Republicans in the U.S. Senate are struggling to forge a consensus on health care. It is possible that Congress will pass (and the president will sign) something. Whether they eventually pass something or not, there will be a role for policy prescriptions at the state level.

Idaho’s three GOP gubernatorial candidates are staking out ground on the issue of healthcare. Any Democrat who enters the race will likely do the same.

Rep. Raul Labrador has been a prominent player in D.C. in the U.S. House as part of the Freedom Caucus. The group was a key player in getting a bill off the House floor and over to the Senate.

But, what are Labrador’s personal views on healthcare?  In May he did some townhall meetings and outlined the following.  First, he doesn’t consider healthcare insurance a right. And, he does not favor the provision in the Affordable Care Act which bars insurers from charging those with health conditions more than those who are healthy. He thinks insurers should be able to charge those who are sick more and those who are healthy less.

Betsy Russell of the Spokesman-Review reported that Labrador told a Nampa townhall in May that: “For me, the perfect health care system would be catastrophic health care – you would pay for that at a low premium, and then everybody would pay out of their pocket for all the other needs. … That would drive down the cost of health care tremendously, if people were actually paying out of their pocket, because they would be able to negotiate directly with the doctors.”

Boise businessman Tommy Ahlquist’s website emphasizes his opposition to Obamacare.  His criticism is grounded in his background as an emergency room physician:  “It’s destroying the doctor-patient relationship—the very foundation of quality healthcare. Premiums continue to rise while federal mandates are changing the very essence of medicine.”

In a forum held in conjunction with the recent Idaho Republican State Convention, Ahlquist was particularly critical of Medicaid, claiming the system is rife with fraud and abuse. 

Ahlquist supports healthcare solutions, according to his website, “based upon personal accountability, protect[ing] the doctor-patient relationship and [promoting] competition between providers and insurance companies”.

Healthcare is of particular interest to Ahlquist and expect more detailed prescriptions from him in the future.

Lt. Governor Brad Little last week waded into the issue.  He points out that Idaho has had a history of fairly modest healthcare costs.  He would reduce costs for those with health conditions by reactivating Idaho’s subsidized high-risk pool.  Some of the bills in Congress would subsidize such pools.

Little would preserve Idaho’s existing insurance exchange but offer non-Obamacare compliant policies and expand the availability of health savings accounts to cover expenses.

The Idaho Republican candidates, like national policymakers, are focused on insurance coverage and the payment of health care expenses. But, that is only half of the equation. What drives expensive insurance policies and large out of pocket expenses is the underlying cost of healthcare itself.

None of the possible cost prescriptions are painless. Should we push more preventative care to avoid future costs once people get sick?  Or, should treatment be reduced or denied for certain patients or conditions? At what rate should patients receive new but often-expensive treatments and medications? These are hard, hard choices but really are the long-term key to affordable healthcare.

Steve Taggart is an Idaho Falls attorney specializing in bankruptcy (www.MaynesTaggart.com).  He has an extensive background in politics and public policy.  He can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it..