{"id":821,"date":"2016-11-13T10:15:22","date_gmt":"2016-11-13T18:15:22","guid":{"rendered":"http:\/\/www.luterra.com\/blog\/?p=821"},"modified":"2016-11-13T10:15:22","modified_gmt":"2016-11-13T18:15:22","slug":"an-open-letter-to-donald-trump","status":"publish","type":"post","link":"https:\/\/www.luterra.com\/blog\/?p=821","title":{"rendered":"An open letter to Donald Trump"},"content":{"rendered":"

Dear Mr. Trump,<\/p>\n

Congratulations on your election.\u00a0 You certainly surprised me and a great many others here on the west coast.\u00a0 Normally I am not one to write to leadership, as it seems that positions are deeply entrenched.\u00a0 You, however, have shown a willingness to modify your positions in response to your constituency.\u00a0 As a repeal\/revamp of the Affordable Care Act is at the top of your priority list, I thought I would offer my perspectives.<\/p>\n

First, though, I would ask that you make a public effort to mend the rifts caused by one of the most negative campaigns in history.\u00a0 Among your supporters there are those who are openly and angrily racist, white supremacist, homophobic, and transphobic.\u00a0 These people are a small minority of American citizens, but they have felt emboldened by your election to bring their hate into the public sphere.\u00a0 On behalf of my friends who are black, Muslim, gay, and transgender, I ask that you publicly denounce these people and their behavior.\u00a0 For better or worse, the haters mostly gave you their votes, but you do not need their support to govern.\u00a0 Every American has a right to feel safe in this country, and too many have been living in fear since last Tuesday.<\/p>\n

With regard to health care, here is my proposal:<\/p>\n

    \n
  1. \u00a0Keep the private insurance companies, at least for now.\u00a0 The federal government is nearly collapsing under its own weight, and the added bureaucracy involved in federal single-payer health insurance may well be untenable.\u00a0 I feel that single-payer insurance would be a positive step but that it is best administered at the state level.<\/li>\n
  2. Change the individual mandate to an individual incentive, e.g. an additional tax deduction for insured taxpayers rather than a tax penalty.\u00a0 People like carrots better than sticks, and the effect would be the same in encouraging healthy people to carry insurance.<\/li>\n
  3. Standardize risk pooling.\u00a0 Create a set of criteria that insurance companies may use to set premiums (e.g. age, tobacco use, local cost of care, chosen coverage\/deductibles), and require insurance companies to charge equal premiums for equal plans to everyone.\u00a0 No more special \u201clarge group\u201d employer and institution plans with lower premiums and higher benefits.\u00a0\u00a0 My car insurance is the same whether I work for Google or run my own farm.\u00a0 Health insurance ought to work the same way.<\/li>\n
  4. Standardize costs of care.\u00a0 An MRI has a specific cost in terms of labor, equipment, and overhead, and this is the same regardless of the patient.\u00a0 So an MRI ought to cost, say, $700 for everyone, NOT (as is currently the case) $600 for in-network insurance companies, $900 for out-of-network insurance companies, and $1200 for patients paying out-of-pocket.\u00a0 With cost standardization, we could greatly increase transparency while eliminating the in-network\/out-of-network distinction and allowing (as you have suggested) for insurance companies to provide nationwide coverage and compete across state lines.<\/li>\n<\/ol>\n

    Thanks, and best of luck in governing our divided nation.<\/p>\n

    Sincerely,<\/p>\n

    Mark Luterra<\/p>\n

    Corvallis, Oregon<\/p>\n","protected":false},"excerpt":{"rendered":"

    Dear Mr. Trump, Congratulations on your election.\u00a0 You certainly surprised me and a great many others here on the west coast.\u00a0 Normally I am not one to write to leadership, as it seems that positions are deeply entrenched.\u00a0 You, however, … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/www.luterra.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/821"}],"collection":[{"href":"https:\/\/www.luterra.com\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.luterra.com\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.luterra.com\/blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.luterra.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=821"}],"version-history":[{"count":1,"href":"https:\/\/www.luterra.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/821\/revisions"}],"predecessor-version":[{"id":822,"href":"https:\/\/www.luterra.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/821\/revisions\/822"}],"wp:attachment":[{"href":"https:\/\/www.luterra.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=821"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.luterra.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=821"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.luterra.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=821"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}