Why replacing Obamacare is so hard: It’s fundamentally conservative - Craig Garthwaite, Washington Post

[Hondo69]

ObamaCare has nothing to do with insurance - it is a tax designed to redistribute income.

And at its root ObamaCare has very little to do with healthcare - it's about power and control.  ObamaCare just happens to have chosen the healthcare industry to assert that power and control.  They could have chosen the coffee industry or the sugar industry to assert that power and control but they chose the healthcare industry instead.

[Sanguine]

ObamaCare has nothing to do with insurance - it is a tax designed to redistribute income.

And at its root ObamaCare has very little to do with healthcare - it's about power and control.  ObamaCare just happens to have chosen the healthcare industry to assert that power and control.  They could have chosen the coffee industry or the sugar industry to assert that power and control but they chose the healthcare industry instead.

QFT.

[Bigun]

How do you know you won't need medical services?  The essence of a free rider is someone who doesn't purchase health insurance when he's healthy,  and then forces others to pay when he eventually and inevitably gets sick.   As many have pointed out,  if you can hold off purchasing insurance until when you get sick, that's not insurance.  It's welfare.   And I resent having to provide welfare to free riders who coasted all those years when I was paying premiums to stay insured like a responsible adult.

I'm pretty damned sure my wife is not going to become pregnant!

[Bigun]

ObamaCare has nothing to do with insurance - it is a tax designed to redistribute income.

And at its root ObamaCare has very little to do with healthcare - it's about power and control.  ObamaCare just happens to have chosen the healthcare industry to assert that power and control.  They could have chosen the coffee industry or the sugar industry to assert that power and control but they chose the healthcare industry instead.

ABSOLUTELY RIGHT!  A Fact which has been pointed out here many times previously!

[IsailedawayfromFR]

Get a grip sir.  I was agreeing with you.  Read what I wrote.  Read it twice if you need to:

No, you just do not get it at all.

You believe someone should be insured for something which happens in the past.  Insurance is only for future events.  No one insures a past event.  It is not insurance.

Go back one more time and try to understand the definition of insurance.

I spelled it out for you but for some reason you are not reading it.

[Jazzhead]

I give up, sir.   You and I have a failure to communicate that cannot be resolved.

[Sanguine]

I give up, sir.   You and I have a failure to communicate that cannot be resolved.

Oddly enough, so do you and I.

[Jazzhead]

Oddly enough, so do you and I.

Over what? 

[Sanguine]

Over what?

Exactly! 

[Jazzhead]

Exactly!

LOL!   Sanguine, I know we disagree about things, but I assume we understand each other's positions.  If my position is unclear, I'm always happy to try to explain.   What's frustrating about ISAFFR is that even when I agree with him, he won't accept it!

[Sanguine]

LOL!   Sanguine, I know we disagree about things, but I assume we understand each other's positions.  If my position is unclear, I'm always happy to try to explain.   What's frustrating about ISAFFR is that even when I agree with him, he won't accept it!

I understand, Jazz.  You and I don't have that problem.

[Hondo69]

[roamer_1]

It's roots are conservative, in the sense that it addresses the free rider issue by taxing those who do not participate in the insurance marketplace [...]

There is *no* Conservative solution that supports anything but free marketplace by the very nature of Conservatism.
There is *no* Conservative solution that supports this overweening regulation, and especially at the federal level...
There is *no* Conservative solution that advocates for mandated purchase of anything.

And: The concept of a 'free rider' is a socialist one.

[RoosGirl]

There is *no* Conservative solution that supports anything but free marketplace by the very nature of Conservatism.
There is *no* Conservative solution that supports this overweening regulation, and especially at the federal level...
There is *no* Conservative solution that advocates for mandated purchase of anything.

And: The concept of a 'free rider' is a socialist one.

And now with some of the news out today we actually are hearing why it's so hard to replace Obamacare; not enough payoffs yet for some of the people in Congress.

[roamer_1]

And now with some of the news out today we actually are hearing why it's so hard to replace Obamacare; not enough payoffs yet for some of the people in Congress.

It's all bull poop and unicorn dreams.
Anything other than a full repeal with a roll call vote is just cover for single payer.... watch and see.

[IsailedawayfromFR]

LOL!   Sanguine, I know we disagree about things, but I assume we understand each other's positions.  If my position is unclear, I'm always happy to try to explain.   What's frustrating about ISAFFR is that even when I agree with him, he won't accept it!

You have a fundamentally flawed argument when you define insurance as taking care of pre-existing conditions.  Here's your own quote on the subject:

But the ship has sailed with respect to scrapping it altogether, and returning to the bad old days when folks with preexisting conditions had no access to coverage,  and imposed their costs on hospitals.
http://www.gopbriefingroom.com/index.php/topic,271268.msg1385444.html#msg1385444

You say here that you want insurance on people with pre-existing conditions.  That is not insurance. 

