2 Words That Spell Doom For The GOP's ObamaCare Replacement Plan

Investor's Business Daily ^ | 3/14/2017 | John Merline

[IBD editorial writer]

When selling the House Republican's health care bill, Speaker Paul Ryan says that ObamaCare is failing and must be replaced. He also promises that the GOP bill will "ensure vital protections for patients with pre-existing conditions."

There is just one problem with this formula. ObamaCare is failing precisely because of those very "vital protections" Ryan wants to preserve.

What Ryan is talking about goes by the technical name of "guaranteed issue." This law bans insurance companies on the individual market from denying coverage or charging people more because of their health status.

It's a reasonable goal, and one that health reformers have struggled to achieve for decades. And not surprisingly, "guaranteed issue" polls well with the public.

But "guaranteed issue" does not work.

[Tymesup]

“2 Words That Spell Doom For The GOP’s ObamaCare Replacement Plan
Paul Ryan”

Besides the economic problems of Obamacare, it was unlikely to succeed because it was supported entirely by Democrats and opposed entirely by Republicans. The GOP plan is unlikely to succeed unless it has some Democrat support.

[Jimmy The Snake]

Let me throw a pre-existing condition horror story in from the 1980s. Mgr at work was at odds with the Director. The Director was not overly kind and would be what the consider today abusive, hostile work environment kind of stuff. The guy would have switched jobs in a nanosecond. BUT his wife had cancer and it was a long cancer fight. He was stuck as if he switched jobs, she had a pre-existing condition, and would not get picked up on the insurance of his new employer. He was stuck and the Director guy knew and would remind him of that from time to time and smirk.

[trebb]

Can you name one President before Trump that was of a mind to do the best he could to allow such to happen?

Your statement is a bit of the reality that we live in and why we can hope for much but not expect a "full-monty" clean sweep. Things will have to be whittled at and even then the tentacles of entitlements are woven so deep we can only hope for a concerted effort and slow progress.

Your statement also outlines the dilemma we are in and what reality brings to the game - we can either support Trump's efforts and help him do what he can or we can try to condemn hi because the reality is even bigger than him. He's a fighter with our interests in mind - I won't condemn him for "failures" that he cannot achieve on his own and which will be fought tooth and nail by the Dems/RINOs/GOPe.

[mad_as_he$$]

I agree 100%. Lou was overselling and Betsy is the best at finding the good/bad in these bills. She rocks.

[b4me]

self inflicted - I’ve heard and it makes sense that 80-90% of all disease/illness/injury can be linked back to thought life and the stress we create in our self (staying up late, making poor choices like indiscriminate sexual partners, smoking, drugs, even OTC and Rx in some cases, addictive/cyclical anger, self hate, victim, it won’t happen to me, I’ll take care of it later mentalities mindless eating, video games, reading just for the sake of reading, addictive over exercising, internet addiction, etc- they all influence us to choose poorly, cause repetitive injury, or slowly lead to imbalance in the body or mind and illness down the road. There are many other “self” choice factors i didn’t even mention.

There is a huge spiritual component (God, self, devil) to wellness and illness that our modern medicine and health system shun for the sale of doctor/consultant visits, pills, procedures, ungodly thinking systems or activities.

Self inflicted can include overwhelming majority of people.
I think it includes just about everyone.

So where do we draw the line about self inflicted health conditions?

[Hugh the Scot]

Unfortunately this is where all government solutions come to rest...

Hand-picked corporatists siphoning taxpayer money from a socialism scheme.

[Drew68]

Some people don't take care of themselves. Many health conditions are self-inflicted. Many are not of course, but the way government operates now is that the innocent are punished along with the guilty.

The problem isn't fatties eating cheeseburgers so much as it is the massive, massive population of baby boomers living longer and longer. Ironically, many of whom did take care of themselves, starting about a quarter century ago when they led society in becoming more health conscious. Having given up smoking, drinking, fast food and embracing exercise and healthy diets, they're now living long enough to need more medical care, unlike their parents who dropped dead of heart attacks at age 60.

