Third Party & Independents Archives

Will There Be an Alternative to Obamacare?

As UnitedHealth pulls out of the ACA, aka Obamacare, the question of it’s costs and benefits rage across the comments sections of countless media articles.

The first problem is agreeing on the benefits. Are there less uninsured people? Yes, most definitely. Are the other economic benefits of affordable coverage for people who already had some form of insurance coverage prior to Obamacare crystal clear? Hardly.

The ACA is a subsidy. It costs an enormous amount of money to pay for the additional health coverage for previously uninsured patients. That's the whole point of Obamacare. And somebody has to pay for that additional cost. While the federal government clearly takes on some of that burden, it's middle class workers and families, say over the 45 K a year income level, who face added premiums. Oh, so do people forced off their plans and into Obamacare, who are facing rising premiums.

Because of the complexity of the plan, the goals of additional health coverage for previously uninsured people comes with enormous overhead costs. Costs which will only become clear over the next few years.

For now, not enough people have subscribed to Obamacare, especially families with incomes around 50K and up. And that means the plans are money losers for the insurance companies - who seem to be undergoing further consolidation as a result of Obamacare. That means further premium increases and higher deductibles. And that means less people in the middle income range deciding to go with the plan. A vicious circle which may spin out of control.

But GOP candidates need a coherent alternative, rather than a return to the previous status quo, as has been repeated ad nauseum. For example, an affordable catastrophic insurance package that wouldn't saddle insurance companies with unaffordable mandates.

There is the problem of pre-existing conditions, and how that can exclude hard working adults who are cancer survivors, for example, from qualifying for health coverage. The question here is how large the pool of people with pre-existing conditions actually is. And how many of them do not have group coverage, where they usually can get coverage. For those who face these tragic conditions without group coverage, what kind of an alternative policy can be designed for them?

The eternal healthcare debate is about the discrimination implicit in pooling, versus the enormous financial costs of moral hazard. In this case the moral hazard being providing unnecessary but mandated bells and whistles in subsidized insurance packages. Paid for as well by employers, especially small business. A major reason for the slow job growth rate in America.

Will a GOP candidate come up with a convincing and detailed plan? Carson needs to flesh out his health care savings plan. And show he is familiar with healthcare economics. And the rest need to be ready should Obamacare stumble.

Posted by AllardK at November 20, 2015 9:28 PM
Comments
Comment #400782

“There is the problem of pre-existing conditions,…”

It is the primary problem.

“And how many of them [pre-existing conditions] do not have group coverage, where they usually can get coverage?”

None or they wouldn’t be in the exchanges.

While the public may not be overwhelmingly in support of Obamacare, it is overwhelmingly is support of prohibitions against refusal of coverage due to pre-existing conditions.

I would like to see a GOP alternative that addresses the pre-existing condition problem.

Universal single payer systems like Canada’s will be the only true and responsible alternative since it assures that all will be in the pool, not simply the young and healthy.

Posted by: Rich at November 21, 2015 6:49 AM
Comment #400784

Megan McArdle has written very poignantly on this:

Does that mean that we’re definitely in for a death spiral? No. For starters, even if there is gaming, there might be a relatively easy fix, such as getting the government to tighten up on its vetting (though this would inevitably mean some people had to go uninsured until the next open enrollment process).

Also, United Healthcare might just be the victim of competition in the free market. As noted by Jonathan Cohn:

Other insurers seem more sanguine. Blue Cross and Blue Shield companies are the dominant insurers in the market for individual health insurance in most states, and their participation in the exchanges is strong. Three of UnitedHealth’s for-profit competitors — Aetna, Centene, and Molina — told the Swiss financial services company UBS on Thursday that they remained confident about their exchange business, even considering short-term financial pressures.

Bernard Tyson, CEO of Kaiser Permanente, vowed to stay the course in a written statement. “American health care is undergoing significant change and evolution, and the health exchanges are part of that disruption. While there have been challenges at times, we believe at the end of the day they are causing healthy disruption, and are forcing the healthcare industry to respond better to consumer needs,” Tyson said.


