Obamacare Repeal or Obamacare 2.0?

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This Thursday, the House of Representatives will vote on a Republican bill that supposedly repeals Obamacare. However, the bill retains Obamacare’s most destructive features.

That is not to say this legislation is entirely without merit. For example, the bill expands the amount individuals can contribute to a health savings account (HSA). HSAs allow individuals to save money tax-free to pay for routine medical expenses. By restoring individuals’ control over healthcare dollars, HSAs remove the distortions introduced in the healthcare market by government policies encouraging over-reliance on third-party payers.

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The legislation also contains other positive tax changes, such a provision allowing individuals to use healthcare tax credits to purchase a “catastrophic-only” insurance policy. Ideally, health insurance should only cover major or catastrophic health events. No one expects their auto insurance to cover routine oil changes, so why should they expect health insurance to cover routine checkups?

Unfortunately the bill’s positive aspects are more than outweighed by its failure to repeal Obamacare’s regulations and price controls. Like all price controls, Obamacare distorts the signals that a freely functioning marketplace sends to consumers and producers, thus guaranteeing chaos in the marketplace. The result of this chaos is higher prices, reduced supply, and lowered quality.

Two particularly insidious Obamacare regulations are guaranteed issue and community ratings. As the name suggests, guaranteed issue forces health insurance companies to issue a health insurance policy to anyone who applies for coverage. Community ratings forces health insurance companies to charge an obese couch potato and a physically-fit jogger similar premiums. This forces the jogger to subsidize the couch potato’s unhealthy lifestyle.

Obamacare’s individual mandate was put in place to ensure that guaranteed issue and community ratings would not drive health insurance companies out of business. Rather than repealing guaranteed issue and community ratings, the House Republicans’ plan forces those who go longer than two months without health insurance to pay a penalty to health insurance companies when they purchase new policies.

It is hard to feel sympathy for the insurance companies since they supported Obamacare. These companies were eager to accept government regulations in exchange for a mandate that individuals buy their product. But we should feel sympathy for Americans who are struggling to afford, or even obtain, healthcare because of Obamacare and who will obtain little or no relief from Obamacare 2.0.

The underlying problem with the Republican proposal is philosophical. The plan put forth by the alleged pro-free-market Republicans implicitly accepts the premise that healthcare is a right that must be provided by government. But rights are inalienable aspects of our humanity, not gifts from government.

If government can give us rights, then it can also limit or even take away those rights. Giving government power to enforce a fictitious right to healthcare justifies government theft and coercion. Thievery and violence do not suddenly become moral when carried out by governments.

Treating healthcare as a right leads to government intervention, which, as we have seen, inevitably leads to higher prices and lower quality. This is why, with the exception of those specialties, like plastic surgery, that are still treated as goods, not rights, healthcare is one of the few areas where innovation leads to increased costs.

America’s healthcare system will only be fixed when a critical mass of people rejects the philosophical and economic fallacies justifying government-run healthcare. Those of us who know the truth must continue to work to spread the ideas of, and grow the movement for, liberty.


 

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14 Comments
Flying Monkey
Flying Monkey
March 20, 2017 7:39 am

..and Ronald Reagan signed EMTALA, mandating that the uninsured get free health care in emergency rooms. I haven’t heard much about the repeal of that. That just started the snowball rolling. So much for Reagan’s “Free Market” attitudes. He could have at least vetoed it even if congress wanted it.

Anonymous
Anonymous
March 20, 2017 8:14 am

We’ll either keep Obamacare as it is or get what the Republican Establishment gives us (which will just be Republican Obamacare).

That’s the only two choices we have. The Republicans don’t stand against Obamacare in principle, they just want to be the ones running it.

starfcker
starfcker
March 20, 2017 9:03 am

Think this through. Repeal obamacare without keeping anything in place, and every person who can’t get insurance because of a pre-existing chronic condition, like diebetes, dies. Let Trump work through this. He had Elijah Cummings in his office last week. Cummings is going to file a bill to drastically reduce drug prices. Stuff like that can get 60 votes in the senate. It’s unrealistic to want an instant fix or nothing

Anonymous
Anonymous
  starfcker
March 20, 2017 9:37 am

It isn’t unrealistic to want a full repeal of Obamacare, that’s something that needs to be done before anything new is implemented and can take place through a transitional period so it doesn’t instantly collapse the system.

Failure to fully repeal prior programs before doing something new is why we have the overall mess we have, nothing ever actually goes away it just gets larger and more complicated as stuff is added to it in under the guise of reform.

In any event I’m old, with way more days behind me than in front of me, and don’t expect to be around long enough to see how it plays out.

But I would like to at least see it start down the right path before I go.

