Posted on 03/05/2017 6:15:34 PM PST by Tolerance Sucks Rocks
I don't think people can just walk into an emergency room and demand a check-up or cosmetic surgery.
First, my point #10 refers to (for example) allowing Aetna Healthcare of Delaware to merge with Aetna Healthcare of Connecticut and Aetna Healthcare of Utah and so on. Paperwork and overhead costs would be reduced.
Second, I think that you and I disagree about the likelihood that ObamaCare could actually be repealed without simultaneously providing a “replacement”.
Since I think that stand-alone “Repeal” is DOA, I want to focus on providing conditions that would encourage free-market entrepreneurs to provide a variety of health-care insurance plans, designed to appeal to many different types of consumers.
IMHO, if the cost of individual, “portable” healthcare plans is reduced by making their premiums tax-deductible, then employer-provided healthcare plans would become less attractive.
If keeping “...the wealthiest...” from getting the full benefit of such tax deductions is desired, then a “cap” to limit deductions is a simple solution.
Congress has said they are working on a simultaneous repeal and replace, including an ability to sell across state lines. If you are now proposing that your plan is to do the two simultaneously, you’re really agreeing with Congress.
And even if employer-provided plans were less appealing, you would have captured the market distortion from them in your own, more direct, government subsidies. That is the major point I think you are missing. How do you think college costs grew so quickly over the past 30 years?
What we most just need to do is to get the government distortions out of the market, such that, for example, people only purchase insurance for catastrophic coverage. But in practicality vested interests, including corporate and union lobbying of Congress, make that unlikely. Thus, Congress is doing the usual and replacing with an Obamacare-lite that will continue to make the market fail—just more slowly than the Democrat approach.
On this, I stand with Rand.
The Paul plan is a good plan. The Ryan plan is just Obamacare in a nice Republican suit.
Replacing Obama-care should be temporary legislation IMHO, not something that lingers. DocFix for example, forgiveness of medical debt if the doctor accepts a generous percenatage from the govt — that’s an annual bill that doctors had learned to count on.
... but ...
Then we can drive wedge issues — grossly self-inflicted disabilities should not be funded in any way.
For example, some goon shoots at a policeman who shoots back. The criminal is hospitalized and crippled for life. Of course we should keep him alive until he is found guillty. But after found guilty?
Since the cripple is hardly a danger in public, why feed him in prison?
Judge could rule ‘time served’, and out in the street the creep goes. NO government aid of ANY kind. It was an incredibly GROSS [and evil] way to get himself crippled. No SS. No hospital — just private charity.
How many people would agree with that?
We need to get the government out of healthcare completely to bring down the costs. But of course we’ve got people who have paid a lifetime into Medicare and expect to get that coverage—so that should be the last to go.
There is zero reason for the federal government to be involved in healthcare at all—and it should transition out of Medicaid.
However, we’re not going to let the truly needy go uncared for—however they got there. (E.g., most most costly Medicaid costs are tied to obesity.) What we need to do is minimize the truly needy with free market reforms and incentives that make more people able to pay for it themselves.
Yes, I know what you’re referring to, but that actually isn’t a big saver (most insurance companies are already pretty big at the state level) and it ignores the fundamental drivers destroying the market.
Making plans “tax deductible” does three bad things—it simply shifts the costs onto others, it provides an incentive for every last thing (as opposed to just catastrophic care) to be covered in a third-party system, and it encourages higher costs and overuse.
What we’ve got and what people who are actually being subjected to that they find so odious is that Obamacare as it stands is tantamount to old catastrophic coverage with a very high deductible but they’re not getting anything in return for that very high deductible, it’s still a very expensive policy, and they’re forced under penalty of law and financial penalty to buy this inferior policy. That’s the problem in a nutshell for people who are in the difficult position of actually having to deal with this boondoggle on the exchange. Arguing back and forth over fine points of political principal is going to be lost on most. Solve the problem of being able to have decent medical insurance at a price that is acceptable. If that involves government at some level, and I don’t see how it can’t with preexisting conditions and indigent care, then so be it. The Ryan bill does not solve this it actually increases the penalty, but it’s not forced by law currently even though the door appears to remain open. On principal the Paul bill is much more appealing, however if principal does not get the above problem for actual policy holders in the exchange solved, it will be just as hated and just as much of a failure as Obamacare but hung around the necks of conservatives.
“But of course we’ve got people who have paid a lifetime into Medicare and expect to get that coverage—so that should be the last to go.”
That is very realistic and practical.
We need a phase-out plan that offers soft landings before we shift completely to private charities and personal accountability. IMHO — the most concrete way to achieve that is via a constitutional amendment. Otherwise, they will keep tinkering with it.
BTW — before we can truly improve healthcare we need to straighten up peoples’ thinking about it.
Not merely education, but I’ve worked out a ‘mandatory debate’ plan that will force key public figures into fair time / no moderator debates with each other.
Not just healthcare but all issues.
Making healthcare insurance costs “deductible” for corporations, but not for individuals, is a ancient distortion, that IIRC dates back to WWII.
True, that distortion could be corrected by repealing that tax deductibility.
Or it could be corrected by providing tax credits to individuals to “balance” the existing corporate subsidy.
Which of those two options has the better chance of being passed now, in your opinion?
Making healthcare insurance costs “deductible” for corporations, but not for individuals, is a ancient distortion, that IIRC dates back to WWII.
True, that distortion could be corrected by repealing that tax deductibility.
Or it could be corrected by providing tax credits to individuals to “balance” the existing corporate subsidy.
Which of those two options has the better chance of being passed now, in your opinion?
RIght—that’s why we are headed to tax credits (even worse than tax deductibility). But though it evens it out, that doesn’t take the distortion out of the system—it just increases the over distortion. All the wrong incentives in an area that government shouldn’t be involved in at all.
If we had serious statesmen, they would link the tax cuts to the healthcare reform, so that those newly getting taxed on their health plans would at least have it offset by the cuts.
But they are all cowards and nobody wants to bother making the case that should be made to the voters.
You said: “...IF we had serious statesmen...” Aye! That’s the problem, isn’t it?
Before the next election, let’s “primary-out” RINOs like Lindsay Graham and Jeff Flake and in that election, let’s cut the number of Democrats “serving” in Congress in half.
After we do that, our conservative majorities can seriously begin to “drain the swamp”.
Even so, let’s remember that the Pontine Marshes weren’t drained in a day...
Yes, the difficulty is getting a gain in the House next time around, rather than a loss. Ryan, etc., seem intent on grinding down to useless or delaying beyond the useful any positive legislation Trump really needs to do. (Real Obamacare repeal and tax cuts, to start.)
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