Why there is No Republican Plan to Replace Obamacare

[HikerGuy83]

Providing healthcare or insurance is not the job of the government or the taxpayers. Take some personal responsibility for your needs is my plan.

I disagree.

Let the states do it.....if they want.

And some do.

But when a New England state attempted to price out a full blown health care system......they scrapped the idea as being "too expensive". Now this blows my mind given all the inefficiencies that exist in the system.

 

[HikerGuy83]

Correct but that is exactly the way insurance is supposed to work.

O.K. let's hear it.

Everyone shares the risk so healthcare is there if and when you need it.

Normally, they get to chose who to share with. They can go through an insurer who will mitigate some of that. But adding full blow health disasters is stupid. Especially, those who could have avoided it. Oh, I smoked for 100 years and now have cancer. Give me all that chemo. Sorry....you can pay for that. Otherwise, it is palliative care for you.

As I understand it, about 5% of the enrollment spends about 50% of the Medicare dollars. How does that happen?

 

[HikerGuy83]

When you buy a house the mortgage company forces you to get insurance on it. Is that shifting funds from the good houses to the damaged houses?

They don't insure homes that are poorly taken care (i.e. neglected). You have to pass muster to get that insurance.

Next, they will put adders on if you have additional liabilities. Wood shingle roofs....cost more to insure than composit. Fireplaces can add cost. Etc Etc.

If some fatty (you know pre-diabietic, high knee/hip replacement candidate/high heart disease potential) rolls through the door, do they get hit with adders?

 

[Greenbeard]

Obamacare isn't health care.

It's health insurance.

Turns out insurance is how ~85% of care is financed in the United States.

And it's so stupidly expensive that people don't use it.

And it's going to get more expensive.

No one in New York drives, there's too much traffic!

 

[HikerGuy83]

It forced EVERYONE to pay into the system.

Yep...gotta love the idea of choice.

 

[Concerned American]

When the government is in deficit, these wealth transfers are simply being pushed down to future generations.

Don't get me wrong. While I love the quality of care, the system stinks. Many doctors I know are pretty fed up.

But we ration doctors and do a whole bunch of other stupid stuff.

Doctors should be paid well, but many of them are flat out way past that. They call it business. I call it leverage and blackmail.

While I agree that a doctor does work just like I do, however I was introduced to an analogy some time ago that changed my tune. The story was about a motorcycle mechanic asking his cardiac surgeon why he was paid so well when the mechanic did basically the same thing. The doctor just replied, can you repair that carburetor while the engine is running? I had to say touche'

 

[HikerGuy83]

Turns out insurance is how ~85% of care is financed in the United States.

But that doesn't address the fib you told.

I get that insurance is what we do. Thanks for nothing.

No one in New York drives, there's too much traffic!

And in Wyoming, they shoot people from New York....just because.......

 

[HikerGuy83]

While I agree that a doctor does work just like I do, however I was introduced to an analogy some time ago that changed my tune. The story was about a motorcycle mechanic asking his cardiac surgeon why he was paid so well when the mechanic did basically the same thing. The doctor just replied, can you repair that carburetor while the engine is running? I had to say touche'

Most doctors are not surgeons.

So the analogy isn't working for me.

We are loaded with inefficiencies.

My wife worked at a hospital where the ward was semi-private. They got what they called "Holiday-Inners", meaning that if the family grew tired crabby granny, she suddenly got sick and had to be admitted. The hospital loved the medicare dollars and so didn't resist.

I know many doctors (G.P.'s) who talk of elderly people who come to see them on the pretense they are sick because they are......wait for it......lonely.

Chronic loneliness in older adults leads to more doctors’ office visits, UGA study finds - College of Public Health UGA

Experiences of loneliness and social isolation can lead to increased health care use among older adults, according to new research from the University of Georgia College of Public Health. The

publichealth.uga.edu

Doctors don't like that. And I sure as hell don't like it.

We need to clean up this system.

I am all for my state doing something.

I DON'T want OBUMMERCARE.

 

[Concerned American]

The hospital loved the medicare dollars and so didn't resist.

I know many doctors (G.P.'s) who talk of elderly people who come to see them on the pretense they are sick because they are......wait for it......lonely.

First point doesn't fly--Medicare doesn't pay but a fraction of the charges paid by private insurance or the uninsured, but I can see and agree with your other point.

 

[HikerGuy83]

First point doesn't fly--Medicare doesn't pay but a fraction of the charges paid by private insurance or the uninsured, but I can see and agree with your other point.

If you have an empty bed....any revenue works.

 

[Concerned American]

If you have an empty bed....any revenue works.

Isn't that contrary to your point that beds don't exist because these people?

 

[HikerGuy83]

Isn't that contrary to your point that beds don't exist because these people?

I don't recall saying that.

I said that these people show up because their families are tired of them. And the hospitals are happy to get Medicare dollars (for a bed that otherwise might go unused and unbilled).

 

[debbiedowner]

Obamacare isn't health care.

It's health insurance.

And it's so stupidly expensive that people don't use it.

And it's going to get more expensive.

Obamacare (ACA) is not insurance it's a law.

 

[Zincwarrior]

The last MAGA plan for healthcare was shoving a flashlight up your ass and drinking bleach to get rid of covid.

