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If we let them, states might eventually solve the health care puzzle

To my detriment, I looked at the national debt clock again. We discussed this remarkable real-time chronometer last summer as the national debt was approaching $20 trillion, and it looks on pace to surpass $21 trillion this summer. The big round number was greeted with a yawn, and Congress wasted no time in passing more legislation that will increase our debt in the future.

Many ideas to increase health care coverage for Americans have been greeted warmly, including expansion of Medicaid, Medicare for All and European-style single payer systems.

I’m having a hard time reconciling these well-intended proposals with the U.S. Debt Clock, which in addition to the mounting national debt, clearly shows future Medicare liabilities of nearly $28 trillion, 57 million current Medicare enrollees, and 75 million current Medicaid recipients. Thirty-nine million Americans live in poverty, 41 million collect food stamps and 27.5 million are without health insurance. The total number receiving some benefits is 165 million, or about one half of the U.S. population.

Lest you become despondent about health care and insurance costs, three states are leading the charge to help solve the problem. Gov. Butch Otter directed the Idaho Department of Insurance to explore lower-cost health plans. Blue Cross of Idaho wasted no time in launching Freedom Blue, with monthly premiums as low as $200 per month for a healthy 45-year-old. (The federal government decided earlier this month that the plans Otter wants are illegal because they skirt the Affordable Care Act.)

Last fall Minnesota introduced a program known as “reinsurance” that spreads claims risk across several insurers. State officials predict 2018 premiums could be 20 percent lower as a result. Tom Price, secretary of Health and Human Services, said the Trump administration is open to state initiatives.

Alaska, an expensive state for health care, received the OK last summer for reinsurance. It pays for high-cost events such as cancer treatment, HIV and AIDS. Recall that Idaho’s high-risk pool worked quite well until it was taken out by the Affordable Care Act.

I’m not against some basic universal primary coverage for everyone, especially checkups and preventative care. Asking the federal government to carry the entire load, when current future liabilities are tabulated, will be next to impossible, so forget it – it’s not going to happen.

Let’s allow the states, long recognized by the Founders for incubation of fresh ideas and solutions, to work out health care for the uninsured and underinsured. Sometimes local decision-making by local people is the best solution, so let’s give it a try, shall we?

Mark Daly is an investment management analyst and partner in the Perpetua Group. Mark@