Healthcare

4 steps for Trump to undo Obamacare 🤥

Does the far right understand health care or health insurance or people? Ah, not so much😏

Read the following; 😷the free market will solve all our problems. 😷Isolating high health care risks solves our problems. 😷Turning people loose on their own to buy health insurance will solve our problems (just like eliminating employer-based pensions solved the retirement savings problem).

Some doctors actually believe that having patients pay out-of-pocket for outpatient services will lower costs. And what about the insurance company competitive market? What nonsense‼️Let them explain exactly what portion of any health insurance premium is subject to competitive factors. Hint; somewhere around fourteen cents of every dollar … and then ask what needs to be done to impact that $0.14🤑

Those conservatives know nothing of the employer environment where about 70 million Americans receive coverage through self-insured plans, no insurance company risk involved. Based on the following they also don’t understand the concept of the insurance risk pool or that with Obamacare it is quite easy for a person to change jobs and still get health insurance.

“Personal health responsibility, individual liberty?” Nice sounding words except when you throw in the reality of human being decision-making. What world do these people live in?

The Republican Party now is moving away from repealing Obamacare and is discussing “reform.” Besides being one more step on the road to GOP irrelevancy and displaying feckless disregard for the will of conservative voters, it is impossible to reform a system predicated on theft and false economics…

The first thing, is to understand what real insurance is. Real insurance (think your house or car) is owned by the individual. It is therefore portable. It is purchased early in life when you are healthy, and the insurance is therefore affordable. It is for catastrophic illnesses only – not for every little sniffle or outpatient test. By paying cash for outpatient tests and doctors visits, and by removing outpatient care from the nightmarish Medicare regulations, fees for services will drop to free-market, competitive levels. And, by paying premiums throughout your life, your insurance company in a truly competitive market – not in a government monopoly market – will offer affordable rates for seniors by investing premiums over their lifetime. Actuaries, not government toadies, will determine rates.

So the four steps to unwinding the medical mess is as follows:

1. Eliminate all government regulation on the sale of health insurance. Do not mandate coverage; do not limit sale across state borders. Sell to people of any age, and reward people who are responsible and in good health with lower premiums. It is time for the GOP to actually do more than spout words of limited government and individual freedom.

2. Set a time for the phasing out employer-based health insurance. Like dealing with any bad business plan or bad debt, there is no pain-free solution to come out of the problem. Your employer doesn’t own your car insurance, and he should not own your health insurance. Personalized insurance you can tailor to your needs can be 50 percent cheaper than what you are having deducted from your paycheck. Everyone will shriek, “How can that possibly work?” The answer is that a real free market manages to price things so people can afford them. Governments make everything artificially more expensive.

Before Obamacare a young healthy person could get individual health insurance for $60-70 a month. An employer might pay $200-300 for the same person’s coverage. By linking health insurance to employment we have created a large group of people in their 50s who cannot quit their jobs without losing their health insurance and because of their age would become uninsurable. These people must be transitioned to either private insurance or to a Medicare type product, whichever they choose.

3. For anyone at or near Medicare age, say 50, or for those with uninsurable illnesses, who have no private insurance, the government will need to maintain the Medicare system till they are deceased. Like dealing with a bankruptcy, we must acknowledge debts that simply must be absorbed. But Medicare must be phased out by letting younger people buy lifetime health insurance unencumbered by government regulations. The Medicare Plantation will go away in favor of top-quality, free-market medicine – which was working well for the elderly until Medicare was forcibly imposed on them.

4. Medicaid – state-run “charity” care – must be replaced by personal health responsibility, individual liberty to buy whatever type of medical care a person wishes and local, personal charity. Medicaid costs my state about $40,000 a year per enrollee. And the worst part is it offers terrible access to sometimes bad quality care. Ultimately, we must make people responsible for their own health.

Source: 4 steps for Trump to undo Obamacare

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2 replies »

  1. Well, too bad you cut off the column before we got to the good stuff.

    She later says: “… Now, to unwind this degrading and unworkable system, and to save money immediately, let’s give every Medicaid patient a $5,000 Health Savings Account, which grows tax-free and can be used for all health-related expenses. Additionally, government would pay about $4,000 for catastrophic health insurance coverage that only pays for big-ticket items. Let the patients prioritize the use of their savings account for smaller medical bills. At the end of five years, stop funding Medicaid at all and let former recipients use these tax-deferred HSA funds to buy private insurance – understanding that they will not be allowed “free health care.” They will be held responsible for their medical bills. …”

    A variant of that methodology would actually work. We don’t need to repeal and replace Health Reform. Don’t ever say I didn’t give you the solution that works at expanding coverage while lowering costs:

    Create A “Replace” Option Within Health Reform’s Existing Rules – Effective January 1, 2018