 

[alang1216]

Normally, they get to chose who to share with. They can go through an insurer who will mitigate some of that. But adding full blow health disasters is stupid. Especially, those who could have avoided it. Oh, I smoked for 100 years and now have cancer. Give me all that chemo. Sorry....you can pay for that. Otherwise, it is palliative care for you.

As I understand it, about 5% of the enrollment spends about 50% of the Medicare dollars. How does that happen?

We have a big enough country to spread the risk. I don't think basing insurance on personal habits will work, for example, how do you know who smokes and who rides a motorcycle without a helmet.

 

[alang1216]

They don't insure homes that are poorly taken care (i.e. neglected). You have to pass muster to get that insurance.

Next, they will put adders on if you have additional liabilities. Wood shingle roofs....cost more to insure than composit. Fireplaces can add cost. Etc Etc.

If some fatty (you know pre-diabietic, high knee/hip replacement candidate/high heart disease potential) rolls through the door, do they get hit with adders?

Do you want to go to a doctor selected by an insurance company every year to be examined and questioned?

 

[HikerGuy83]

We have a big enough country to spread the risk.

Just because we do, doesn't mean we should.

It's that kind of enabling attitude that will cause me to always vote no on a national program.

I don't think basing insurance on personal habits will work, for example, how do you know who smokes and who rides a motorcycle without a helmet.

Hmmm.....I think they can tell if you smoke.

Motorcycle helmet might have to be a different story.....if you wipe out on your bike and are not wearing one.....you are not covered. Have a good time.

Do you want to go to a doctor selected by an insurance company every year to be examined and questioned?

I go every year now and get examined and questioned.

There are ways to do this. If you want insurance, you have to abide the policy.

And cost reduction means enforcement against risky behavior or adding premiums to cover it (i.e. you don't want to wear a helmet....your health insurance just doubled).

 

[HikerGuy83]

The last MAGA plan for healthcare was shoving a flashlight up your ass and drinking bleach to get rid of covid.

How'd that work out for you.

I'll bet you have a good supply of flashlights now.

 

[Manonthestreet]

None with a chance to succeed, anyway. There have been some plans offered that never went anywhere.

Compare Proposals to Replace The Affordable Care Act | KFF

President Donald Trump and Republicans in Congress have committed to repealing and replacing the Affordable Care Act (ACA). How do their replacement proposals compare to the ACA? How do they compare to each other? Includes the Graham-Cassidy-Heller-Johnson amendment (introduced 9/13/2017) as...

www.kff.org

Published: Sept 18, 2017

In 2017, President Donald Trump and Republicans in Congress unsuccessfully pursued several efforts to repeal and replace the Affordable Care Act. How did their replacement proposals compare to the ACA? How did they compare to each other?

Plans available for comparison:

• Graham-Cassidy-Heller-Johnson Amendment – Updated 9.25.17 (PDF)
• The Health Care Freedom Act, 2017 (PDF)
• The Better Care Reconciliation Act of 2017 (PDF) – Updated 7.20.17
• Obamacare Repeal Reconciliation Act of 2017 (PDF)
• The Better Care Reconciliation Act of 2017 (PDF) – Updated 7.13.17. Includes Cruz amendment.
• The American Health Care Act, as passed by the House of Representatives on May 4, 2017 (PDF)
• The Affordable Care Act, 2010 (PDF)

The problem is this:

Any Republican plan to "replace Obamacare" would have to be a plan very much like Obamacare, but which follows Republican principals. Those are contradictory requirements that cannot be simultaneously fulfilled.

We have to remember what Obamacare is in both purpose and design. Jonathan Gruber gave the only honest answer by drunkenly saying the quiet part out loud (more than onece):

It is a scheme to transfer wealth from the healthy to the unhealthy. The healthy pay far larger premiums in order for insurance companies to survive the requirment that they accept patients already sick with expensive maladies.

What Gruber left out is that much of the funding to the unhealthy comes from borrowed money and printed money used for the subsidies. The overwhelming majority of the marketplace premiums are paid for by government, not the individual.

The current healthy taxpayer/policy purchaser pays a large part of the burden, but the rest will be borne by most of the grandchildren of the healthy and by some of the grandchildren of the unhealthy.

Another plan that accomplishes that wealth transfer cannot follow expressed (if not followed) Republican principals like low taxes, fiscal responsibility, freedom of choice, and individual responsibility.

The solution to Obamacare is no Obamacare so we can go back to the far lower premiums and freedom of choice that existed prior to that legislation being passed under a cover of lies. There is not the political will to repeal it, and probably never will be.

Most voters and nearly all politicians prefer pain later to pain now. As Keynes himself taught us, "In the long run we are all dead." Not our grandchildren or their grandchildren, of course, but Keynes at least is dead and thus safe from the economic disaster his policies are sure to lead to.

So, the Republicans can do nothing but tweak Obamacare to get rid of the worst of its worst excesses. Allowing the COVID Suplementary Subsdies to expire as provided for by those who voted them in is a baby step in that direction. So is barring illegal aliens who were granted "a legal status" en masse by the previous administration from the subsidies and from Medicaid.

Shocking boosts in premiums thrust ACA policyholders into health care crisis

One said she's being "run out of my country because of healthcare costs."

www.yahoo.com

OOOOOPS

 

[alang1216]

Yep...gotta love the idea of choice.

You're assuming people will act responsibly.