Replacing the Affordable Care Act

I don't think it needs to be replaced. Just take out the individual mandate, get rid of tax subsidies, but the basic legislation is still there. People will still be able to sign up for it (assuming their state wants it) and it will be like a standalone medicual insurance program that thrives or dies on its own merit.

Who could you blame for saying "Here is the freedom version of obamacare, if you want it"?

 

It was not a government imposition when conceived as an inexpensive perquisite that private businesses chose to offer.

In any event, since everyone has potential medical cost liability, those who happened to be employees of private companies are no more likely or less likely to requite heath insurance, so insurance through an employer, even if it were not heavily subsidized by the federal government, is a senseless choice to be accorded special treatment.

 

If you do what you suggest, the entire ACA simply goes away.

And, that would include all the policies of Americans today, as whatever would happen next would certainly be different enough that all corporate and private plans of today would no longer be attractive to insurers.

The reason for the mandate was that insurance companies can not afford people jumping in when they get sick. Dropping the mandate ends too many central assumptions - including for employers.

The ACA is a balancing act constructed to keep insurance companies, providers, and the insured in reasonable shape. The GOP idea that radical change can be made without killing all policies is a political lie. Let's remember that the move to the ACA caused insurance companies and employers to change their offerings. Gutting the ACA would just as surely end today's policies, but would leave us without a consistent set of rules for employers and insurance companies to use in figuring out what they can offer.

The ACA can be improved, but if we decide to trash it, we need to have a replacement plan that we like. And then, like with the ACA, there needs to be a transition plan.

 

He knows that

 

This was actually pointed out by conservatives back before it was implemented. The rebuttal was that we should at least give it a go, and if it dies, then it dies.

Besides, it wouldn't actually go away. It would be more like another one of those 'no walking alligators in central park on sundays' laws. It's on the books, at least. That way obama has his legacy.

 

Maybe, but I see no evidence of that. His proposal would trash every plan in America today, even impacting Medicare and Medicaid, while suggesting no baseline for the design of new offerings by insurance companies and employers - no statement on preexisting conditions, no statement on dumping sick patients, no statement on portability when changing jobs or retiring, etc.

My guess is that wit out an actual replacement plan we would revert to the 1980's or so - before our previous health care system was revamped.

 

That is absolute nonsense. No insurance company is going to write policies based on dead laws. And, corporations will not do that, either.

 

I doubt it would be that good

 

The only law insurance companies need is the ability for two or more parties to enter into a legally binding agreement. Anything else is unnecessary, and quite frankly, unamerican.

 

I wouldn't give points for wisdom to any political entity, other than that the conservative view is for accepting responsibility and the liberal view is for getting others to do it for you. That part is quite consistent. I never post anything without expecting some knee-jerk reaction from an armchair expert.

Are there more covered? Yes. Why? Because if you didn't want insurance, the ACA forced you to take it or be fined.
Are there more who previously couldn't get insurance covered? Yes. Why? Because we have forced the cost of their insurance to be spread over those who didn't need insurance in the first place, inventing a sort of forced support of welfare. The ACA wanted everybody in the same pool, including against your will, in order to do that. When somebody else has to pay your bills, both those paid and those paying are worse off. Dignity and self respect are less impaired in an individual when the government gets in the middle and tells you that someone else owes you, however. Doesn't change the reality, just the perception. It's still a free ride at someone else's expense.

The $5 aspirin is just an example of the gross excess that medicine has become. I didn't say the ACA caused all the expense- I said it complicated it, failed to address it, and thereby did not reduce costs- but it made things more difficult. Paperwork and regulation has exploded. That is overhead that costs money- but does not produce value in return. Doctors hate it. Hospitals hate it. Most insured hate it. And when we talk about making sense, consider that there is now a short calendar window to sign up, like it was a seasonal sport. If you make enough regulations for anything, you will either kill it off or make it incredibly expensive. The government does both of these- but what it doesn't ever do is make things work fairly and efficiently.
If you like the idea of helping those who "can't pay", feel free to do that with your money- but when you advocate doing it with other peoples money by force of law, you have crossed a line that enters into moral corruption.