    Most observers believe the Republican Congress will use a two pronged attack to repeal/replace the Patient Protection and Affordable Care Act of 2010 (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HERA):
    • “Repeal” – The Republicans will use the reconciliation process to avoid a filibuster and curtail PPACA/HERA future financial revenues (including avoiding transfers from general revenues) after a transition period (perhaps starting July 1, 2018 to run out of money just before the 2018 mid-term elections), and
    • “Replace” – The Republicans will attempt to pass revisions to PPACA (endorse health savings accounts, multi-state policies, etc.) while retaining attractive PPACA provisions (kids to age 26, no pre-ex, etc.), only to fall short of the 60 votes needed for cloture (a vote to stop debate in the Senate). That is, while Democrats can’t stop “repeal”, they can impede “replace” and use broadcast and print media allies to place the blame on Republicans – particularly once the funding for taxpayer subsidized PPACA provisions is exhausted (Medicare Rx, Medicaid, public exchanges, etc.). Republicans, in turn, attempt to blame Democrats for failing to agree to “replace” and curtailing 20+MM American’s health coverage – specifically targeting the 25 Democratic senators up for reelection in 2018 (10 in states carried by President Trump)

    Reconciliation is a legislative process requiring only a simple majority in both houses of Congress. It adjusts the budget to reduce spending, raise revenues, or change the debt ceiling. Typically, it selects a committee which identifies the dollar savings to be achieved by a stated deadline. Senate debate is limited to 20 hours. So, “repeal”, by curtailing funding, is “easily” attained. But, the reconciliation rules don’t apply to “replace” legislation.

    A Better “Replace” Option/Alternative:

    PPACA §1332 and §1115 provide for State Innovation Waivers to replace public exchange coverage (effective 1/1/17) and Medicaid (effective 1/1/14), respectively. Five states have Medicaid waivers – including former Governor Mike Pence’s Indiana. Alternatives are permitted if they don’t reduce the percentage of a state’s population with health coverage and if they offer health coverage that is just as affordable/ comprehensive. The alternative must equal or exceed PPACA coverage, affordability, and regulatory goals.

    Note that today, 30+MM Americans remain uninsured.

    This proposal retains PPACA (along with IRC §§105, 106, 125, 223). It replaces all Medicaid. It limits Public Exchanges to a single option. It makes employer-sponsored coverage more attractive. Ohio is the pilot:
    • Default all lawfully present in Ohio (including Medicare & Medicaid participants) to “Minimum Essential Coverage” (MEC) plus a per person, $25,000 calendar year attachment point stop loss coverage in which covered expenses > $25,000 are limited to Medicare allowable, subject to modest point of purchase cost sharing (copays, etc.), and
    • Individuals/employers would be encouraged to buy “basic coverage” for the 1st $25,000 of potential, non-preventive expenses in a calendar year. The MEC/stop loss premium would be part of all “basic coverage” option – individual insured policy, insured/self-insured employer-sponsored plan, or Medicare. Medicaid would be eliminated. “Basic coverage” is limited to point of purchase cost sharing equal to or less than IRC §223 limits (HSA-qualifying HDHP).
    • Limit Medicare Advantage to HSA-qualifying HDHPs (Medicare allowable limits) – insurers may/may not fund a HSA.
    • Traditional Medicare will not be offered for anyone commencing coverage on or after January 1, 2018. Those with traditional Medicare who transfer to Medicare Advantage will not be permitted to transfer back.

    The MEC/stop loss default covers all lawfully present Ohio residents – exceeding PPACA’s coverage goals and meeting PPACA’s affordability goals (remember, per Health Reform’s provisions, any MEC coverage is deemed to meet PPACA’s affordability requirements even if does not include “Essential Health Benefits”).

    Stop loss premium will be set on a cost-plus basis – administered by private insurance companies similar to Medicare Part A & B intermediaries. Stop loss cost exposure is capped by limiting eligible expenses to Medicare allowable amounts – offering employers a significant financial incentive to offer “basic coverage”. Similarly, stop loss minimizes insurance company concerns about catastrophic losses and preexisting conditions.

    All individuals without Medicare coverage can elect public exchange “basic coverage” – only one option is available using IRC §223, HSA-qualifying coverage (minimum deductible = HSA-qualifying deductible, IRC §223 maximum out of pocket). Where not employed, or where the employer does not offer “basic coverage”, individuals can qualify for taxpayer financial support at the 2017 subsidy levels – including anyone with adjusted gross income less than 400% of the FPL (significantly reducing taxpayer cost). Dual eligibles receive coverage comparable to that in place today.

    * MEC coverage includes the preventive coverage mandated by health reform and normal medical expenses required for medical trials.

    Post your criticisms (if you have any) so that I can make this proposal better.

    Like

    • Do you seriously believe that Medicaid beneficiaries can and will handle those decisions? Heck average working people can’t make prudent choices.

      Like

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