Republicans are always talking about how the “free market” will fix everything.
They’re the ones who insisted that the free market be a component of the ACA.
That free market component is the only part of the ACA that isn’t working well.
Any chance the Repbublicans will admit that the free market isn’t all it’s cracked up to be and that we should just expand Medicare to cover everyone?
My company BCBS when up so much the first year of ACA that they switched to UHC. I always assumed it was because BCBS was doing that to cover their participation in ACA picking up folks they knew were probably sick because they were poor and unable to get treatment.
Well it could be if the companies weren’t greedy bastards. Per a 20/20 or 60 minutes episode a while back about how other countries do health insurance, I believe Germany uses private but well regulate private companies that have to operate without profit. Their incentive is they can pay themselves better if they operate efficiently.
Thanks for this great article. The problems are indeed fixable, but it will take a Democratic House and Senate to enact them. In other words, get out and vote!
If private insurance can’t cover Americans without ripping us off, it’s time to offer everyone a government-provided, medicare-for-all, option.
“Free Market” is BS. Any “free market” will quickly become manipulated by its powerful players unless it’s regulated - proper regulation being, ironically, the only thing that can keep a market free.
Republicans lie about free markets because they’re paid by the forces working to manipulate them.
Not quite. Private health insurances in Germany are for profit, but there is an equivalent to Medicaid that is open to all employees. Self-employed Germans have to purchase health insurance on the open market. Salaried workers above a certain income threshold are free to also purchase private health insurance, which can offer higher service levels (i.e. individual hospital rooms rather than room sharing, the freedom to pick whatever specialist you want to see etc.). I.e. the “German Medicaid” is a base line health insurance, but it does include dental.
In addition there is a ridiculous amount of not-for profit health insurances that are supposed to compete to keep the price down. This only works on paper, and is IMHO a huge wast of money by duplicating administrative structures. I like the way it’s done up here in Canada (Ontario) much better. Just one public insurance for everybody, KISS principle at it’s best.
So much depends on the willingness of GOP lawmakers to come to the table for a compromise fix, and politics will play a major – if not a deciding factor – in the ACA’s ultimate success.
That will never, ever, happen. Ever. If the ACA is “fixed” then it succeeds and the last thing the GOP will ever do, is allow Obama’s signature piece of legislation to succeed. They don’t care how many people go broke or die, they don’t care what parts of the economy suffer, they won’t ever work to fix it. Ever. If anyone needs proof, just look at the past 7 years of their previous attempts to “fix” it.
The only way to ensure the viability of the ACA is to remove Republicans from Congress AND remove them from state legislative bodies which have worked hard to stop parts of the ACA from being implemented in their own states.
Fixable? Of course it’s fixable. Move people off the exchanges and into Medicare.
The last point is key. “Real but fixable” is meaningful only if you have a Congress interested in fixing the problems. That is going to require members of Congress to stop being partisan Republican hacks and start being members of Congress.
Making the fixes and adding the public option as described in the article make sense, and with any reasonable cooperation and compromise could be done. But, therein lies the problem. It’s so much easier, especially in this election year, to yell “Obamacare disaster - repeal and replace” and give absolutely no viable alternative.
The idea that the problem is “lack of competition” is dogmatic and ridiculous. With insurers required to have at least an 85% medical loss ratio (i.e. they have to spend at least 85% on payments to providers rather than administration and profit), there is very little room for competition to make a difference, unless it’s competition to create spammy plans that try to force out sick people by, e.g. restricting the drug formulary.
The problem is provider charges. Period. Because there really isn’t any constraint on those other than those insurers negotiate, and all those do is raise prices for everyone else.
This is the real place for “pay-to-play”. You want to sell insurance of any kind in my state? Create market-competitive Obamacare plans. No competitive Obamacare plans? No customers at all.
It’s so much easier, especially in this election year, to yell “Obamacare disaster - repeal and replace” and give absolutely no viable alternative.
I would disagree with that insofar as many more people who now have health insurance who didn’t have it before, would need to be told exactly what the replacement will be. We never anticipated that SCOTUS would hobble the ACA so badly as to allow states to opt out. The people who DO have it, however, need to know exactly what they’re getting as a replacement (or, as the Rethugs would say, “nothing. You get nothing”)
The ACA was always meant to be a stepping stone to something better. Preferably a public option. However, if that STILL isn’t politically possible in this environment, there’s no doubt that drug price control will, least, at be on the agenda of Madame President’s administration…
Anytime I encounter someone talking about the “free market,” I ask them if they want to eliminate patents, trademarks and copyrights.
The market isn’t truly free until I can sell my own iPhones or publish my own Harry Potter books.
Democrats have touted the benefit of this legislation, by talking about how many more people have insurance now. They don’t seem to understand the difference between access to health insurance, and access to health care. How much are copays and deductibles under these plans? The costs for those may just be so prohibitive as to make going to the doctor not much better with this insurance, than without.
The legislative fixes to this bill aren’t very palatable, either. To get healthier people to sign up for the exchanges, Congress would need to increase the penalties. That wouldn’t go over very well. Congress could also increase the subsidies to encourage people to sign up. That would just be a back-door subsidy to insurance companies. Or, they could approve direct subsidies to the insurance companies, to encourage “competition” by pulling more of them into the various markets that they’ve abandoned.
Democrats, and cheerleaders for Team Blue, have been forced to defend this legislative turd, because it’s Obama’s bill. They do this, even after he sold them out on single payer, and cut deals with Pharma to block Medicare from negotiating drug prices, among other things. And, he played them for chumps by dangling the public option, which is nothing more than a bait-and-switch scheme, to cut off single payer.
The Republicans oppose this legislation for (mostly) the wrong reasons, but that doesn’t mean that they’re wrong to do so. After all, hardly anything gets done in Washington for the right reasons.
I am curious on how we allow health insurance companies to service Medicare, and not insist they service the ACA? Pretty sure Medicare participants are not the healthiest of people! They are evidently making a profit on Medicare clients. Taken together (ACA, Medicare, and Medicade). They should be looked at in total, not allowed to break out ACA as unprofitable.
Our ACA was supposed to contain costs and make health care affordable. It did bring coverage to 20 million but 30 million remain uninsured. Data indicate that the bad outweighs the good. It’s too expensive, unsustainable, overly complex and bureaucratic. Even worse, it’s a gift to private insurers and other corporate stakeholders and profiteers in the medical-industrial complex, eg the health costs for a family of 4 covered by an average employer PPO are now $25,000! We could save $500 billion a year by enacting a nonprofit single-payer,
“MEDICARE FOR ALL” national health program. Those savings would be enough to guarantee everyone high-quality care, with no cost sharing, on a sustainable basis.
To protect profits, the private health insurance industry and their Congressional supporters oppose universal Medicare for All, or single-payer/public health insurance. Private health insurance companies know that with low administrative costs and no need to produce profits, a universal Medicare for All insurance plan would have pricing advantages for the American public since health care would be financed through progressive taxation as a public social service.