Friday, August 17, 2018

ObamaCare vs TrumpCare

Jerry referenced the opinion piece by Alex M. Azar II is U.S. secretary of health and human services that was posted on WAPO.  There is some truth to it and yet it is also worth serious review and analysis.   Obamacare forgot about you. But Trump didn’t.  I copied it here for your convenience.
For all the discussion of Obamacare since its passage, it is too rarely known that the law effectively split the United States’ individual insurance market in two .

One group of Americans — about 8 million enrollees in 2017 — now pay, on average, less than a quarter of the cost of their health insurance, receiving ever-growing taxpayer subsidies to insulate them from Obamacare’s high premiums. But there is a second group of Americans who have faced the full premium increases driven by the law’s broken regulations. Roughly 5 million Americans, as of 2017, have chosen to pay those premiums without any subsidies, while 28 million other Americans remain uninsured, many priced out of coverage entirely.

The law’s skyrocketing subsidies have kept subsidized insurance enrollment fairly steady — although more than 50 percent below what was once expected. But Americans who make too much to receive subsidies have begun to opt out of the insurance market en masse. An independent analysis found that the entire unsubsidized individual insurance market shrank by more than 40 percent from the first quarter of 2016 to the first quarter of 2018. In other words, Obamacare has forced unsubsidized Americans to choose between unaffordable insurance and no insurance at all.

This is unacceptable. It is one reason the Trump administration recently expanded an affordable insurance option the previous administration had all but discarded, providing new choices for these forgotten men and women.

Americans will once again be able to buy what is known as short-term, limited-duration insurance for up to a year, assuming their state allows it. These plans are free from most Obamacare regulations, allowing them to cost between 50 and 80 percent less.

President Trump said on June 19 that association health plans will "rescue Americans from Obamacare."

Insurers will also be able to sell renewable plans, allowing consumers to stay on their affordable coverage for up to 36 months. Consumers can also buy separate renewability protection, which will allow them to lock in low rates in their renewable plans even if they get sick.

Unsurprisingly, experts believe there will be healthy demand for these affordable options. Up to 2 million Americans, and possibly more, are expected to enroll within the next few years.

Such plans were offered for terms of up to 12 months for decades until, in an effort to push Americans into Obamacare, the previous administration restricted the plans to 90 days and prohibited insurers from renewing them beyond that time period. This eliminated them as an option except for the shortest transitions between other sources of coverage.

But these short-term plans can be a good option for many Americans priced out of Obamacare’s regulations — especially small-business owners, independent contractors in today’s “gig economy” and younger Americans transitioning between school and employment.

The Trump administration has gone to significant lengths to ensure customers know that these plans are not subject to the same regulations as Obamacare plans and that they are not the right choice for everyone. In fact, we require more robust warnings about the limits of these plans than President Barack Obama’s administration did.

Some have raised concerns about the possibility that short-term plans will pull healthy consumers out of the Obamacare exchanges, driving up premiums. But estimates from the Centers for Medicare & Medicaid Services actuary suggest any such premium increases would be minimal and would not affect subsidized consumers. This is, in part, because those without subsidies who were previously enrolled in Obamacare plans have already left those plans in droves because of premium hikes under the law. For these consumers, short-term plans can offer an affordable option. Our decision to allow renewability and separate premium protections could also allow consumers to hold on to their short-term coverage if they get sick, rather than going to the exchanges, which improves the exchange risk pools.

Fundamentally, this administration believes in more options, not fewer, for consumers. Expanding short-term insurance is just part of President Trump’s larger agenda to improve health-care choice and competition for Americans.

The president signed legislation that will end the individual mandate penalty starting in 2019. Repealing the mandate and expanding short-term plans mean that millions of middle-class Americans who couldn’t afford health insurance will now be able to do so. The Labor Department has also made it easier for small businesses and self-employed Americans to band together to purchase more affordable insurance through association health plans. And last year, the Trump administration took rapid, decisive action to help stabilize the Obamacare markets and end ways to game the system. We have also worked closely with states to develop solutions that can bring down premiums and expand choices.

Starting about two months from now, thanks to this president, insurers and states will have more freedom to offer consumers more options. Obamacare remains broken at its core, but this administration isn’t shutting out the law’s forgotten Americans. Instead, we’re finally giving them affordable choices.


