What a country…
On Friday Salon said, “Amid reports that Republican leaders have been frantically rewriting their Obamacare repeal bill so as to win more support, even as GOP voters themselves have only lukewarm support for it, there are now early signs that the Trump administration is pessimistic about the vote scheduled for later on Friday.”
How sad was that?
I’m a fiscal conservative, but I’m going to take this opportunity to speak to how Republicans have failed healthcare reform in a more egregious manner than even the Democrats.
Make no mistake, ObamaCare is a failure of Harvard Business Case magnitude.
It was built on a flawed business model. The same business model any insurance plan operates from – that you must have more revenues coming in from premiums paid than outgoing expenses from claims filed.
From day one, this program based its success on hipsters and healthy young people – the ones who see themselves as invincible – buying policies in droves. All those revenues would offset older, less healthy users of the plans. However anyone who had a BUS101 course could tell you that was destined for failure – and fail it did.
That’s why so many providers have pulled out of so many states.
When my company closed in January, I had to turn to the AHC market. Prior to then, I had the best PPO plan money could buy. Office visits, drug cards, tiny deductibles, all you could ask for. For this I paid roughly $200 per pay period.
When I tried to buy a comparable plan, that price increased four fold.
After looking at all the limited choices available, the only thing I could afford was a plan that covered nothing for basic visits with a $6,000 deductible for me and my wife.
So for me, ObamaCare – Affordable Healthcare – was neither “affordable” nor “healthcare.”
Hey, if I keel over with a catastrophic illness, I’m covered. If I have a $250,000 bypass surgery, I won’t be left bankrupt.
But today, as we absorb the news about the failure of the vote, the blames lies firmly and only with the Republicans! After all, this is all they have screamed about for seven years – seven years.
Couldn’t they have developed a good, alternative plan in those 7 years!
Okay, let’s forgive them that…
However, when it was apparent Trump got the nomination, couldn’t the Republicans have kicked it in gear then? Wasn’t that time enough to develop a substantive plan? Of course it was, but they didn’t.
As much as the finger is being pointed at Trump, this isn’t a Trump problem.
This has been his cry the entire campaign – REPLACE AND REPEAL Obamacare!
This wasn’t news to the Republicans.
They should have had a flawless plan ready, proof read, triple checked and ready to vote on. But what did they do instead? They spent all those years complaining.
Republicans, it was your only job….
ObamaCare is a failure; that’s the OLD NEWS. Replace/repeal has been the Republican cry for seven years. When the time came, were the ready with the end all-be all plan?
No.
The Republicans got caught with their pants down and have nothing to show for themselves.
Healthcare Failure Scoreboard:
ObamaCare 1
Republicans 1
The winner – President Obama.
The loser – President Trump and the American People.
So now we get to watch that buffoon Paul Ryan, admitting, “We came up short.”
Hey, Republicans….
It was your ONLY job.
Yes Obamacare was trying to force “hipsters” and the like to purchase insurance by applying a tax penalty if they failed to do so. The abortion that the Republicans came up with was to penalize the same group by allowing insurance companies to hang a 30% surcharge on anyone who let an insurance policy to lapse. That’s a joke. You have to actually have already purchased a policy AND let it lapse for any sting at all. That incentivizes no one to purchase insurance. Trump campaigned on “cheaper premiums and superior insurance” for EVERYONE and the angry white trash rust belt cretins bought it hook line and sinker. They are the same ignorant trash who believe that the high paying manufacturing jobs are coming back. Its no surprise the chickens are already coming home to roost. Trump and company are bitching they got no help from Democrats and that’s a joke as well. They got as much help as they gave Obama on ANYTHING he tried to do. Its just goes to show the Republicans are great when they can be against something but they absolutely shit their pants when they actually have to govern. As long as the Sarah Palin Tea Party drinking wing of the party control things then nothing will get done. Can’t wait for the midterms or Trump’s impeachment—whichever comes first.
I unfairly used the term, “hipsters” when I should have simply delineated the demographic as “young, premium paying NON users of the plan.”
But thanks, as always, for your comment.
