Replace Obamacare with what?

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March 2010: Pres. Barack Obama signs the health care bill in the East Room of the White House. (AP Photo/J. Scott Applewhite)

Listen To You Tell Me Texas Friday 1/27/17

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President Trump and the Republicans in Congress promise to repeal and replace Obamacare. But the question immediately becomes, replace it with what? Another law that mixes the free market for health care and government-funded health care into a massive, unsustainable mess? Let’s sincerely hope not.

The biggest problem with Obamacare is that it imposes huge and mostly unsustainable burdens upon the very many for the benefit of the very few. At the time that Obamacare was being promoted by Democrats, the stated goal was to provide insurance to the 40 million or so people (the number was never entirely precise) who did not have health insurance coverage. That works out to about 12 percent of the population.

For this, the entire health care industry was turned on its head. And after all that, the estimate today is that 28.5 million Americans are still without health insurance.

Most Americans get their health insurance through their employers and, prior to Obamacare, most Americans were reasonably happy with the arrangement. Yes, premiums were rising and yes, employers were more and more passing those costs to their employees. But for the most part, people on employee benefit health care plans were happy. Thus President Obama’s oft-repeated (and conspicuously unkept) promise, “If you like your health care plan, you can keep your health care plan.”

Fear of losing coverage with which they were satisfied is what drove many to oppose Obamacare in 2009 when it was being debated. It’s one of the biggest reasons that Obamacare has never enjoyed majority support among the public.

That fear of losing a health care plan with which consumers were happy proved well founded. Most people in fact did lose the coverage that they had prior to Obamacare.

In place of those plans came policies burdened with the mandates and regulations attendant to Obamacare. Costs have exploded. Premiums are way up. Deductibles are way, way up. Choices as to doctors and providers are down. It’s a mess.

All of the apologies for Obamacare notwithstanding, Obamacare at its core is little other than a welfare program. Its primary function (as opposed to its purported purpose) is to provide health coverage for people who can’t afford to obtain coverage on their own.

The vast majority of Americans pay for their health care either through private insurance (mostly provided by employers) or by reaching into their own wallets. Anything that replaces Obamacare should leave these consumers alone. Left unmolested by over-reaching bureaucrats and crushing regulation, the free market will strike a balance between availability and cost – just as it does with every other necessary product and service.

Whatever replaces Obamacare, it should address only the 16 percent or so of Americans who cannot afford their own health insurance.

A massive federal program that comingles private-market insurance with government-funded assistance, as is the case with Obamacare, will be no better in the end than Obamacare – which, we can’t help noticing, is collapsing before our very eyes.

Paul Gleiser

Paul L. Gleiser is president of Gleiser Communications, LLC, licensee of radio stations KTBB 97.5 FM/AM600, 92.1 The Team FM & KYZS in Tyler-Longview, Texas.

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9 Responses

  1. Linda E Montrose says:

    In the first place, to mandate that every person have insurance is UNCONSTITUTIONAL. As a FREE( or supposed to be)people we should not be told we have to buy something that we can not afford or do not want. If someone can not afford insurance now, what makes any law maker think just because it became a law, it can now be afforded? I can tell you right now the insurance that is provided by obamacare is not much better than having none at all. You can NOT see the doctors you had been seeing unless they are on their list of doctors they say you can see. You should be able to pick your own doctor, not have one picked for you. A doctor, as well as a hospital, is or should be an individuals CHOICE. I do not know what the answers are. But I do know that lawmakers should not be in charge of OUR health care needs. How does someone in Washington know what I NEED??? They don’t and never will. If obamacare was so good why then wasn’t every congressman and woman on it as well??? That should be a starting point of thought.

  2. David Snyder says:

    “In the first place, to mandate that every person have insurance is UNCONSTITUTIONAL.” – That would make Medicare unconstitutional as well.

    “If obamacare was so good why then wasn’t every congressman and woman on it as well??? ” – This is not true. Section 1312 of the Affordable Care Act requires that Members of Congress and their official staff obtain coverage by health plans created under the Affordable Care Act or coverage offered via an Affordable Insurance Exchange (Exchange).

    https://www.opm.gov/healthcare-insurance/changes-in-health-coverage/eligibility-enrollment/#url=Members-of-CongressStaff

  3. Richard Anderson says:

    As President Ronald Reagan said, “The nine most terrifying words in the English language are… I’m from the government and I’m here to help.”
    Obamacare was the most massive boondoggle and sham {aka socialism} ever attempted to be forced & foisted upon the American people.

    The United States is the home of FREEDOM. American Free Enterprise–CAPITALISM–is the best path to a better life FOR ALL and is “still” the economic cornerstone of our great country since its founding.

    What is imperative is this…. REPEAL Obamacare “in toto” first & last.

    That’s what’s crucial as it is a “political curse from the left” upon the American spirit.

