Q: How did "Obamacare" wind up in the tax bill?
A: The Senate version repeals the Affordable Care Act's tax
penalties on people who don't have health insurance. That would
result in government savings from fewer consumers applying for
taxpayer-subsidized coverage, giving GOP tax writers nearly $320
billion over 10 years to help pay for tax cuts.
What's more, repealing the fines would deal a blow to the
Obama-era health law after a more ambitious Republican takedown
collapsed earlier this year.
Q: Those fines have been very unpopular, so how could repealing
them undermine the health law? Other parts of the ACA will remain on
the books.
A: Premiums will go up, and that's never popular. The fines were
meant to nudge healthy people to get covered. Because insurance
markets work by pooling risks, premiums from healthy people subsidize
care for the sick.
Without some arm-twisting to get covered, some healthy people will
stay out of the pool. That's likely to translate to a 10 percent
increase in premiums for those left behind, people more likely to
have health problems and need comprehensive coverage, says the
Congressional Budget Office.
The CBO also estimated that 13 million more people would be
uninsured in 2027 without the penalties. If they have a serious
accident or illness, uninsured people get slammed with big bills, and
taxpayers wind up indirectly subsidizing the cost.
Q: So just taking away an unpopular penalty would destabilize the
health insurance law?
A: Repealing the fines is part of a broader context. -
Q&A: Tax bill impacts on health law coverage and Medicare, Newser, 12/05/2017
Link to the entire article appears below:
http://www.newser.com/article/4729348d72844801ae4686e91afbb1fb/qa-tax-bill-impacts-on-health-law-coverage-and-medicare.html
“There are powerful reasons to kill ObamaCare's individual mandate to buy health insurance. This regressive tax has fallen primarily on modest earners who face a choice of paying a fine or buying the cheapest $7,000-deductible plan, which may be of little use until long after their finances are in distress.
Yet how the individual mandate is eliminated makes all the difference in the world. If done while easing up on ObamaCare's counterproductive rules — from the employer mandate to coverage options that have led just as many people to leave subsidies on the table as to claim them — getting rid of the mandate could facilitate a big step toward universal coverage.
But getting rid of the mandate in the way Republicans propose, as a $300 billion pay-for that will help keep the cost of tax legislation under the $1.5 trillion maximum allowed under Senate rules, would not only ensure that millions of people drop their insurance on top of the 28 million already uninsured, but it would deepen already-daunting fiscal challenges and seriously undermine any hope of fixing our troubled individual insurance market for the foreseeable future.
Understanding the true impact of repealing the individual mandate is necessary for making sense of the Joint Committee on Taxation's official score of the Senate tax legislation. Because millions of individuals would give up their health insurance tax subsidies, JCT found that households earning up to $40,000 a year would face an ever-larger tax hike equal to $6.4 billion in 2021 alone (or a $4.4 billion tax hike once the effect of the corporate tax cut is considered).
Republicans say, in essence, "No harm, no foul." If people are voluntarily dropping coverage, that hardly amounts to a tax increase. Yet the GOP argument that people would be giving up coverage they don't want, while technically true, depends on a flawed presumption that all those millions of people with modest incomes would reject health insurance, not because of a lack of affordability, but because they would prefer to be uninsured.
Just consider a scenario in which people were able to use their available health insurance subsidy to cover the full cost of a high-deductible or catastrophic health insurance policy and have at least $200 left over for a Health Savings Account deposit — $100 of which could be cashed out if left unspent at year end.
If there were this kind of flexible option that included free cash on the table, the word would get out and there likely wouldn't even be any need for advertising to get close to 100% enrollment among the subsidy-eligible group.
While this hypothetical isn't necessarily an ideal model, it is eminently possible to combine the health care security Democrats insist upon with the freedom that Republicans believe in, killing the mandate while dramatically reducing premiums and continuing to provide moderate-income households ample reason to get covered instead of rolling the dice.
