Why Trump Should NOT Repeal or Replace ObamaCare (Just Let It Die)

[r9etb]

Personally I think torte reform and opening insurance markets up across state lines would play a big role in bringing down prices for both care and insurance. From there we have 50 states; let them compete on the best way to solve this problem. That usually works better than the Federal Leviathan issuing and orders from on high that they have to pass to even find out what they passed.

I think also that finding some way to move normal medical care away from the insurance model would help a lot.  Doctors have to hire full-time employees just to deal with insurance claims -- the overhead from hiring 2-3 such people is probably a couple of hundred thousand a year.

[Jazzhead]

Personally I think torte reform and opening insurance markets up across state lines would play a big role in bringing down prices for both care and insurance. From there we have 50 states; let them compete on the best way to solve this problem. That usually works better than the Federal Leviathan issuing and orders from on high that they have to pass to even find out what they passed.

Tort reform can help, but only a little.   As for opening up insurance markets across state lines, how does that square with your opposition to the "Federal Leviathan"?    States have historically regulated insurance with respect to their own citizens.  Why should Idaho's rules be trumped by a Federal rule that allows an Idaho resident to purchase insurance not sanctioned by the state of Idaho?   (I'm not saying this can't be a good idea, but let's not kid ourselves - it represents a Federal usurpation of traditional state authority.)   

[Emjay]

Our neighbor had a similar story.  She'd long been dismissive of American health care and moved back to the UK, where she ended up injuring her shoulder.  The waiting list for a National Health Service MRI was months long, and it would have taken 2 years to get shoulder surgery.

Luckily for her they have the wherewithal to get into the private medical system, and she got her surgery.

They've since moved back -- they're more American now than anything else; but she willingly ate crow about her previous disdain for the "wasteful" American approach.

Yep!  And that's just two stories from a small group of people here.

There's not gonna be a perfect healthcare solution but there can certainly be a better one than Obamacare.

[Jazzhead]

I think also that finding some way to move normal medical care away from the insurance model would help a lot.  Doctors have to hire full-time employees just to deal with insurance claims -- the overhead from hiring 2-3 such people is probably a couple of hundred thousand a year.

This I agree with.  I'm intrigued by a "stop loss" insurance model, where insurance kicks in only when combined medical bills exceed a certain dollar amount.  This would encourage consumers to pay cash for services and doctors to price their services to factor in the savings that result from not having to process claims through insurers.   

[Jazzhead]

There's not gonna be a perfect healthcare solution but there can certainly be a better one than Obamacare.

I don't disagree, but believe that the ACA can be FIXED to address its worst failures.  But if we're not going to enforce the "fascist mandate",  then the alternative is single payer.   

[truth_seeker]

 Well,  when it comes to the health care FINANCING business, there are only four potential players - the government,  private insurance companies, charity, and one's own thrift and savings.  Take your pick.

That is no change from each decade going back in history. Intelligent, thoughtful higher income people picked insurance and savings, to finance their medical care needs.

Less responsible and lower income people relied on charity and government. In my county, two of the best known large hospitals go back decades, one catholic, the other Presbyterian.

Is it a moral given, that all are entitled to the same level and quality of care? Is it a given that one man must pay for the care of another?

Finally if there is no "cost," poor people are encouraged to stay poor, irresponsible people are encouraged to remain irresponsible.

"Cost" also defined as little, or no care.

[r9etb]

This I agree with.  I'm intrigued by a "stop loss" insurance model, where insurance kicks in only when combined medical bills exceed a certain dollar amount.   

OK, but that's something that an insurance company can offer as an option; I believe that catastrophic health insurance plans are essentially that sort of model.  It is not something I'd want a government to get involved with.

This would encourage consumers to pay cash for services and doctors to price their services to factor in the savings that result from not having to process claims through insurers.

That's a different issue.  There is already a movement, small as yet, toward offering standard medical care on "concierge care" basis, but most people -- and most doctors -- are still tied to health insurance plans, which are mostly provided through employers.  The doctors who have moved to "concierge care" do it for a couple of reasons: one, it costs less, and two, they're more interested in practicing medicine than in managing formularies.

[skeeter]

I don't disagree, but believe that the ACA can be FIXED to address its worst failures.  But if we're not going to enforce the "fascist mandate",  then the alternative is single payer.   

You have not made this case.

[Emjay]

I don't disagree, but believe that the ACA can be FIXED to address its worst failures.  But if we're not going to enforce the "fascist mandate",  then the alternative is single payer.   

Nope.  Too many holes to be patched.  Just get a new tire or a new plan.

[truth_seeker]

This I agree with.  I'm intrigued by a "stop loss" insurance model, where insurance kicks in only when combined medical bills exceed a certain dollar amount.  This would encourage consumers to pay cash for services and doctors to price their services to factor in the savings that result from not having to process claims through insurers.

One used to be able to get reasonably priced "high deductible" insurance plans. No more, however.

Self-insuring most routine/preventative care, but insurance kicks in for "catastrophic" needs.

However such an option would require a society with citizens responsible enough, to save and prepare for ongoing medical needs.

