Posted on 03/09/2017 5:37:44 AM PST by pgkdan
The moment Republicans bought into the notion that Obamacare must not just be repealed but “replaced,” Democrats won. Democrats argue that health care is a “right.” Republicans claim they disagree, that nowhere in the Constitution does the federal government guarantee health care treatment or health care insurance. But Republicans' behavior suggests otherwise.
President Donald Trump, for example, says that in replacing Obamacare no one should be worse off; that insurance companies cannot decline those with pre-existing medical conditions; that insurance carriers must allow parents to keep their “children” on their insurance plans until the age of 26; and that insurance companies cannot drop people under any circumstances. Polls show that these are the most popular features of Obamacare. But forcing an insurance company to cover people with pre-existing conditions completely destroys the concept of insurance. Insurance is about pooling groups of people whose premiums cover unknown risks, not known ones.
The “replacement” plan runs head-on against two principles of economics. Competition makes products and services better, cheaper and more accessible. And there’s no such thing as a free lunch.
Health care — just like cars, sweaters and smartphones — is a commodity. But health care is one of our most regulated industries, a far cry from a free-market-based system.
Start with the supply of doctors. Because of regulations, the supply of doctors has been artificially limited. Economist Milton Friedman once compared the American Medical Association to a medieval guild that shuts out would-be practitioners and artificially protects the wages of doctors. In a piece called “American Medical Association: The Strongest Trade Union in the U.S.A.,” Mark Perry, a professor of economics and finance at the University of Michigan and an American Enterprise Institute scholar, writes:
“Between about 1970 and 1984, there was a significant increase in medical school graduates that pushed the number of new physicians from 4 per 100,000 Americans in 1970 to almost 7 per 100,000 by 1984. Since 1984, the number of medical school graduates has been relatively flat … while the population has continued to grow, causing the number of new physicians per 100,000 population to decline to only 5.3 per 100,000 by 2008, the same ratio as back in 1974. Over the last few years the number of medical school graduates has increased slightly, and the ratio of graduates per 100,000 increased to 5.56 last year, the highest in a decade.”
What’s wrong with this picture? An aging population, in need of more doctors, on a per capita basis, has fewer of them. Economics 101, supply and demand and plain common sense tell us the opposite should be happening.
This is the argument Republicans should be making. The true replacement plan should be loosening regulations that prevent would-be doctors from entering the field, and prevent less-schooled and less-credentialed paraprofessionals from doing things that only licensed doctors can now do.
We train battlefield medics in Iraq and Afghanistan to deal with battlefield trauma, saving countless lives. The Oscar-nominated film “Hacksaw Ridge” depicted the true story of a medic with aspirations of becoming a doctor, whom the army trained to treat battlefield injuries. But that man, had he returned stateside and tried to set up a practice to treat victims of urban gun violence, would have been guilty of practicing medicine without a license.
There are many examples. In some states midwives cannot legally deliver babies, despite ample evidence that they possess the experience and ability. In his joint address to Congress, Trump criticized the lengthy and expensive process of getting a drug approved by the FDA. In some cases, drugs that could help people do not become available even when risks are known and desperate patients would be willing to assume these risks.
We strangle the health care and insurance industries with regulations, licensure requirements and barriers to entry that artificially increase the cost of health care. We prevent people from buying health care across state lines.
We advise developing countries to follow the well-worn path to prosperity — free markets, free trade, rule of law and property rights. Yet when it comes to nearly one-seventh of our economy— health care — we ignore our own advice. For health care, we don’t write ourselves the proper prescription.
But repeal the damned thing first!
We all have short memories. We all knew that if Obama were reelected that his monstrosity would be so rooted in this country that we could never get rid of it. We need to remember this. It is the Herpes of all government programs and I don’t think there is all that much we can do about it.
I completely agree with your solution. It’s not within the purview of the federal government to be involved in health care. Any legislation regarding health care should be geared toward removal of restrictive federal laws.
I know what is best. But do you have the votes to do what you ask. I don’t think you are close. In fact, I don’t think you have the votes even in the House.
The house voted for several bills that were never going to go anywhere. But they will not go anywhere now. Because those bills will drop people from health care and most republicans will not vote for something that drops people from coverage.
ABSOLUTELY!
Let the free market determine cost. But ACA was never about cost, it was always about control.
If it is repealed outright, won’t millions of people be left with no insurance until something new is implemented?
Why would they? They have plans in place that they're paying for. If it's a genuine concern it can be addressed in the Repeal legislation.
They don't have the votes for the obamacare-lite plan that Ryan's pushing.
Free ‘Basic’ healthcare should be provided to all US citizens regardless of income. Beyond that... not
Strange that this crappy nothing insurance is a must have but people adjusted to no jobs, no houses and everything costing 4x as much PDQ.
But forcing an insurance company to cover people with pre-existing conditions completely destroys the concept of insurance. Insurance is about pooling groups of people whose premiums cover unknown risks, not known ones.
I disagree: insurance spreads the risk among those in the pool, known and unknown. If you do not want to pay the risk of others don’t buy insurance.
That said, portability should be obvious. It makes no sense to have a diabetic covered under the policy of company A only to have to wait 2 years if he moves to company B...sometimes using the exact same insurer. Now, most folks automaticly cover new hires without questions.
So, like the keeping kids on policies until they are 26: just how big a deal is that? Really doesn’t matter: If you WERE covered, you should BE covered. Even in a market based solution someone will offer that and will gain because of it.
This zerocare boondoggle just has to go away. The replace folks need desparately to step back.
Not gov’t job to insure ....get gov’t out of healthcare and out of our pockets
“But repeal the damned thing first!”
How would you repeal it when every second of every day people are in the Hospital using it?
Would doctors/Hosp’s agree to preform operations they won’t get paid for?
Try changing medical ins while you are in the middle of being treated for a serious injury/illness. You will have half the bills rejected by both ins companies.
Bingo!
How basic are we talking? I mean, if your “basic” care covers, say, cancer treatment, it’s still going to be incredibly expensive.
On the other hand, I can see an argument to be made for some things. Prenatal vitamins, for example, cost little and can prevent the birth of children with mental defects that will leave them as a cost to the state for the rest of their lives. And anything cheap that can keep people from racking up emergency room bills that they won’t be able to pay (and thus pass on to everyone else) - such as antibiotics and whatnot - I can support that. Vaccines, too - you don’t want disease spreading.
But you have to be careful because people are going to try to pack as much into “basic” healthcare as they can. You know, where there’s a solid economic case that it saves us money to pay for something... good, go for it. But if the healthcare is to make other peoples’ lives longer/better, at our expense... it’s their responsibility to make their lives better. Anything else is socialism.
No they're not! They're using the lousy health insurance they were forced to buy under the law. Repeal the law and let the market place set prices. We don't need the frigging government making these decisions for us.
The old “Mend it, don’t end it” mantra doesn’t cut it this time around.
Do your job Congress (for once).
The insurance will still be there. Their ability to pay for it would no doubt be impacted by ending the subsidies or if the end of the Medicaid expansion tightens eligibility.
They did last year when they sent the bill ending subsidies and Medicaid expansion to Obama. What's different now, except for the fact that this time it might get signed?
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