In yesterday’s Washington Post, Bobby Jindal came out of hiding, hoping most of America has forgotten about his disastrous speech, to pen an op-ed where he discussed his 10-point healthcare plan. Jindal appears to be positioning himself for a Presidential run, attempting to appeal to conservatives. He began by writing “health care is an American issue, and the Republican Party has an opportunity to demonstrate that conservative principles work when applied to real-world problems”. Yet his plan has some fundamentally non-conservative points. Let’s explore his concepts.

— Voluntary purchasing pools: Give individuals and small businesses the opportunities that large businesses and the government have to seek lower insurance costs.
— Portability: As people change jobs or move across state lines, they change insurance plans. By allowing consumers to “own” their policies, insurers would have incentive to make more investments in prevention and in managing chronic conditions.
— Lawsuit reform: It makes no sense to ignore one of the biggest cost drivers in the system — the cost of defensive medicine, largely driven by lawsuits. Worse, many doctors have stopped performing high-risk procedures for fear of liability.

I agree for the most part with his first three points, which are basically multi-group pooling, inter-state portability with the same tax incentives given to businesses also shared with individuals, and tort reform. However, his following positions overall stray sharply from conservative principles.

— Require coverage of preexisting conditions: Insurance should not be least accessible when it is needed most. Companies should be incentivized to focus on delivering high-quality effective care, not to avoid covering the sick.

Requiring coverage does not allow the marketplace to work properly. It actually adds costs. This is part of the problem we are currently experiencing as each state requires differing specific coverage levels. We should allow insurance companies to differentiate themselves by what they do and do not cover and what they will and will not charge for it by what the market dictates. Requiring coverage is not a conservative principle.

— Transparency and payment reform: Consumers have more information when choosing a car or restaurant than when selecting a health-care provider. Provider quality and cost should be plainly available to consumers, and payment systems should be based on outcomes, not volume. Today’s system results in wide variations in treatment instead of the consistent application of best practices. We must reward efficiency and quality.

The price for every medical service should be clearly posted. This would be a great driver of competition. Quality data being kept is also a good idea. However, this should not be mandated. If there is a market for quality data, let the marketplace provide it. Mandating the tacking of quality data will only increase costs for everyone. Besides, the nature of this data is extremely subjective, based upon the individual being treated and that individual’s specific circumstances. Mandating quality data being kept is not a conservative principle.

— Electronic medical records: The current system of paper records threatens patient privacy and leads to bad outcomes and higher costs.

This is another mandate. Mandates add cost. If the business case exists to make records electronic, then individual providers or groups of providers should make of their records electronic. There is no evidence to suggest that patient privacy is not equally at risk with electronic records. The risks are simply from difference sources. As another mandate, this is not a market-driven conservative principle.

— Tax-free health savings accounts: HSAs have helped reduce costs for employers and consumers. Some businesses have seen their costs decrease by double-digit percentages. But current regulations discourage individuals and small businesses from utilizing HSAs.

Reducing barriers for tax-free health savings accounts is a good concept. This is a market innovation that adds value. This point does indeed follows conservative principles.

— Reward healthy lifestyle choices: Providing premium rebates and other incentives to people who make healthy choices or participate in management of their chronic diseases has been shown to reduce costs and improve health.

Again, this is mandate. Individual providers can choose to differentiate themselves in cost and service by providing “healthy lifestyle rewards” if they so choose. Once again, as a mandate, this is not a conservative principle.

— Cover young adults: A large portion of the uninsured are people who cannot afford coverage after they have “aged out” of their parents’ policies. Permitting young people to stay on their parents’ plans longer would reduce the number of uninsured and keep healthy people in insurance risk pools — helping to lower premiums for everyone.

This is perhaps Jindal’s craziest point. Young adults who aren’t covered are usually intentionally self-insured. This group has perhaps the lowest risk profile. If they chose to be covered, their cost for even private policies is one of the lowest available. Rather than recognizing this fact, Jindal propose yet another mandate, so again, not a conservative principle.

— Refundable tax credits (for the uninsured and those who would benefit from greater flexibility of coverage): Redirecting some of the billions already spent on the uninsured will help make non-emergency care outside the emergency room affordable for millions and will provide choices of coverage through the private market rather than forcing people into a government-run system. We should trust American families to make choices for themselves while we ensure they have access to quality, affordable health care.

Additional tax credits do not necessarily mean those who the government gives more money to will spend the money in the way intended (on healthcare). This simply creates more bureaucracy. He is right that “we would trust American families to make choices for themselves”. However, the creation of more bureaucracy does not solve that issue. Jindal’s point is kind of a muddled explanation, seemingly made to get to the magic number of “1o” for a “10-point plan”. Although tax reductions do follow conservative principles, creating bureaucracy to redistribute wealth to a targeted group does not.

It seems that Jindal is trying to be the man for all people with this plan. Overall, he clearly is not espousing conservative ideals. He is only labeling his views as this. Jindal will not have credibility going forward if he continues to say one thing yet shows himself to be another.