Posted by: Warren Porter at November 21, 2015 9:19 AM
Comment #400799

It seems to me the problem is the corporate mentality of profit before people. The purpose of health insurance is to pay the costs for health related items although as we see the real reason for UHC is to make a huge profit at the expense of those that use the insurance. Imagine wanting to insure only the young and healthy while abandoning the old and sick as the free market answer to the high costs of health care, no wonder it costs so much more here than elsewhere in the world.

Time to socialize healthcare costs and let the profiteers compete for the peripheral insurance market. Kinda like the rest of the 1st world. But hey what do I know, we have endured what 50 or so attempts by conservatives to derail Obamacare in Congress, seems they must have an answer to this problem. I wonder if they will put it on the table before election time?

Posted by: j2t2 at November 21, 2015 4:36 PM
Comment #400804

“…seems they must have an answer to this problem. I wonder if they will put it on the table before election time?”

They have no answer, j2t2. None. We can only hope that some of them are dumb enough to present their numbskull plans in sufficient detail for the public to fully appreciate the consequences. There is a reason that the “repeal and replace” mantra never got beyond the repeal phase.

Posted by: Rich at November 21, 2015 11:52 PM
Comment #400805

Rich surely our conservatives friends here on WB wouldn’t back a repeal without a better option, without finding out what conservatives in DC have in mind to replace the ACA. Who would vote for anyone that voted to repeal “Obanmacare” without hearing what those that would repeal it have in mind for this country down the road.

Certainly the most foolish amongst us wouldn’t go along with a trivial scheme such as vouchering Medicaid/Medicare as Paul Ryan ……wow, conservatives tell me this isn’t true no one could think this is a serious answer to the problems we face in this country and our expensive health insurance system.

Posted by: j2t2 at November 22, 2015 1:15 AM
Comment #400842

Wow who would have thought the conservative echo chamber could be so quiet. So much conservative anger,so many conservative myths, many lawsuits all aimed at Obamacare, repeal after repeal, defunding attempts for the health care plan that would reign disaster and ruin upon the nation and not one conservative can explain the conservative plan for the after repeal plan they certainly must have had!

Does any of the rightist out there realize what this lack of any coherent plan does to conservative integrity..oh wait that is an oxymoron isn’t it. How many years does it take for conservatives to realize they have been played?

I find it kinda ironic the whole issue is centered on health insurance when the real problem is health care costs. Why aren’t costs coming down as more people enter into the market? Why are costs rising faster than inflation. What happened to economics of scale, why is productivity not working for the health care sector? Why is the invisible hand of the free market not controlling costs in health care?

The CEO of UHC made 66 million dollars in 2014 yet cannot make enough money for the shareholders to justify staying in the exchanges! Competition doesn’t seem to be working in the health insurance industry, well not for some of the companies least. The simple act of making insurance companies insure people not cherry pick people and the entitled class moans and groans about not enough profit! Five billion dollars in 2014 just wasn’t enough profit for UHC! And we still can’t figure out the health insurance problem?

Posted by: j2t2 at November 23, 2015 11:20 AM
Comment #400843

There is no ‘alternative’ to the ACA. It is, and always has been, a stepping stone by the dependent class to get the government single-payer plan they desire.

“The eternal healthcare debate is about” emotion and the dependent class preys upon that to trample upon the rights that prevent them from having government provide for them.

Any GOP plan that does not pander to the greed, selfishness and laziness of the dependent class, will be rejected.

Posted by: kctim at November 23, 2015 12:19 PM
Comment #400844

And you talk about me and my conspiracy theories kctim!

Using your crystal ball to tell us any plan would be rejected doesn’t wash with me kctim. The lack of a plan is still there, hiding behind this type of framing tells us Rich may be right, the conservatives who have shouted down Obamacare for years have nothing but name calling and deflection as a plan.