Government provided or mandated/subsidized health care discourages responsible planning, utilization of care.

The same concepts apply to food, shelter, education,, etc.

That which comes too easily, is taken for granted, abused, etc.

[Idaho_Cowboy]

Tort reform can help, but only a little.   As for opening up insurance markets across state lines, how does that square with your opposition to the "Federal Leviathan"?    States have historically regulated insurance with respect to their own citizens.  Why should Idaho's rules be trumped by a Federal rule that allows an Idaho resident to purchase insurance not sanctioned by the state of Idaho?   (I'm not saying this can't be a good idea, but let's not kid ourselves - it represents a Federal usurpation of traditional state authority.)

Not sure I see that. There's not reason I can't buy other products and services across in another state. It's the federal law shrinking the market and reducing competition in the current system.

[Idaho_Cowboy]

You have not made this case.

I haven't seen any evidence it's better than the screwed up system we had before Obama. Costs have risen. Insurance choices have dropped. The government has collected a lot of fees I mean taxes from folks who couldn't afford insurance. Many people have lost insurance.

[geronl]

Kill it. Kill it dead.

[Weird Tolkienish Figure]

I haven't seen any evidence it's better than the screwed up system we had before Obama. Costs have risen. Insurance choices have dropped. The government has collected a lot of fees I mean taxes from folks who couldn't afford insurance. Many people have lost insurance.

It has helped a few people. It just shifted winners and losers IMO.

[Smokin Joe]

I'm failing to see how either Obama care or singler payer are step in the right direction compared to the emergency room problem. Better to subsidize the care than the insurance. Insurance isn't a god given right. Sorry.

This touches on the crux of the problem. Obamacare was not health CARE, but health INSURANCE. Nothing got fixed with health care, and the cost of insurance just got shifted onto the poor slob who was trying to keep his job, build a business, and keep his own insurance. Coverages were degraded (or flat out eliminated) and prices went up, for those who could afford it, and for those who couldn't, the guy who could afford it got to pick up the tab, which he was doing before, only not for insurance so much as for health care.

So, the parts of the industry which could operate in the black became government subsidized, and the rest pulled back in the marketplace, which was the idea anyway--the "consumer" be damned.

[skeeter]

I haven't seen any evidence it's better than the screwed up system we had before Obama. Costs have risen. Insurance choices have dropped. The government has collected a lot of fees I mean taxes from folks who couldn't afford insurance. Many people have lost insurance.

And ACA hasn't covered a single person who didn't have access to healthcare before.

[Idaho_Cowboy]

@Jazzhead If you do want to drag the gobmint into this. It should be as simple as possible. Health Savings account that is a real account for each person; the way social security was supposed to work. Keep it simple, keep the money out in the open where people can see it, and make it pay for care not insurance.

Obama care due to the sheer size can never achieve any of those goals. 

[Bigun]

 Just do what you said you would do and repeal it entirely then file legislation to implement what you want to keep. Seems like the correct path to me.

[Smokin Joe]

Just do what you said you would do and repeal it entirely then file legislation to implement what you want to keep. Seems like the correct path to me.

Yep. THat way all the hidden nasty bits get repealed, too.

[Idaho_Cowboy]

Yep. THat way all the hidden nasty bits get repealed, too.

Yes, there is a lot of wording that leaves things up to the desecration or discretion of the HHS Secretary and that needs to go. We don't need the rules to change every election.

[Bigun]

Yep. THat way all the hidden nasty bits get repealed, too.

Which is exactly why they don't want to go that route!

[Jazzhead]

And ACA hasn't covered a single person who didn't have access to healthcare before.

The issue is access to health care insurance .   Millions of folks who did not have access to health care insurance before have been enrolled in the ACA-expanded Medicaid and ACA marketplace individual policies.   The problem with the ACA is that many policies in the former individual insurance marketplace became non-compliant, or were forced into narrower provider networks so folks had to switch doctors.  ACA was a boon to many, but the promise that "if you like your plan you can keep it" was a cruel lie.   

There are serious problems with the ACA - but it CAN be fixed without resorting to single payer.   

[Idaho_Cowboy]

The issue is access to health care insurance .   Millions of folks who did not have access to health care insurance before have been enrolled in the ACA-expanded Medicaid and ACA marketplace individual policies.   The problem with the ACA is that many policies in the former individual insurance marketplace became non-compliant, or were forced into narrower provider networks so folks had to switch doctors.  ACA was a boon to many, but the promise that "if you like your plan you can keep it" was a cruel lie.   

There are serious problems with the ACA - but it CAN be fixed without resorting to single payer.   

Why do you think that is better than a repeal and replace approach?

[Jazzhead]

Why do you think that is better than a repeal and replace approach?

Because the ACA has indeed been a boon to many.   Why not keep what's good and fix what's bad?     

[Norm Lenhart]

Because the ACA has indeed been a boon to many.   Why not keep what's good and fix what's bad?   

Because your liberal ponzi scheme has hurt the country more than helped.

But as a supporter of myriad liberal causes, you pound away, intent to keep it forced on America.