I’m disgusted with the GOP for the reasons you just named. They had 6 or 7 years to build an alternative. That being said, how long was Obummer in office before the laughable ACA was voted into law? Hell, Trump’s been here less than 4 months. But what’s REAL comedy, is that frozen faced twat Nancy Pussygalore trumpeting this as a “victory” for the Democrats and the American people. HAHAHAHAHAHAHAHA! Congrats! Such a victory for America to have to stand there and watch the ACA collapse under it’s own bloated weight. Hey Democrats…if you haven’t noticed, your crowning achievement over the past 8 years has cancer, and is dying a slow ugly death. Think you might want to come up with a fix or at least make some suggestions instead of sitting in the corner, or cheering that the GOP couldn’t figure out a way to euthanize that monstrosity that belched out of your canals.
Thanks for the comment, Guy. Good to hear from you.
Nice article…I couldn’t agree more.
I don’t follow it too closely (no sense getting irritated at something I can’t influence), but wasn’t the tax “penalty” supposed to force the hipster doofuses to get coverage? And fwiw, I’m in the same boat as you…self-employed with a high-deductible plan with premiums that have more than doubled in the last two years.
Maybe the solution is to tax sugary drinks/foods and make America skinny again.
Thanks, Phaedrus. Looking forward to maybe chiming in here a little more often.
People usually judge the ACA by the effect of the law on themselves as individuals. That’s what the author’s done here. Judging the law by its overall statistics, the ACA is doing a good job at lowering the increase in premiums and insuring more people. The upward arc of premium increases is lower. Taken together, the ACA, expanded Medicaid, subsidies and the penalties for non-coverage, have resulted in the lowest uninsured rates in decades.
If it perfect? Does it work for every single situation? No. It’s only better than the previous system and there isn’t enough room here to point out the flaws in the previous system.
The author’s right that the GOP had years to develop an alternative and didn’t. Their focus wasn’t fix the law, but eliminate it.
Unregulated free markets, despite what the purists claim, do not provide stability. Lightly regulated markets do offer a comprise that produces stability in a number of areas of the economy that are taken for granted because they work well. The issue in all areas of the economy is this: what constitutes too much regulation?
That’s an argument that’s constantly revisited over and over in Congress. The debate is a good one. As conditions change, regulations should change also. However, the fact that the GOP couldn’t come up with a better plan should tell people that despite its flaws, the ACA is better than the previous system. The challenge is to take its framework and make it better, not blow it up for some pipe dream that an unregulated free market approach will work better. It won’t.
Good to see you, Laura. My only argument with you would be…it almost has to be judged on an individual basis as that’s where it matters.
How is affordable health care an accurate description if I have to come $1100 out of pocket for an MRI for my wife? How is it affordable if you live in fear of ending up in an ER, $5500 out of pocket since you have a $6300 deductible? How’s it affordable if every office visit is $120 out of pocket and no drug coverage when a family member has $300/month in medications? I don’t know how the average Joe Blow can do that?
Other than that, I agree with you!
Companies that go out of business aren’t required to offer COBRA. I’m sorry that happened to you, Paul. That’s a tough one.
The high premiums in coverage offered under the ACA when your income is too high to qualify for a subsidy comes from “qualified plans.” Plans offered under the ACA must have a minimum amount of coverage by law. It’s better than catastrophic coverage and is more expensive.
However, if you chose the maximum deductible, you’re not charged the full cost of office visits and procedures because you’re still in a group insurance plan and the company will have negotiated lower rates for those items. And the drug benefit begins immediately. Plus, once your deductible is met, you might find everything covered at 100%.
The sticker shock is severe, but you may qualify for a subsidy next year. I certainly hope so and, once again, I’m sorry for your problems.
Thanks, Laura. Seems at time, change is our only constant, huh?
Newsflash for Laura…the ACA will ALWAYS be judged by the individual. And it’s the individual that votes. The individual is the one paying the premiums and out of pocket expenses. The individual doesn’t give a rat’s ass how healthy the rest of the country is. He/she is just trying to make ends meet, week to week, month to month. And please stop crediting the ACA for lowering the uninsured, as if if was such a great deal with low rates and great coverage. No. It was made a law that people HAD to buy it.
