Wednesday, March 8, 2017

What happened to all of this 'repeal and replace' stuff?

The announcements are in.  The conservative majority in the House and the Republican president who ran and were elected on promises of 'repeal and replace Obamacare' are now starting to weasel out of their promises.

This newly announced "American Health Care Act" still has many of the prohibitively expensive taxes and mandates that Obamacare had:

  • you still have to have insurance, but now if you don't have it rather than pay Uncle Sam, you pay the hated insurance companies.
  • The 'Cadillac' plan tax is still there, although deferred until 2025.
  • "Kids" still stay on their parent's policy until age 26.
  • Pre-existing conditions cannot disqualify anyone from obtaining insurance.
In other simpler terms, it has now accurately been called "Obamacare-Lite" or "Obamacare 2.0".  And for good reason: all of these provisions are unsustainable, and will never control costs.  The pre-existing conditions clause alone will bankrupt the system sooner or later, as taking on gravely sick people ('adverse selection') and not charging them accordingly is an actuarial unsound principle.  This is not insurance, it is something else.

This nonsense sounds nothing like their promised 'repeal and replace.'  It is bad public health policy.  I rarely agree with Utopian dreamer Sen. Rand Paul (R-Ky), but in this case I have complete agreement with him: this is no better than Obamacare.  Costs will not come down, levels of care will not get better, deductibles and premiums will still be God Awful.

Heads have got to roll on this one.  At least The Donald has said that he is open to negotiation on this bill.  Nowhere in this mess is the allowance for insurance companies to cross state lines to compete in any state they choose to participate in.  This alone would do wonders for lowering premiums.  

Regardless of what we finally get out of this Congress and president, it will come up short of getting the job done: control skyrocketing costs of health care.  We started down the path of expensive health care bills when we as a nation no longer paid for services directly to doctors with cash money; a mere 75 years ago, our health care system had no government involvment, no insurance, no middle men, none of that.  Then Franklin Delano Roosevelt decided that things had to change.  And they indeed changed - for the worse.

Back in the day, we paid for health care ourselves, directly to our doctor.  Once we started putting middle men in between our doctors and patients, concern for costs became a thing of the past: why bother worrying about costs if everybody perceives that somebody else is paying for things?

Sure, when we feel like we don't have to pay for it, we'll have the Chateau Briand, the beluga caviar and the Maine lobster.  And keep it coming, damn you!  

And that's what things have come down to.  Nobody wants to have to pay for their health care, only a few measly bucks for a co-pay, but no more.  When did we start with this foolishness of mandating that doctors have to treat patients, regardless of their ability to pay?  That is killing us, too.  Free health care for everybody, woo hoo!

And this latest bill is not going to fix what is essentially wrong with our system.  Everybody thinks it should be almost free, and consume as much doctor's care as we can dream of.

It's killing us.  Some kinda health care, if you ask me.


LL said...

It can't be an entitlement.

As you point out, there are measures that help reduce the price of healthcare and healthcare insurance. Those should be embraced. For everyone else, pay for what you want or don't get insurance.

That philosophy will bring the price down. If the government is incentivizing anything it will drive up the cost.

Adrienne said...

I have to look a bit closer at what is being called "phase one" of the plan. I thought from day one that it's going to be pretty complicated untangling the total mess of Odumbocare.

I am also of the opinion that businesses should be completely out of the insurance business. That started when there were wage freezes during the war. When a business couldn't offer better pay they started offering bennies instead to attract good employees.

Another factor in cost is malpractice insurance and people suing so doctors order every test under the sun to make sure they don't get sued.

The doctors who have started concierge offices are doing great.

Gorges Smythe said...

I knew it was too good to be true.

LindaG said...

And it doesn't address the doctors leaving in droves because they can't get paid, or won't take patients because of the insurance they do have.
I don't like it. But I am guessing what you or I think don't matter.
Sucks lemons, it really does.

Fredd said...

LindaG: it does indeed get frustrating when both you and I can clearly feel the Zeitgeist here, and our GOP leaders have such tin ears. We are all screeching from the mountain tops, and the GOP just doesn't get it.

Fredd said...

LL: the government has to leave this market, that's all there is to it. They are, and have always been, screwing things up to the point that it is not a market anymore; here in the land of free markets. Of course Q-Tips, Band-Aids and aspirin will cost $30 each under any government program.

Fredd said...

Gorges: the average GOP voter is just like Charlie Brown; Lucy Van Pelt promises to hold the football this time, and not pull it away at the last second when Charlie tries to kick it. We have been promised in the mid-terms in 2010 and 2014, along with the last two general elections that if elected to office, the GOP will repeal and replace Obamacare.

Here we all are again. Listening to Lucy Van GOP, promising to hold the football this time. And she really means it. This time for sure.

Fredd said...

LL: unfortunately, it is indeed an entitlement mind set when it comes to health care. Nobody should be denied a life saving $500,000 operation just because they don't have half a million bucks. That's not who Americans are, right?

Everybody should live on the sunny ocean front, everybody should have multi-level mansions with multi-level heated swimming pools, we all should have a Rolls Royce in every garage. To deny anyone these things is just not American.

It's just not who we are as a people, you see.

Fredd said...

Adrienne: of course, when lawyers get involved in anything, things go to crap straight away.

I've got good news and bad news, Adrienne: the bad news is that a crowded bus ran off a cliff, killing everyone aboard. The good news is that the bus was packed with lawyers heading to a malpractice convention.

LindaG said...

Ah yes. I forgot about the outrageous malpractice insurance. One thing the dumb new healthcare law could do is limit malpractice lawsuits.
We are, after all, human (yes, human) and not God.

Kid said...

Congress still bought and (maybe) paid for. Until Tort Reform enters the conversation this will be a stinking pile.

DaBlade said...

I agree 100% Fredd. I heard Mark Levin compare this so-called 3 phases rollout thing to buying a muffler before you able to see the entire car. Now the Republicans will own the meltdown.

Kid said...

Tort Reform is the only thing that will make healthcare affordable. And I want government out of it but at this point I don't know how you do that with so many unemployed.

Fredd said...

Kid: yes, lawyers screw things up all the time, regardless of the industry. Once we finally pass legislation that requires the loser of any litigation to pay the court costs, etc., then the lawyers' damage to our country will subside somewhat

Fredd said...

We'll see how the Republicans handle this mess. No matter what happens, we will have TrumpCare, and the GOP will own it, for better or worse.

Kid said...

Fredd, needs to happen in criminal cases too. Some 50+ phycho chick at work, dating a 20 something dumb kid, who after a year or so, broke up with her at her appt. She punched hom in the face a few times, he grabber her wrists, so she started head butting him. She called 911 and had him hauled off. 6 months later is the trial and he gets off because her story is so pathetic. Prosecutor probably never even looked at the case until it started in court. he's out an est. 10 grand and she walks away laughing, and no consequence for the prosecutor either of course. It is guilty until proven innocent.

Fredd said...

Kid: that case is a perfect reason why the loser has to pay. It would shrink the dockets by 90%.

dc said...

Hi Fredd, I've sent you a few comments - are they in or spam folder or?

Fredd said...

dc: just thought I would publish one of your comments - it appears to me that you did not read the post, so I have a policy of just marking as spam any comments such as these. Just so you know. That, and if they have crack pot rantings - I spam those, too.