The key point is that every dollar of the projected savings from killing the individual mandate depends on keeping ObamaCare just as consumer unfriendly as it was in 2017. In other words, taking those savings – all that extra tax revenue lying around because even more people leave their health insurance tax credits unclaimed — and applying it to tax cuts means that a significant chunk of the funding now available for health insurance premium tax credits will essentially disappear, all but ruling out consumer-friendly and coverage-increasing reforms of the ACA in a fiscally fraught future.” - The Right Way To Kill ObamaCare's Individual Mandate, Investor’s Business Daily, 11/28/2017
Link to the entire article appears below:
https://www.investors.com/politics/policy-analysis/the-right-way-to-kill-obamacares-individual-mandate/
Note: Yet another interesting demand-side argument. However, “affordability” of healthcare and hence the price of health insurance is a supply-side and demand-side phenomena. Moreover, health insurance price is, in the main and upon normal occasion, a reflection of the price to supply healthcare. The constant stream of demand-side arguments is going to do little to affect the supply-side price. More importantly, the supply-side price is not strictly a result of market forces as much as it is a function of special interest legislation and certificate of need (CON) legislation providing the conduit of distorted price and limited competition that the providers within the greater supply-side enjoy at the expense of the consumer of healthcare.
"A headline this week in The Hill shocked me: "ObamaCare enrollment strong in third week of sign-ups." The Hill is a serious, well-respected, non-partisan news
source. But any reader taking this headline at face value would be
seriously misled about what is really going on with Obamacare
enrollments during this fifth open enrollment season.
The Hill's reporter correctly notes that "the pace of sign-ups has
exceeded last year: In the first 26 days of last year's open enrollment
period, 2.1 million people signed up compared to the 2.3 million people
who signed up the first 18 days of this year's period."
Those figures imply that the daily rate of sign-ups this year is outpacing last year's rate by 58% [originally reported as 28%: Update #2]. Surely that is evidence of strong enrollment, no?
The reason it is not is buried at the tail-end of the story where the
reporter notes "the enrollment period ends Dec. 15, which is about half
as much time as people had to sign up last year."
Yipes! If enrollees have only half the time to sign up, then by pure arithmetic, the daily enrollment pace needs to be double
last year's in order for total enrollment at the end of the enrollment
period to match the level reach at the end of last year's enrollment
period: 12,216,003.
But if current enrollment is 158% [originally reported as 128%: Update #2] of
last year's when it needs to be 200%, a more accurate way to frame this
year's performance would be to say that Obamacare is on track to sign
up 21% [originally reported as 36%: Update #2] fewer enrollees than last year (i.e., 158/200=79% which would mean signing up 21% fewer). [originally reported as 128/200=64% which would meaning signing up 36% fewer: Update #2]. That's a pretty bad news story rather far removed from the rosy picture painted by The Hill's headline." - No, Obamacare Enrollment Is Not Strong, Not By A Longshot, Forbes, 11/24/2017
Link to the entire article appears below:
https://www.forbes.com/sites/theapothecary/2017/11/24/no-obamacare-enrollment-is-not-strong-not-by-a-longshot/#439262b4919d
“Robert Frank made the familiar cost-effectiveness case in the New York Times earlier this summer, and, as usual, it left me with more questions than answers. Frank made three points. First, administrative costs are lower in single-payer systems. Second, single-payer systems save money by not having to advertise. Third, the government can use its monopoly on demand to negotiate lower fees paid to providers.
Even if all three points are true, it is unclear why they are unique to health care. Someone arguing for single-payer plumbing or single-payer automotive maintenance would probably make the same points. To what extent is the case for single-payer health care different from the case for government financing of all goods and services? Frank doesn’t say.
As for whether costs are indeed lower, “you get what you pay for” would seem to apply regardless of whether the payer is the government or a private insurance plan. Want better fraud detection? Administrative costs have to go up. Want more program utilization? Increase advertising costs. Want better doctors? Compensate them more. How a single-payer system is supposed to change this basic relationship between cost and quality is not clear.
Compare health care with education. Public schools are essentially single-payer education systems within the areas they cover. When was the last time we heard anyone argue that public schools are a great tool for containing education costs? When has Bernie Sanders or any Democrat called for the government to push down teacher salaries in order to save money? Any suggestion that teachers should be paid less is met with the obvious counter-argument that teaching quality would suffer. And yet single-payer health care, which comes with the explicit promise to pay doctors less, is supposed to reduce costs without reducing quality. By what magic?” - The Single-Payer ‘Cost-Effectiveness’ Mystery, national review.com, 09/14/2017
Link to the entire essay appears below:
http://www.nationalreview.com/corner/451384/single-payer-health-care-cost-effectiveness
“There is an alternative, if not a very satisfying one. Republicans seem to be able to achieve near-unity on ending the individual mandate, allowing insurers to offer discounts for younger people, protecting taxpayers from having to subsidize abortion coverage, and giving states some freedom to relax regulations. They should work for legislation that achieves these goals and includes as much Medicaid reform as 50 senators are prepared to tolerate.
