Friday, March 3, 2017

Replacing Obamacare

You will hear two things that appear to collide in covering the 5% sickest and poorest who spend 50% of all US healthcare GDP. You will hear Mike Pence say that they will be handled by the States as a part of Medicaid.  You will hear from Paul Ryan that we will have an “advanced premium tax credit” to handle this expense. I prefer the Medicaid solution with the States determining the need. The cost of treatment for this 5% needs to be cut in half by finding less expensive treatments and States should be able to do this.


Insurance Companies will not control their costs. The Health Insurance industry is a single-cell animal with no brain and three working parts; they collect premiums, pay claims and increase premiums. They have no incentive to drive down the cost of healthcare.  State governments like to strangle things, so let them strangle healthcare costs.


Before the passage of Obamacare in 2009, health insurance was affordable, but healthcare costs had been rising because of federal mandates, damaging federal and State regulations, predatory malpractice lawsuits, free healthcare for migrants, predatory pricing of prescription drugs and costly defensive medical treatments and similar abuses associated with 3rd party payment schemes.   


In 1986, companies were hit with the new tax law that was written by the Insurance Companies.  It removed IRS 502 deductions by inserting a 10% of income subtraction to all IRS 502 medical expenses and were forced to conduct an “annual election” of benefits.  The “annual election” continues to be an unnecessary bureaucratic nightmare and needs to be repealed. The 10% subtraction needs to be removed. We had it right before 1986 and we need to return to the pre-1986 model.


In the 1990s, lawyers were dispatched by the Insurance Companies to cancel employer sponsored medical trusts that allowed companies to bypass insurance companies and administer their own health insurance plans.  This needs to be restored.


There were always people who refused to buy health insurance.  Insurance companies supported Obamacare to get force these folks to buy health insurance whether they needed it or not.  The “free stuff” gang jumped on this, but Obamacare sank under its own weight. 


Before Obamacare, a wide variety of health insurance policies were available and premiums were low. High deductible individual plans were extremely low.


When hospitals were required to treat all patients, regardless of their ability to pay, hospitals shifted those costs to paying customers and hospital bills rose drastically.  Before this, counties had hospitals and clinics for the poor that replaced the earlier “charity medical practices” that had provided medical care to the poor when doctors volunteered their time and money to do this on their own.


My grandfather was an MD in St. Louis from 1905 to 1962 when he died. He spent every Saturday in Prairie du Rocher Illinois, 50 miles south of St. Louis, treating the poor farmers in this rural area.  He bought their medications and did home visits. His poor patients paid him with their produce.


Norb Leahy, Dunwoody GA Tea Party Leader

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