YPSILANTI, Mich. — Republican presidential candidate Ben Carson unveiled a broad outline Wednesday to reform health care in the United States, calling for the repeal of President Obama's signature health-care law while detailing a restructuring of Medicare that would raise the eligibility age to 70.
The retired neurosurgeon's proposal rests on tax-protected “health empowerment accounts” — a de facto expansion of health savings accounts, which in Carson's vision would be opened for each citizen upon birth and grow over time based on individual contributions. Those accounts would be paired with high-deductible "catastrophic" medical coverage to cover patients facing significant and unexpected health problems.
Carson has characterized the plan as a "market-based solution" that will incentivize competition among insurers and give individual consumers greater flexibility in choosing their health providers. The policy proposal published by Carson's campaign Wednesday did not include budget estimates and did not outline the potential economic impacts of such an approach. Health care remains one of the largest and most complicated components of the nation's economy.
“Health-care decisions are some of the most important decisions a person will ever face and the government should not be the one to make these decisions,” Carson said in a statement. “The power to choose your health-care plan and your doctor was always intended to be placed within the hands of ‘We The People.’ ”
He added: “I am pleased to release my vision for the American health-care system and offer a blueprint for empowering the American people instead of the federal government.”
The proposal — found here — did not detail an implementation plan or policy language for the new "health empowerment accounts," instead focusing on painting broad priorities for health-care reform. At its core, the proposal rests on a deep disdain for the Affordable Care Act, which Obama signed into law in 2010.
"Through Obamacare, the federal government of the United States has used its power to coerce American citizens to buy health insurance coverage they don’t want — while restraining private insurance companies from offering policies that consumers demand," said the pamphlet.
"I don't like to complain about something without having an alternative for it. So right here, this is going to be the prescription for 'We the People,' " Carson told a crowd of about 200 people during a campaign event here in Michigan. "The diagnosis is that the government has gotten involved and consequently the doctor-patient relationship just doesn’t exist like it used to before."
Asked about provisions in the Affordable Care Act which prevent insurance companies from discriminating against people with preexisting conditions and allow young adults up to age 26 to stay on their parents' insurance plans, Carson spokesperson Doug Watts responded that "Dr. Carson's plan explicitly calls for the repeal of Obamacare, in its entirety." He added that questions about preexisting conditions and young-adult insurance policies were "rooted in an old paradigm."
The proposed health empowerment accounts "are by definition much less expensive than classic Blue Cross/Blue Shield 'fee for service' health insurance plans or even the government-approved health insurance plans offered under Obamacare," Watts said. "So for young adults just out of college, buying individual health insurance will be much cheaper.
The proposal noted that family members would be able to transfer funds to each other from their individual accounts; when a member of the family passed away, their loved ones could also inherit the accounts. Immigrants — here legally or undocumented — appear to be excluded from the plan.
Part of Carson's pitch includes overhauling Medicaid as well, giving users private insurance options — funded through state-run Medicaid programs — and seed funds for their own health empowerment accounts. Carson says that will end what has become a "two-tiered health system in which doctors are harder to find and waiting periods grow longer every year."
Carson’s plan calls for the eligibility age for Medicare to gradually increase over the next 30 years, two months each year until the eligibility age reaches 70. That's a suggestion he's made on the campaign trail several times this year, which he has characterized as gradual enough to avoid creating financial setbacks for middle-class taxpayers planning for retirement age.
Under Carson's proposal, Medicare would also be restructured to rely on fixed contributions from the government which eligible individuals could then use to purchase a private insurance plan. That coverage would exist alongside the "health empowerment accounts" that Carson has pitched.