Here is what Kiplinger Finance had to say about the "bargain plans". And here is a Politico piece describing Trump Admin spin.

69 comments:

Anonymous said...

Kind of a mess isn't it?

Health care insurance is simple. It's the politics that's hard. Basically, this author wants to break up the insurance pool in ways that distribute the cost of health insurance that are less accountable, and less likely to fall on his supporters thereby enabling larger tax cuts.

--Hiram

Sean said...

Azar plays fast and loose with the facts, just like his boss. The Trump actions lower costs by covering less. Period. There's no other fundamental reform in there. Of course, they don't want to say that because people won't like it, so they don't. And a lot of people are going to get nasty surprises as a result.

jerrye92002 said...

And what is wrong with covering less, if otherwise the plan is so costly that people get no insurance coverage at all? The point I would emphasize is that, if people CHOOSE these 50-80% less expensive plans, why is the job of government to tell them they cannot make such choices?

John said...

Hiram,
Healthcare insurance is simple when all of the citizens have money to pay for it and do so.

And if government let companies charge premiums based on the citizens risk level.

It gets real complicated when:
- citizens do not have money or do not buy it
- companies seek to maximize profits by cherry picking
- government tries to fix the 2 above issues

Jerry,
Read the Kiplinger piece.

And it is a problem because Tax Payers and society end up picking up the costs when it turns out a citizen "under insured".

Anonymous said...

"...why is the job of government to tell them they cannot make such choices?"

Because someone will have to pay when the coverage is inadequate.

Moose

Anonymous said...

Healthcare insurance is simple when all of the citizens have money to pay for it and do so.

Well obviously we do.

--Hiram

Anonymous said...

America can afford health care. That's the simple part. Where the politics comes in is with how the burden of health care costs is allocated. That's what complicates the issue, and that's what up until the enactment of Obamacare, was the problem we weren't able to solve.

--Hiram

John said...

Hiram,
It's sounding like you are preaching that "no personal property rights" belief again. The reality is that America is deeply in debt because most citizens want to get more and pay less.

How do you rationalize taking money from Peter to pay for Paul's colonoscopy?

Even if Peter has been learning, working, saving, investing, etc and Paul has not?

Anonymous said...


It's sounding like you are preaching that "no personal property rights" belief again.

I don't know how that follows. We have made a decision that Americans should get health care. That being the case, it's a question of how it's paid for. And if you read that Azar piece, what he is careful not to say that Americans should be denied health care. Among other things, that was what the death panel argument all about.

Insurance is a way of allocating and managing costs. Paul is going to have his health care one way or another, it's a question of how it's paid for. Azar's approach will raise overall costs, because it breaks up insurance pools.

--Hiram

jerrye92002 said...

"And it is a problem because Tax Payers and society end up picking up the costs when it turns out a citizen "under insured". --John
And one more time, why is it the TAXPAYERS problem?

As for the Kiplinger piece, it seems based on the idea that, by some magic, government plans can pay out more in benefits than they take in through premiums and stand aghast at the reality that private plans cannot.

jerrye92002 said...

"Because someone will have to pay when the coverage is inadequate." Yes, so why should that NOT be the person who willingly (assuming government allowed them the choice) purchased inadequate coverage?

Anonymous said...

"And it is a problem because Tax Payers and society end up picking up the costs when it turns out a citizen "under insured"

The bill has to go somewhere. Absent insurance, the bill for care goes to doctors, and nurses. It goes to hospitals. All of these folks, to the extent they are able, pass the bills on to others who are better able to pay them. And that process costs money, and I assure you, the people who do it charge extra for their services. The end result of what the author of the piece above is proposing is that it will simply be more difficult to determine the true cost of health care and who exactly is paying for it.

--Hiram

Anonymous said...

There is an argument around, I see forms of it here occasionally, that we should think of health care in the same way we think of housing or a job, in other words as something optional, something we don't have a right to. But we don't really think of health care that way. Whether we acknowledge it so many words or not, in fact we regard health care as a right. That's why the argument against death panels was so compelling. Death Panels were entities that would have the right to deny you health care. Remember how vigourously and successfully Republicans campaigned against them? That's because they knew Americans regarded health care as a right, and that no institution of government should be able to deny it. I thought they were right then, and I think they are right now.