Life works on simple principles, and all the species of the earth thrived on those principles for millions of years- until man came along, and eventually decided he was so smart he could re-write the rules. When we act as individuals, we take individual responsibility- and consequence. We we try to force everybody to support some person's idea of perfection, we destroy other persons ideas- and right- of perfection. That is the liberal mind, always willing to force something on others for their own good. That is always a long-term disaster. There are exactly the same number of people on earth as there are that need to be cared for. If each takes care of one person, none go uncared for. But when some liberal sees someone else doing well and decides that they should be entitled to share in it because it's "fair", the real greed comes out- the desire for benefits and money that you haven't earned. That is the core principle behind the ACA, Bernie's free lunch program and a lot of other crap. They pass garbage laws like that because there is always people who think that there should be free rides for those who won't walk. "Free" always sells well to those who aren't paying the bills.

We are not smart enough to re-write the natural laws, although many believe that... hence the horrible state of the world, all a result of the endless stream of great ideas that all shift our burdens to someone else. ACA is another award winning loser on that list.

MAN is the most dangerous animal that has ever existed, and the only one who has a high probability of being the primary cause of it's own extinction. The government could serve the nation a lot more effectively on all issues- including health care- if it would stop having grand ideas and just get the hell out of the way.

 

False premise, that any such nation, 1st world or other, needs such a system.

 

A a pragmatist, I am always open to demonstrable superior paradigms.

Airy fairy "ideologically correct" pipe dreams might abound, but offer no practicable possibilities.

 

Nothing here changes the fact that you proceed from the false premise I described.

 

You can pretend that a premise is false, but you, apparently, cannot offer an alternative approach that is validated by reality anywhere.

I'm sure many folks entertain fanciful notions, but what actually works best is a different matter.

 

Another false premise -- that for your premise to be false, I must offer an effective alternative.
In fact, for your premise to be true you must demonstrate the necessity of the system you describe.

.

 

I may have missed something, but it appears that you don't think we need healthcare for everyone?

 

Yes. Pay better attention.

 

I agree that insurance companies don't need more than that. But, our health care system isn't guided only by what insurance companies want.

Health care is not a commodity like other commodities that we can simply allow to be part of the free market system. The root catch is that when someone gets sick, they don't have a choice between health care and subscribing to Netflix. And, when someone shows up at the ER, they will be served, whether they have insurance, can pay, or none of the above.

 

Food is part of the free market system; people need food more than health care.
That being the case, why shouldn't the goods and services that make up the heath care system be part of the free market?

 

uh, dying of starvation can be avoided for less than $5. Dying of brain cancer can't be avoided for less than $50K.

see the difference?

 

When you have a heart attack your not in the position to shop around for the best price, without insurance it's how much is your house worth, we're going to take it all!! And you have no choice but to accept or die. (it's not a free market)
Insurance companies have buildings full of lawyers with one goal, to deny your claim, that's where they make the big money.

Teriffic system, let's go with that.

 

Yes. The difference is that the "free" market keeps people alive for five bucks, and the government keeps people alive for 50k.

Is it any wonder prices are so high? If you were in the market for a used car, instead of health care, you'd drive off the lot in an ancient ford pinto for 100k complaining about high prices, and thank jesus for the affordable car act.

 

uh, food is regulated by the federal government.

no idea where you are getting these comparisons from. Hospitals can charge anything they want for services. Pharmaceutical companies can and do charge whatever they want for life saving drugs. If you are dying you have no choice on where to go, or what medications to take to save your life. Healthcare is by definition not compatible with the free market.

 

You can buy ACA compliant insurance any day of the year. The sign up periods have to do with applying for support.

Health care costs have NOT ballooned due to the ACA. So, your comments about overhead and $5 aspirin are not supportable.

Everyone who walks into an ER will get served. Your "go help someone with your own money" solution does not solve that. And, it doesn't solve the problem in general, either, as there is no possibility of your solution achieving any measure of distribution.

As I've said in the past, I've never been a fan of the ACA (accept that it is superior to what we had before!).

Every industrialized nation spends LESS than we do per person on health care, and they do a FAR better job than we do in ensuring that citizens get health care.

I don't get it.

Why are you opposed to that?

Why would we follow some pure ideology such as you project even when we SEE systems that do a far better job for less money? Don't you have any ideology concerning THAT?

 

Some of it, sure. Now try and think of some aspect of health care that isn't regulated by the federal government. How much is "free" like medicare, medicaid, the VA, and then you have the AMA requiring extremely expensive education before you can even practice medicine.

There really would be mass starvation if food was as heavily controlled as health care.

They do what everybody else does, and charge what the market can bear.

No matter what you think, healthcare really is the same as any other service. You'll pay whatever they can get you to pay. The only difference between food and health care is that health care is a lot more regulated. The more you think "it's different and I need this, and the government has to help me pay for it!" the more it will cost.