Republicans should not claim that such legislation would repeal and replace Obamacare, since it would not, and should make it clear that additional legislation will be needed in the future. The conservative holdouts should be prepared to judge this limited legislation based on whether it gives people more freedom to choose the health insurance they want, not on whether it does everything for which Republicans have been campaigning over the last seven years.” - Don’t Settle for Nothing, National Review, 07/18/2017
Link to the entire article appears below:
http://www.nationalreview.com/article/449616/republican-health-care-bill-fails-obamacare-repeal-mitch-mcconnell
“The Congressional Budget Office score of the American Health Care Act shows that the bill will reduce deficits by $119 billion over the next decade and result in 23 million more people being uninsured by 2026. This leaves the impression that people would be better off if Obamacare were unchanged. But a new report from the Department of Health and Human Services dispels this myth.
The DHHS report shows that premiums in the individual market exchanges increased by 105 percent in the 39 states using Healthcare.gov from 2013 to 2017. This is equivalent to $244 per month in additional premium payments for people buying insurance through the exchanges, or $2,928 over the course of a year. People not eligible for exchange subsidies are fully exposed to these increases, while taxpayers will bear the brunt in the form of higher outlays for subsidies for enrollees who are eligible.
Despite the promises that Obamacare would “cut the cost of a typical family's premium by up to $2,500 a year,” average premiums on the exchanges more than doubled over this period. In some states, such as Alabama and Alaska, the average premium more than tripled.
The high average increase is not driven by a few outliers, as 23 out of the 39 states included in the analysis experienced premium increases in excess of 105 percent. Only three states, North Dakota, New Hampshire, and New Jersey, had cumulative premium increases below 50 percent.” - Memo to CBO: Obamacare Is Unsustainable, economics21.org, 05/24/2017
Link to the entire article appears below:
https://economics21.org/html/memo-cbo-obamacare-unsustainable-2364.html
“Health insurance company Aetna (AET) announced Wednesday it will completely withdraw from the ObamaCare marketplace in 2018, a decision Health and Human Services Secretary Tom Price perceived as a sign of continued instability in the health care sector under the Affordable Care Act.”
‘“At this time [we] have completely exited the exchanges,” Aetna said in a statement to FOX Business.
In April Aetna said it would not participate on the state exchanges in Virginia next year and last week committed to pulling out of Iowa. In 2016 the insurer sold plans across fifteen states. It trimmed that position to just four states at the outset of 2017, citing financial losses.
“Our individual Commercial products lost nearly $700 million between 2014 and 2016, and are projected to lose more than $200 million in 2017 despite a significant reduction in membership. Those losses are the result of marketplace structural issues that have led to co-op failures and carrier exits, and subsequent risk pool deterioration,” the company said Wednesday.’ - Aetna to Completely Pull Out of ObamaCare Exchanges by 2018, fox business.com, 05/10/2017
Link to the entire article appears below:
http://www.foxbusiness.com/markets/2017/05/10/aetna-to-completely-pull-out-obamacare-exchanges-by-2018.html
"Media reports say that 20 million Americans will lose their “health
care” under the Republican plan to replace ObamaCare, as if health care
is like a cellphone, wallet, or item of clothing unintentionally left
somewhere or stolen by someone.
Such confusion about “health care” stems from the misuse of the term
itself. In common usage, the term “health care” is used as a synonym for
“medical care” and “medical insurance,” although these terms have
widely different meanings. This is more than an issue of semantics.
There are serious policy implications of using the wrong words, and the
misuse reflects an entitled attitude among the populace and lazy
thinking by the media, academia, and politicians.
Health care means taking care of one’s health. It’s
what one does to stay healthy—namely, to have a heathy diet, exercise,
not abuse alcohol or drugs, and avoid risky behaviors.
Medical care or treatment is what you seek from medical professionals when you have a medical problem and aren’t in good health.
Medical insurance is what you obtain to protect
yourself financially from a catastrophic illness or injury requiring
expensive medical treatment. In insurance terms, you pool the risk with
others."
- Stop Misusing the Term "Health Care", FEE, 03/16/2017
Link to the entire article appears below:
https://fee.org/articles/stop-misusing-the-term-health-care/
“More than four decades ago, Congress passed and President Ford signed the National Health Planning and Resources Development Act of 1974. The act withheld federal funds from states that failed to adopt certificate-of-need (CON) laws regulating healthcare facilities. CON laws require healthcare providers wishing to open or expand a healthcare facility to first prove to a regulatory body that the community needs the planned services.”