And did I mention this population is massive? There's a whole bunch of these Boomers, their productive years behind them and a decade or two of spiraling medical costs ahead of them (not to mention pensions and social security). This is why it was mathematically imperative that young, healthy people offset their medical costs.

This demographic imbalance of baby boomers, and what they will cost society, may be beyond the ability of politicians to fix.

[Drew68]

So where do we draw the line about self inflicted health conditions?

For most of us, no matter how healthy you are, at some point you will need expensive medical care. It doesn't matter if you are 40 and dying from alcoholic cirrhosis, 50 and dying from smoking-related lung cancer or 85 and dying from multiple organ failure, for those of us who die naturally, about 90% of all our medical costs will be spent in our last two years of life.

[Drew68]

That’s a gift from Donald J. Trump. He made that a stipulation, that pre-existing conditions must be covered.

Baby boomers will not accept anything less. And since there is a bajillion of them and they all vote, this was pretty much non-negotiable.

[FirstFlaBn]

This is all a result of politicians making unsustainable promises in 1965. Everything is about cost shifting from Medicare and Medicaid.

I have yet to see any responsible analysis of what the cost per insured is for covering pre-existing conditions and allowing 26 year olds to stay on their parents’ policy.

It must be high or there wouldn’t be such a total effort to conceal.

One final question: would Ryancare legally prohibit groups of individuals from forming co-ops to pay the 30% penalty for anyone in the group waiting to sign up for health insurance who then gets sick? Since the penalty only applies for a year, the cost, say for a group of ten healthy folks, would be minimal.

[SkyPilot]

Excellent points both of you. Yes, the Boomers living longer, and the costs associated with taking care of them (medical, social security, pensions) may be something that is unsolvable (politically and financially).

I also agree with b4me that there is a spiritual aspect to health. His/her statements have a Biblical foundation.

If health insurance was sold and priced like car insurance, it would go something like this:

Carrie: Excellent driving record, zero traffic accidents or violations, one parking violation, drives a modest mid-size. Annual insurance premium: $650

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David: multiple DUI arrests, 4 major traffic accidents in the last seven years, multiple speeding and traffic violations, license suspended twice and recently reinstated. Annual insurance premium: $3,500

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Aaliyah: One recent accident (cited at fault), average driving record. Two speeding tickets last 12 months. Annual insurance premium: $1,500

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José Luis: Illegal alien. Multiple traffic violations. Involved in recent traffic fatality, serious injuries to other driver. Annual insurance premium: $0, he carries no insurance.

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And this is how our politicians deal with the situation:

"Let's even this out. The older woman can't pay the full amount, so let's subsidize hers. The illegal's car insurance has to be paid for, or else he just goes without insurance. Let's make the premium for the young woman with the good driving record $2,850 to help pay for everyone else. Sound fair?"

[semimojo]

The seeds of success are in this bill in the section of this bill that pays directly for the cost of the sickest, allowing premiums to come down for the healthy

So this shifts the costs from those buying insurance to every taxpayer.

You can pay via your insurance premium, which is pretty transparent and keeps the issue of medical costs front and center, or you can bury those costs and cover them via general tax revenues as we've historically done.

Either way, as a society we're still paying the costs.

[slowhandluke]

Re: multi-state access

This keeps the Fed in control. Every insurance company is already allowed to sell in every state, they just have to follow state rules.

Since state rules can be considerably different from state to state, insurance policies will differ from state to state. Texas, with their plantiff friendly courts, will likely always have higher insurance rates than Delaware to cover higher malpractice awards.

No state is limited to only one car insurance provider, as they are with Obamacare for medical insurance. The multi-state-access bit is just a cover for the insurance companies wanting a single place to lobby/bribe for better profit.

[IBD editorial writer]

Exactly right.

[IBD editorial writer]

Thanks for the feedback.