--Hiram

jerrye92002 said...

We may think of health care as a right, but it is not and cannot possibly be. We may think, perhaps correctly, that it is a very important "optional purchase" but many people, even today, consider food and shelter more important, or they would not be forgoing health insurance they cannot afford. And yes, the costs have to go somewhere, which is why Obamacare is such a fantabulous idea, that if we just give everybody insurance, that somehow we can wring more dollars worth of health care out of the system then we put in through our premiums.

I will go this far: You have the absolute right to all of the health care that you pay for, in some fashion. If you choose to buy insurance, you have the absolute right to buy as much coverage as you want and can afford. Nobody should tell you to take less care, or more coverage, than those limits.

For example, if I have "cheap insurance," (my choice), and it doesn't pay for that Lasik surgery I decide I want, I should pay for it myself. I should not be forced to buy insurance that would cover it for me.

Anonymous said...

You forgot...”and remember that you have no right to your own life if you’re poor.”

Moose

jerrye92002 said...

That doesn't make any sense, Moose, logically, theologically, or legally. You have the right to life (unless you are not yet born). You do not have the right to avoid disease or accident, nor do you have the right to force others to treat your unfortunate maladies without remuneration. The poor have the right to free speech. They do not have the right to speak for an hour on prime-time TV.

John said...

"Because someone will have to pay when the coverage is inadequate." G2A

"Yes, so why should that NOT be the person who willingly (assuming government allowed them the choice) purchased inadequate coverage?"


Jerry,
So someone with that bargain insurance develops a chronic condition that requires expensive treatments / medications / long term care.

Who pays once the individual is broke?

Or are they free to die?

Anonymous said...

We may think of health care as a right, but it is not and cannot possibly be.

Sure it can. All that requires is the political will.

--Hiram

jerrye92002 said...

"Who pays once the individual is broke?"

Who pays when Medicare stops paying, or insurance stops paying? Or if the individual has no insurance at all?

Hiram, it requires more than political will. It requires a complete overturning of the only possible definition. But then, considering the liberal penchant for defying the laws of chemistry, physics, economics and human nature by simply passing a law, perhaps you are correct.

Anonymous said...

Ultimately the people who pay for health care are the people who are best at avoiding the expense.

==Hiram

John said...

Jerry,
If you have exceeded a good quality insurance policy or Medicare, often the person is dead or covered by Medicaid.

Please feel free to keep denying the reality that it is in tax payer and society's best interest to force citizens to pay for good quality health insurance.

The people who scrimp on health insurance just transfer their costs on to us responsible citizens through bankruptcies, collections costs, etc.

jerrye92002 said...

Wrong again. When my father ran past his Medicare limit, I wanted to pay for his continued care and was prohibited from doing so.

I deny it is in society's best interest to tell ANYBODY what they must buy, or how to pay for their health care. Again, people can get adequate insurance for less than half what the wizards of Obamacare think is necessary. Why should it be prohibited?

People who "scrimp on insurance" (and then have an extraordinary and unlikely health event) SHOULD go bankrupt. It keeps the responsibility for individual health care exactly where it belongs, with the individual. You always complain when the government bails out the stupid, why the exception when it's health care?

John said...

Jerry,
You could have gone to another hospital, but you did not. You should start taking more responsibility for that unfortunate situation.


Because it is not adequate for most people who have little savings and no idea what bad fortune may be in their future.


Because bankruptcy and uncollectible debt is not paid by the individual. Especially if the patient dies. They are carried by all of us in the way of higher healthcare costs.

John said...

Remember that knowing the rules of the game was your responsibility.

And another

How to Fight a Hospital Discharge

jerrye92002 said...

Right there in your citation, the headline reads "Why Discharge Is Your Payer’s Decision"

"They [bankruptcy and uncollectible debt] are carried by all of us in the way of higher healthcare costs." That's just silly. The health CARE cost was already incurred. That cost is the responsibility of the patient, and the provider will try to collect, or negotiate. Sort of like the IRS does. You can't get blood from a stone. And if the patient falls short of paying, NOBODY does, so the providers simply do not get the money they wanted/expected. It's "vapor-cash." Sort of like when government gives people a tax cut.

