As Rosered said, the ultimate fix is single payer.
Barring that, ACA could be improved by including the public option, which Obama wanted at the start, but dropped in a (futile) effort to get bipartisan support. That could be an option for people like @lje62 .
We need a compromise plan that addresses some of the shortcomings in the current ACA.
Thanks for that @sherpa. Frum is an amazing writer and speaks my mind.
There are several options if they worked together. Obviously expanding Medicare is one way and people or companies could purchase secondary coverage just like those over 65 can do now.
Switzerland has an interesting national program which we could actual get to within the framework of the ACA. They have a highly regulated insurance industry and a requirement that every person must purchase insurance. The maximum cost you would spend is 8% of your income for the cost after that you get a subsidy. They have created incentives for behavioral changes to improve health by rebating previously paid premiums for lifestyle changes that improve health.
Such as a type 2 diabetic loses weight and exercises and no longer has the diabetes would get a rebate of some form. I read the plan a year or two ago so I will have to go back and look into again.
The Swiss recently had an election to go full single payer but I believe 65% voted to keep the current system.
I should add national health care is not the end of a capitalist economy. Look at the ranking of CATO’s freest world economies and all of them have a national system but the US.
Re: #623
The Switzerland system also has everyone purchasing medical insurance as an individual, without the distorting effects of many more people getting it from their employers versus purchasing it individually.
Yes and I actually think the ACA could become that system,
I think if we went to Medicare for all the option to buy supplemental insurance would be available.
IMHO either option is better than our current or previous systems
Yes, great link. All should stop to read it. The divisiveness 7+ years ago got worse. It’s time to think rationally about this huge country, its common and its disparate needs. We can tone down the rhetoric and extreme stands that only serve to roadblock real improvements.
I also like the Medicare example, but we can’t just leave people with the Medicare Part A minimum.
Although my policy preference is Medicare for All, right now we need to think of centrist policies that could be enacted now to help people who need help now. Some suggestions: http://chirblog.org/fix-it-dont-end-it-common-sense-prescriptions.
Medicare as it currently exists is much more confusing and complicated than it could or should be. Many/most buy supplemental Medicare Advantage (MA) or Medigap plans, otherwise the beneficiary is on the hook for 20% copay with NO CAP, that most folks can’t handle.
Personally, I find these supplemental policies mind boggling and a handout to the insurers. I read that insurer get $10K per person they get to sign up for a MA policy–that’s a LOT of money that could help remedy a lot of issues in the current system.
That $10K that Medicare Advantage plans get is for health care. If you take away the $10K, you take away the healht care-- it’s not like doctors and hospitals provide health care for free.
But it’s a simple and smaller, more consistent, range of options. And every supplement I looked at was far less costly than the exchange options.
Agree that a simpler, more consistent set of options which include annual caps on out of pocket expenses would be MUCH less confusing. The alphabet soup in all the different Medicare options is bewildering.
A traditional Medicare enrollee costs the government $10k (perhaps a little more), so it is not like the government loses money if a Medicare enrollee takes a $10k voucher to buy a Medicare Advantage plan instead of using traditional Medicare at a cost of $10k.
I am on Medicare with a supplemental plan. I do NOT have Medicare advantage.
I have two kids who have individual insurance, one subsidized,and one not.
My husband has a company provided insurance plan.
Medicare is far and away the easiest to use. It can be used across state lines with no issues. My supplement happens to be an excellent one (which I pay for) that includes my RX, dental, vision, hearing, and medical. I’m very fortunate to have access to this plan.
Everyone else in my family pays more per month (and that includes the portion my husband pays for his employee plan), as well as more for all of their medical services…than I do with my Medicare and supplemental plans.
My only gripe about Medicare,.,when you need to call them, you can sometimes be on hold for a while.
@himom not sure why you find this complicated. It really isn’t.
It does seem so, when you first broach it. I got so much mail, mostly advertising, which stacked up. I am on MA (BCBS) and supposedly have my own concierge-like phone support.
I have not had personal problems with it, but I must say their customer “service” leaves much to be desired. We applied and thought H got part B but wondered when we’d get the card. We spent 2 hours in line trying to talk to someone. We finally spoke with a guy who said his application was NOT processed because he did it wrong. The next day, H went back and waited (much shorter line because state but NOT fed holiday). He turned in the EXACT same paperwork and was instantly signed up! It we had done it any later, we would have been hit with a lifetime 10% penalty because some clerk didn’t like the paperwork that others found just fine!
I know quite a few intelligent people that are intimidated by all the different plans and hype about why they’re great. We plan to keep our A, B and H’s employee health plan. That should provide enough protection for yes.
Potential effects of policy actions within HHS on ACA:
https://fivethirtyeight.com/features/the-future-of-obamacare-is-in-trumps-hands/