Guy Who Says What Others Think is Say What I Think.
Newsflash for “Guy:” No, there is NO mandate to buy coverage. Anyone can pay a penalty and go without.
And while you may not give a “rat’s a**” (your term, not mine) how healthy the rest of the country is, fortunately the people sent to Congress DO. They may disagree about the best way to build a healthcare system, but I assure you each one of them cares.
The facts are irrefutable about the effect the ACA has had on lowering the uninsured rate as well as lowering the increase in premiums. Yeah, it’s a big deal. Can Congress build a better system? We’ll see.
I’m sorry you don’t care … you should.
No, I shouldn’t. Because I’ve made career and financial decisions that keep my family covered at all times. And that’s my primary responsibility. Take care of my family. Basically, I believe the government sucks at everything it puts it’s hands on, and healthcare is no different. The ACA is a large scale disaster, and I’ve seen it firsthand within my friends and family. And no amount of spin doctoring by ACA proponents can make it any better.
Very well said. They didn’t have the guts to repeal the AHCA or the policies to form a consensus to replace it. Word is that the final bill even removed the ban against charging more for pre-existing conditions. That’s been a staple of Republican healthcare philosophy for 30 years but Ryan and company caved to the wing nuts and is still wasn’t enough to satisfy them. Its a colossal failure and really proves that Trump had no clue what he was doing. Republicans in the room during the “supposed” negotiations said the man wasn’t informed enough on the details of the plan to negotiate anything. His intellectual loafing and his “wing it” mentality is going to hurt our country bad. Damn right America lost. Obama didn’t “win” a thing but his administrations plan is far better than what was proposed. If Washington worked right they all could get together and fix Obamacare but that won’t happen either.
The problem with Republicans and their efforts, was the “optics”.
Trump should have instructed his team, from top to bottom, including elected politicians from the Right, to preface every, EVERY single comment with regard to Health Care, by telling the truth. Democrats infected the American People with the Cancer we call “Obama Care” and the Republican Chemo Therapy is going to be painful, inconvenient and may not save the patient.
Obama Care, was a premeditated, wealth transfer, that no one, including Democrats actually thought would improve the status quo, no matter how much you hated that same status quo. Slime ball p.o.s. Johnathan Gruber was outed, like Donna Brazille when the video came out of him explaining on film, how the American People were lied to about “keeping their doctor” health plan, premiums going down etc etc.
The pretense that the Federal Government could oversee a national health care system, was insane. Any grade school kid with a couple of brain cells, could look at, wait for it…, OH YEAH!!! The Veterans Administration and see the abject failure of Government run Health Care. Of course, putting that business genius, Barack Obama, who had never received a check from a for profit company in his life in charge of the whole thing, should have raised a few eyebrows.
Socialism results in shortages, inefficiencies, bureaucratic cluster f….. and the next thing you know, you are standing in line in Venezuela, hoping to get a few drops of the last gasoline available in a country that has as much oil as Saudi Arabia.
Before we get into the anecdotal, pre-existing condition argument, I get it. The old health care system wasn’t perfect.
Gimme a break. This poorly conceived, painfully initiated, inefficient, government boondoggle is categorically, the greatest fraud ever perpetrated on any group of people in human history and making excuses for it in retrospect means you are either insane, or, the beneficiary of middle class dollars, euchred out of tax payers into your pocket. Obama Care only works for those who DON’T work.
Guy who says what others think is dead on the money.
Nice article Paul.
Chuck! I can’t believe it! You’re CHUCK and you actually commented on my story!!
“Hey, honey, its CHUCK! He just commented on the story I did! I can’t believe it….”
I’m in town this week. If you can get out of that ditch you’re digging, go home, take a shower, and can have a cigar, I’m your guy!
🙂
Ok.
🙂
Really good read, PW. You pretty much covered any/all points I would have made.