May I suggest conservatives use the “Healthcare we don’t need no stinking healthcare” framing of the issue kctim. So much more accurate than the whole “dependent class” thing, IMHO.


https://www.youtube.com/watch?v=-lj056ao6GE

Posted by: j2t2 at November 23, 2015 1:13 PM
Comment #400845

J2,

The leftists desire to take away rights to get single-payer, is not a conspiracy theory. Neither is the ACA being a step towards single-payer.

http://lasvegassun.com/news/2013/aug/10/reid-says-obamacare-just-step-toward-eventual-sing/

If an idea or plan doesn’t give you your precious single-payer, you dismiss it as a scheme and claim the lack of a plan.
One does not need a crystal ball to know that you guys will reject any plan that does not give you the dependency you want.

You can suggest whatever you want, but at least try and make it relevant to the discussion. Unlike the dependent class being 100% accurate, I don’t know of one Conservative who says we don’t need no stinking healthcare. They may not want to pay for it for you like you want them to, but that doesn’t mean they think we don’t need it.

Posted by: kctim at November 23, 2015 1:54 PM
Comment #400847

If someone said let’s scrap the ACA and implement single payer would you still be advocating for the ACA? There are plenty of alternatives to the ACA by the way:

http://healthaffairs.org/blog/2015/09/18/what-would-republicans-do-instead-of-the-affordable-care-act/

Posted by: George in SC at November 23, 2015 3:37 PM
Comment #400848

Personally, I would be absolutely in favor of scrapping the ACA in favor of single-payer. The private health care insurers companies serve no useful purpose whatsoever. None. Having said that, the ACA is STILL a big improvement over health care prior to reform. The ACA allows private health care insurers to continue existing, while ensuring people with pre-existing conditions receive coverage. It also makes health care accessible to everyone regardless of income, shifts the stress among professionals from specialists to generalists, and ensures a minimum standard of preventative health care. By the way, the ACA also instituted a number of back office reforms that were badly needed, and brought health care into the 21st century, but no one ever talks about that.

The GOP proposals have never made it out of committee for two simple reasons: 1) the GOP will not vote for them, never mind Democrats, and 2) they are clearly inferior to the ACA.

Posted by: phx8 at November 23, 2015 5:04 PM
Comment #400862

George in SC,

As the article points out, none of the conservative proposals have ever been presented in a manner that would even allow a CBO scoring. If there was an acceptable alternative don’t you think that a Republican controlled Congress would have presented it?

Here is the conservative answer on the principal issue of pre-existing conditions: “Six plans would permit the sale of health insurance across state lines and promote re-establishing state high-risk pools for individuals with pre-existing conditions.” In essence, the state through tax dollars can take care of those with pre-existing conditions.

So,whether the risk is spread across all insured (community rating) or by tax dollar subsidy of state high risk pools, the effect is the same. That, in my opinion, is why we should simply employ a Medicare for all alternative. It is straightforward and simple. It is also far less costly to administer.

We should move beyond the unnecessarily complicated and convoluted means of financing individual health insurance. As long as we are committed as a society to providing everyone health care, including catastrophic care, we should make the financing system as simple as possible. Maybe then, we could begin to consider the outrageous cost of health care.

There are alternatives blending conservative and liberal concepts but they won’t see the light of day in our current political environment.


Posted by: Rich at November 23, 2015 9:26 PM
Comment #400868

No one ever talks about those “back office reforms” because they could have been done without the individual mandate.

If not for the individual mandate and punishment for non-compliance, the ACA could have been a good starting point for fair reform.

Posted by: kctim at November 24, 2015 9:29 AM
Comment #400870
The leftists desire to take away rights to get single-payer, is not a conspiracy theory. Neither is the ACA being a step towards single-payer.

Kctim, but that is not the point, this deflection away from what conservatives have to offer as a health plan is the issue here. How can you back conservative politicians, who have tried to repeal Obamacare so many times it is a joke,when they have no alternative plan just a bit of mumbo jumbo they use as talking points?

So this claim you make about the violation of your rights, why hasn’t this claim been brought to the SCOTUS for a decision? Which right exactly are you giving up with single payer health insurance.