“In 1986—as evidence mounted that CON laws were failing to achieve their stated goals—Congress repealed the federal act, eliminating federal incentives for states to maintain their CON programs. Since then, 15 states have done away with their CON regulations. A majority of states still maintain CON programs, however, and vestiges of the National Health Planning and Resources Development Act can be seen in the justifications that state legislatures offer in support of these regulations. Policymakers claim CON regulation is intended to:
ensure an adequate supply of healthcare resources,
ensure access to health care for rural communities,
promote high-quality health care,
ensure charity care for those unable to pay or for otherwise underserved communities,
encourage appropriate levels of hospital substitutes and healthcare alternatives, and
restrain the cost of healthcare services.
Research, however, shows that CON laws fail to achieve these laudable goals. In fact, by limiting supply and undermining competition, CON laws may undercut each of these aims.”
“CON programs limit the introduction and expansion of a wide variety of medical services and equipment, such as rehabilitation centers, nursing home beds, and medical imaging technologies. The process for obtaining a CON can take years and tens or even hundreds of thousands of dollars. By definition, CON programs restrict supply, making them unlikely to ensure an adequate supply of healthcare resources. Research on the supply of dialysis clinics and hospice care facilities finds that CON programs do, indeed, restrict the supply of both.”
“Unlike other regulatory regimes, such as occupational licensure and scope-of-practice rules, CON regulations do not specifically aim to improve quality. That is, CON regulators typically do not attempt to assess whether providers are qualified to do their jobs, focusing instead on whether there is an economic “need” for their services. Nevertheless, CON advocates sometimes claim that because CON regulations reduce the number of institutions providing care, they will cause more procedures to be performed by the institutions that do obtain permission. Thus, the argument goes, practitioners in CON states will tend to see more patients with the same conditions and therefore might become more specialized and proficient. This theory must be weighed against competing theories that suggest that competition tends to increase quality, especially when regulations prevent price competition.”
“As economists Jon Ford and David Kaserman put it, “To the extent that CON regulation is effective in reducing net investment in the industry, the economic effect is to shift the supply curve of the affected service back to the left. . . . The effect of such supply shifts is to raise . . . [the] equilibrium price.” The empirical evidence on how CON regulation affects cost has been consistent with economic theory, showing that CON regulation tends to increase the cost of healthcare services.” Certificate-of-Need Laws, Mercatus Center, 04/17/2017
Link to the entire essay appears below:
https://www.mercatus.org/publications/certificate-of-need-laws-goals
“As Republicans continue to debate the specifics of their plan to repeal and replace the Affordable Care Act (ACA or ObamaCare), two provisions have taken center stage: “Guaranteed Issue,” the requirement that insurers offer policies to all applicants, and “Community Rating,” the requirement that they offer all policies at the same price, regardless of risk factors like health, lifestyle, or even gender.
These rules were obviously designed to allow people with pre-existing conditions to purchase health coverage, and to equalize the premiums paid by everyone. But as nice as that sounds, the experience of different states shows that these rules don’t benefit many consumers and aren’t the best way to foster functional and fair insurance markets.”
“Before the ACA, everyone was guaranteed a policy in every state. First, employer-based or group carriers could not deny you coverage due to a pre-existing condition. Second, if you kept continuous coverage and followed the requirements of the 1996 Health Insurance Portability and Accountability Act (HIPAA), you had the right to buy an individual insurance policy with no exclusions for pre-existing conditions.
HIPAA required that a carrier could not raise your rates nor drop you if you developed a condition after the policy was in place. Sadly, the architects of the ACA misled people about these protections, saying they didn’t exist, and many people still believe that today.”
“While guaranteed issue and community rating may sound nice in theory, in reality, they don’t work out as intended. Unfortunately, these rules can create bad incentives. By raising the cost of insurance for healthy people, these rules can discourage some people from buying insurance until they become sick, when they will still be guaranteed a policy.”
“Before the ACA, 43 states allowed the sale of “true insurance.” Rates were based on your potential of claims, so carriers could inquire about your health conditions, occupation, and lifestyle choices. This provided an incentive to practice a healthy lifestyle because your premium would be lower if you did. Most applicants received very affordable rates since most people are healthy. Unlike the proponents of the ACA claimed, scores of common conditions like mild allergies and even elevated blood pressure and cholesterol were accepted. In fact, 87 percent of applicants received coverage, even with their pre-existing conditions.
