CDZ Economic impact of repealing Obamacare

[Fishlore]

One key part of ACA is definitely up for grabs. If the Democrats win in the next election there will be a "public option" on the menu for sure. This modest seeming feature of the original Democratic plan is where the revolutionary dynamite is stored.

What the public option is and how it works is all laid out and the change can be made in a matter of days. Once in place, the GOP claim that for-profit corporations can deliver more for less than a governmnet-run insurance plan will up for an open test before the entire nation. If those who believe that a public insurance company can provide better coverage for less money are correct, the USA will move to Medicare for All on a voluntary, one-policy-at-a-time basis. What could be farier than that?

 

[320 Years of History]

One key part of ACA is definitely up for grabs. If the Democrats win in the next election there will be a "public option" on the menu for sure. This modest seeming feature of the original Democratic plan is where the revolutionary dynamite is stored.

What the public option is and how it works is all laid out and the change can be made in a matter of days. Once in place, the GOP claim that for-profit corporations can deliver more for less than a governmnet-run insurance plan will up for an open test before the entire nation. If those who believe that a public insurance company can provide better coverage for less money are correct, the USA will move to Medicare for All on a voluntary, one-policy-at-a-time basis. What could be farier than that?

Hell, just repealing the prohibition against Medicare using its buying power to negotiate lower drug costs would help a lot. Why anyone thought so hobbling what is the single largest health insurance fund into which Americans pay is beyond me. I "get" why drug companies wanted that provision; I don't know why citizens allowed it be enacted.

 

[william the wie]

Neither of those reforms will pass the house. Logistics will probably prevent loss of the Senate. but even if taken the Ds up in 2018 will delay until after the election even sustaining an EO.

 

[Fishlore]

Neither of those reforms will pass the house. Logistics will probably prevent loss of the Senate. but even if taken the Ds up in 2018 will delay until after the election even sustaining an EO.

We are the last advanced democracy to attempt to provide medical care for all our citizens. We are showing the world why be our once powerful nation is rapidly receding into minor league status. Greed and corruption have crippled a once-great nation. ACA is only a small part of the collapse.

 

[320 Years of History]

Neither of those reforms will pass the house. Logistics will probably prevent loss of the Senate. but even if taken the Ds up in 2018 will delay until after the election even sustaining an EO.

We are the last advanced democracy to attempt to provide medical care for all our citizens. We are showing the world why be our once powerful nation is rapidly receding into minor league status. Greed and corruption have crippled a once-great nation. ACA is only a small part of the collapse.

Bold:
That strikes me as a bad reason for doing the right thing.

 

[320 Years of History]

Frankly, I'm sick and tired of hearing about repeal the ACA, particularly in connection with lines of argument pertaining to cost. Government control in health care can have desirable results in the form of better and equitable access to care and good health outcomes. Some of the more successful health care systems on the planet are government controlled with little influence from the market and others are very tightly regulated.

A good example of a government controlled health care system is the Cuban system. It is built on a strong primary care foundation. It provides comprehensive health care to all its residents with nobody falling between the cracks. Despite Cuba being a poor country, it attains health outcomes that are comparable and sometime better than those of rich economies such as the USA.

For example, Cuba enjoys higher vaccination rates (99.9%); an excellent ability to control and quell epidemics effectively; high life expectancies (78–84 years), and low infant mortality rates. Despite being under a trade embargo, Cuba has developed a unique methods of treating illnesses such as Parkinson’s disease, retinitis pigmentosa, multiple sclerosis and other neurological disorders. It exports medical products such as vaccines. Consequently, Cuba attracts about 20,000 health tourists annually. (Drain PK, Huffman SA, Pirtle SE, Chan K. Caring for the World: A Guidebook to Global Health Opportunities. Toronto: University of Toronto Press; 2009.) Cuba sends doctors to provide services all over the world and trains doctors from other countries through a programme of international giving and support. One fundamental difference between the Cuban system and market-based systems is the philosophy on which the system is built.

The philosophical question for any health care system is, “Should health care be traded for profit?” a question that relates back to an even more fundamental question, “Should health be treated as a human right or as a commodity that can be traded for profit?” The Cuban system is built on the belief that health care is a human right that should be accessible to all. Based on this belief, the system is set up to make sure that health care is accessible to all Cubans.

The fundamental philosophy governing the health care system in any country is reflected in the kind of system that is in place to provide care. If a country treats health and access to care as a basic human right for its citizens, then the question of profit maximisation would be a non-issue. The health care system would have a different objective function with a slightly different focus. Efficiency in health care markets would be judged by a different standard because then the objective function of the health care system would be different from a typical economics objective function. The structure of the health care system and its distribution patterns and channels would also be different and would reflect the system’s basic philosophy about health and health care.

Efficiency in health care does not always lend itself to market forces because health care takes on properties of merit goods. Consumption of such goods is desirable because the social benefits exceed the private benefits, i.e. there are positive externalities. Like education, health can be viewed as capital stock or human capital. According to Grossman, each individual is endowed with a stock of health which depreciates over time, but the individual has the ability to increase this stock through healthy behaviour such as good diet, accessing health care and preventive measures. The stock of health is a merit good because an individual’s health has an effect on the rest of society. A healthy population provides a productive labour force that builds a country’s economy. An individual sees the benefits of being healthy, but might not necessarily see the benefits of his/her good health to the rest of society, i.e. the private benefits of good health are less than the societal benefits. So an individual’s decision about the optimal level of their health might be less than optimal considering the larger societal benefits. This is also true of education and that is why the governments play a big role in it. If merit goods are left to the private sector—or the market, there is under-consumption (e.g. vaccination) and therefore, inefficiency.

Moreover, other desirable features in a country might not be attainable through market forces alone. For example, if health and health care equity are desirable features, there might be need for government intervention because these qualities are not easily attained through the market. Government involvement in health care is often necessary because there are many market failures in health care and the market is not always able to correct such failures.

It is even more important for smaller countries to determine and explicitly state the philosophical foundations of their health care systems. The reason for this is that smaller countries might have economies that are more open and therefore more vulnerable to economic changes than other countries/economies. Furthermore, their citizens might be dependent on accessing care from other countries, or at the very least they might depend on getting health care manpower from other economies. These conditions might cause the small country to “import” inefficiencies from other economies that are a result of market failures or even government failures.

For example in Oman, the health care system might use care providers from outside the nation. This might make their system more vulnerable to inefficiencies from outside Oman. However, the example of Cuba indicates that a small economy can avoid the inefficiencies of other economies by being clear about what the fundamental purpose of their health care system is and then building it to attain the stated purpose. Another example is Thailand that reformed its health care system in 2001 with a clear purpose of attaining universal health care. With this aim, the country built a health care system supported by an insurance system and an electronic data storage and access system that improved efficiency and increased access for the poor.