3rd Attempt: GOP/Trump Repeal & Replace ACA and Trump lie about pre-exist coverage

Why don't you reply to Major's question with an answer? Give an example of a system in existence that is what you claim to want and works. Go ahead. If you and others like you truly believe what you claim to believe, there must be several examples of similar healthcare systems that are successful. Point them out to us. Instead of spouting fantasies, give actual real world examples that work.

We're waiting. Thanks in advance.

 

lol at this headline

"fire insurance policies really only work for houses that aren't on fire"

 

wake me up when we stop beating off about the idea of 'free market' healthcare.

unless i die first, which is highly likely. especially in a world of republican healthcare.

lolz.

 

Meh, you always do the sneering insulting John Oliver thing.

It's telling that my view is an extreme minority one, and I wouldn't concede otherwise.

I don't know the survey of world health systems, I doubt there are any that would be my ideal. That doesn't mean it wouldn't work in practice.

Individual liberty and free markets are not the natural state of human society. But it is the most moral and gives the highest quality of life. The tendency toward authoritarianism, mandates, prohibitions, subsidies, wealth confiscation and redistribution happens everywhere.

All the Cruz plan does is say that insurance companies are still required to offer everything to citizens they were required to under ACA, but they now have the freedom to offer something else to citizens. No one is forcing insurance companies to offer these alternatives, or citizens to purchase them. It's all voluntary, expanding liberty and choice.

What the Cruz amendment does is expose the lie that ACA would reduce premiums. Right now, citizens on individual exchanges are outlawed from purchasing or being offered cheaper plans. So their premiums go up, as a means of subsidizing more expensive customers. The Cruz amendment would do what ACA did not, bring premiums down.

The existing insurance company cartel is happy with every customer being forced to purchase the more expensive plan (mandated price fixing, they love it), so it's no surprise they oppose the Cruz amendment.

 

It'd stupid, that's what's wrong with it. You dopes don't understand how or why insurance works. You're professionally obtuse.

 

You support mandating coverage of those with pre-existing conditions. I'd say you are the one that doesn't understand insurance. Here is a basic primer. An insurance company accepts payment of premiums against a risk of loss. The insurance company hopes that over the course of your policy, the premiums received (as well as monies generated by receiving those premiums early in the course of events) will exceed the payouts they need to make when a risk is realized. The insured is paying a premium to ward against a financial disaster if a covered risk is realized, understanding that they may very well end up spending more on premiums than they will receive in payouts.

Mandating coverage of pre-existing conditions turns this model on it's head. Instead of an insurer accepting premium payments against a risk of loss, they are now accepting premium payments against guaranteed larger payouts. This is not insurance. This is the government mandating the transfer of wealth from the insurance company to the medical establishment on behalf of the patient. Why is the insurance company responsible for this? Why not mandate that the hospital has to pay for those with pre-existing conditions, or the doctor, or the nurses, or the state? How are any of those options more or less correct than sticking the insurance company with the bill?

 

Agree, if we've decided to use federal tax dollars to pay for care for pre-existing conditions (a bad idea, it should be done through states or through private means), then it makes no sense to launder the money through insurance companies, when we know the provider is eventually going to get it to provide the care for the pre-existing condition. Just cut out the middleman and pay the provider directly.

Essentially single payer for pre-existing conditions. Not ideal, but better and more transparent than distorting the insurance market by funding it through higher premiums (with insurance companies in the middle taking a cut)

 

This is indeed what would happen. No competition, no incentive or profit motive to drive down costs or improve quality.

Everyone except the rich would have VA/DMV/Medicaid style care, with shortages, wait lines, few choices of provider, and poor quality of care.

 

Medicaid was originally intended for the poor/disabled, but was expanded under ACA to include working-age, able-bodied adults.

 

Wrong. Check out the UKs health care. Single.payer, better quality, less lines, much cheaper. Destroys the us system in every single relevant metric.

 

Maybe instead of just deciding it *would* work in practice, you should ask yourself why (1) no one has done it if it's so wonderful and cheap and (2) why every health policy expert on both sides of the aisle think it's unworkable. Do you really think you're smarter at all this than basically every expert worldwide based on ... generic Libertarianism 101 theory?

No, that's not all it does. ACA was built around a compromise of the needs of a bunch of different parties, to make a really poorly designed US healthcare system work better. It's not ideal, and it's individual provisions do not work independently. The reason the EHB exist is to make the rest of it work - if you just rip that one piece out, similar to ripping out the mandate or other critical elements, the whole concept no longer works. If you knew anything about the ACA, you'd know this clearly. The Cruz Amendment doesn't just give people the choice to buy a cheaper/crappier plan - it blows the balance up that was created and results in an unworkable system. It does give young and healthy people the ability to buy insurance. It also takes away the choice of sick, poor people to buy insurance by making it completely unaffordable.

Health care is NOT a free market. It IS regulated, whether you like it or not, and that is not changing, even if you just repeal Obamacare it's entirety. It's regulated at the local, state, and federal levels in all sorts of ways. So just taking out random regulations without considering their effect on other parts of the regulatory structure is absurd.

 

Medicare was also designed before our current healthcare inflation explosion over the last 20-30 years when healthcare was relatively cheap for working-age, able-bodied adults (by the way, those people sometimes qualify as poor). The GOP has steadfastly refused to do anything to improve our healthcare system over the past 23 years since the failure of HillaryCare despite numerous opportunities (especially in the 2000's when they controlled all branches of government). That's resulted in many new health care problems requiring new health care solutions. Medicaid was a functional, already existing system that could be used to address some of those problems.

 

This is only true if you look at one individual in isolation. And, of course, if you ignore that not all pre-existing conditions involve larger future payouts. No one has ever had an issue with group employer coverage covering pre-existing conditions, because the idea of *health* insurance is that we take a pool of high and low risk people and try to equalize. It does work differently than other types of insurance - everyone (except you and a handful of others) accepts that because health is different than the other types of thing we try to insure.

The big change with ACA is that, by having an individual mandate, we're trying to turn all the self-employed people and people who work at non-health-coverage jobs into a big group and treat them the same as the group insurance market that everyone has no issues with. This is why health care reform was a massive undertaking and you don't just piecemeal random regulations together ad-hoc. The pre-existing conditions ban increases risk to insurers. The individual mandate decreases it. The goal was to find a combination of regulations that redirects the system to better serve the public - it has always been and always will be a mix of regulations. The only difference with ACA is that it put a different combination of regulations into effect. The Senate Bill simply changes the regulations again, in a way that completely wrecks the market.

 

Democrats would likely be fully on board with basically giving anyone who can't get other insurance access to Medicaid or Medicare or a public option. The GOP is the one that is opposed to that idea and demands everything be done through private insurers. And no, high-risk pools are NOT the same thing - they are still completely unaffordable to most of the general public - these existed before ACA and we saw how terrible they were and in many cases, they are just subsidies to private insurers. Same thing, different mechanism.

 

So.... what happens when can these folks become Medicare eligible?