Posted on 03/28/2017 8:46:45 AM PDT by Kaslin
The failed House Republican American Health Care Act (AHCA) was always a work in progress. The three-phased approach to reform health care called for passage of the AHCA to repeal the Affordable Care Act (ACA) taxes and mandates; and slow the growth in Medicaid as (i.e. phase one). Phase two was the selective removal of Obamacare regulations by the Secretary of Health and Human Services. Phase three was to be a forthcoming health care bill to revamp onerous insurance regulations.
Passage of the AHCA (the Obamacare repeal bill) would have resulted in numerous benefits – getting rid of the individual and employer mandates, stopping the open-ended exchange subsidies and the huge expansion of Medicaid that will bankrupt America over time, are but a few.
However, it had its shortfalls. One misguided provision was the Managers Amendment, which would not allow Americans to use any part of their tax credits to fund Health Savings Accounts (HSAs). Instead of being able to use a portion of their tax credit to pay for doctor visits, prescriptions, and OTC drugs, Americans would only be allowed to use their credits towards insurance. This was a big mistake for a variety of reasons. Purportedly the amendment disallowing tax credit to fund HSAs was designed to appease those who do not want anyone using their tax credit for an abortion. Of course, this same rule would have also prevented Christian health sharing ministry members from using the credit towards their and fellow members’ medical care.
Tax credits were a sticking point for some conservative Members of Congress. A tax credit for those who lack employer coverage is the right thing to do politically, however. Higher-income workers get huge subsidies through the tax code for employer coverage, so it’s hard-hearted to tell moderate-income people who lack employer coverage they get nothing. A tax credit is also an opportunity to give millions more Americans an HSA. If the credits were automatically deposited into individuals’ HSAs, they could be used for health insurance premiums, copays, cost-sharing and to pay directly for care.
If allowed to do so, Americans may even decide to forgo health insurance coverage and use the entire credit/HSA to pay directly for medical care. That provision allowing this should be included in any future bill. For well over half the population, an HSA with $2,000 to $4,000 would be sufficient to fund their entire annual health care needs in cash.
Consider this: the goal of Obamacare was to get as many healthy people into the insurance market as possible to subsidize the money-losing enrollees with pre-existing health conditions. That’s why I say Obamacare is a bad deal for most Americans by design. As a result of the high Obamacare premiums, millions of Americans now have health insurance coverage with deductibles so high that their health plan pays little if any of their routine medical bills. Yet all plans are required have no annual limits or lifetime limits on benefits. Stated another way, people are required to buy expensive health coverage that is not expected to pay for their own care; rather it’s designed to pay for someone else’s catastrophic medical needs. There is nothing wrong with pooling risk, but Obamacare goes far beyond pooling risk and instead coercively redistributes wealth from young to old; healthy to sick.
The key to reining in runaway health costs is not to boost coverage to more and more people as Obamacare tried to do. The key to slowing the growth in health care spending is to make more and more people care more about their medical spending. To this end, it would actually be better for the health care system if millions of Americans decided to forgo insurance, dropped coverage and used their tax credit/HSAs on direct primary care. That is something that most policy analysts fail to understand. Increasing comprehensive health insurance coverage does not reduce health care expenditures (it increases spending). Rather, starving the beast does reduce expenditures. To that end, another good idea is to revamp the essential health benefits required in all plans. It cannot be done through budget reconciliation along, but some experts believe that Secretary Price has the authority to tweak these provisions. Secretary Price already has the power to drop the appeal of House vs. Price (formerly House vs. Burwell) that found the ACA’s cost-sharing subsidies are illegal because they have not been appropriated by Congress. Dropping the appeal would stop the government from paying Obamacare’s illegal cost-sharing subsidies, which would likely cause insurers to pull out of the market unless changes were made. That too would put pressure on Congress to find a solution to the stalemate that exists on reforming insurance regulations. These are the regulations that make Obamacare premiums so expensive.
The Republicans in the House need to use their brains and grow a spine. Obamacare is collapsing. All that will prevent the collapse is either: 1) Huge budget-busting taxpayer subsidies until the end of time; or 2) reforming the insurance markets, which Democrats are loath to do. Congress needs to get back to work on a new health reform proposal. While that is in progress Secretary Price should continue with Phase Two (tweaking regulations), which might lead to a sound health reform.
Yes. And that's why there is nothing the Republicans can do to fix Obamacare or come up with a less expensive replacement.
Correct, except when discussing this issue, when you use the term "expensive", it's important to be clear about "expensive for whom"?
Right now, a lot of the expense to productive citizens is concealed, because they would never tolerate it were it explicit.
But, again, the People will not tolerate zero care for the people of WalMart.
Libertarian dreams about these people along the lines of "If only they read Adam Smith" are autistic if not retarded.
Solve the problem of WHERE 50 million adults incapable of balancing their checkbook or exercising minimal self-care will GO to get care, and WHO will pay HOW MUCH for it, and UNDER WHAT CIRCUMSTANCES, then you can have a kickass system for everybody else.
Don't solve that problem, you will have the USSR system within ten years.
While it is true that the uninsured have simply walked into emergency rooms countrywide, received care, and for the most part stiffed the hospitals and doctors. Those hospitals and doctors increased their fees to cover it, while at the same time deducting it as a business loss.
The bottom line is that WE paid it through increased fees and through higher taxation.
At that level, you are right. The government (we the people) have been paying for years.
The idea is to bring the actual costs out into the open. That makes sense to me, since extortion generally costs more than open payment based on standard prices.
As much as some conservatives would like to dream, we are not going back to the wild west of health care, each man for himself. It isn’t going to happen in my lifetime, anyway.
That does not, however, mean that there is no way to incentivize the system so that people aspire to be independent and with that independence acquire insurance that meets their needs, whether extravant or bare bones.
There must be some sense on the part of those swiping a government health care card in a doctor’s office that theirs is a plan that isn’t all that it could be.
They must be paying for 15 year old used cars, while others are able to buy new efficient or luxury models because they can afford it.
We can all aspire to a 20 room mansion on 50 acres, but we are content with 2000 square feet in a good neighborhood.
Others choices should be 600 square feet in a run-down complex.
Give people something to aspire to.
1. There will be a VAT to pay for it. That hamburger, now, that 8 years ago was $5.99 and is now $12.99 (for nothing) will cost $21.99--apply that to everything--sneakers, jeans, underwear, etc.
2. The system will be known to SUCK and no self respecting person of any means will use it. In fact it will be akin to driving a 1977 Pinto as far as status and prestige go.
What a nightmare.
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