Republican Priorities on Health-care Reform

Epsilon Delta

Jedi Master
Jul 16, 2008
2,687
373
48
Central America
This is a list from The Economist's blog, which analyses item by item the Republican proposals to scale back health-care reform ( http://www.nytimes.com/2010/11/04/business/04care.html?src=busln ). They conclude that none of this things lower costs or cut the deficit in any meaningful way:

The Economist said:
Repealing the "1099 rule", which would require businesses to file 1099s for anyone to whom they paid $600 or more. Repeal of the rule is probably a good idea and is supported by Barack Obama and many Democrats, but it would increase the cumulative deficit by $17 billion over the next ten years.

Eliminating the provision requiring employers to contribute to the cost of insurance coverage. This will have no effect on the cost of health care, but will force employees to pay more for their health insurance. If the government then has to replace employers' contributions with more subsidies to make sure workers can afford to buy the insurance they're required to have, that would mean more government spending, which would increase the deficit.

Eliminating the tax on high-cost employer-sponsored health plans. This would raise the cost of health care and insurance, and deprive the government of tens of billions of dollars per year in revenue, raising the deficit.

Reducing or repealing a tax on manufacturers of medical devices. This would raise the deficit.

Allowing states more freedom to define what sorts of insurance plans will be acceptable on their exchanges. This threatens to create a race to the bottom in standards for health insurance, but probably has no significant effect on the cost of health care or on the deficit.

Reversing cuts to Medicare. The law envisioned cutting $500 billion out of Medicare over ten years. Whatever spending Republicans put back into Medicare adds to the deficit. Notably, the law envisioned cutting funding for Medicare Advantage's private-sector plans, because they're much more expensive than public-sector ones. Republicans want to continue giving taxpayer subsidies to private insurance companies.

Eliminating the mandate that requires people to buy insurance, while keeping the law's provision that insurance companies can't refuse to cover people with pre-existing conditions. This is impossible. It would drive the entire private health-insurance industry out of business. Therefore, Republicans will not actually attempt to do this, whatever they're currently saying. The question is whether they can figure out some way to force Democrats to vote to keep the mandate, allowing Republicans to evade responsibility for having failed to repeal it.

Health-reform repeal: Republican priorities on Obamacare | The Economist

It goes on to say that Republicans have also talked of eliminating the "the Independent Payment Advisory Board, an expert panel which would have the power to reduce Medicare payments without congressional approval. Eliminating the IPAB would cost $15.5 billion in this decade, according to the CBO, but more importantly, it would scrap the most promising existing mechanism for bending down the cost curve on Medicare."

Now in all honesty, there's really not much of a chance for the Republicans to go ahead and totally scrap the bill; the Senate and White House would not allow it. So they have to I suppose propose things that dismantle it to please their constituents. But at the same time none of these measures really do much for anything of the two key issues of cost and deficit. What do you guys think, especially Republicans I guess, is it important (either for real policy reasons or simply political reasons) to go through with these as a matter of principle or should the priority be doing things that actually solve the core problems?

Comment away, and feel free to bring your own sources.
 
So their priorities are essentially:

  • Remove all revenue-raising portions of the law but none of the spending (genius! and great for the deficit)
  • Remove the part that preserves the employer-based system so that employers can dump employees into the exchanges without penalty (and without helping to finance the additional costs they're shifting to the government which, of course, is also no longer raising money to pay for those costs)
  • Remove the consumer protections in those exchanges so that, on net, you're shifting people out of HIPAA-protected group coverage and into now-useless exchange coverage
  • Remove the individual mandate which either means exchanges--which significantly more people will be shifted into in the absence of the employer mandate--will collapse through adverse selection, or once again allow insurers in the individual market to exclude people (the people who used to have HIPAA protections from this through their employer-sponsored coverage but no longer do are going to love this)

This is almost bizarrely stupid. We know they already filibustered a repeal of the 1099 provision in September that had majority support. That's virtually the only thing on the list that makes sense. The only reason I can think of to remove key cost controls, ramp up spending, and eliminate revenue sources simultaneously is to make their prophecies self-fulfilling. They're either very dumb or very nuts.
 
