Sunday, August 11, 2013

Obamacare - An Alternative and Comprehensive Review

The president held a press conference last week, and one of the things he addressed was the status of Obamacare.  The program has been growing less popular, and the president last month announced a delay in enforcement of the employer mandate, but not a delay in the personal mandate.  Some Republicans, for example Senator Ted Cruz, have called for a cutoff of funding for Obamacare, even if this results in a shutdown of government.
The president was defiant over the last point, and he continues to ask anyone who thinks they have a better plan to put it forth.  I would now like to take up the president’s challenge.  Here is how our country should be approaching health care.
1.       Employer Provided Health Insurance – We need to stop giving tax breaks to employers for providing employees with health insurance.  Employers need to get out of the health insurance business.  They should provide employees with the same amount of money they are currently spending to provide health insurance, but no longer provide it directly.  People should go out onto the open market and purchase health insurance.  This will make health insurance subject to free market capitalism, and true competition.
2.      Health Insurance Across State Lines – Think of car insurance companies like Geico and Nationwide.  They operate across state lines.  Health insurance companies always have a state name, like Blue Cross and Blue Shield of Michigan.  They do not operate across state lines.  We need to change the laws so that health insurance can be bought across state lines from national companies.  I am a fan of states’ rights, but this is one case where the product should be sold on a national basis.
3.      Tort Reform – We have long needed to reform the laws in this country so that frivolous and costly lawsuits against medical providers do not drive up costs for everyone.  This will lower the cost of malpractice insurance and therefore lower health care costs for everyone.
4.      Standardize Fees – Health care providers should have standard fees for the services they provide.  Whether it is gall bladder surgery or a tonsillectomy or whatever, there should be some sort of standard cost, and the patient should be given an estimate of total costs before treatment, to the extent that is possible.  Other industries do this and it helps consumers to make decisions and shop around for medical care.  A medical provider should not be able to charge different patients different amounts for the same service.
5.      Eliminate Medicare – Yes, you read that correctly.  Medicare is the government mandated health care program for senior citizens.  Some senior citizens rely on it, and other seniors could do just fine without it.  The program needs to be eliminated, but please see the next point.
6.      Expand Medicaid – Americans are a generous people and we don’t want to see people die needlessly or go without proper medical care.  People who cannot afford health care should be given the option of Medicaid.  Medicaid will never be the Cadillac of health care plans; it is a bare bones safety net for the poor.  However, it should provide basic insurance for people who cannot afford to pay for it themselves, including those elderly who cannot afford health insurance.  Medicaid should be operated by the states, and the states should be allowed to innovate and be creative with ways to improve on the program.
7.      Expand Health Savings Accounts – Health savings accounts are a great way for people to save for unexpected health care needs that may arise in the future. The government should provide tax benefits for contributions to HSA’s in order to incentivize people to save for unexpected medical problems.
8.      Prevent Insurer Abuses of Patients – A health insurance provider should not be able to drop you or raise your premiums if you get sick after having paid your premiums.
9.      Promote Healthier Lifestyles - People should be able to get a break on their health insurance and perhaps a tax deduction for gym membership and other healthy lifestyle choices.
10.  Maintain Popular Common Sense Reforms – Some of the more popular common sense reforms of Obamacare could be preserved, such as not being denied insurability for pre-existing conditions or staying on your parents policy until 26.  These mandates will necessarily raise the costs of policies for everyone and are subject to debate, but should be considered in the context of what is otherwise a free market system.
These are bullet points and cannot compete with the specificity of the 1000+ page Obamacare bill, but the general points are as follows.
·         Allow free market forces to operate on health care costs.
·         Remove ridiculous impediments to sound health care policy.
·         Institute common sense reforms of the way health care operates.
·         Do not rely on government and bureaucracy to fix the health care system.
Health care and health insurance are separate and different things.  People should go and shop around for a health insurance policy that fits their needs and their budget, and then hope that they do not have to use it.  With all Americans actually shopping around for health insurance the competition will create change and drive prices down.  Innovation in the marketplace will cure a lot of the current problems we see.  Health care providers will see a difference, too as consumers will give more scrutiny to what they are paying for and who is providing what care.
I will admit there is a lot of work left before the above skeleton could be called a plan, but already I like it much better than Obamacare.  And I am not alone.  A poll taken in June showed 66% worried about their health care.
The New Hampshire Union Leader found a similar drop in popularity of the program.
According to AMAC the Medicare Trustees Report show a bleak future for seniors.
Labor Unions are abandoning their support of Obamacare.  This report from The Hill.
Here is another report on criticisms of Obamacare by union leaders such as James Hoffa.
The IRS employees union has made it clear they want no part of Obamacare.
You may have heard that the Obamacare call center itself will not provide employee health care benefits
Members of the House and Senate were afraid that they and members of their staff would be subject to Obamacare and so a bill was rushed through and signed by the president to make sure that did not happen.
With things falling apart in terms of implementation of Obamacare, and people like Democrat Max Baucus calling it a train wreck, the President has not only been giving waivers right and left, but he decided to delay enforcement of the employer mandate for another year.  Forbes says the White House is in a panic.
The Washington Post points out that the employer mandate was not the only part delayed.
Have you heard of the Federal Data Hub they are going to use to sign up people for Obamacare subsidies?  It will combine lots of your personal information in one convenient spot.  They can sign you up for Obamacare and register you to vote!
The Wall Street Journal thinks the president’s maneuvering (delaying the employer mandate but not the individual mandate) may backfire and open his actions to judicial review.
Oh, that data hub, the one with all your personal information?  No worries, but Reuters says the government is way behind on testing the security of the system.  I am sure they will get around to it.
The Weekly Standard, as you might expect, thinks what is going on with Obamacare is madness.
The CEO of the Hardees chain explains why he is not a fan of the program.
One good thing, if you sign up for the subsidies you will not need to verify you are eligible, they will take your word for it.  Seriously, I could not make this up.  This comes from the Washington Post.
All of this uncertainty is putting some Democrats in a tight spot, and a few are jumping ship.
Senator Mike Lee sums up a lot of the concerns in this video from the senate floor.
Believe it or not The Heritage Foundation took a humorous look at the promises of Obamacare.
And finally, in case you have not realized it, this Obamacare thing is about to get very real for our healthy young people very soon.  Let’s say in a month or two.  Pull out your wallets, kids.  Some real life figures on what it is going to cost them.
That’s it for the review.  There is a lot to look at above, I realize.  But the debate is about to turn to whether or not to shut down the government in one last ditch effort to defund the program.  It is the law of the land but the president apparently gets to pick and choose which “law of the land” he wants to enforce, and on whom.  Laws can be written, but whether or not they are enforced is up to the whims of the emperor.


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