Hard Truths about Health Care ‌ by Michael Tanner

Micheal Tanner

Michael Tanner

“Every health-care system in the world rations care in some way, either through bureaucratic fiat (Scandinavia, the U.K.), waiting lists (Canada), or price (that’s us). One can argue about which of these rationing mechanisms is fairest or most efficient, but let’s not pretend that it won’t occur.”

http://www.nationalreview.com/article/446439/health-care-basic-facts-and-hard-truths

Free Market Care – John Stossel

John Stossel

Imagine if you had “grocery insurance.” You’d buy expensive foods; supermarkets would never have sales. Everyone would spend more.

Insurance coverage — third-party payment — is revered by the media and socialists (redundant?) but is a terrible way to pay for things.

Today, 7 in 8 health care dollars are paid by Medicare, Medicaid or private insurance companies. Because there’s no real health care market, costs rose 467 percent over the last three decades.

By contrast, prices fell in the few medical areas not covered by insurance, like plastic surgery and LASIK eye care. Patients shop around, forcing health providers to compete.

The National Center for Policy Analysis found that from 1999 to 2011 the price of traditional LASIK eye surgery dropped from over $2,100 to about $1,700.

Source: Free Market Care – John Stossel

A Path Towards a Viable Interstate Health Insurance Market | Robert Nelson, MD | Pulse | LinkedIn

Alternatives to our current over-priced and dysfunctional health insurance market are often biased, and thus limited, by our current operational and regulatory structure. These structures are so entrenched in our healthcare psyche that it makes it difficult sometimes to set these aside in our minds while entertaining how another approach might work.

If we view all alternative plans to replace the Affordable Care Act from the vantage point of “what is”, then there is little room for anything other than attempts at further regulating the problems away. If one presupposes that the current regulatory framework remains unchanged, indeed the same framework has served to suppress the very market we wish create, then of course that market will not be created.

The dilemma facing alternative healthcare plans being considered to replace the ACA is particularly evident when it comes to the issue of selling health insurance across state lines. A brief on this subject published by the American Academy of Actuaries in February of 2017 speaks to the the main challenges facing the advent of a viable interstate market for the sale of health insurance.

Source: A Path Towards a Viable Interstate Health Insurance Market | Robert Nelson, MD | Pulse | LinkedIn

Obamacare Replacement Act – Senate Bill 222 by Senator Rand Paul – KY

Sen. Rand Paul, R-Ky., speaks during an event at the University of Chicago's Ida Noyes Hall in Chicago on Tuesday, April 22, 2014. (AP Photo/Andrew A. Nelles) ORG XMIT: ILAN114Lots to like and consider here.  We need more details about how tax equalization in the group market vs the individual market will be handled.  The expansion of uses and benefits of HSAs is robust and will go along way to establishing more ways to self-insure and less reliance on networks and government programs; both are a good thing.  The flexible, market-friendly Interstate Market for Health Insurance Cooperative Governing of Individual Health Insurance Coverage will be a welcome change.  Again, devil is always in the details.  Stay tuned for more details and insightful analysis here on the Sovereign Patient; we will post them as available. 

Some highlights:

Effective as of the date of enactment of this bill, the following provisions of Obamacare are repealed:

  • Individual and employer mandates, community rating restrictions, rate review, essential health benefits requirement, medical loss ratio, and other insurance mandates.

Protecting Individuals with Pre-Existing Conditions:

  • Provides a two-year open-enrollment period under which individuals with pre-existing conditions can obtain coverage.
  • Restores HIPAA pre-existing conditions protections. Prior to Obamacare, HIPAA guaranteed those within the group market could obtain continuous health coverage regardless of preexisting conditions.

Equalize the Tax Treatment of Health Insurance:

  • Individuals who receive health insurance through an employer are able to exclude the premium amount from their taxable income. However, this subsidy is unavailable for those that do not receive their insurance through an employer but instead shop for insurance on the individual market.
  • Equalizes the tax treatment of the purchase of health insurance for individuals and employers. By providing a universal deduction on both income and payroll taxes regardless of how an individual obtains their health insurance, Americans will be empowered to purchase insurance independent of employment. Furthermore, this provision does not interfere with employer-provided coverage for Americans who prefer those plans.

Expansion of Health Savings Accounts:

