But not getting preventive care often leads to much more expensive care later that could have been, well, prevented. It’s cheaper to pay for the little things before they become big things. Pretty sure that was the idea with ACA covering office visits and vaccines and the like.
True, no one does. People like us grumble a little and pay out of pocket. Low income people don’t get the care at all. Just be aware that that’s the result of what you’re advocating – poor people won’t get care, especially in view of the proposed Medicaid cuts.
I know it’s hard for us CC parents to even imagine, but there are a lot of people for whom the cost of routine annual care is simply out of the question.
When you offer people the option of catastrophic policies, who will get those policies? People who are healthy enough to assume they won’t get much if any care this year. Which leaves the pool for comprehensive care sicker than it other wise would be. What do you suppose happens to the premiums of that second group?
“People were going bankrupt from catastrophic illnesses that without insurance they couldn’t pay for. No one goes bankrupt over office visit charges, flu shots, or the like.”
Not just some bankrupting illness and not all situations are as simple as an OV or a shot. And catastrophic can have quite high deductibles. You want to pay up to the first, say, 5k, when you don’t have that sitting around, you’re trying to make the monthly bills? And then your portion of the charges? And maybe the next year, too? You fall off your bike and may have broken something, but can’t afford xrays and treatment, so go without? And that’s supposed to be fine because it’s not hundreds of thousands of dollars?
Minimizing is a core problem with health insurance issues. People want to over-simplify what’s involved.
Roy does have a few paragraphs about Medicaid & the “benefit cliff” as a disincentive to make more money (losing benefits with a relatively low increase in income) and effectively trapping people in poverty (because there is an incentive to make less money to hang on to benefits).
Roy also says that Medicaid is dysfunctional. States are unable to manage their Medicaid budgets without ratcheting down what they pay doctors, which in turn has led many providers to drop Medicaid patients. This results in sub-standard care or lack of access to care despite “full coverage”.
I heard Avik Roy speak on the right-of-center podcast, The Ricochet Podcast (episode: A Healthy Debate). I tried to find a transcript on line, but was not successful. He said something about health care being something the government provides as a right, similar to providing K-12 education for everyone. He said, we don’t look at schools in poor districts as “welfare”; it’s something our citizens need. It doesn’t seem like the new GOP proposal addresses this.
I’m still not clear how the Swiss system works with a combo of free market and social safety net. And, I’m definitely in no position to evaluate the merits of Roy’s arguments.
Like you, I’ve been trying to understand, mostly by listening to conservative podcasts. So far, my questions are not being satisfactorily answered.
@LasMa I don’t know what to think, really. On the surface, it’s hard to comprehend how this will actually help the GOP in the mid-terms and in the next presidential election (when it appears so many people will be worse off).
Then again, maybe it’s mostly political theater and the GOP knows it won’t pass.
@Midwest67 I won’t give my political ideas about what this will do. But just looking at the bill, what is there in it which addresses ANY of the problems with ACA which people have been howling about for 7 years? Does it make insurance cheaper? No. Does it make insurance better? No. Does it cover more people? No.
If the goal had been to make insurance better, there were things they could have done, starting with reestablishing risk corridors to lure insurers back, and significantly increasing the penalty to lure healthy people in. Ask yourself why, instead of incentivizing healthy people to enroll as ACA does, this bill DISincentivizes them.
So if it doesn’t make any sense from an insurance standpoint, how does it make sense? Well, follow the money. Who benefits? Once you answer that question, it all falls into place.
I think that there are several fallacies at work here, especially after hearing Judy Woodruff’s interview last night on the PBS Newshours with the Republican Chairperson of the Budget Committee. She is a representative from TN. She reported that in some rural counties of TN there is only one provider as so many health care companies have pulled out of the exchanges initially created. So… right off the bat, there isn’t any back-up offered. Who knew if any of the companies that initially were created had any capitalization behind them or had secured adequate participation from physicians from the get-go? The Trump/Paul Ryan proposal is “assuming” that because the new plan offers “choice” all of a sudden these providers will rush back or new ones will arise. The second fallacy is that the tax credit offered will cover the cost of medical premiums… based on what? If someone has a tax credit of $4000 but the only plan offered that makes sense in their area has a premium of $8000 where are they getting the balance to pay the difference?
From a dollars/cents point of view this makes no sense. From a moral perspective, it is despicable and totally not a surprise. The positions espoused by our country’s President during the campaign made no sense and either were outright lies or shows someone who definitely lacked an understanding of the entire health care picture. Paul Ryan has been pretty clear about what his mission is/has been all along.
Yes, I’ve read about the YUGE tax breaks in the bill, and I can see where the money is going. However, it doesn’t necessarily add up for me when I think about political costs and voters and upcoming elections.
Impossible to continue the discussion without wading into the politics pool.
Every time I espouse any programs for the working poor or low income groups I’m called a “bleeding heart”. When did compassion suddenly fall out of favor? It seems like if you show any element of compassion or grace you’re considered “weak-minded”.
How can this not pass - it’s the “World’s Greatest Healthcare Plan of 2017”
IN THE HOUSE OF REPRESENTATIVES
March 1, 2017
Mr. Sessions introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and the Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
A BILL
To eliminate the individual and employer health coverage mandates under the Patient Protection and Affordable Care Act, to expand beyond that Act the choices in obtaining and financing affordable health insurance coverage, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; PURPOSES; TABLE OF CONTENTS.
(a) Short Title.—This Act may be cited as the “World’s Greatest Healthcare Plan of 2017”.
@ohiopublic I think that’s because since circa 1981, the idea has been pushed that poverty is a choice. If you believe that, then you’re free to reject anything that helps the poor. You’re free to express contempt for the poor (there was an example of that this week, with the iPhone incident). And you’re free to disparage those who advocate for the poor, like you. And unfortunately, the idea that poverty is a choice is now the prevailing idea of our government.
“Another wrinkle: Anthem, the largest insurer on the ACA exchanges said it will leave the market next year unless the new bill passes.”
It’s not as straight forward as the article in your link suggests. They want Medicaid funding to continue and the ACA subsidies until 2020 (which I thought it did but maybe I am wrong.)
Oh terrific. One of my kids has an individual Anthem policy. This is exactly what needs to CHANGE in the legislation.
My opinion…if Anthem decides to leave the individual market, they cannot broker ANY insurance in states they pull out of. If they want the group market, then they should be required to be part of the individual market.
I am sick of these insurance companies holding all the cards.
But just looking at the bill, what is there in it which addresses ANY of the problems with ACA which people have been howling about for 7 years? Does it make insurance cheaper? No. Does it make insurance better? No. Does it cover more people? No.