A health care plan for Ted Cruz: Universal Healthcare Vouchers

WASHINGTON, November 20, 2013 — Senator Ted Cruz has backed himself into a position where he has the opportunity to take control of the national health care debate, destroy Obamacare and become a hero, if he can seize the moment.

Wednesday morning on CNN’s “New Day,” Chris Cuomo agressively pursued Cruz with a question which the media is raising more and more often, responding to Cruz’s criticism of the Affordable Care Act. He asked, “You don’t think that you have a responsibility as a U.S. senator to do better than that, in terms of offering a solution for what to do next?”

Cruz attempted to defelect and bring up more examples of Obamacare failures and Cuomo hit the question again, even more clearly, saying, “The problem is, I don’t have the power to fix it. You do. That’s what a U.S. senator does, is you sponsor law. You know this. It’s not a lecture, it’s a concern; I’m asking, what are you going to do about it?”

Cruz deflected again. With his prosecutorial background he’s very good at asking questions and making criticisms, but as Cuomo points out, it might be time to come up with some answers instead.

Cruz could point to the House Republican plan as he gets asked questions like this. And they are being asked more and more often. Clearly he does not want to endorse their “Obamacare light” proposals, yet the more he gets asked this question, which the media now realizes is the way to derail his attack tactics, the more important it is that he come up with a strong answer to it. His non-answer tactic is starting to become a problem.

It’s also an opportunity. If he doesn’t wait to long, there will be a moment on a major news show where Cruz is confronted like this again and it will be the perfect moment to stop and say, “Why yes, since you’re asking, I do have a solution.”


SEE RELATED: The passion of Ted Cruz: Time for Amendment 14


If what he says next is a short summary of a truly superior health care plan, Senator Cruz will have seized control of the entire healthcare debate and could become a national hero, not just the biggest thorn in President Obama’s side.

For this to work he needs a plan which is simple, proven to be effective, and capable of being explained briefly so that newscasters and the average citizen can understand it immediately. It needs to provide access to coverage for every citizen at a price they can afford and be easy to implement. It needs to be everything the Democrats promised and which the Affordable Care Act is not.

To seize this moment, all he needs to do is steal a couple of pages from the Democratic playbook. One of the ways they have defended the Affordable Care Act  and defused Republican criticism is to claim that it is all based on past Republican ideas like Romneycare and the rejected 1994 bipartisan health care bill, making Republicans look like hypocrites for opposing it.

Senator Cruz can do the same and use their own past health care plans against them.  


SEE RELATED: Ted Cruz, Mitch McConnell and the power of Republican surrender


In 2005 Dr. Ezekiel Emanuel was one of the authors of a paper for the Brookings Institution proposing a comprehensive health care plan. This paper led to a series of articles in major media outlets like the New York Times and the Wall Street Journal, and ultimately to his book “Healthcare, Guaranteed.” The plan he describes is one based around Universal Healthcare Vouchers, and it was specifically designed to meet the needs of Republican legislators.

Emanuel is the brother of President Obama’s close confidant Rahm Emanuel. He’s currently working for the administration as the the Special Adviser for Health Policy at the Office of Management of the Budget. He is the guy Obama should have gone to when writing the Affordable Care Act, but did not. If his credentials are not good enough to win over Democrats to a new health care plan, no one’s are.

When he wrote his book, Emanuel was acutely aware of the need to produce a plan which would address what he saw as the nation’s desperate need for universal health care and also be acceptable to the Republicans who controlled the government at the time. He rejected single-payer solutions as contrary to American economic principles. He rejected massive modification of the current system (like Obamacare) as inefficient and leading to increased costs. He saw the answer in tying healthcare to individuals rather than group plans or state controlled insurance pools.

Emanuel seems to have drawn on two sources. He clearly borrowed some basic ideas from an article written for the Hoover Institute in 2001 by venerable free market economist Milton Friedman, who proposed the idea of universal healthcare vouchers. For confirmation of the validity of those ideas all Emanuel had to do was look to countries like Australia and the Netherlands, which have already implemented simple systems which provide health care to all their citizens. They do it through a free market with vouchers subsidizing the cost for all citizens so that even those who cannot pay at all get basic coverage, while those who can supplement the basic vouchers can purchase higher quality coverage.

Emanuel points out that a Universal Healthcare Voucher system preserves and encourages competition and takes away the protections and monopolistic practices which have corrupted the current system. It will bring down prices for consumers substantially, keep insurance companies profitable, and make sure everyone has health care.

Not everything in Emanuel’s plan is perfect. His proposal for funding Universal Healthcare Vouchers through a Value Added Tax would never pass the House. No Republican wants to be on board for creating a new national sales tax to finance health care. But there are other ways to raise the needed money by absorbing already existing taxes for Medicare and Medicaid into the system with some added revenue.

In his Washington Monthly article, “Saved!” Emanuel explained why this plan can work, writing “what elevates UHVs above the ranks of attractive yet doomed health-care reforms is the way that vouchers reshape the politics of the issue, attracting some powerful interests that have traditionally opposed reform while isolating and limiting the remaining opponents. To put it bluntly, it will be hard to oppose this plan on grounds that aren’t strictly partisan.” The same things which would have made it work for Democrats under a Republican administration can make it work for Republicans in a Democratic administration.

It answers the needs of both parties.

The next time someone like Chris Cuomo asks Senator Cruz what he can offer as an alternative to Obamacare, Cruz ought to have an answer.

It would be devastating if the Senator were able to respond, “I think a great starting point would be a plan proposed by a member of the president’s own administration, Dr. Zeke Emanuel’s plan for Universal Healthcare Vouchers. Why the president didn’t adopt it instead of the Affordable Care Act beats me, but I think that with some small changes it’s a plan which Republicans and the American people could get behind.”


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Dave Nalle

Dave Nalle has been writing political analysis since the 1980s for newspapers, magazines and now online journals. He is currently Execitive Director of the Center for Foreign Policy Priorities, is on the board of the Coalition to Reduce Spending, and served four years as National Chairman of the Republican Liberty Caucus.

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