Republican Health Care Fiasco, Part II

John C. Goodman

“Only a few years ago, the party was united behind three reforms that are consistent with individual empowerment and limited government: (1) a universal health refund that transfers all government tax and spending subsidies to ordinary citizens each year with no strings attached other than the requirement that it be used for health care, (2) a flexible Health Savings Account that allows people to manage some of their own health care dollars and (3) pre-existing condition protection for people who lose their insurance because of government policies.

For well over a decade House Speaker Paul Ryan (R-WI) was a steadfast supporter of all three ideas, including replacing tax and spending subsidies for health care and health insurance with a universal tax credit. John McCain ran on these ideas in the 2008 election. The legislative embodiment of McCain’s plan was the Patients Choice Act, which Ryan cosponsored in 2009 along with Devin Nunes (R– CA) in the House and Tom Coburn (R–OK) and Richard Burr (R–NC) in the Senate.”

“The American Health Care Act (AHCA), proposed by the House leadership, was not about health care. It was about taxes. Over and over, Ryan said he needed to do health reform before tax reform. In particular, he said he needed to reduce Obamacare taxes by $1 trillion and to reduce spending by more than $1 trillion.

As noted, a tax cut tied to health care is part of good health reform. But the Ryan tax cut wasn’t tied to health care. It consisted of repealing the very revenues that were funding Obamacare. (See below.)  Since the tax cut took money out of the system, the spending cuts paired with it also removed money from the system.”

Source: Republican Health Care Fiasco, Part II

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

PassionForSubro » Health Insurance is NOT Health Care

“Just as health insurance is not health care, so too health insurance reform is not health care reform.  Yet, because the ACA got so much press, and many previously uninsured individuals did secure insurance (giving us all the warm and fuzzies), the result was a nationwide misconception that affordable insurance equates with affordable health care. For many, ObamaCare is therefore viewed as a success because millions of uninsured Americans are now insured.

Yet, insurance isn’t a magical money-tree. Like a college student wielding his first credit card, a newly insured America forgets that “someone” has to pay, eventually.  What you buy – with your own money, or with insurance – and how much it costs, still matters.  Insurance just passes the buck – to other insureds, and to you, when the time comes to renew. It blows my mind.  People are involved in car accidents, get out of their vehicle, examine the minor damage, and agree NOT TO REPORT IT TO THEIR INSURANCE, because they DON’T WANT THEIR PREMIUM TO INCREASE! People actually choose to pay for car repairs out of pocket, because they fear insurance premium increases and want to save their insurance for “when they really need it.”  Yet, if we treated auto insurance the way we treat health insurance, we’d be outraged that insurance doesn’t pay for the air in my tires, or the dancing hula girl on my dashboard.”

Source: PassionForSubro » Health Insurance is NOT Health Care

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

Can Tom Price Fulfill Donald Trump’s Campaign Promises?

“A couple details need fixed, but Tom Price’s plan and the Cassidy-Sessions Plan are on the right track.  This is an important article that anyone should read who really wants to understand the economic issues AND the political issues surrounding healthcare reform as it related to repealing and replacing ObamaCare.” – R. Nelson, MD

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John C. Goodman

There is no practical way to achieve universal coverage by giving everyone a tax deduction for health insurance. The tax relief must be in the form of a credit and it must be refundable – allowing people access to it even if they owe no taxes. Yet refundable tax credits and the idea of universal coverage in general strike many in the Republican Party as socialism.

Price is of the view that we are going to end up subsidizing the health care of the poor and the indigent one way or the other. We can do it through cost shifting and subsidies conferred on impersonal hospital bureaucracies or we can give the money to the people and let the bureaucracies compete for their patronage. The Price tax credit would be refundable and it would vary by age. But unlike the Obamacare credits, Price’s credit would be the same, regardless of income.” –  a quote by John C. Goodman, author of the article in Forbes below.

Elevators close on Rep. Tom Price, R-Ga., as he arrives at Trump Tower, Wednesday, Nov. 16, 2016, in New York. (AP Photo/Carolyn Kaster) There are two things you need to know about Congressman Tom Price’s views on health policy : he believes in universal coverage and he believes in tax credits. Why […]

Source: Can Tom Price Fulfill Donald Trump’s Campaign Promises?

California’s Public Option Would Not Rescue Obamacare | Health Policy Blog | NCPA.org

The wheels are falling off Obamacare in California. UnitedHealth Care, the nation’s largest health insurer, only participated in the state’s exchange, Covered California, for one year before deciding to bail out. Participants are much older and sicker than the Administration or health insurers expected. So, premiums are spiraling up, beyond people’s ability to pay.

Covered California is already responsible for a significant taxpayer-funded cash flow. Currently, only a very small share is borne by the state. That will change if a public option relieves beneficiaries of their sky-high premiums. Last March (after the dust had settled on Obamacare’s third open season), Covered California had just under one million policies in force, covering almost 1.4 million enrollees. Total annual 2016 premiums would amount to $6.8 billion.

However, nine of ten enrollees pay significantly discounted premiums, because the insurers who write the policies receive significant tax credits to induce them to participate. Only $2.4 billion of the estimated total 2016 premium will have been paid by enrollees. Fully $4.4 billion will have been funded by federal taxpayers. So, if the public option eliminates enrollees’ responsibility to pay premium, state taxpayers would be on the hook for $2.4 billion.

But wait, there’s more! The U.S. Department of Health & Human Services estimatesthere are 313,000 Californians who are eligible for subsidized health insurance in Covered California, but chose to buy unsubsidized individual policies outside the exchange. It is not clear why they forgo the subsidies. Perhaps they want access to more doctors and hospitals than are available in Covered California’s infamously narrow networks. If they were freed from the responsibility of paying for any part of their premium in Covered California, surely many would get onboard.

If they are similar to the current enrollees, they would add almost half a billion dollars to the state taxpayers’ tab…

(A version of this Health Alert was published by the Orange County Register.) Dave Jones, California’s Insurance Commissioner, has lifted a page from Hillary

Source: California’s Public Option Would Not Rescue Obamacare | Health Policy Blog | NCPA.org

Another Grim Reminder that Obamacare Has Made Healthcare More Expensive | International Liberty

danmitchel

Dan Mitchell

Way back in 2009, some folks on the left shared a chart showing that national expenditures on healthcare compared to life expectancy. This comparison was not favorable to the United States, which e…

Source: Another Grim Reminder that Obamacare Has Made Healthcare More Expensive | International Liberty

Overwhelming Evidence That Obamacare Caused Premiums To Increase Substantially – Forbes

obamcare_individual-MarketPMPM-Chart-MercatusTwo scholars at the renowned Brookings Institution, Loren Adler and Paul Ginsburg, have published an analysis finding that “average premiums in the individual market actually dropped significantly upon implementation of the ACA [Affordable Care Act].” This contrasts with a plethora of evidence, including a rigorous 2014 Brookings study, showing the ACA significantly increased premiums. In this post, I discuss methodological concerns with the Adler and Ginsburg approach as well as evidence that leads most scholars to reach a very different conclusion.

Source: Overwhelming Evidence That Obamacare Caused Premiums To Increase Substantially – Forbes