If not for the individual mandate and punishment for non-compliance, the ACA could have been a good starting point for fair reform.

Wow kctim, after all time of has this been a consistent opinion of yours? I don’t recall hearing anything close to this from a rightist. I’ve heard the ACA was spawned by the devil and would collapse the country any day now for many years but nothing like it is a fair start to our very high cost health care system. The problem with it IMHO is we still saddle the individual with insurance dictated by employers. We still have employers saddled with insurance unlike many other 1st world countries, how do they remain competitive?

Why on earth cannot we expect those Repubs/Conservatives in Congress who for 6 years have berated the ACA to have an alternative? How can they continue to criticize, defund, repeal and not have the wrath of those that vote for them? What does it take for conservative voters to hold their own accountable? According to more than a few conservatives the ACA violates their rights as individuals yet in Congress after 4 years of repub/conservative control of Congress the only thing that these elected representatives have done is…. nothing!

Posted by: j2t2 at November 24, 2015 12:24 PM
Comment #400871

J2,

Conservative politicians offer the hope of repealing the individual mandate. Do I think they have the stones to actually do it? No. But that hope gets my backing on this issue.
I’m kind of fond of freedom of choice.

“Wow kctim, after all time of has this been a consistent opinion of yours?”

If you are trying to ask if this has been a consistent opinion of mine all this time, the answer is yes. I am opposed to the ACA mainly because it strips freedom of choice and my posts reflect that.

“The problem with it IMHO is we still saddle the individual with insurance dictated by employers.”

That is the problem you have with it. I do not believe money trumps individual rights, so I see a different, more urgent, problem.

“Why on earth cannot we expect those Repubs/Conservatives in Congress who for 6 years have berated the ACA to have an alternative?”

Because heavy government involvement and control is the only alternative you will accept.

“According to more than a few conservatives the ACA violates their rights as individuals yet in Congress after 4 years of repub/conservative control of Congress the only thing that these elected representatives have done is…. nothing!”

Very true. Perhaps you should discuss a tee=time with people like Cantor and Boehner and ask them about it.

Posted by: kctim at November 24, 2015 1:05 PM
Comment #400872
Conservative politicians offer the hope of repealing the individual mandate. Do I think they have the stones to actually do it?

So that is it, they have put on a show for conservatives for years instead of coming up with a viable conservative alternatives and this is acceptable to conservatives!!

Because heavy government involvement and control is the only alternative you will accept.

Kctim, you are telling me these conservatives in Congress haven’t done anything for years because of me!! I would suggest that is just an excuse, partisan excuse at that. Since when has my opinion made a difference to these guys?

Posted by: j2t2 at November 24, 2015 1:55 PM
Comment #400873

J2

You asked: “How can you back conservative politicians”

I am not a Conservative and was just answering the question you posed.
As far as if it is acceptable to Conservatives, I cannot answer that for them. It is my opinion though, that they also hope that a Conservative majority will repeal the ACA and give them their freedom of choice back, so they are working to get such a majority. It is also possible that they know government dependency is now too great and they are more worried about the few rights we still have left.

“you are telling me these conservatives in Congress haven’t done anything for years because of me”

No, because of all leftists, J2. Obama created that at the beginning when he demanded that government must play a major role in any health care reform. He proved it when he dismissed any Republican input and then rushed passage of the ACA to avoid the people having a say. The rest of you prove it everyday by pretending that government is the ONLY viable option, and screaming racism and sexism to all who disagree.

It’s the fault of the ever growing dependent class, J2. Not just yours.

Posted by: kctim at November 24, 2015 2:49 PM
Comment #400874

kctim,

I think I’ve asked you this before, but I will repeat the question just to clarify:

Let’s say we modified the ACA and permitted people to choose not to purchase health insurance without fine or penalty, but we forced such people to sign a waiver abrogating their right to be free from discrimination on matters of preexisting medical conditions. That is to say, an individual who chose to forgo buying health insurance risks finding himself unable to purchase insurance at a future date if he finds himself afflicted with a preexisting condition.

