Let's Say Obamacare Is Repealed. What Then?
nytimes.com
nytimes.com
Also, I fully expect that I'm remembering completely wrong. I'm human, and in mobile, and about to prep a turkey, sorry.
While I admit that it's not a fleshed out plan, the website does provide reasonable guidelines for what his administration wants to perform. Republicans have, half-assedly, been trying to do the same in the House for years. Perhaps all of the saber rattling will lead to a coherent plan.
In reality, American healthcare is just a big scam and ripoff. On my last trip to Germany my girlfriend had a problem with her eye. We went to an eye doctor there and paid 25 Euro out of pocket without insurance. Doctors in Germany don't starve but they have nice cars and houses. In the US she had recently several surgeries and every hospital bill has had massive errors in the range of thousands of dollars. It's just a racket. How about enforcing some standards of billing accuracy instead of allowing this kind of scam?
[0]: http://www.rd.com/health/wellness/wildly-overinflated-hospit...
http://www.vox.com/policy-and-politics/2016/11/18/13678690/r...
1. Insurance companies must cover everyone but can charge more based on pre-existing conditions. Insurance companies know acturatially how much treatment will cost based on a person's condition, so they charge that person and exhorbant amount. People complain and the government either has to subsidize the cost and pay insurance companies the difference or have the dreaded public option - just what the Democrats originally wanted.
2. Alternatively, everyone has to get coverage so you can't game the system and only get insurance when you think you will need it - an individual mandate.
Either way, all roads lead back to some form of either ObamaCare, a public option, subsidies that go directly to insurance companies, or people not being insured.
We also need to be able to have plans where we can specifically choose what kind of care we need (IE: women, men, children, etc).
I run my own business and my costs went up 100% this year for a higher deductible and less coverage. If this happens again, I may not be able to afford it.
The only thing I liked about Obama care was the pre-existing conditions clause.
We can quibble about rates for men vs women, but unless you were matured to adulthood in a lab, it's hard to argue that men as a class do not benefit from improved and cheaper access to reproductive healthcare for women. (Also, better reproductive health means fewer criminals, if only because they're born healthier and with fewer mental handicaps.)
Opening up insurance across states would be nice theoretically, but you must realize that it's a states' rights issue for a large segment of the GOP, and a cause for concern among Democrats. It would necessarily limit and perhaps destroy the ability for states to meaningfully regulate insurance within their own borders. Unchecked, it would also mean a race to the bottom in terms of regulatory oversight as every provider would only sell insurance from states with the least restrictive regulations.
What state do you live in? Coverage in states like California and many other states that haven't fought tooth-and-nail has been fairly stable as far I know. The Kaiser HMO rate at my company actually decreased slightly for 2017, with no change in coverage. And California not only has a rigorous regulatory framework, it even maintains a weird tax on hospital income to pay for uninsured coverage.
Also, you don't need a federal law to support an inter-state insurance scheme. States could voluntarily permit policies to be sold from other states. For example, states in different regions could elect to normalize their regulatory schemes and open up their markets to each other. There's plenty of precedent for this. It doesn't require Congressional approval; just coordination among state legislatures like is so often done for other regulatory frameworks.
$1,200 is typical for a decent-quality medical plan, if California is any measure. And California law has far stricter minimum coverage requirements than Obamacare.
It's true that under Obamacare it has been more difficult for some people to stick with their same, preferred insurance provider. It seems some providers will jack up rates in an attempt to reconfigure their insured base. I can't see how that would change without restricting insurance providers even more. Less regulation, as is likely with Republican policies, would likely lead to more shenanigans. It might lead to slightly cheaper coverage for the well-off, but I'd take a slightly higher premium knowing that if I got laid off and lost income I'd still be able to afford decent healthcare. Even with Obamacare a major medical condition can still bankrupt you, especially if you lose your job.
Purchasing insurance to subsidize income if you become sick or injured is still a smart thing to do. It's just that with solid minimum coverage requirements you're paying part of that premium directly in the cost of your healthcare.
I just don't see how this system will work for insurers in the long run -- I know I'm certainly not going to the Dr. unless I'm really sick. Somehow even yearly checkups seem to cost me over $500 so I delay those until they threaten to not renew prescriptions.
A $6000 deductible is basically a catastrophic policy, it discourages care which is perhaps the point. Of course if you have ever seen an uninsured ER bill then that $6000 suddenly looks comparably cheap.
How expensive will it all get before it breaks?
As an example (though I'm unsure if this is in particular a federal or state mandate in California), the maximum deductible for child delivery is much less than a typical policy's maximum deductible in the aggregate. Our deductible on our family policy is $3,500, I think; but we only had to cut a check for a fraction of that.
So when people say they have a $5,000 deductible, it absolutely does not mean that most care is entirely out-of-pocket. In fact, most routine preventative care has a very low deductible. Otherwise, as you said, it would basically be worthless to almost everybody.
There are plenty of single men that should not be forced to pay for women's reproductive healthcare.
"What state do you live in? "
http://time.com/money/4535394/obamacare-plan-premium-price-i...
8 states rose by at least 30%.
"States could voluntarily permit policies to be sold from other states. For example, states in different regions could elect to normalize their regulatory schemes and open up their markets to each other. There's plenty of precedent for this. It doesn't require Congressional approval; just coordination among state legislatures like is so often done for other regulatory frameworks."
Great, but Obamacare in its current form needs to go.
I have to say this attitude makes me viscerally angry. Men have a much higher incidence of heart disease, so maybe women should not be forced to pay for that? Men engage in lots of unhealthy, risky behaviors, but I've never heard a woman make a statement analogous to yours. It's like saying "Well I'm not handicapped, so why the hell should I have to pay for special accommodations for those people?".
If you accept that socialized healthcare is a good idea, then it seems to follow fairly obviously that we're all unique and will have individualized healthcare needs.
But few men are willing to come out and plainly state that they aren't interested in subsidizing prenatal care. When you say it aloud it just sounds so obviously wrong, whether or not you're asexual, homosexual, or infertile. And it's especially hypocritical for the anti-abortion set.
It's like the argument that childless property taxpayers shouldn't have to subsidize public schools. People just rely on vague handwaving about fairness and risk allocation. And, FWIW, it's also like arguing that taxes paid by pacifists shouldn't support the military. Even most liberals understand that it's a ridiculous assertion as a practical matter.
But there's a difference between change and discarding the whole thing. The _core_ part of Obamacare, particularly wrt fiscal viability of adequate universal coverage, are 1) no pre-existing exclusions, 2) individual mandate, 3) and minimum coverage requirements.
Even Obama agrees that the system of exchanges needs changing. Those and other details, like subsidies and integration with Medicaid and Medicare aren't part of the core calculus. They were part of the political horse trading (among politicians, with the insurance industry, etc) necessary to see any national program passed. If sentiments change than those details can obviously be changed, too.
But if neither of those three things change, you'll still basically have Obamacare, and middle-class independent contractors or people with employer-sponsored policies are unlikely to see substantial changes from the status quo. If any of those three things change, you're likely going to see either a contraction of coverage in both quantity and quality, or ballooning government deficits.
If all people really want to see is the name change, have at it.
As I understand it, this is the first step toward removing all regulation on the healthcare industry. Some pro-big-business-controlled state legislature will slowly start removing regulations to lure insurance companies. They'll move to that state, and then they'll be able to sell their product from that state to the rest of the country.
No insurance company wants to compete for high risk people. It won't help. Besides, most of the big insurance companies already have plans in most states.