Guest Post by Ron Paul
Last month marked nine years since the Patient Protection and Affordable Care Act (popularly known as Obamacare) became law. Obamacare’s proponents promised that the law would reduce costs, expand access, and allow us to keep our doctors if we liked our doctors. The reality has been quite different.
Since Obamacare was enacted, individual health insurance premiums have more than doubled while small businesses have been discouraged from providing health insurance benefits. The increased costs of, and decreased access to, health care are a direct result of Obamacare’s mandates — particularly the guaranteed issue and pre-existing condition mandates. Another costly mandate forces most plans to cover “essential health benefits.” This mandate is why postmenopausal women must pay for contraceptive coverage.
The increase in health insurance premiums has not helped those who like their doctors keep their doctors. Instead, patients’ choices of providers are restricted to ever-narrower networks. As leading health care scholar John C. Goodman observed, the result is that a cancer patient from my hometown of Lake Jackson, Texas who obtains insurance through Obamacare’s exchanges cannot get treatment at nearby MD Anderson, one of the country’s top cancer treatment centers. If health care were a true free market, insurance companies would compete for the business of cancer patients and others with chronic conditions by developing innovative ways to give them the best care at an affordable price.
Sadly, few in Congress support free-market health care. The Democrats are divided between progressives who want to repeal and replace Obamacare with “Medicare for all,” the latest euphemism for single-payer healthcare, and establishment Democrats who want to save Obamacare by spending more money on subsidies for individuals and insurance companies.
President Trump has made some regulatory changes that make it easier for individuals to find affordable insurance. He has also recently called on Republicans to renew efforts to repeal and replace Obamacare. Most Republicans reacted to the president’s call the way Dracula reacts to a crucifix. These Republicans are terrified of the issue because they believe their half-hearted attempts to enact phony repeal bills cost them control of the House of Representatives in 2018.
President Trump himself does not actually want to repeal all of Obamacare. He just wants to repeal the “unpopular” parts. However, because the popular parts include many of Obamacare’s most destructive mandates, even if President Trump gets his way, Americans will continue to suffer with low-qualify, high-cost health care.
Any system combing subsidies that artificially increase demand with regulations and mandates that, by raising costs, artificially limit supply inevitably results in shortages, rationing, and lower quality. Therefore, no matter how much Democrats spend or how many “reforms” Republicans enact, Obamacare and other types of government-controlled health care will never “work.”
Instead of ignoring the issue, trying to prop up Obamacare, or implementing a single-payer plan, Congress should restore individuals’ control over health care dollars by expanding health care tax deductions and credits, as well as Health Savings Accounts (HSAs). Expanded charitable deductions could help ensure those who need assistance can obtain privately-funded charitable care instead of relying on inefficient government programs. Before Medicaid and Medicare, doctors routinely provided charitable care, while churches and private charities ran hospitals that served the poor. Individuals are more than capable of meeting their health care needs, and providing for the needs of the less fortunate, if the government gets out of the way.
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Biggest boon to insurance companies in the history of the world.
I’m a 70 year old, software contractor. The entire system is fucked up.
It is impossible to completely understand Medicare. Medicare Part B (Dr visits) is $130 month + Medicare Advantage Plan $99 month. The problem with Part B is that it only covers 80% – there is no upper limit of out of pocket – thus one needs and Advantage Plan. However there is Part D – which covers drugs, has a deductible – but has a ‘donut hole’ – it’s crazy – either you should have insurance or not.
If you want – you then have to get donut hole insurance – these insurer’s want to know your pre-existing conditions. I said to my insurance agent: “Didn’t Obama do away with pre-existing conditions?” – yes he did – BUT NOT FOR MEDICARE!
I see the health insurance offered to the ‘wage slaves’ that work for my clients. These people have $4,500 – $12,000 deductibles. Previously they paid the same premium for $2,000 deductibles.
The HNIC lied, lied, lied, and nobody confronted him. If you want to fuck things up – put a nigger in charge.
Sounds like the best thing you could have done is at age 65 sign up for traditional Medicare (with ~$105 part B premium at that time) and also taken a Medicare Supplement (coverage and premiums vary; Part F is the “Cadillac”-it pays the 20% that Medicare does not, so you have 100% coverage. Yes, it is also the most expensive Supplement). The most important thing: if you take out the Supplement within the first 6 months it comes with the guaranteed issue clause, which means the insurance company cannot reject you for preexisting conditions. If your sign up age is later because you are still working and have other health insurance the 6 month rule for guaranteed issue still applies. You would also want to consider the extra cost Part D drug option. Both the Supplement and the Part D plans are generally offered by at least a dozen companies in most states. So, if you go with Part B, Supplement, and Part D you can tailor your coverage to your available premium dollar.
Or, you can go with Medicare Advantage if good plans are available in your state (often the best plans are in populous areas, while the least populous areas have less robust-or maybe even no choices in an Advantage plan).
The key is to start learning about your choices 12-18 months before you sign up. It is confusing, but it is not hard to map out a good strategy if you have good resources, work hard, and keep at it. Most states have SCIP counselors to help out; if you have a Senior Center in your town they often have seminars; your county government may have resources and/or seminars also. Plus, there is tons of information online that SSA puts out.
My wife went on 2 years after I did; between us we attended 7 seminars put on by 2 different organizations by the time she made her selections, and she (of all people) understood it pretty well. It is tedious, but once you master it you should be okay. Parting comment: like anything the government does, there are plenty of gotchas, so make sure you keep digging, ask plenty of questions, and get advice from people who have experience or knowledge of the many corner cases that can trip you up.
A good source it Larry Kotlikoff-he has written a lot of online stuff in conjunction with PBS.
We should just amend it.
You know, repeal certain words and replace them with other, better, words.
Our costs have gone up by a factor of ten. Dont know where you get doubled from.