Ben Carson has long prided himself as a political outsider who delivers unvarnished truths, whether it’s his assertion that Obamacare is the worst thing since slavery, that Muslims should not be allowed to serve as president or that Jews could have stopped the Nazis if only they had been armed.
But as his GOP presidential campaign is beginning to pick up steam and he surges ahead of Donald Trump in Iowa, Carson is beginning to look more like a traditional, cautious politician. On Sunday, he disavowed his highly controversial proposal to replace Obamacare and Medicare with health savings accounts to cover the lion’s share of Americans’ annual health care needs.
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As recently as May, Carson was singing the praises of his plan in an interview with John Harwood of CNBC. Asked whether he thought that his proposal was politically feasible given the popularity of Medicare health coverage for seniors, Carson replied: “When people are able to see how much more freedom they will have, and how much more flexibility they will have, and how much more choice they would have, I think it's going to be a no-brainer.”
“The reason that I've come up with the health savings account system, utilizing the same monies that we use to pay for health now, [it] provides a very different paradigm,” Carson added.
But when Chris Wallace of “Fox News Sunday” asked Carson over the weekend to defend his plan for supplanting Medicare, Carson responded as if Wallace hadn’t received the memo: “No, that’s completely false. And that’s a narrative that somebody’s putting out there to scare people.”
When Wallace pressed him on his previous statements that sounded suspiciously like a plan to replace Medicare with personalized health savings accounts financed with federal contributions, Carson replied: “No, that – that’s the old plan. That’s been gone for several months now.”
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Carson told Wallace that the savings accounts would be an "alternative" to the popular Medicare program.
Carson has been promoting his health care funding scheme for more than two years and has spurred interest among conservative audiences even as he has baffled experts on precisely how it would work and how it would be funded. While federal tax law currently encourages employees to supplement their health care coverage by contributing pre-tax dollars to health savings accounts, the idea of using health savings accounts in place of health insurance purchased through the Affordable Care Act or Medicare coverage for seniors seems far-fetched at best.
Carson’s campaign website offers only the sketchiest description of his proposal. But as he has said in the past, “When a person is born, give him a birth certificate, an electronic medical record, and a health-savings account to which money can be contributed – pretax—from the time you’re born till the time you die. If you die, you can pass it on to your family members.”
Under this approach, the federal government would contribute a minimum of $2,000 to each individual’s tax-free account on an annual basis. About a third of those funds would go for purchasing insurance to cover severe medical incidents.
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Wealthier individuals and employers could contribute additional pre-tax funds to the accounts if they choose, and money left over could be shared among family members. His main argument was that his plan would eliminate the government “middleman” – Medicare and Medicaid -- and give individuals far more control over their health care spending. In the process, he argues, it would help to bring down the overall cost of the U.S. health system by encouraging Americans to find the least expensive coverage.
At one point last year, Carson estimated that his plan would cost the federal government $630 billion a year to provide a $2,000 contribution to an estimated 315 million Americans. He said in an April 2014 video that the total is “not a whole lot compared to what we’re spending now, and everybody would have healthcare.”
However, as Politico reported recently, Carson’s estimate doesn’t take into account growth in population, inflation and administrative costs. Nor does that total cover a continuation of Medicare and Medicaid-style government programs – as he described them -- to cover the treatment of an estimated five percent of patients “with complex pre-existing or acquired maladies.”
With so many years of experience as a nationally renowned surgeon and health care expert, you would think Carson would know better. But even under the best of circumstances – with savings compounding for younger Americans with few health problems -- Carson’s medical savings accounts would barely begin to cover the overall health care costs of individuals. The government estimates that U.S. per capita spending for health care costs more than $9,000 a year, while the figure exceeds $11,000 a year for elderly patients.
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Carson's call for replacing Medicare for many Americans runs counter to the GOP national platform and is highly risky in Iowa, where polls show he currently draws a quarter of the senior vote, or more than twice as many as any other GOP candidate except Donald Trump, according to Politico. Trump said over the weekend that he was “okay” with medical savings accounts, but he has said before that he doesn’t favor tampering with Medicare or Social Security, two of the most politically sensitive programs.
During his appearance on “Fox News Sunday,” Carson bobbed and weaved in attempting to recast his medical savings account plan as one that empowers average Americans while still allowing them to remain with Medicare or Obamacare if they choose.
“What the program that I have outlined using health savings accounts starting from the time you are born until the time you die, largely eliminates the need for people to be dependent on government programs like that,” he said. “But I would never get rid of the programs. I would provide people with an alternative.”