Your solution-- universal insurance-- would put all of us on the hook for that care in ADVANCE of the delivery of care, making us all responsible for every patient's cost and keeping the provider fully reimbursed. VERY expensive, by its very nature. Sort of like the tax and welfare system, which it is.

Anonymous said...

Costs are shifted in a lot of ways. Cost shifting is why hospital tissues cost seven hundred dollars a box. The kind of changes Azar is proposing are designed to make costs harder to track, not to avoid them.

Something Republicans frequently argue, and which I with agree with is that health insurance isn't about health care, it's about how we pay for health care.

--Hiram

John said...

Jerry,
Yes the payer (insurance company) does have some say in if they are willing to keep paying the bills per the terms of their contract with their customer (the patient). It is the responsibility of the customer (patient) to request mediation if the disagree with the view of the Doctor and the Payer (insurance company)

And with more people having poor insurance (ie limited coverage, lower max payouts, etc), more people will face the choices you did. And many of them are not as educated, capable or wealthy as yourself.

Most successful first world countries have some form of universal insurance. And it costs their nations less than ours.

Finally, Hiram is correct. Of course, the businesses will reclaim losses from the rest of us citizens.

jerrye92002 said...

you are incorrect. Nationalized healthcare systems do not PERMIT the patient to pay for their own care beyond what the government will pay. And if you think somebody with a rapidly metastasizing cancer can wait six months while you go through mediation (if it is even possible, with government), you're simply accepting "death panels" by default.

And on top of that government, being the single-payer, gets to decide what the healthcare provider gets paid = price controls. Yes, it costs less, but quality and quantity of care will suffer. Try to buy a steak in Venezuela these days. The official price is just pennies.

John said...

Jerry,
Of course one can pay for their own care... You just go to a different clinic or hospital that is not affiliated with the insurance system that you use.

Every insurance company sets acceptable fee levels with the providers who decide to join their network... That is why Children's and Blue Cross got in a row last year...

And a lot of daring people are becoming healthcare tourists. Of course if something goes wrong... Good luck.

jerrye92002 said...

"You just go to a different clinic or hospital that is not affiliated with the insurance system that you use."

EXACTLY. So, find me a clinic that is not affiliated with Medicare or the nationalized health system. The key to lowering costs is competition and a free market, NOT any government program. Why do you insist otherwise?

And not every insurance company uses a "fee for service" reimbursement model. That was imposed because that is the way Medicare and Medicaid (and Obamacare) work and it drives up costs while driving down quality. Nature of the beast. Insurance designed as "prepaid care" leaves treatment up to the doctor and patient, in exchange for a fixed annual reimbursement. It is usually quite cheap because of the reduced paperwork and the copays.

John said...

Try this site maybe. Opt Out Database

Or this one

jerrye92002 said...

Notice the condition, that the provider may not treat ANY Medicare patient. Why should that be? Most physicians I know accept all kinds of different insurance plans for non-Medicare patients, including cash. Why not let everybody that wants out, or wants to treat those who opt out, to choose freely? Again I ask, what is it you are defending?

John said...

Insurance and prepaid care are very similar. Someone estimates costs, charges fees and likely buys re-insurance in case they are wrong.

John said...

Try Again...


"Opt-out providers do not accept Medicare at all and have signed an agreement to be excluded from the Medicare program.

This means they can charge whatever they want for services but must follow certain rules to do so.

◦Medicare will not pay for care you receive from an opt-out provider (except in emergencies). You are responsible for the entire cost of your care.

◦The provider must give you a private contract describing their charges and confirming that you understand you are responsible for the full cost of your care and that Medicare will not reimburse you.

◦Opt-out providers do not bill Medicare for services you receive.

◦Many psychiatrists opt out of Medicare.

John said...

Now as for what am I defending...

I guess it would be that every citizen in the USA should be forced to carry health insurance that meets basic reqts. (ie ACA like)

Otherwise they are able to transfer their negative consequences on to tax payers and society when something goes wrong for them.

Anonymous said...

I guess it would be that every citizen in the USA should be forced to carry health insurance that meets basic reqts

That would mean lower overall health care costs. But it also means that lots of people, and many of those people have a lot of political influence, would pay more. That's what makes the politics difficult.

