Following are the key provisions of Trump’s replacement strategy for Obamacare. Look hard and you still won’t find anything of substance or value. And, nothing close to a replacement. But look real hard and you will find more cost shifting to individuals, especially the tens of millions of Americans with employer-based coverage.
“Free markets” is a buzz phrase with little meaning in health care. Anyone who talks about competition among insurers as a key factor in controlling health care costs DOES NOT know what he or she is talking about.
HSAs are nothing more than cover for high deductibles and cost-shifting. Sure because the individual pays more out-of-pocket, premiums will be lower but the rate of increase is unaffected. And HSAs and high-deductible health plans are outright harmful to modest and lower-income individuals.
Shop for the best price for a procedure? Is that how we are to receive high quality health care? Doc to patient: “You are going to need a double bypass.” Patient: what do you charge?” Doc: My fee is $4,500 and the anesthesia will be about $2,000.” Patient: Oh I think I can do better than that. I’m going to take my time and shop around.” Doc: “I wouldn’t shop too long. And by the way, keep in mind I only do surgery at XYZ hospital.”
Trump (and others) also want insurers to be allowed to sell coverage across state lines in the misguided notion that increased competition will result in lower premiums. Nonsense‼️ How does he think that will happened. Insurers use networks of providers with their ability to negotiate (whoopee a Trump word) lower fees based on the patient volume they can deliver. The more insurers in an area the less leverage each will have. In addition, each insurer must create and administer a network in the additional regions they sell insurance.
Once again the “experts” view health care costs as premiums and insurance.
Trump, You’re fired !
Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.
Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.
Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.