Others who had delayed applying until they developed a serious condition or were expecting an expensive claim were offered a guaranteed plan through a carrier or through a high-risk pool. High-risk pools offer a variety of plans from different insurers to high-risk customers at subsidized rates. Those rates were typically up to 150 percent of standard rates and were funded partially through a state tax on carriers, the premiums of enrollees, and an occasional grant from the federal government.
These higher rates were only charged to a few people, and they were similar rates to what everyone is now paying under the ACA. As more people buy private plans before they develop a serious condition, rates will remain low and fewer people will be buying in the subsidized high-risk pools.” - Obamacare’s pre-existing condition rules sound nice but don’t work, 04/10/2017,
thehill.com
Link to the entire article appears below:
http://origin-nyi.thehill.com/blogs/pundits-blog/healthcare/328174-obamacare-misled-americans-about-pre-existing-conditions-now
“But the great puzzle of health care policy: Just why is it, to accommodate this worthy goal, must your and my health care and insurance be so deeply regulated and so thoroughly dysfunctional? As one small example, why does a 20 minute skin check with the resident of my dermatologist generate a phoney baloney bill for over $1000, meaning a cash and carry market for such a simple, elastically demanded, and perfectly predictable service is impossible?
Why, in order to provide for the unfortunate, do we not simply levy taxes, and pay for charity care, and leave the rest of us alone? Regular Americans have jobs, buy houses, buy TVs, cars, and smartphones, negotiate the complexities of 401(k) and IRA plans, cell phone contracts, frequent flyer programs; hire the complex professional services of contractors, car mechanics, lawyers and accountants, and deal with the insane complexity of our tax system.”
“I think the answer is relatively simple. Our political system is allergic to the word "tax." Instead of straightforwardly raising taxes in a non-distortionary way (a VAT, say), and providing charity care or subsidies -- on budget, please, where we can see it -- our political system prefers to fund things by forcing cross subsidies.
Medicare and medicaid don't pay what the service costs, because we don't want to admit just how expensive that service is. So, large hospitals make up the difference by overcharging you and me instead. The poster child (though not really a cost driver) is emergency room care. The government passed a law saying hospitals must provide emergency room care for free. But money does not grow on trees, so again you and me (via private insurance) must get overcharged to cross-subsidize. The ACA tried to force young healthy wealthy (not getting subsidies) to vastly overpay for insurance, to cross subsidize the poorer and sicker.
This might seem like a wash. OK, if instead of paying taxes, it makes you feel good to pay business class prices for health insurance, what the heck. Economically, a cross-subsidy works the same as a tax. In fact, we do have Europe-size taxes and subsidies, we just hide them.
But it's not a wash. Cross-subsidies are dramatically less efficient than taxes. Choosing cross-subsidies over taxes is indeed the second original sin of health care and insurance regulation. Cross-subsidies cannot stand competition.
If as now you and I are grossly overpaying for health care and insurance, to cross-subsidize others, a competitive market would come along and peel us off. A local skin-check clinic could offer that service for $50.
Low prices, efficiency, and innovation in the provision of services like health care come centrally from competition, and especially disruptive competition. With no competition -- especially no entry by new doctors, hospitals, clinics, insurance companies -- costs spiral up. As costs spiral up, the cost of the charity care spirals up. As that spirals up, the size of the cross-subsidies spirals up. As that spirals up, the need to restrict competition spirals up.”
“Bottom line: Much of the pathology of health care and health insurance comes from this second original sin, choosing cross-subsidies rather than straightforward taxes. Cross-subsidies require the government to stop competition, so an initially clever way of hiding taxes eventually builds into a monstrously inefficient system. (That's a key point. Initially, it is about the same. But the cross subsidy system gets more and more inefficient over time.)
We would be far better off to admit this; raise explicit taxes enough to provide the charity end of our care, and let health insurers and care givers compete for the rest of us, as airlines, computer makers, and everyone else does. The politician's job is to explain to people that what they pay more in taxes they will more than make up in lower health care and insurance costs.” - The second original sin of healthcare regulation, John Cochrane, 04/05/2017
Link to the entire essay appears below:
http://johnhcochrane.blogspot.com/2017/04/the-second-original-sin-of-healthcare.html
“U.S. Senator and physician Rand Paul introduced S. 222, the Obamacare Replacement Act, to provide Congress with a health care plan grounded in broadly supported conservative reforms that is ready for an immediate vote after Obamacare is repealed. Dr. Rand Paul’s proposal would expand access to higher-quality, lower-cost health care for more Americans, regardless of medical history.