--Hiram

jerrye92002 said...

Finally, clarity, but clear error. The intention is great, that everyone would be insured and therefore spread the risk as widely as possible. In practice, it is terrible.

The first problem is that the young and health risk maternity and sky-diving accidents, while the elderly risk osteoporosis, cataracts and heart disease. Combine those in the same risk pool and costs go up for everybody. Add in some bureaucrat deciding that even Seventh Day Adventists must insure against drug and alcohol treatments and lung cancer from tobacco, and costs go through the roof.

Second, just having everyone be insured does absolutely NOTHING for the availability of care. Not a single additional doctor will be added to the supply. And with government determining the (we assume single) payment structure, FEWER doctors will find themselves interested in the job, and some will simply quit because their costs exceed their income.

We have a glaring example of just these failings in the ACA. Millions are supposed to be covered; only about half of those supposedly eligible are, and THAT number a small fraction of what was promised. Insurance costs have skyrocketed. Many choose to pay the penalty rather than buy something they don't want and can't afford. Many more simply dropped their insurance, since "Affordable Care" is neither care nor affordable for them.

If you want to defend the dream and the good intentions, feel free.

jerrye92002 said...

As for opt-out providers, what is different between what you said and what I said, that Medicare will not pay the doctor for ANY patients, and therefore many patients will not go to said doctor-- it's a monopolistic practice, a "restraint of trade." That the patient may choose such a doctor has nothing to do with the coercion involved.

jerrye92002 said...

Prepaid care, as I am using the term, is exactly like insurance. The differences are: vastly decreased paperwork, care determined strictly by the doctor and patient, greatly reduced cost.

John said...

Sorry, I don't have time to continue this pointless back and forth... Especially when you write something like putting more people in the pool will raise costs...

jerrye92002 said...

It seems like simple logic to me, but as you will.

John said...

Actually it occurs like this...

"Combine those in the same risk pool and costs go up for some and down for others."

It is how insurance works.

jerrye92002 said...

Exactly so. But the fact that everybody pays for everything, need it or not, must on aggregate increase costs for everybody, it seems to me. Yes, the young and healthy will pay far less, and the elderly more, but otherwise you have the young subsidizing the elderly and that isn't right, is it?

John said...

Yes broad banding insurance premiums is fine... If the young receive that control when they get old...

That is of course unless you want to financially break all the old people.

The total cost does not increase, just the mix.

John said...

I mean this is how all of our business insurance policies work...

Older employees do not pay more than younger employees.

jerrye92002 said...

Actually, the total cost of the CARE does not increase, but the total cost of the INSURANCE does, because both old and young are paying for things they will never use. And the reason employee health plans typically charge equal fees is because the insurer is using a "community rating," that assumes all of your employees are working age and have healthy jobs, and because the risk is spread over many years of premiums. Not every employee gets cancer every year.

John said...

You are so funny...

The population of the USA between 18 and 65 is no different than my work place... We are just huge population of people that may or may not get cancer next year, may get legionnaires disease, may have a psychotic break, may have a baby, may have a stroke, may become addicted, etc.

That is why putting us all in one big pool makes sense with maybe a 1:3 max premium variation because of age or unhealthy behaviors.

John said...

And yes ... " because the risk is spread over many years of premiums"

jerrye92002 said...

I think that is mostly correct. But remember Obamacare insisted on community rating, and on coverage of pre-existing conditions. That meant that actuarial risk got covered by raising premiums, and people only started paying premiums when they got sick, and insurance rates had to cover that. No wonder the insurance companies had to get bailed out until they could get their rates up.

I haven't read it all, but Heritage

John said...

And many of those people with pre-existing conditions had been paying premiums until they lost their insurance... Remember that we had few protections for them before ACA.

And of course their will be a transition period of slightly higher premiums as the pool adjusts for decades of too low premiums.

For more on premium controls by community... Are you saying you want older folks to pay more than 3 times their younger peer?

From your source... "Some regulations-such as essential health benefits and actuarial value requirements-had discrete effects on premiums. A cluster of regulations prohibiting medical underwriting, requiring the issuance of coverage, and banning pre-existing condition exclusions under any circumstances collectively had the largest effect on premiums. Additional provisions of the ACA, such as those that induced costly enrollees with other coverage options to migrate to the subsidized individual market, also drove up premiums."