  4. R. Eagleman says:

    I feel that Paul’s opinion piece and all of the current replies have nailed the issue. The only thing that could be added is the misunderstanding between HEALTH INSURANCE COVERAGE and HEALTH CARE; many times these two descriptions are used interchangeably, but they are much different. Deductibles, access to providers, inappropriate procedural coverage (obstetric coverage for men), and other factors make the A.C.A. inconsistent with the stated goals of the EX-president and his allies. It seems clear that the unstated goals were to have the ultimate vehicle to control the population, and therefore the power of the government. What better way to achieve compliance of the citizens than by the threat of withholding health care to those who do not behave in the way that the politicians think is best? Understandably, some of the gun control advocates have stated that it is entirely reasonable to believe that the presence of a firearm in the home is a health hazard for children or those who contemplate suicide, and should be registered or removed in order to obtain health coverage. The Progressives were salivating at the potential of the A.C.A., and I am sure that they are devastated that their dreams are vanishing right before their eyes; the massive anti-Trump demonstrations are proof that they “do not go gentle into that good night”.

  5. Carol Meyers says:

    Paul, here is what I just sent our Texas Senators since it sounds like the Senate wants to start from scratch in health care legislation . . . . Carol

    My Dear Texas Senators,

    Sometimes, taking the time to simplify problem definitions will help us reach simpler solutions . . .

    My early training in problem solving insisted on a clear statement focused on what the problem is and is not . . . what successful outcomes/solutions will produce and not produce . . . and what unintended outcomes might occur and ideas about how to minimize or eliminate their impact, should major ones occur.

    First, and most important, I suggest defining some possible health care patient categories for U.S. citizens*, such as the following:

    A) health care for citizens and non-citizens enrolled in naturalization proceedings who can’t afford necessary care.

    Cost to be covered by funding from others, e.g., state and federal tax payers, individual donors (who may receive tax deductions) and benevolent organizations.

    This is not an insurance plan. It provides eligible population members with necessary health care at no cost as part of a welfare plan, in exchange for satisfying (certain typical) welfare package eligibility requirements.

    B) health care for those citizens who choose to and can afford to pay cash for services at time of delivery.

    C) health care for citizen employees whose companies, government agencies or self- employed enterprises provide coverage for a schedule of health care services.

    Cost to be covered by purshased arranged coverages which may or may not be insurance based.

    Such arranged coverages may become part of the compensation packages offered to eligible employees (along with pay plans, performance adders, service awards, COLA, relocation and retirement plans, etc.)

    D) health care for those citizens who shop for and choose to purchase insurance to cover a level of health care services, which may be in addition to what an owner/ employer does or does not offer.

    So, does it not seem inappropriate for government/s to intervene in covering health care costs in any patient category other than in A above??

    In other words, does it not seem appropriate to leave the rest of health care costs to free market demand and individual choice. To intervene in other potential patient categories would seem to deny freedom of choice to citizens, employers and insurers who are able to choose care for their own individual/company needs as they see fit.

    Wouldn’t such inappropriate actions lead us closer to the slippery slope of single-payer government-run “insurance”, which like other gov’t sponsored enterprises would likely become as ineffective as Veterans’ Hospitals, Railroads, Postal service, SSA, etc.??

    Whatever happened to the original Obama premise that we must rescue the 14 million citizens? who back then couldn’t afford health care – so now we have Obama Care in which none of us (the other hundreds of million citizens) have lost our freedom of choice and can “ill” afford the ever-escalating costs and indignities of the “crumbling” “Affordable Care Act” – need I say more???

    Citizen and native Texan, respectively

    Carol Meyers
    _____________________
    * Illegal aliens, pregnant or not, I suggest not eligible to be included in healthcare solutions: they and their new borns need to be dealt with by immigration policy & regulation changes.

    • L Miles says:

      I prefer the KISS principle for this Health Insurance/Care issue. Let’s separate Welfare (free) health services (taxpayer paid) from Insurance covered health services (policy premium paid). Health insurance is like automobile insurance. You buy it to cover low probability catastrophic health issues just like a costly automobile accident, also low probability. This type of “insurance” is affordable because it can be paid for by premiums of those that, thankfully, never need to use it. That is why “insurance” exists, at all. It is NOT a general WELFARE program. There are laws to protect these insurance arrangements from fraud and abuse by those creeps that would “game” the system at the expense of the honest premium payer.

      Routine and common health services should be paid out of pocket by the patient as he pays for his routine automobile maintenance. A well maintained automobile is likely to cost less to operate as a person who takes care of himself by intelligently avoiding sickness by adopting healthy and proper living habits. The free market forces of competition with both the medical services and health insurance businesses will ensure that more care can be bought with fewer funds as long as we are free to shop around for that plan or medical service that fits our budget and requirements the best. This works everywhere else, doesn’t it?

      For those that are willing to skip the responsible health insurance route and want to leach on society (yet have modern conveniences and products in every other venue that they PAY for), the Welfare Health approach is available if they are willing to take the risk. States currently have numerous welfare plans (with Medicaid) to “help” these people that “claim” to be “poor”. They will be subject to the non-free market regulations that strictly limit how, when, and where, they get the care they are willing to take for free. It can be no other way, because everyone knows that free loaders will always be with us. This is the consequence of the human weakness where learning to “do better” is taught by the Law of Nature’s Rod of Correction: “you reap what you sow.”

      The truly indigent must be identified as those that are suffering due to no fault of their own and are to be treated with kindness and respect. It takes careful and rigorous screening to make this happen. No one should be able to “game” the taxpayer paid Welfare system and get away with fraud, period. Otherwise the cost of the Welfare part of “health care” will make all of us suffer and probably collapse the free market answer to health care that is most beneficial when it thrives.

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