The Obamacare Replacement Act empowers the American people to: 1.) Choose inexpensive insurance free of government dictates; 2.) Save unlimited amounts in a health savings account (HSA) and have wider options for using those funds; 3.) Buy insurance across state lines; and 4.) Join together in voluntary associations to gain the leverage of being part of a large insurance pool." - Rand Paul Introduces His Own Obamacare Replacement Plan – Read All 4 Pages Here! cscmediagroupus.com, 03/08/2017
Link to the entire article appears below:
http://www.cscmediagroupus.com/robert-zerfing/rand-paul-obamacare-replacement
Note: You can download all three and one-half pages of S.222 near the end of the article.
“How does Clinica Mi Pueblo offer these medial services at the “most affordable prices possible”? Here’s how: the clinic operates on a cash-only basis, with transparent prices that are listed both on the clinic’s website and on the wall at each clinic. Further, the clinic accepts no insurance, and it will not submit insurance claims on patients’ behalf. If patients have insurance, they can easily take the paperwork the clinic provides and file an insurance claim on their own. Reducing the costly, time-consuming mountain of paperwork associated with insurance, Medicare and Medicaid is one of the main reasons that cash-only medical clinics can keep their costs down and prices so low and affordable. That’s the same business model that keeps surgery costs so low/affordable at the Surgery Center of Oklahoma, the “free market-loving, price-displaying, state-of-the-art, AAAHC accredited, doctor owned, multi-specialty surgical facility in central OK” that has been featured on CD many times over the years.
So how does the cash-only, no insurance, price-displaying business model of the Clinica Mi Pueblo compare to medical coverage under Obamacare? Well, deductibles for individuals enrolled in the lowest-priced Obamacare health plans will average more than $6,000 in 2017, and families enrolled in bronze plans will have average deductibles of more than $12,000. Importantly, the deductible is the amount of money patients must personally pay out of pocket for health services before Obamacare insurance policies cover any medical costs. And what about the monthly Obamacare premiums? A 40-year-old unsubsidized bronze Obamacare plan patient will pay slightly more than $350 per month this year for their “health coverage” with a deductible of more than $6,000. And that’s supposed to somehow be “affordable” health care? In contrast, spending $350 per month out-of-pocket at Clinica Mi Pueblo, instead of going toward an Obamacare plan that provides almost no actual medical care, would actually purchase quite a lot of actual medical services.
Bottom Line: For routine medical care (annual physicals, flu shots, routine office visits, X-Rays, ultrasounds, MRIs, blood tests, etc.) most Americans, especially younger, healthier patients, would be much better off with a cash-only medical clinic like Clinica Mi Pueblo than with Obamacare, no? Under Obamacare, a 40-year-old American pays more than $4,200 per year in premiums. The out-of-pocket limit for an Obamacare plan is $7,150 this year but that doesn’t include the monthly premiums, so an individual could pay more than $11,000 out-of-pocket this year before his or her health plan would start to pay 100% of the costs of covered benefits. Only in some fantasy world of Big Government progressives and collectivists would that ever be considered an “affordable” health care system!” - An antidote for Obamacare: Cash only medicine with transparent pricing and no insurance — the future of medicine?, AEI, 03/26/2017
Link to the entire article appears below:
https://www.aei.org/publication/an-antidote-for-obamacare-cash-only-medicine-with-transparent-pricing-and-no-insurance-the-future-of-medicine/
“The goal of health care reform is to provide better health care to everyone at a lower cost, year after year. The solution is not to provide a better third-party-payer system — e.g., health insurance or government-provided health insurance — but instead to allow technological development and entrepreneurship to improve the current business model through groundbreaking innovations that empower consumers, improve quality and cut prices. We have seen it happen in many industries, such as transportation, room and board, and tech.
Of course, special interests benefiting from the old model do not appreciate being challenged. As a result, rather than make it easier for new models to thrive by ensuring that rules and regulations do not stifle innovation, politicians often choose to protect established industry players at the expense of consumers.”
“Some services strive to do something even more impactful by making health care more affordable and accessible, yet they are held back by outdated rules and hostile competing industries. Take, for example, telemedicine — the use of modern communications technology, such as videoconferencing and using smartphones, to facilitate patient care. It has the potential to help millions of Americans struggling to pay the skyrocketing costs of health care. But instead, some politicians are siding with their campaign contributors in the health care industry and not the constituents they supposedly are in office to serve.”