Last edited:
Wow, what a boondoggle this ObamaCare is turning out to be. Better just get rid of it because gubamint is too corrupt to run it.
 
Gee, thanks for posting, guys. Guess any in-depth analysis is pretty worthless on this board if it isn't encapsulated in an easily-remembered 15-second soundbite.
 
The 1099 provision just sounds like paperwork.....

States rights to regulate healthcare.....only makes sense if Georgia promises to keep their sick ppl inside their own border and not let them go to Virginia or other states. What a joke.

Medicare should be combined with the Obama system. Economy of scale.

Really Republicans should be all for a forced Federal system instead of this Nixon era freeloader system we were suffering through. Obama care needed to be named the 'make everyone pay their fair share from the day they are born' system.

Rising costs of new tech make the old system obsolete. I am not waiting for sci fi tricorders to be invented to magically make my next kidney transplant cheaper.
 
I hope all of ObamaCare is repealed because it's a worthless piece of crap to be called a "law". Democratic stupidity at it's finest.
 
I hope all of ObamaCare is repealed because it's a worthless piece of crap to be called a "law". Democratic stupidity at it's finest.

we disagree then. Well not about how good the new law is. I really dont know until i see the loopholes in action lol.

Did you like the old Kennedy / Nixon era pro freeloader system where broke me can just show up at the hospital and make middle class you pay for my gallbladder surgery? I found it to be part of an ideal hippie 'love everyone in the commune' type world. Just not realistic.
 
Repealing the "1099 rule", which would require businesses to file 1099s for anyone to whom they paid $600 or more. Repeal of the rule is probably a good idea and is supported by Barack Obama and many Democrats, but it would increase the cumulative deficit by $17 billion over the next ten years.
Eliminating the provision requiring employers to contribute to the cost of insurance coverage. This will have no effect on the cost of health care, but will force employees to pay more for their health insurance. If the government then has to replace employers' contributions with more subsidies to make sure workers can afford to buy the insurance they're required to have, that would mean more government spending, which would increase the deficit.
Eliminating the tax on high-cost employer-sponsored health plans. This would raise the cost of health care and insurance, and deprive the government of tens of billions of dollars per year in revenue, raising the deficit.
Reducing or repealing a tax on manufacturers of medical devices. This would raise the deficit.
Allowing states more freedom to define what sorts of insurance plans will be acceptable on their exchanges. This threatens to create a race to the bottom in standards for health insurance, but probably has no significant effect on the cost of health care or on the deficit.
Reversing cuts to Medicare. The law envisioned cutting $500 billion out of Medicare over ten years. Whatever spending Republicans put back into Medicare adds to the deficit. Notably, the law envisioned cutting funding for Medicare Advantage's private-sector plans, because they're much more expensive than public-sector ones. Republicans want to continue giving taxpayer subsidies to private insurance companies.
Eliminating the mandate that requires people to buy insurance, while keeping the law's provision that insurance companies can't refuse to cover people with pre-existing conditions. This is impossible. It would drive the entire private health-insurance industry out of business. Therefore, Republicans will not actually attempt to do this, whatever they're currently saying. The question is whether they can figure out some way to force Democrats to vote to keep the mandate, allowing Republicans to evade responsibility for having failed to repeal it. Based on Democrats' tactical astuteness over the past year, I would not put it past them to wind up kneeling in their own end zone on this sort of issue.
The article doesn't mention the fact that Republicans are already trying to eliminate the most significant cost control on Medicare spending included in Obamacare: the Independent Payment Advisory Board, an expert panel which would have the power to reduce Medicare payments without congressional approval. Eliminating the IPAB would cost $15.5 billion in this decade, according to the CBO, but more importantly, it would scrap the most promising existing mechanism for bending down the cost curve on Medicare, which is the make-or-break fiscal problem facing America over the next 25 years. For months, the GOP has been complaining that Obamacare is a budget-buster, and then stripping out the cost controls that pay for it.

This isn't surprising. Cutting spending, especially Medicare spending, is unpopular. Still, the speed here is pretty striking. Voters elected Republicans with a mandate to shrink the budget deficit on Tuesday. These are their proposals.
 

New Topics

Forum List

Back
Top