In the event of such a modification, would you support the ACA?

Posted by: Warren Porter at November 24, 2015 2:52 PM
Comment #400876

Warren,

An opt-out option for individuals would be a good start, but there are other issues that would have to be addressed before I could actually say that I support the ACA. Employers, organizations, doctors, insurance companies etc… should also have choice.

Ideally, the ACA would be totally voluntary and funded only by members, so there would be no need for any waiver.

Posted by: kctim at November 24, 2015 3:38 PM
Comment #400882

Rich, so first there’s no alternatives and then there’s no alternatives scored by the CBO. I doubt even the Republicans would be foolish enough to offer up a bill that they know will be vetoed by the President who’s name is on the act they want to replace.

Again if single payer was proposed all of you would be first in line to support it. Unless, that is, it’s President Trump that proposes it (he’s supported it in the past). I openly posted on here that I would support single payer over ACA so I guess he’s not alone there.

Posted by: George in SC at November 24, 2015 7:36 PM
Comment #400884

I think the point, George, is that conservative politicians have only proposed vague outlines and are unwilling to flesh out the proposals and subject them to scrutiny. For good reason. As the article you linked to points out, there would be unpleasant real world consequences for repeal/replace as many of the Obamacare provisions are actually quite popular and already ingrained into our health care system, i.e., prohibition against pre-existing exclusions, elimination of annual and lifetime caps, Medicaid expansion, premium and cost sharing subsidies, Medicare “doughnut hole, ” coverage for young adults up to 26, etc.

As I said before, there are many reasonable alternatives blending the best of conservative and liberal thought. But, they require a willingness to compromise and overcome the influence of vested interests. Fat chance.

Ultimately, the economics of health care will force a change. Too bad that we cannot act sooner to avoid the pain that a collapse of the health care system will bring.

Posted by: Rich at November 24, 2015 9:25 PM
Comment #400890
It is my opinion though, that they also hope that a Conservative majority will repeal the ACA and give them their freedom of choice back, so they are working to get such a majority. It is also possible that they know government dependency is now too great and they are more worried about the few rights we still have left.

Doesn’t that make you wonder why instead of repealing these two pieces so we all can get our “freedom of choice” back they choose instead to defund it or remove other parts of the act instead?

“Freedom of choice”, that is a great one kctim. Conservatives are fighting tooth and nail to eliminate freedom of choice while you believe they are trying to regain freedom of choice, You must be dizzy from that spin in the irony zone.

I would give them the benefit of the doubt were these “rights loving” conservatives actually fighting to regain the “rights” you and they claim we have lost instead of imposing their will and religious beliefs on us and especially on minorities, if they didn’t spend so much time and effort overturning the “Warren court rights” we have lost during the conservative revolution in this country.

Posted by: j2t2 at November 25, 2015 11:02 AM
Comment #400891
Obama created that at the beginning when he demanded that government must play a major role in any health care reform.

By major role you mean regulate the system, or as some might say, do the job of government?

He proved it when he dismissed any Republican input and then rushed passage of the ACA to avoid the people having a say.

The myth continues and kctim has fallen victim to the misinformation perpetrated by conservative propaganda outlets. I think Obama took the repub/conservative line of “we will filibuster anything” for what it was worth kctim. After all 6 months may seem fast but look how long it took the PATRIOT ACT to become law, from that perspective Obamacare took eons.

The rest of you prove it everyday by pretending that government is the ONLY viable option,

Based upon the evidence we see from healthcare systems and funding around the world….. well…… I would suggest that unless your team comes up with something better than “poof then it happens, the invisible hand guides us all” you should drop this nonsensical argument. We are asking for you guys to put the other viable options on the table and all we get is…. vague and ambiguous half a** nonsense.

and screaming racism and sexism to all who disagree.

You must be talking about voter registration ID, while closing down drivers license locations in poor/minority communities and other covert attempts to poll tax minorities kctim. That and covering Viagra but not birth control as part of health insurance, right?