“The California State Board of Optometry used taxpayer dollars to engage in a public relations campaign against one telemedicine startup. Indiana enacted a law last year to prevent the use of online eye exams. Georgia and South Carolina have also enacted bans, and the Virginia Legislature just sent a bill to the governor's desk that would do the same.
All of this is done not to safeguard patients but to protect older and more expensive business models. This is highly unfortunate. Telemedicine not only can help reduce health care costs but also has the potential to greatly expand access to care — something politicians claim to care about. Yet many states nevertheless prevent doctors licensed in other states from offering telemedicine services to their residents. This makes it more difficult for poorer citizens living in medically underserved areas to achieve the same access to care that their wealthier neighbors can discover by traveling out of state.” - Cronyism Thwarts Telemedicine and Other Innovations, mercatus.org, 02/23/2017
Link to the entire article appears below:
https://www.mercatus.org/commentary/cronyism-thwarts-telemedicine-and-other-innovations
"The Trump Administration has promised to deliver to the American people a healthcare plan that is, in President Trump’s own words, “much less expensive and far better” than Obamacare. But While Obamacare is expected to spend over $900 billion from 2018 to 2027, focusing solely on the Obama administration’s signature achievement ignores bigger fiscal challenges; Namely, the Medicare program.
Our insurance program for the elderly and disabled – Medicare – is expected to cost $900 billion in 2024 alone. From 2018 to 2027, this comes to a whopping $8.5 trillion—an order of magnitude larger than the cost of the ACA. Beyond the topline price tag are a number of endangered programs.
Medicare’s hospital insurance trust fund, commonly known as Part A, is expected to run out of money in the next 10 years. This would mean an immediate reduction in benefits when the money runs out—2028, according to the program’s actuaries. Meanwhile, the funds that Medicare uses to pay for physician services (Part B) and prescription drug benefits (Part D) are consistently growing as a share of revenue". - Repeal & Replace: Missing the Medicare Forest for the Obamacare Trees, realclearhealth.com, 02/24/2017
Link to the entire article appears below:
http://www.realclearhealth.com/articles/2017/02/24/repeal__replace_missing_the_medicare_forest_for_the_obamacare_trees_110464.html?utm_source=RCP+Morning+Note&utm_campaign=8da8cfe47f-EMAIL_CAMPAIGN_2016_11_11&utm_medium=email&utm_term=0_a4db5f2336-8da8cfe47f-84790497
"We believe the American health care system is desperately in need of reform. The Affordable Care Act has failed to achieve its goal of affordable, universal coverage. Instead it has forced people, especially those in middle-income households, to choose from insurance plans with deductibles that are unreasonably high and provider networks that are too narrow to adequately help many afflicted with serious health problems.
The following proposals would vastly improve coverage by making health insurance affordable for all and by ensuring access to reliable medical care. They are incorporated in bicameral legislation introduced in the House and the Senate by Rep. Pete Sessions and Sen. Bill Cassidy and in the Patient Freedom Act, sponsored by Sen. Cassidy". - Replacing Obamacare and Insuring the Uninsured, The Independent Institute, 02/13/2017
Some highlights are:
(1) uniform tax credit for people buying their own health insurance coverage,
(2) tax credit can be used toward coverage in the individual market or the credit is transferable to an employer willing to purchase group health insurance for the individual,
(3) portability between individual and group health insurance coverage,
(4) integrate Medicaid and private insurance for seamless coverage,
(5) remove incentives for dumpling plans onto the individual market via “health status risk adjustments”,
(6) removal of mandate and the use of Medicare type penalty rates (higher premiums) for those not signing up for coverage when first eligible.
Note: At the link below one can download the “Executive Summary”.
