Sunday, January 8, 2017

Repeal & Replace

Fully Repeal & Replace shouldn’t mean Half Repeal & Delay-Contact your Reps, by Jason Wisniewski  1/5/17

As a licensed health insurance agent I can tell you that Rand Paul is right. The latest effort in the Republican controlled Senate to tie a partial repeal of Obamacare to a budget resolution that not only doesn’t fully repeal the law but also delays its replacement reforms and adds 9.7 trillion in new debt over 10 years is a disgrace to conservatism and a betrayal of the voters who gave Republicans control of both chambers of congress and most recently the White House.  

There is a mandate for the repeal & replacement of Obamacare and a mandate for conservative principles such as balancing a federal budget. Yet the Republicans in the Senate & House who have been campaigning on the repeal & replacement of Obamacare ever since the Democrats rammed it down the throats of the voters in 2009 can’t bring themselves to do what they have been promising to do for the past 8 years.

So why is this happening?  This is something I have been sounding the alarm bells on for quite a while when I first started to see some concrete Republican replacement plans for Obamacare. There have been several replacement plan proposals and they largely look the same.  Expansion of Health Savings accounts, High Risk Pool Insurance for those with Pre-existing conditions, ability to purchase insurance across state lines, tort reforms, price transparency, repealing the Obamacare taxes on medical devices and insurers, returning the stolen Medicare funds back to Medicare, allowing people to take employer based coverage with them from job to job, etc.  

All of these are popular reforms that would do a great deal of good towards making insurance more affordable for the majority of Americans, especially the ones who voted for these reforms.  Yet the Republicans continue to split hairs on the details and still don’t have a consensus plan for which a majority of them can sign onto.  

One plan was the “American Healthcare Reform Act” HR3121.  It died in committee.  In my home state of Wisconsin we had Reid Ribble & Sean Duffy both signed on to it but Paul Ryan refused to.  Why?  We had both Dr. Ben Carson & Donald Trump run Republican presidential campaigns on the expansion of health savings accounts and it was brought up in numerous GOP debates. Yet the Senate Republicans & House don’t want to introduce a replacement plan and prefer to do this in a halfhearted piece meal way that doesn’t actually address the problem of costs?  

Yes President Trump could do away with the individual mandate by executive order, but this still does not address the root causes of the premium increases.  Only a replacement reform bill can do that.  It is so much easier to spread out the subsidizing of state run federally backed high risk pool plans among all taxpayers as an extension of Medicaid than it is to sacrifice your own personal insurance rate as part of a much smaller pool to cover those same conditions of the sick.  The adverse selection spikes your insurance rates through the roof to pay for these individuals.  

It’s the same as if someone with a risky driving record got to choose from the same insurance pool you did instead of a car insurance risk pool.  Do we want the risk spread out across the country or do we want the risk spread out only to the customer base of each independent company?  

The law of large numbers says you need a bigger base so this is why we should do it as a Medicaid extension and not forcing insurance companies to take all comers.  Besides they are better served by a Medical plan that allows them to see any provider rather than being stuck in a tiny HMO (As that is primarily all that is left on Obamacare exchanges).

It will now be up to President Trump to keep the pressure on his GOP congress to come up with a bill they can all agree to move forward and get to his desk.  Gather them all up in a room with VP Pence and don’t let them leave the room until they hammer out a solution.  

Have Trump in the room. Have Dr. Carson in the room. Get it done. Repeal and Replace. That is what we voted for. Nobody voted for Half Repeal and Delay.

Comments

This article suggests that the really poor and sick should be covered by Medicaid. But Medicaid is mandated by the federal government and administered by the States. Increasing federal block grants to allow the Sates to take this on would continue the political game allowing Liberals to return to carping about Medicaid as a second-class coverage.

Before the 1960s, county hospitals and clinics served the poor, along with providers who had charity practices in addition to their regular practice. That’s before healthcare was a “right”.  The federal government took this over and ruined it.  Insurance companies will continue to charge customers 120% of what they cost.  Let’s not let this continue. 

Lumping the truly sick with the poor will not address the waste and overtreatment causing the truly sick to remain sick. It also allows the healthy but poor to seek unnecessary visits.  Preventive medicine needs to be the responsibility of the patient, not the government.

We need to allow healthcare to be reformed by eliminating 3rd party payers and federal subsidies. That will end the healthcare scam of excessively expensive treatments and drugs and no cures.

Norb Leahy, Dunwoody GA Tea Party Leader


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