Posted by: j2t2 at November 25, 2015 11:29 AM
Comment #400892

J2

Conservatives don’t have the numbers to repeal the ACA. There are still plenty of Republicans who believe there are parts of it that can be worked with, or who are afraid of losing votes.

Conservatives are not “fighting tooth and nail to eliminate freedom of choice.” Your freedom of choice is not taken from you simply because government does not provide the material things you want, or if it doesn’t create laws that give you special treatment.
People exercising their freedom of religion are not imposing their religious beliefs on you. Government not providing minorities with special treatment is not discrimination, bigotry, racism, sexism etc…

“By major role you mean regulate the system, or as some might say, do the job of government?”

Governments major role that leftists demand is that it provides health care in some way. It is not governments “job” to provide material things.

“The myth continues and kctim has fallen victim to the misinformation perpetrated by conservative propaganda outlets.”

The left knew government providing health care on such a grand scale was a non-starter for Republicans and Conservatives.
Republicans and Conservatives did not support the ACA.
The constant legal questions, changing of definitions, roll out problems, loss of plans, loss of doctors, raising costs and failures, all prove the act was not done properly.
The only misinformation is coming from those who are STILL trying to claim democrats weren’t rushing to get it passed before they lost power.

“Based upon the evidence we see from healthcare systems and funding around the world…..”

We are not those other countries, we are the United States of America and unlike them, we have a Constitution that guarantees individual rights. The fact that half the country does not want to trample on those rights in order to please you, does not make other options “vague and ambiguous half a** nonsense.”

“You must be talking about voter registration ID,”

Not really. I couldn’t care less that you believe leftist voters are too dumb to get an ID.
I’m talking about how people against the ACA and gun control are called racists. How not supporting high taxes and special treatment, is called racism. How expecting government to have and create common sense immigration policy, is racist. How disagreeing with Obama on anything, is racism.

“That and covering Viagra but not birth control as part of health insurance, right?”

Again, not even close. What a private company does or does not offer its customers is of no concern to me.
I’m talking about how expecting women to pay for their own birth control is now labeled sexism.

The lack of special treatment doesn’t make one a victim, J2.

Posted by: kctim at November 25, 2015 12:39 PM
Comment #400894
Your freedom of choice is not taken from you simply because government does not provide the material things you want, or if it doesn’t create laws that give you special treatment.

Yet you complain government is doing just that by not giving you special treatment when it comes to health insurance kctim. Why would equal rights for minorities be considered special treatment?

Freedom of choice must in the conservative mind be limited to health care insurance because I’m pretty sure if you ask about reproductive rights,conservatives, as it seems you do, would say “what freedom of choice” kctim. Or I guess they would label it as special treatment if it is a right they choose not to acknowledge!

Oh wow kctim there is just to much denial on your part to continue responding to the rest of these diversions in your comment. Suffice it to say I consider it to be extremely slanted propaganda, half truths, myths and misinformation for the most part.

have a good Thanksgiving kctim.

Posted by: j2t2 at November 25, 2015 1:31 PM
Comment #400901

J2, how exactly is my wanting government to respect the freedom of choice for all, equate to me wanting special treatment of some kind?
LOL! Dude, you have really gone off the deep end with that.

“I’m pretty sure if you ask about reproductive rights, conservatives, as it seems you do, would say “what freedom of choice”

And you would again be wrong.
When it comes to abortion, Republicans and Conservatives fall into one of three groups:
- They acknowledge that there are two lives in the equation.
- They don’t care about abortion, but don’t want to pay for others to have them.
- They don’t care about abortion or who pays for it.
None of those strip a persons freedom of choice.

And don’t try to kid yourself or others, J2. There isn’t any denial or propaganda on my part, you can’t continue responding because you know you have nothing left but more emotional opinion and false stereotypes that can’t stand up to the facts.

You have a happy Thanksgiving also.

Posted by: kctim at November 25, 2015 2:59 PM
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