-9-9 plan would eliminate.

When it comes to the most politically difficult subject of all, Medicare reform, Cain appears to have been light on details. Cain supports “reducing the Medicare bureaucracy,” whatever that means. “Talk to the states, talk to the doctors, and find out what we can do first to reduce the Medicare bureaucracy,” he said. “The bureaucrats don’t trust states and hospitals.”

To give Cain credit where it’s due, any President who could achieve elimination of the exemption for employer-sponsored insurance, while also block-granting Medicaid to the states, will have accomplished more for health-care reform than anyone has in the last fifty years. But it would have been nice to see Cain differentiate himself from the field by applying his experience and knowledge of health-care issues to Medicare reform. Oh well.

UPDATE: Over at National Review, Grace-Marie Turner is more sanguine:

Herman Cain spoke with passion and conviction today before a Capitol Hill audience about the essential importance of repealing Obamacare and replacing it with “market-driven, patient-centered reform.”

He spoke at a forum organized by the Congressional Health Care Caucus, chaired by Texas Rep. Michael Burgess, M.D., that was inundated with dozens of reporters and televisions cameras. They got a big dose of health reform when what they really wanted was to ask him about the National Restaurant Association sexual-harassment controversy. He didn’t take those questions.

Instead, he talked about the destructive impact of Obamacare, which is driving up costs and forcing at least 1,500 companies to seek waivers just to keep offering health insurance to their workers. “The problem with health costs in America goes back to 1943,” he explained, which set the foundation for the employer-based health insurance system that insulates people from the costs of health care and puts employers in charge of choices.

As for medical care, “We have the best health care system in the world,” he said, as he recounted his own experience in 2006 with stage four cancer of the liver and colon, saying he is alive today because of the immediate, high-quality care he received. “I was finished with two rounds of chemotherapy and two surgeries in nine months — less than the time it would take to get a CT scan in countries with socialized health care systems,” he said.

He then took questions from members of Congress: Rep. Andy Harris (R., Md.), a physician, asked him how to help people understand the critical importance of reforming Medicare. “I would paint a clear picture of the disastrous path we are on if we don’t act,” Cain said. He also said he wants to work with states, hospitals, and doctors to push decisions closer to the people who are using medical services and would block grant Medicaid for the same reason.

House Energy and Commerce Health Subcommittee Chairman Joe Pitts (R., Pa.) asked about the Independent Payment Advisory Board “whose decisions can’t be appealed and that takes a 2/3 vote of Congress to overrule.” Cain said he encourages members to do everything they can to “educate the public about how this takes away freedom.” He urged members to push for repeal now and to help the American people see why the whole law must be repealed.

Cain said he wants to sign a repeal bill on March 23, 2013 — the third anniversary of passage of Obamacare.

Rep. Glenn Thompson (R., Pa.) asked about medical malpractice reform, and Cain said he strongly supports medical liability reform to cut down on “frivolous lawsuits.”

Rep. Billy Long (R., Mo.) asked what Cain would do about preexisting conditions and interstate competition for health insurance. Cain said he strongly supports cross-state purchasing of health insurance, and he said he believes it is a proper role for government to provide a safety-net, with both state and national contributions. “We don’t want to leave anybody out of getting health insurance coverage,” he said.

As a good “starting point for reform,” Cain says he supports HR 3400, introduced by Rep. Tom Price, a physician and chairman of the House Republican Policy Committee. (The measure was re-introduced as HR 3000 in this Congress.)

Cain spoke without notes and clearly had ownership of the business of health care, the powerful impact of the tax treatment of health insurance in shaping the American health sector, and the crucial importance of repealing Obamacare to provide a path to change that put doctors and patients in charge of choices.

Avik Roy is a health care analyst at Monness, Crespi, Hardt & Co., and writes on health care policy for Forbes at his blog, The Apothecary where this post first appeared. You can follow him on Twitter at @aviksaroy.

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Peter1Barry CarolsteveJohn Ballardrbar Recent comment authors
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Peter1
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Peter1

“Cain criticized the employer-based insurance system, something his 9-9-9 plan would eliminate.” ““The problem with health costs in America goes back to 1943,” he explained, which set the foundation for the employer-based health insurance system that insulates people from the costs of health care and puts employers in charge of choices.” I can’t wait until this happens. Fastest way to government run single-pay. Put everybody on the street trying to buy affordable insurance. “We have the best health care system in the world,” he said, as he recounted his own experience in 2006 with stage four cancer of the liver… Read more »

Barry Carol
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Barry Carol

“OTOH, if he legalizes selling insurance across state lines, I will be rich.”

Steve —

Could you elaborate on this?

steve
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steve

Setting aside the part of me that wants to control health care costs so that my son will live in a better country, let us look at this from the entrepreneurial side. As a provider, I want as many insurance companies as possible bidding for my services. With no individual company having a dominant share, I dont have to discount for anyone. Most people tend to think of it as insurance companies competing against each other cutting costs. I am looking at what happens when they have to come negotiate with me. This is what will happen if large numbers… Read more »

steve
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steve

Shame on you Avik for carrying water for this guy. How can you take anyone seriously who does not address Medicare? OTOH, if he legalizes selling insurance across state lines, I will be rich.

Steve

John Ballard
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Cain’s appeal is that he honestly believes the nutty ideas he advances are truly excellent. His sincerity is not contrived. And he presents those ideas with the clarity and simplicity of a preacher who says in unmistakable language “If you don’t change your ways you will burn in Hell.” In the case of healthcare reform he really believes that the invisible hand of the market will resolve all problems. It is significant that the only bi-partisan legislation this administration can claim, PPACA, has been targeted for destruction by the GOP, even though every administration since George H.W. Bush, both Republican… Read more »

BobbyG
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rbar
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rbar

“wonky takedown of President Bill Clinton at a town hall meeting … Herman Cain walked President Clinton through the math of why Clinton’s plan would drive Godfather’s Pizza out of business”

Listening to HC, it’s hard to believe that he says anything with particular expertise/”wonky”. The Newsweek quote agrees but does not prove it either (they just list some nondescript boilerplate from HC). I would be genuinely curious if HC said anything smart/knowledgeable on the topic, and if anyone has a link to a video or transcript, I’ll watch/read (even though HC likely will go under anyway).

BobbyG
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