[Oceander]

ObamaCare isn't conservative.   It wreaks too much havoc with private markets and consumer choice for that.   In many places,  it's devolved so there's only one insurer in the market.    That's not competition,  that's not conservative.

It's roots are conservative, in the sense that it addresses the free rider issue by taxing those who do not participate in the insurance marketplace,  thereby expanding the risk pool sufficiently to (theoretically) make community rating coverage affordable.   There are fewer folks with "pre-existing" conditions since more people are part of the pool in the first place.   The costliest folks' expenses are spread among a wider group.  Remember, of course,  that the idea of individual mandates to achieve affordable community rating coverage has always been proposed in the context of the alternative of single payer.  The conservative rationale of the individual mandate has always been to preserve private markets and avoid single payer.   

But the ACA goes about it all wrong - principally, in my view,  by forcing the young to subsidize the old (effectively driving those healthier lives out of the pool),  and by eliminating competition with respect to the scope of coverage.   The only policies in the marketplace are gold-plated, with competition coming in the form of deductibles/copays and the skinny-ness of provider networks.

Yes,  the ACA can be reformed in a more conservative direction, as both the House and Senate bills attempt to do.   But the ship has sailed with respect to scrapping it altogether, and returning to the bad old days when folks with preexisting conditions had no access to coverage,  and imposed their costs on hospitals.   Some have proposed the alternative of high risk pools for the most expensive lives,  or slicing off that population and simply providing them with Medicare.  Such approaches also have merit,  so long as those outside the pools have access to affordable coverage that fits their needs, and effective penalties exist for the free riders.

You can't put on a fig leaf of conservativism by creating the free rider issue and then pretending to solve it.  A conservative solution would not have created the free rider issue in the first place. 

[Smokin Joe]

How do you know you won't need medical services?  The essence of a free rider is someone who doesn't purchase health insurance when he's healthy,  and then forces others to pay when he eventually and inevitably gets sick.   As many have pointed out,  if you can hold off purchasing insurance until when you get sick, that's not insurance.  It's welfare.   And I resent having to provide welfare to free riders who coasted all those years when I was paying premiums to stay insured like a responsible adult.

Well, for starters, I'm not plumbed for a pap smear, there is no way in Hell I'll ever be pregnant (and if I am, by golly, I'll make enough to pay the bills off the book rights alone), and unless my wife and I have a moment like Abraham and Sarah (which, considering the damage her second pregnancy did, the ligation, and age, really would require a miracle) I can safely say there are services required to be covered by Obamacare we simply will not need. I don't have to be the amazing Kreskin, just have a little knowledge of biology and medicine.

Likelihood of one of us coming down with HIV/AIDS? I'm not sure I can express that as an appropriate fraction without using exponents, so let's simply say 1*10^-4000 for a wildeyed guess.

Now, I HAD catastrophic health care to cover any really big expenses, and savings to cover the deductibles, but your cherished ACA took that insurance off the table. I have gone over the crippling downside of the economics of a Cadillac plan which simply provides coverage which we will not need, at a rate that is prohibitively expensive on more than one thread, and will spare you a reiteration you obviously didn't comprehend, if you even read it.

So fine me. Use the IRS to seize all I own, my home to auction for pennies on the dollar and put my ass on the street so I can die there? Is that my reward for paying my bills AND picking up the tab for others all my life by paying taxes, too?
That scenario would meet with resistance that will incur medical costs.

Just get the damned government out from between the patients and their doctors.
It'll save a lot of money, we'll get better care.
The ACA needs to go.

[Smokin Joe]

I don't know what's so Conservative about Socialism.

Nothing to know; there is nothing at all.

[Smokin Joe]

ObamaCare has nothing to do with insurance - it is a tax designed to redistribute income.

And at its root ObamaCare has very little to do with healthcare - it's about power and control.  ObamaCare just happens to have chosen the healthcare industry to assert that power and control.  They could have chosen the coffee industry or the sugar industry to assert that power and control but they chose the healthcare industry instead.

You are correct. It is about taking from the 'rich straight white man' and giving it away.

It is the "paybacks" Valerie Jarrett was talking about. It is class warfare, waged on the breeders and middle class by the Government. It has to go.

[Maj. Bill Martin]

No, INVAR, I'm just the resident old school Republican.   I remember as a young man devouring the policy proposals of the Heritage and AEI folks concerning the use of an individual mandate to achieve a workable structure for community rating.   It was seen as the effective conservative antidote to single payer, by encouraging an efficient and affordable private insurance market that could cover most able-bodied adults without regard to health or employment status. 

Yes, the roots of ObamaCare are indeed conservative.       

Late to the party here, but I just have to respond to this point because I see Democrats making this argument all the time and it is frustrating as hell.

Cherry-picking the policy preferences of a few conservative intellectuals and then labelling them "conservative ideas" as if conservatives or Republicans in general supported them is bogus as hell.  If these were truly "conservative" ideas that "conservatives" supported, you'd think that they'd have actually been passed at some point during the Reagan or either Bush Administration.  After all, they're ideas that Democrats always would have supported in preference to the status quo.

