Posted on 07/11/2019 5:42:55 AM PDT by DoodleDawg
So, you're telling me that they don't compete for business, other than the myriad ads we see?
Sure. I can look at an EOB and see what rate the insurer actually paid to the provider. Now there are often other payments and discounts based on management metrics that we can’t see but combined with the insurers’ public financials we can get a decent feel.
On the other hand, the allocation of uncompensated care costs between the providers, insurers, including various government entities, not to mention legal and bankruptcy costs, is super murky.
Imagine Reagan saying:
"Tear down that wall and replace it with high tech surveillance"
or
"We seek to topple the evil of Communism and replace it with a kinder friendlier form of totalitarianism"
You see ads in areas where they do business. You won't see adds in states where they don't.
With Medicaid and Medicare we're never going to reach that point again. But Obamacare itself could be dead by next June, if not sooner.
Most people think "selling insurance across state lines" means that a low-cost insurer in Mississippi will be able to sell plans in New York with very low premiums. That's not the case at all. For one thing, there will be a major cost for the insurer up front to set up contracts with a network of doctors, hospitals, etc. in New York. And you can be damn sure that no doctors or hospitals in New York are going to accept Mississippi reimbursement rates for their procedures and treatments.
This is why most figures I've seen suggest that a fully operational system of insurers selling across all state lines would probably only result in about a 5% reduction in premiums.
It's highly unprofitable for the reasons you state. If an insurer has no network established then they are at the mercy of whatever the medical provider will charge. Since they have no network, then any claim the insurance policy holder makes will be covered at the out-of-network rates so the policy holder will pay far more as well. It makes zero sense for either side to enter into that kind of deal.
One could substitute almost any word for Obamacare in this headline, and it would inevitably be true. The GOP is a phony political party (excluding Trump) that needs to be banished to the ash heap of history. Unless they are going to be a party of limited government, they have no reason to exist since we already have a party of big government, namely the Democrats.
True....but inevitable..... no matter where the threshhold
What exactly is sustaining obozocare? When the mandate was lifter that should have been the dagger in the heart for it.
Government subsidies.
I forget who it was when asked what R’s had to replace Ebolacare said “If you put out a fire, what do you replace it with?” Thomas Sowell, I think.
Seriously, if things are worse now than before passage, then it’s self-evident that standalone repeal would be an improvement.
Now, would there still be room for reform? Sure, but it has to do with damage done by previous rounds of government “help”, not with the minute amount of freedom that survived in the healthcare market pre-ACA.
If the court strikes down Obamacare in June of 2020 then 5 months before the election the pre-existing coverage requirement, the elimination of caps on coverage requirement, and the coverage of dependents up to age 26 requirement all are struck down as well. While Obamacare as a whole may not be overly popular, those three aspects of it are the exception. So five months before the election the Republicans will have to explain why they eliminated those three popular features and the Democrats will have an issue that they can run against. And if McConnell really thinks that Congress would "act quickly, on a bipartisan basis" to fix it then he really is a colossal idiot.
Reduce costs, reduce taxes, take away the “individual mandate,” but still ensure people that want healthcare have the ability to purchase it
The whole problem, succinctly stated, in one clever, incoherent sentence.
The reason the Republicans can't crack this nut, in fact, the reason their party won't exist as a single party by 2024, is that they are divided and unable to be reconciled over the contradiction so ably stated above.
"Ensure people that want healthcare have the ability to purchase it"
Let's break it down:
Nobody "wants" "healthcare" (whatever that is). I suppose the author of the sentence means "health insurance".
People either need health care (meaning, hospitalization, surgery, medications, doctor visits, Xrays, MRIs, and nursing services), or they don't. WHEN they need it, they want it (or are too sick to know they do), but when they don't need it, they most certainly don't WANT it.
When people NEED hospitalization, surgery, medications, nursing services and all the rest, (and notice how much people don't want to think about that - they invented the euphemism "healthcare" to describe it) - when they need it, "having the ability to purchase it" is absolutely, totally, 100% completely the last thing on their minds. So is organizing society so that it will be available. What is on patient's minds at the point of need is death, or life - disability and disfigurement, or recovery. They do not know, or care, who pays, or how.
So, the Democrats have resolved the philosophical question that comes before the practical problem. They want to ensure that "healthcare" (by which they mean services) is given to all by the government without regard for ability to purchase (pay for) it. Whether this is right or wrong, smart or stupid, practical or akin to skittles from unicorns is not my point. My point is that they have resolved the contradiction embedded in "lower costs, lower taxes, no mandate, ensure ability to purchase (pay for it) for 100% of the population". The Democrats know what they want, and they are united and determined to have it.
The poor, stupid Republicans, OTOH, are divided about the underlying premise. They really do want health insurance to be cheaper without the lost revenue being made up by taxes, and they want no requirement to have it, BUT they also want "people that want healthcare" (again, whatever that means) to "have the ability to purchase it".
This is incoherent. If hospitals, surgeons, drug manufacturers and nurses do not get paid for their services, they will no longer be available. Many, many people who NEED (and therefore "want") those services cannot pay 1% of what they cost. "Ensuring that people that want healthcare have the ability to purchase it" either means cheap insurance that doesn't cover anything OR nationalization of the resources to deliver care to those who cannot, or will not, pay.
There is no middle ground. The Democrats know what they want. The Republicans don't.
As Sun Tzu said, "It is said that if you know your enemies and know yourself, you will not be imperiled in a hundred battles; if you do not know your enemies but do know yourself, you will win one and lose one; if you do not know your enemies nor yourself, you will be imperiled in every single battle."
The Republicans do not have a plan because they do not have a philosophy that can support their opposed goals of more freedom for the well and perfect security for the sick.
+1
Republicans didn’t eliminate it if it was unconstitutional. In fact they’ve done next to nothing to interfere with it.
Anyone who votes to diminish individual autonomy and give the power to a private collective or to the government should be tried for treason and executed if guilty.
Republicans are the ones fighting in court to have it declared unconstitutional and the current Republican administration is supporting that effort.
And the voters know that.
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