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

[r9etb]

Answer the questions or begone fly.

Yes, apparently Bigun is as thought-free as his on-line presence makes him appear to be. 

Satisfied?

[Bigun]

Yes, apparently Bigun is as thought-free as his on-line presence makes him appear to be. 

Satisfied?

See ya Troll!  Have a nice life!

[Jazzhead]

The House GOP plan apparently approaches the problem by offering so-called "tax credits," which is perhaps a fancy way of saying "means-tested subsidies" that can be used for premiums or HSAs.  If these can be applied with minimal regulatory overhead then I think it's not perfect but about as good as can be expected.

There's no perfect solution, but I think I agree with you that this is probably as good as it gets.   A key to bringing costs down is to encourage those who receive health care services to be good consumers.   To avoid a single payer system - which leads straight to the rationing of care - the problem of selfish free riders needs to be addressed.  The ACA individual mandate was one such idea -  but it has failed for several reasons, not the least being that the options made available in ACA's individual insurance marketplace are expensive and unattractive.   

Replacing the individual mandate with refundable tax credits to a health savings account can provide everyone with the means, if they choose,  to cover themselves with basic insurance protection covering annual check-ups and preventive care, acute emergencies and "stop loss" coverage for catastrophe.     The cost of such credits can be financed in part by requiring the value of employer-provided health insurance to be taxed as ordinary income.    Consumers could use the amounts in their health savings accounts to either purchase insurance or pay for medical expenses directly.   

Give everyone a one-time opportunity to purchase insurance without regard to pre-existing conditions  and permit insurers to deny coverage for pre-existing conditions for anyone who doesn't take advantage of the one-time buy-in.

 Finally, allow and encourage insurers to write unconventional policies that tailor coverage to the specific risks for which consumers want to purchase protection.   If a consumer wants, for example,  to pay less for coverage that doesn't cover drastic treatments for cancer,  then he should be able to do so.     

[libertybele]

There's no perfect solution, but I think I agree with you that this is probably as good as it gets.   A key to bringing costs down is to encourage those who receive health care services to be good consumers.   To avoid a single payer system - which leads straight to the rationing of care - the problem of selfish free riders needs to be addressed.  The ACA individual mandate was one such idea -  but it has failed for several reasons, not the least being that the options made available in the individual insurance marketplace are expensive and unattractive.   

Replacing the individual mandate with refundable tax credits to a health savings account can provide everyone with the means, if they choose,  to cover themselves with basic insurance protection covering annual check-ups and preventive care, acute emergencies and "stop loss" coverage for catastrophe.     The cost of such credits can be financed in part by requiring the value of employer-provided health insurance to be taxed as ordinary income.    Consumers could use the amounts in their health savings accounts to either purchase insurance or pay for medical expenses directly.   

Give everyone a one-time opportunity to purchase insurance without regard to pre-existing conditions  and permit insurers to deny coverage for pre-existing conditions for anyone who doesn't take advantage of the one-time buy-in.

 Finally, allow and encourage insurers to write unconventional policies that tailor coverage to the specific risks for which consumers want to purchase protection.   If a consumer wants, for example,  to pay less for coverage that doesn't cover drastic treatments for cancer,  then he should be able to do so.   

Allowing those to become 'good consumers' as you put it, will only happen when the free marketplace is allowed to work.  Secondly, I don't know of any proposed plan that denies coverage for pre-existing conditions and a one-time deal mirrors what is available today; threatening one to join in either now or they can't every join in -- not exactly allowing one to be a good consumer.

I feel a combination of Cruz and Paul's plan will work ... not even allowing their plans to get off the ground because of the fear the left has invoked will only ensure that Bammycare will not be repealed or replaced which is exactly what their hoping for.

[Smokin Joe]

How about something different?

Everything you spend on Medical CARE is tax deductible, and below a means-tested threshold becomes a refundable tax credit. Everything you spend on Medical Insurance is deductible.
That includes preventive care, vision, dental, replacement parts and appliances, supplies, prescriptions, the works right down to capital improvements to accommodate any disability and scooters and wheelchairs, service animals--all of it. Some will abuse that, others will find it a godsend.
It isn't the rich getting pounded here, they can best afford care (and the best). It isn't the poor--they have medicaid. The elderly have Medicare, and supplemental insurance. But working age middle class people are getting flogged. Not poor enough to qualify for Medicaid (they own stuff), not rich enough to pay for insurance and pay taxes on that money too (20-33%), the Middle Class is the one getting hit from all sides.

Of course, the Socialists have had it out for the Middle Class all along.

One-time deals will only let those in who can, and if someone is not in a fiscal position to be able to opt in, then they will be excluded? No. That stinks.

I like a al carte ideas, I for one do not ever anticipate that I will need a hysterectomy (I ain't wired that way), nor an abortion (elective abortions are something I'd love to be able to exclude), a pap test, etc. My wife, on the other hand, as gutsy as she is, won't need the prostate exam. At our age, I don't anticipate we'll need maternity benefits either. For couples some of those risks might be melded, but for a single guy or gal, no. 

I'd like to see some more honest underwriting, too. I use tobacco, but I don't smoke (quit that over a decade ago), but I don't drink, or do drugs.

While we are told (constantly) how good exercise is for us, in 2005, for instance, over half a million people showed up at the ER with basketball related injuries. the tally looks like this: The Top 15:

    Basketball: 512,213
    Bicycling: 485,669
    Football: 418,260
    Soccer: 174,686
    Baseball: 155,898
    Skateboards: 112,544
    Trampolines: 108,029
    Softball: 106,884
    Weightlifting: 65,716
    Volleyball: 52,091
    Golf: 47,360
    Roller skating: 35,003
    Wrestling: 33,734
, Well, I don't do any of that stuff, so how about a break so I don't have to pay for all those people who hurt themselves 'being healthy'? I'll pay for the risks associated with Swimming/Diving: 82,354
    Horseback riding: 73,576

as occasional activities.
source:
http://www.livescience.com/803-dangerous-sports-america.html

Factor in my driving record, and I might be a better risk than people who are supposedly healthier than me.

But the system wasn't designed to be fair. I thought I'd get a break on vehicle insurance when I quit smoking, but noticed the language had been changed to "tobacco user". People put more effort and concentration into chewing gum than I do in using tobacco (and likely are more distracted by it), but I'm still paying like I was chain-smoking Chesterfields.

It never will be "fair", but some better actuarial assessment might do something to close all those cracks that seem to open underfoot. But then, the biz wouldn't be as lucrative as it is.