One thing I would add is that this was a glaring confirmation of the complete hypocrisy of politics. Repubs spent 7 years screaming about the ACA being shoved down their throats with ZERO input from their side of the aisle. Remember all of the run they got with Dems saying they had to pass it before they knew what was in it?
Now that the shoe is on the other foot, the Repubs did the EXACT same thing. Throw something together in 3 weeks, exclude Dems from any input and call it a healthcare plan.
The end result? ZERO Repubs voted for the Obamacare and ZERO Dems (would have) voted for Trumpcare.
Helluva way to govern a country.
Thanks, AKA. Good to see you. I’d agree 100% with your comment. I was in favor of Trump becoming President and shaking things up. I made the comment in an essay, post election in some newspapers who carry my crap, that I had but one reservation and it was a big one; could he transfer a business based negotiating ability into the government. I made it abundantly clear, I thought it would be hard for him, because you DON’T control all the outcomes. Congress ISN’T on your payroll. They don’t work for you. At the end of the day, you’re not just dictating orders, you need massive amounts of consensus and that deck, my friend, was stacked against him from the start.
The rancor on both sides may prove to be his undoing.
It’s a lot easier to say, “AKA, here’s what I need done, do it, or your fired!” when I control all the strings. That’s what he’s used to. That’s NOT the case here.
Its left to be seen, but this healthcare failure may be the beginning of the end of his capabilities….
Here! Here! No such thing as bi-partisanship in politics anymore and there hasn’t been since 1992 when Clinton was elected.
Sadly, you are correct.
Paul, you just did a kick-ass job of summing up my opinion as well.
A single-payer plan, and the ability to shop across state lines would be nice. Real nice.
The will of the people will never jibe with the decisions made in DC until after the next revolution, which by the way, will be televised.
Yo, Lib…. thanks once again for your comment and you are correct. We may be closer than we think. Now, about that cigar break…..
Hey sports fans…
Give it up for THE Paul Wilson…back from the dead and – with luck – raring to go!
Thank you, admin…. tomorrow, in my next installment, I’ll be asking the readers if they are happy with how their scrotum is hanging…..
I know, you just can’t wait, can you?
It’s always good to have your offerings here Paul and you picked a great topic. Sorry I haven’t chimed in earlier as nothing like healthcare in America to motivate me to opine here.
First off, the old system prior to the ACA was ruinous to both the health of our citizens as well as the economy itself. We spent about 18% of our GDP on healthcare (when the rest of the developed world spends closer to 10% of theirs) and for that we get a healthcare system that doesn’t even crack the top 35 in terms of delivery and results (as ranked by the World Health Organization). With a GDP of around 18 trillion dollars, if we could reduce the spending to closer to the 10% standard, that would put back almost $1.5 trillion into our pockets. Even in DC, that’s some pretty serious savings. We are swimming in the ocean with an anchor around our neck. Clearly a single payer plan makes the most sense but too many people operate under the misconception that the government cannot do anything beneficial in any arena. Those who think “the pretense that the Federal Government could oversee a national health care system, was insane” haven’t heard about Medicare. Certainly there are sectors of our economy where the federal government does not belong, but there are also places in our economy where the federal government MUST be involved and healthcare is clearly one of them (along with defense of our shores and maintenance of our infrastructure). When a self identified “Libertarian” calls for a government payer plan, that speaks volumes.