Dutchman
Dutchman
March 20, 2017 9:10 am

It’s so simple – we have allowed health care to cost too much. All the bullshit about HSA’s, insurance across state lines, etc, etc – all just crap. It will still cost way too much.

Did you know 5% of the population consumes 50% of the healthcare expenses? And of that 5% – 1% consumes 25% of the costs.

Anonymous
Anonymous
  Dutchman
March 20, 2017 9:39 am

So how would you change this? How would you make it different?

It’s worth discussion in detail, I think.

starfcker
starfcker
  Anonymous
March 20, 2017 10:13 am

Look, healthcare is a huge part of the bullshit ‘service economy’. Why is anybody dumb enough to think throwing a fifth of our economy into chaos is a good idea? Why does anybody think putting many of their fellow citizens in hugely stressful and possibly deadly circumstances is a great idea? There is no instant fix. ‘Liberty’ ain’t going to fix this. It’s going to be a process, it’s going to take some time. But they are on it. Let Trump and Price do what we hired them to do. Which is, fix this without crashing the system.

Dutchman
Dutchman
  Anonymous
March 20, 2017 11:17 am

“How would I change this?”

It’s going to sound bad… but you can’t get something for nothing. People on medicaid need to start paying – something.

I’m for ‘giving’ everyone $100,000 of catastrophic insurance for free. We can define any one year expense of say $10,000 as catastrophic, and the insurance will pay, otherwise you pay for everyday care. When you use that up $100k- you’re on your own. You can sell your assets, ask for charity, but you’re on your own. Everyone has the same benefit.

What good are these people who don’t/can’t work, get SNAP, section 8, medicaid, $10,000’s of drugs a year? These are the 5% that are consuming 50% of our medical costs. I think we should make them comfortable, and let them pass on.

Anonymous
Anonymous
  Dutchman
March 20, 2017 12:09 pm

“The elderly (age 65 and over) made up around 13 percent of the U.S. population in 2002, but they consumed 36 percent of total U.S. personal health care expenses. ……………… People 65-79 (9 percent of the total population) represented 29 percent of the top 5 percent of spenders.”

https://archive.ahrq.gov/research/findings/factsheets/costs/expriach/index.html

European socialist healthcare systems address this by rationing healthcare over a certain age, or in multiple chronic conditions, basically telling patients to “go home and die”.

That’s going to be hard to get accepted here.

starfcker
starfcker
  Dutchman
March 20, 2017 1:05 pm

Dutch, two things you might find interesting. Ryancare will block grant medicaid to the states, and the states are going to have the option of a work requirement. Second, I saw Price on TV yesterday say basically that Trump does not consider medicaire disability to be untouchable, and they plan to hit it hard. You will get at least some of what you want.

Don Levit
Don Levit
  Anonymous
March 20, 2017 5:36 pm

Using those same percentages, the patented Health Matching Account accumulates 213(d) medical dollars instead of cash
The vast majority of people in a pool are low claimants, so their HMAs grow
The crediting increases each month until it caps out at 300 percent
Account balances double in 35 months – guaranteed
To learn more go to nationalprosperity.com and click on HMA

TampaRed
TampaRed
  Dutchman
March 20, 2017 1:41 pm

Guys,it’s gonna get worse b4 it gets better.
I get a weekly email letter from my “conservative” Republican congressman,Gus Bilirakis,(Pos),12th Fl.
A piece of it is below.

Eliminating the Medicare Part D Coverage Gap

The Medicare Part D program has proven to work well for our seniors and keep their prescription drug costs low. Under the American Health Care Act , seniors will see no changes made to Medicare and the “donut hole” in Medicare Part D will continue to be phased out. The donut hole is the coverage gap reached when a beneficiary’s total drug costs surpass $3,700 and their catastrophic coverage does not kick in until drug costs reach $8,000.

I will soon introduce a resolution in Congress to ensure that all of my colleagues are on board with preserving the phase out of the Medicare Part D donut hole. We cannot allow our seniors to fall through the cracks when it comes to helping them with prescription drug costs.

BL
BL
March 20, 2017 1:07 pm

Anyone here seen companies offering catastrophic coverage at a reasonable price? Reasonable price would be “cheap”, IMHO. Don’t hold your breath for reduced cost from big pharma and big medical industry.

Insurers are raking in the bucks and laughing all the way to the bank and without Trump busting these cartels NOTHING will change. Save your breath debating this one.

Per usual Dr. Paul sounds like the friend to the common man but what did he ever do while in CONgress to turn this mess around? Zip, zero, nada.

anon
anon
  BL
March 20, 2017 5:48 pm

Testify BL!

Ron Paul was controlled opposition. Anyone who doesn’t believe it is a fool.