I guess I would agree that making Insurance companies fit everyone into the pool has an effect. Of course the alternative is financially ruining families, incurring bad debts on businesses, and funding bankruptcies... All pre-ACA costs that were in the shadows until it's passage.

jerrye92002 said...

But the costs, whatever they may have been, were assigned to the responsible party, not the taxpayers in general. There were no "bailouts." And what they purchased, or did not purchase, was their choice, meaning they held their costs to what they wanted and needed, and not some one-size-fits-all unaffordable Rolls Royce policy.

Your concern for bankruptcies is surprising, considering Obama's "too big to fail" bank program and how he essentially expropriated GM rather than permit bankruptcy.

As for PEC, many States had high-risk pools for them, and insurance companies offered PEC waivers for coverage. Obamacare made them illegal or at least unavailable, not to mention tossing millions off their existing plans and forcing them to seek out PEC coverage. It just did not work as promised. Maybe it worked as intended, to destroy the health care system.

John said...

Costs assigned to the responsible party and Rolls Royce policies... Really?

ACA Reqts

Essentials


Of course I care about poor individuals and families who are driven to bankruptcy and the costs that are transferred to the rest of us. I am more surprised that you do not care about these poor people being charged or you being charged more to pay for it.


Sorry, pre-existing condition coverage was terrible before ACA... If it was working well the adding of these folks would not have increased premiums because they would have already been in the pool... Which we have agreed that it did.

jerrye92002 said...

"If it was working well the adding of these folks would not have increased premiums because they would have already been in the pool... Which we have agreed that it did."

You are going to have to explain that one. Raising the coverage of existing plans to that of a "qualifying plan" must of necessity increase the cost of insurance. Thus fewer people will find "affordable care."

Even if I concede problems with the "old system," I contend that Obamacare is not an improvement. If we want government to offer a solution, we need a complete do-over. Or better yet, a rollback of government intrusion into this marketplace.

John said...

If the people who find the improved policies too expensive get subsidies... No problem.

Please remember that my company and I pay ~$25,000 / yr for good full coverage of my family of 5 in MN... (ie $5,000/ person) And this is based on a very age diverse population. We have a few 70 year old workers here.

If people expect to pay less than that, they are likely dealing with a sub-standard insurance. By the way, the average per capita cost in the USA is $10,348. I assume that is because of adding "out of pocket" and high cost of the last years... (ie old people are real expensive)

jerrye92002 said...

"If the people who find the improved policies too expensive get subsidies... No problem."

Really? What if they do NOT get the subsidies? And notice that the total cost of CARE, while presumably unchanged, still says the total cost of insurance has increased. We are paying more for the same amount of health care. How is that a benefit?

You're still comparing the cost of health insurance and the cost of health care. That's a tenuous relationship. I will note again that I went from paying (with company share) about $12,000/year for family coverage, to about $6000/year, just by a switch from fee-for-service to prepaid care, and the quality of my care IMPROVED.

John said...

Actually, they are paying more for:
- guaranteed coverage for reasonable premiums even if you get ill or old
- dependent care for children until age 26
- care for more potential future expenses
- reduced risk of bankruptcy due to large bills

As for you $6,000 story. There is no logic, benefit definition, max payout, future coverage, etc information to it, so it is ignored.

Every deal comes with a hook...

jerrye92002 said...

So you simply deny my experience?

And paying more is paying more, whether you want or need those "extras." Why should people be denied the choice of an insurance policy they want and can afford, and why should insurance companies be prohibited from offering innovative and less costly policies?

John said...

No facts, data, corroborating sources, etc. Yep.

As I often use automotive liability insurance as an example. We as a society could let drivers choose their insurance, or allow them to drive without it.

However we know that is a real bad idea... We do not want their choices to negatively impact other citizens or society. Therefore we mandate a minimum amount of insurance one must buy.

Healthcare insurance is no different, since we have agreed to not let people die in the streets. Stupidity / stinginess on their part should not mean higher costs for all of us. Therefore everyone should have at least a bronze policy.

jerrye92002 said...