What the federal government possesses is the size and leverage to control prices. Providers may not be crazy about the Medicare reimbursement schedules but it is a critical step in controlling out of control pricing by hospitals, doctors, and drug companies. If you have health insurance now and have had any involvement with claims, you are familiar with the “Explanation of Benefits” (EOBs) forms sent to you by your carriers. When your carrier receives a bill from your provider, they will send you the EOB that tells you what was billed, what they are contractually agreeing to pay (what is written off), what goes towards your deductible and coinsurance, and then what you still owe. What is billed and what is accepted is often bordering on ridiculous. In my work I see EOBs quite a lot and even I am surprised sometimes by the huge difference. Saw one last week where a surgical procedure was initially billed by the provider to the carrier at $38,000+. The provider wrote off $35,000 + and accepted $3,000 for the procedure. Another where a surgeon billed $110,000 for a spinal procedure but accepted $60,000. If you don’t think that is symptomatic of a serious problem in our healthcare system, you are not paying attention. The private sector has proven again and again for over a century that they cannot handle healthcare to the benefit of the country. Presidents, starting with the republican Roosevelt, have tried and failed to initiate government involvement in healthcare and now we finally have taken a critical first step. The ACA is not perfect but it is so much better than what went on before it. To those who think the ACA is too expensive, they are not paying attention to the money. Just because the costs did not appear in the form of premiums prior to the ACA does not mean we weren’t paying them. When you tell an insurance company they will now be covering pre-existing conditions, do you think maybe the premiums they charge will not reflect that model? Now these costs are showing up in premiums as opposed to being hidden in the price we pay for everything else. Having people go bankrupt because of a health condition is not in the best interest of the nation’s economy. If there is any segment of our economy that screams for government involvement, it is healthcare.
You must first ask yourself, “is healthcare a right or a privilege”. Personally I think it is a right. Prior to the ACA, I think a majority of conservatives/republicans would respond that healthcare is a privilege and the federal government had no responsibility to step in. Now, after the ACA has become law, it seems that an inordinate number of those same conservatives/republicans now have signed on to the proposition that pre-existing conditions must be covered by health insurance. You can’t have it both ways. If you think pre-existing conditions must be covered by health insurance, then you are saying that healthcare is a right and not a privilege.
Our problems with our healthcare system go far beyond what is mentioned here. First of all, our “fee for service” method of delivery is counter productive and providers should be reimbursed on a measurement of successful outcomes method. Secondly, we should separate health insurance from employment. We might see the prior addressed in our lifetime but probably not the latter.
Sorry that you got caught in this clusterfck. Paul but you also had the misfortune to live in a state that chose to screw it’s own citizens rather than accept the federal money to expand Medicaid.
Great piece, Paul. Can’t wait for your next offering.
Well, hello there, Stomp! Sorry for the absence but I’ve had my hands full!
I’ll read this when I land in more detail, but I’m sure it’s your usual; even if we disagree your comments are more precise than my story, as a rule.
Thanks again and we’re past due for another lunch.
Stomper, this may be too close to stepping on your toes, but its hard for me to think that capitalism, profit, should have anything to do with healthcare or prisons. Insurance could be a zero sum game for healthcare. Much like some of the examples in the Christian community where members pool their money. Why shouldn’t health insurance do just that? Why should it be the enormous profit center it is?
There are all kinds of ways to make money in this world. I don’t think assuring our health should be one of them.
Thoughts on that?
Wow Paul, to read your comments on separating health insurance and the private sector gives me great hope for the country. To have you, as one who leans to the right in politics, recognizing that the federal government has a valid role to play in this arena is encouraging. So many just regard the federal government as evil and incapable of doing anything positive that it hampers the ability of society and the economy from moving the country forward. I’m a capitalist that always thinks the private sector ought to have the first shot but while there are places that only the private sector should be and places where the private sector and the public sector should coexist (ie regulation), there are also places where only the public sector should take the lead. As you know, I’ve worked for a private insurance brokerage firm for 40+ years and I have come to believe that with regards to health insurance, the private sector takes far more out of the system in terms of commissions and fees than they bring to the table in benefit. There are lots of very intelligent and talented people in the industry but there are also lots of people making six and seven figures that don’t bring an equivalent level of validity to the game. That’s money that could be better spent elsewhere.
On a side note, (and with apologies to Laura Black) I wanted to support your last comment above to our esteemed administrator on your next topic. As a much younger guy, I know you were joking but as an older senior citizen here, I must tell you that the topic of low hanging scrotums is of great concern to those in my age group. Looking forward to your research and commentary on this critical area of concern.
🙂
Thanks Paul.
Being of the appropriate age group that occasionally checks the temperature of the toilet water with his own low-hanging-fruit, I too welcome your research and insight on the subject.
Oh, just wait for tomorrow….
As usual, Stomper, well reasoned, well spoken, from a man who had skin in the game. Thanks.