  • Tax Credit for HSA Contributions
    • Provides individuals the option of a tax credit of up to $5,000 per taxpayer for contributions to an HSA. If an individual chooses not to accept the tax credit or contributes in excess of $5,000, those contributions are still tax-preferred.
  • Maximum Contribution Limit to HSA. Removes the maximum allowable annual contribution, so that individuals may make unlimited contributions to an HSA.
  • Eliminates the requirement that a participant in an HSA be enrolled in a high deductible health care plan. This section removes the HSA plan type requirement to allow individuals with all types of insurance to establish and use an HSA.
  • This would also enable individuals who are eligible for Medicare, VA benefits, TRICARE, IHS, and members of health care sharing ministries to be eligible to establish an HSA.
  • Allowance of Distributions for Prescription and OTC Drugs o Allows prescription and OTC drug costs to be treated as allowable expenses of HSAs.
  • Purchase of Health Insurance from HSA Account o Currently, HSA funds may not be used to purchase insurance or cover the cost of premiums. Allowing the use of HSA funds for insurance premiums will help make health coverage more affordable for American families.
  • Medical Expenses Incurred Prior to Account Establishment o Allows qualified expenses incurred prior to HSA establishment to be reimbursed from an HSA as long as the account is established prior to tax filing.
  • Administrative Error Correction Before Due Date of Return o Amends current law by allowing for administrative or clerical error corrections on filings.
  • Allowing HSA Rollover to Child or Parent of Account Holder o Allows an account holder’s HSA to rollover to a child, parent, or grandparent, in addition to a spouse.
  • Equivalent Bankruptcy Protections for HSAs as Retirement Funds o Most tax-exempt retirement accounts are also fully exempt from bankruptcy by federal law. While some states have passed laws that exempt HSA funds from being seized in bankruptcy, there is no federal protection for HSA funds in bankruptcy.
  • Certain Exercise Equipment and Physical Fitness Programs to be Treated as Medical Care. Expands allowable HSA expenses to include equipment for physical exercise or health coaching, including weight loss programs.
  • Nutritional and Dietary Supplements to be Treated as Medical Care o Amends the definition of “medical care” to include dietary and nutritional supplements for the purposes of HSA expenditures.
  • Certain Providers Fees to be Treated as Medical Care o Allows HSA funds to be used for periodic fees paid to medical practitioners for access to medical care.
  • Capitated Primary Care Payments o HSAs can be used for pre-paid physician fees, which includes payments associated with “concierge” or “direct practice” medicine.
  • Provisions Relating to Medicare o Allows Medicare enrollees to contribute their own money to the Medicare Medical Savings Accounts (MSAs).

Interstate Market for Health Insurance Cooperative Governing of Individual Health Insurance Coverage:

  • Increases access to individual health coverage by allowing insurers licensed to sell policies in one state to offer them to residents of any other state.
  • Exempts issuers from secondary state laws that would prohibit or regulate their operation in the secondary state. However, states may impose requirements such as consumer protections and applicable taxes, among others.
  • Prohibits an issuer from offering, selling, or issuing individual health insurance coverage in a secondary state: If the state insurance commissioner does not use a risk-based capital formula for the determination of capital and surplus requirements for all issuers. Unless both the secondary and primary states have legislation or regulations in place establishing an independent review process for individuals who have individual health insurance coverage; or The issuer provides an acceptable mechanism under which the review is conducted by an independent medical reviewer or panel.
  • Gives sole jurisdiction to the primary state to enforce the primary state’s covered laws in the primary state and any secondary state.
  • Allows the secondary state to notify the primary state if the coverage offered in the secondary state fails to comply with the covered laws in the primary state.

Source: Microsoft Word – Obamacare Replacement Act SBS.docx

Fascism: A Bipartisan Affliction – Ron Paul

ron-paulFascism’s distinguishing characteristic is a “mixed economy.” Unlike socialists and communists who seek to abolish private business, fascists are content to let business remain in private hands. Instead, fascists use regulations, mandates, and taxes to control business and run (and ruin) the economy. A fascist system, then, is one where private businesses serve politicians and bureaucrats instead of consumers. Does the modern American economy not fit the definition of fascism?

Obamacare is an example of fascism that is often mislabeled as socialism. Obamacare did not create a government-run “single payer” system as would exist under socialism. Instead, Obamacare extended government control over health care via mandates, regulations, and subsidies. The most infamous part of Obamacare – the individual mandate – forces individuals to purchase a product from a private industry.

The true path to real free markets, peace, and individual liberty starts with rejecting the bipartisan authoritarianism in favor of the non-aggression principle. 

Source: Fascism: A Bipartisan Affliction – Ron Paul

Single-Rural Heath Care: Obamacare Insurers Retreat, Leaving Only One ACA Insurer In Some Areas – Matt Vespa

Monopoly?

Obamacare has been disastrous for health insurers, like UnitedHealth Group, billions have been wasted on state exchanges, which are hanging by a thread, and the law’s enrollment projections (calculated by the CBO three years ago) were off by 24 million for 2016. Now, more Americans are opting to pay the penalty and remain uninsured because it makes more sense for their finances. No wonder why this law is unpopular. Oh, and did I mention that premiums are projected to rise (again) this year. Given the expensive nature of the Obamacare market, some insurers are dropping like flies, giving Americans in some rural areas just one choice when it comes to their health care. Of course, some folks are worried about monopoly dynamics

Source: Single-Rural Heath Care: Obamacare Insurers Retreat, Leaving Only One ACA Insurer In Some Areas – Matt Vespa

Obama Speechwriters Laugh About ‘You Can Keep It’ Obamacare Lie – Matt Vespa

So, basically, these clowns are laughing at selling a lie to the American people that the president’s health care plan is going to be affordable. It’s not. More Americans are opting to remain uninsured because it’s more economical for them—that’s failure. UnitedHealth, one of the largest health care providers in the country, pulled out of the Obamacare exchanges in two states after incurring horrific losses, and might pull out from the individual market altogether by 2017. The last remaining Obamacare exchanges are on the brink of collapse, and the billions have been wasted as a result. In a recent CBO projection, Obamacare’s enrollment numbers for 2016 are off by 24 million. Since the law went into effect, 9 million people (5 million employer-based, 4 million on individual plans) have lost their health insurance plans. I’m sure they find this hilarious, bros.

Last time I checked, laughing at millions of people who got their insurance gutted because you put to paper a bold-faced lie is sort of messed up.

Source: Obama Speechwriters Laugh About ‘You Can Keep It’ Obamacare Lie – Matt Vespa