You have a seriously flawed analogy and analysis here. Liability insurance is not to protect YOU, but to protect others from your actions. And even though it is the law that you must buy this insurance, It is still offered, and I still CHOOSE to carry "uninsured motorist" coverage (along with several other options), to protect ME. Medical insurance is to protect YOU, and should be specifically chosen as to limits and coverages, by YOU, just like the rest of automotive insurance.

Healthcare IS different, and has little to do with health insurance. We already have mandatory emergency room care for everybody, so nobody "dies in the streets" unless it's Chicago. Obamacare does not seem to have solved that problem. More people would be insured if they could choose a policy which offered what they want and need at a price they can afford. Obamacare simply fails that logical imperative on all counts.

OK, that's an unsupported assertion. Let's try an example. Why should a 60-year-old bachelor farmer have to pay for insurance covering maternity benefits? Why should a 22-year-old male athlete pay for osteoporosis, cataract or hip replacement coverage? Why should ANYBODY be forced to buy a policy that pays a doctor better for pneumonia than for bronchitis, or a bad cold? It's the nastiest combination of wage and price controls, PLUS forcing people to buy something they don't want, can't use and can't afford. How does any of this possibly make sense to you?

John said...

"Liability insurance is not to protect YOU, but to protect others from your actions."

Correct... Mandating appropriate healthcare insurance is to protect all of us from irresponsible people transferring their expenses to us. (ie bankruptcies, uncollectible debts, etc)


Simple, insurance works best when everyone is in the pool. Not having hundreds of pools for each niche... The old farmer may not need maternity coverage, however the young woman likely does not need the stroke coverage... But they both will experience costs that need to be paid.

And please remember that ACA did allow for the premiums of that old farmer to be 3 times higher because he is more likely to incur significant health care expenses.

jerrye92002 said...

"Mandating appropriate healthcare insurance is to protect all of us."

Let's see what is wrong with that statement. The words "mandating," "appropriate," "insurance," "protect" and "all" seem out of place.

Anonymous said...

If "all" is out of place, then you don't really understand what it means to be part of a community. As it turns out, I'm no longer surprised by the profound stupidity of Republicans.

Moose

jerrye92002 said...

Any statement with "all" in it is almost always false. It is stupidity not to recognize such.

John said...

Moose,
Jerry seems to think that we should also let people decide if they need liability insurance on their car.

I mean they may think:
- they are a good driver and do not need it
- they could use the money else where
- they have enough savings to pay the bills
- someone else may pay their bills

Perfectly logical? Not...

John said...

Usually I think that "all" is inappropriate, however in this case...

Since the costs of the "under insured" or those with "no insurance / money" go to the tax payers, the hospitals, the clinics, the banks, etc... So in essence we are pretty much all paying the bill.

jerrye92002 said...

"...let people decide if they need liability insurance on their car." Not what I said at all. Liability insurance is mandated because it affects others (though many cannot afford it and don't have it, which is why I need "uninsured motorist" coverage), but if I want comprehensive I can CHOOSE to have it and pay for it. Health insurance is ALL for your benefit, so none should be mandatory by YOUR analogy.

And you are still not grasping the difference between health care and health insurance. Those who are under-insured, deliberately or by virtue of it being unaffordable [under the "Affordable Care Act" :-( ] still get health care through the emergency room, or charity, or by running up bills they can or cannot pay. Yes, we "all" (some of us far more than others) "pay" for that care, in some fashion. But YOUR solution would have us all pay for INSURANCE against those events, whether needed or not, whether wanted or not, or usable or not, or whether the cost of care could be covered by any of a number of other mechanisms. And that drives UP costs for everybody, meaning FEWER people can afford coverage. It's just backwards.

Just look at what happened after Obamacare mandated that everybody have "acceptable" insurance. Emergency room visits for basic care went UP. People lost the plans they liked. Doctors left the profession rather than accept the mandates and poor reimbursements. Like all liberal utopias, Obamacare was long on good intentions and short of sensible policy. Trumpcare, regardless of what it may be, must be better.

Anonymous said...

All the more reason to do away with the need for insurance.

Moose

Sean said...

Here in the real world, the number of licensed doctors in the U.S. increased by 100,000 between 2010 and 2016. A Census of Actively Licensed Physicians in the United States, 2016

John said...

Continued Here