The idea for an individual mandate was floated back in the days of the debate over HillaryCare by a few guys at Heritage, but there was never significant support for it within the GOP caucus, or among conservatives in general other than those Heritage guys.  It was used not as an "antidote" to single-payer, but simply a disingenuous, politically-clever tool to kill HillaryCare.  And as soon as HillaryCare died, the very few GOP members of Congress who liked the idea (all moderates) were swamped by all the Republicans (including all the conservatives) who wanted nothing to do with a mandate.  That's why it never went anywhere until Democrats got 60 votes in the Senate, control of the House, and the Presidency.

It's a fundamentally liberal idea pushed by a couple of conservatives who overthought the issue.  The rest of us rejected it out of hand by seeing it for what it was.

[Smokin Joe]

There is *no* Conservative solution that supports anything but free marketplace by the very nature of Conservatism.
There is *no* Conservative solution that supports this overweening regulation, and especially at the federal level...
There is *no* Conservative solution that advocates for mandated purchase of anything.

And: The concept of a 'free rider' is a socialist one.

If he wants to see 'free riders' they are the people (like the 1.3 million I keep mentioning) who did not have insurance but who want to be covered for 'preexisting conditions'. The insurance that I HAD covered my basal cell carcinoma, as I had had that insurance for years before the cancer. Now, thanks to the ACA, my being a cancer survivor will be factored into whatever insurance eventually replaces the insurance I HAD. Why? Because the pool I paid into all those years is gone, dried up by the sponges who will suck the life out of any insurance in the future as long as the ACA is in effect.

The free riders are the infected GLBTs and needle-sharing junkies and otherwise promiscuous types who have laid a trillion dollars in present and future medical payments on the people who would not engage in their behaviour by forcing them to 'share the burden' in order to get little Johnny's cut foot sewed up or little Suzie's arm set when she falls off her bicycle, not to mention the millions who lost their full time jobs over coverage rules, often people who could least afford it.  They're the ones raking in wild profits in scam artist 'treatment programs' for addicts that were never intended to work, only rake in the Gubmint money.

That's just wrong.
So, let's tap into Forbes to see who is exempt from Obamacare's tender ministrations:

Certain individuals will be exempt from Obamacare. According to the website, healthcare.gov, you may qualify for an exemption if:

    You’re uninsured for less than 3 months of the year;
    The lowest-priced coverage available to you would cost more than 8% of your household income;
    You don’t have to file a tax return because your income is too low;
    You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider;
    You’re a member of a recognized health care sharing ministry;
    You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare;
    You’re incarcerated, and not awaiting the disposition of charges against you; and
    You’re not lawfully present in the U.S.

It should also be noted that if your income is less than 133% of the federal poverty level, you will be relieved of this penalty. At first blush, the exemptions seem to focus on the poor, those in prison, Native Americans, and illegal immigrants. There is, however, another list of qualified exemptions.

Hardship Exemptions

This is the list I suspect holds the greatest potential for loop-hole abuse. You may qualify for a hardship exemption if:

    You were homeless; (You get to die in the streets anyway! sj)
    You were evicted in the past 6 months or were facing eviction or foreclosure;
    You received a shut-off notice from a utility company;
    You recently experienced domestic violence;
    You recently experienced the death of a close family member;
    You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property;
    You filed for bankruptcy in the last 6 months;
    You had medical expenses you couldn’t pay in the last 24 months;
    You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member;
    You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case, you do not have the pay the penalty for the child;
    As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace; and
    You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act.

And let's not leave out the Congress and their staffers, who are also exempt.

Now, I reckon none of those people are going to get sick, right?

Folks have a lot of damned gall calling people who can no longer afford insurance because of stupid government decrees 'free riders'.  We're not riding at all, the Government shot our horses.

[Jazzhead]

The rest of us rejected it out of hand by seeing it for what it was.

You rejected it out of hand because you didn't think there was a problem.    It is a consequence of our current system, where most of the able-bodied population is covered by employer-provided group insurance,  that those between jobs or who work for smaller employers are faced with the reality of no protection from catastrophe.   That used to be seen by conservatives as that's-life unfortunate, but nothing that government was obligated to try to fix.  It's still seen that way by many,  but ObamaCare represents the creation of an entitlement for which there is no precedent for dismantling. 

Working people want affordable health insurance.   While ObamaCare is a failure,  I'd like to see what the states can do to remedy the scandal of millions of uninsured.     

 

[roamer_1]

You rejected it out of hand because you didn't think there was a problem. 

No, we reject it out of hand, because 'We're from the government and we're here to help' is never, ever the solution.

[roamer_1]

Folks have a lot of damned gall calling people who can no longer afford insurance because of stupid government decrees 'free riders'.  We're not riding at all, the Government shot our horses.

Damn straight.