http://www.independent.org/publications/article.asp?id=8994
Note (B): A more detailed discussion appears at this link:
http://www.independent.org/newsroom/article.asp?id=8979
“Health insurance company Humana announced Tuesday that it would leave the ObamaCare market in 2018. The insurer said it would offer plans through 2017, but that the market has not stabilized enough to participate next year. Humana said it was losing money from taking on too many sick people without enough healthy people to balance the pools. The decision came after Humana scaled back participation and raised premiums, among other changes. "All of these actions were taken with the expectation that the company’s Individual Commercial business would stabilize to the point where the company could continue to participate in the program," the company said in a statement. "However, based on its initial analysis of data associated with the company’s healthcare exchange membership following the 2017 open enrollment period, Humana is seeing further signs of an unbalanced risk pool." - Death Spiral: Humana Completely Abandoning Obamacare Marketplaces After 2017, townhall.com, 02/15/2017
Link to the entire article appears below:
https://townhall.com/tipsheet/guybenson/2017/02/15/death-spiral-humana-completely-abandoning-obamacare-marketplaces-after-2017-n2286358
“Unwise public policies have allowed this market [ACA] to become a dumping ground for people who are older and sicker than average. The states were allowed to end their high-risk pools and send their enrollees to the exchanges. The federal government did the same thing with the (Obamacare) risk pool (the Pre-Existing Condition Insurance Plan). Cities and counties are ending their post-retirement health care programs (which are almost always unfunded) and sending people to the exchanges, where they pay premiums that are well below the cost of their care thanks to limited age rating. That includes, for example, 8,000 former employees of the city of Detroit.” - How We Can Repeal the ACA and Still Insure the Uninsured, Independent Institute, 01/20/2017
Link to the entire article appears below:
http://www.independent.org/newsroom/article.asp?id=8979
“In the employer-sponsored market, costs continue to increase. According to the Kaiser Family Foundation, average family premiums for employer-sponsored plans have increased almost 32 percent from 2010-2016.
In the individual market, where the bulk of Obamacare’s new rules and regulations have taken effect, the average nationwide premium increase has been 99 percent for individuals and 140 percent for families from 2013-2017, according to an eHealth report.
Deductibles keep rising, too, especially for Obamacare exchange plans. According to an analysis by HealthPocket, the average deductible for a bronze plan in 2017 is $6,092 for an individual and $12,383 for a family. The average silver plan deductible for an individual is $3,572 and $7,474 for a family.” - 8 Reasons Why Obamacare Should Be Repealed, daily signal.com, 01/23/2017
Link to the entire article appears below:
http://dailysignal.com/2017/01/23/8-reasons-why-obamacare-should-be-repealed/?utm_source=TDS_Email&utm_medium=email&utm_campaign=MorningBell&mkt_tok=eyJpIjoiWVRVMFltWTJORGxtTkRFMyIsInQiOiJ5Z3hKTlNCSlVtNk9PTG5jM3RYQVNlSDhQU0U5N0Z6RHBxNUtHNnhrQmN6RG1tVVlXbnpHdGppMHY2TnlqQWZsSVJxeG5GUjE1Z0VudDdcL1E0c2RxSzcyYTdYSDE5eVArYnFjeGlhQjFxR0IyQjZMaUlIckJ2U0E0T1NvU2JFcGkifQ%3D%3D
‘Hours after taking the oath of office, President Donald Trump followed up on his campaign pledge to try to start chipping away at Obamacare, and curb federal regulations.
Trump signed an executive order on Friday evening from the Oval Office “to ease the burden of Obamacare as we transition to repeal and replace,” White House press secretary Sean Spicer told reporters Friday.’
‘“Potentially the biggest effect of this order could be widespread waivers from the individual mandate,” Larry Levitt, a senior vice president at the Kaiser Family Foundation, told The Washington Post. Currently, individuals who do not have health insurance and do not qualify for an exemption must pay a $695 annual fee or up to 2.5 percent of annual household income.
“They’re very aware of the fact that the first job is to prevent the Affordable Care Act from doing more damage than it’s already done,” says Ed Haislmaier, a senior research fellow in health care policy at The Heritage Foundation. “As we saw with the premium increases in the fall, people who are buying individual or small employer coverage without a subsidy are getting hammered.”’ - Trump Signs Executive Order Curbing Obamacare, daily signal.com, 01/20/2017
Link to the entire article appears below:
http://dailysignal.com/2017/01/20/trump-signs-executive-order-curbing-obamacare/?utm_source=TDS_Email&utm_medium=email&utm_campaign=Top5&mkt_tok=eyJpIjoiWkdVM00yUXpNbVUwT0RZNSIsInQiOiJ6REZKMWNcLytNMm8zc2lXa29kMXdcL1NRYXVGbVQ5RGtpdGxcL3p3d1JPc1ZyRkpQcUw1RE4welB5bVZMS2tQUkU3Y01hUzRseVhBSVRDYUpkNjlOUTZkU2N5eXZXVjNkSUVmOXg3YXdwbFc0SFwvRUpoWk9OcEtGN3VDVlVuaFNicHhtWDIyY2tiMjBCbG84MnBacjBUUEF3PT0ifQ%3D%3D
