Beginning of a GOP alternative to Obamacare?

[Katsmeow]

Of course that situation does not exist today, but I thought this post was about coming up with alternatives. That would be the best case solution from my perspective.

Well, we were discussing the specific alternatives suggested. Those alternatives that let insurers sell across state lines don't set up minimum regulatory standards. That is the point. They allow exactly the problem situation...insurers running to the state with the least regulation.

 

[mpeirce]

Those alternatives that let insurers sell across state lines don't set up minimum regulatory standards. That is the point.

It is (part) of the point.

One problem with "minimum regulatory standards" is that they grow and grow over time (rarely going down).

And one big reason they grow is that interest groups (they're all "special") have a incentive to get get their treatments into the minimum standard. Everyone should have dental - says the dentist. Then the orthodontists make their case and get their services included. Same with chiropractors, acupuncturists, herbalists, homeopathy, and on and on. This is a form of regulatory capture where the various provides are have huge interest in getting their noses under then tent.

And while there's some case for each incremental "improvement" to the standard, after a while, costs end up higher than we can really afford.

 

[eytonxav]

Well, we were discussing the specific alternatives suggested.

Sorry, I didn't realize we had to stick just to Walker/Rubio proposals. Thanks for being a moderator

 

[Katsmeow]

Sorry, I didn't realize we had to stick just to Walker/Rubio proposals. Thanks for being a moderator

Sorry. Not trying to be a moderator. "We" was an inartful meant to refer to
what I thought was what you and I were discussing which was the current proposals that had been made. I think that you and I are in agreement that selling across state laws with consistent regulations could be workable.

mpeirce -- yes I agree that regulatory standards can be problematical. At the same time, having no minimum standards ends up with every insurer wanting to go to the state with the least regulation where they can raise rates with impunity and there are no consumer protections. I am on view that the "cure" for the problems of bad regulation isn't no regulation. It is better regulation.

 

[mpeirce]

mpeirce -- yes I agree that regulatory standards can be problematical. At the same time, having no minimum standards ends up with every insurer wanting to go to the state with the least regulation where they can raise rates with impunity and there are no consumer protections. I am on view that the "cure" for the problems of bad regulation isn't no regulation. It is better regulation.

Keeping on topic, Rubio's proposal allows states to opt out of the existing mandates.

That coupled with cross state insurance means some will have relaxed standards, while others won't. Then people can choose which plans from which states they want.

The system would then benefit from market feedback on what bundles of coverage people actually value and are willing or not willing to pay for. That seems better than some "smart person" in Washington telling us all what is best for us.

 

[Gotadimple]

The system would then benefit from market feedback on what bundles of coverage people actually value and are willing or not willing to pay for. That seems better than some "smart person" in Washington telling us all what is best for us.

Except most healthcare insurers will make up "packages" of desired coverage based on utilization and on focus groups.

Market feedback becomes a moot exercise. People don't know what they need. Today you feel well, and only see a doctor once a year, sometimes you just go to the pharmacy for a flu shot. This afternoon, you get hit in the parking lot as you roll your grocery cart to your car. Now you need hospitalization, physical therapy, and drug therapy.

If healthcare was really a commodity, then people would pick packages of coverage. But healthcare is not a commodity when we hold others accountable (work site injury, automobile accident, tobacco companies) for our health.

For the most part, the two politicians' plans are election rhetoric. That's health care coverage by committee and anything designed by committee is guaranteed not to work for everyone.

- Rita

 

[jim584672]

You can bet if the government is giving a tax credit they will certainly have a say in what is policy acceptable or not.

The Walker proposal seems to just pick credit amounts out of thin air. Unlike the ACA which is based on the second lowest cost silver plan. The problem is, you know how these things go, first everyone gets it, then they start means testing, then they don't adjust for inflation. Eventually it becomes like the $255 Social Security burial benefit which hasn't been changed in decades.

These proposers are philosophically opposed to this, so they will do something that sounds good up front, then gradually weaken it to uselessness.

 

[Mulligan]

Editing to add: I know this not on topic. I just wanted to share what my employer is doing to avoid the Cadillac tax due to ACA, which I thought might be interesting to others. No responses necessary.

I'm not sure this is true. My employer is going from an HRA to an HSA next year - which I'm happy about - in order to avoid the "Cadillac" tax.

I would assume this would be true for most employers. I'm skeptical many will pay the additional tax, since human nature indicates we are all well conditioned to minimize our taxes. Companies aren't exempt from that condition.

My GF is nervous about this. Nothing is coming out from company but I imagine a $150 yearly deductible is close to the "Cadillac Plan". It is union negotiated and current contract expires in 2017, so I imagine that is where it will get negotiated. No way a company of thousands will pay an additional 40% tax on top.


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[Live And Learn]

If Obamacare went away my husband and I would have to go back to work effectively ending our early retirement.

He's had controlled high blood pressure for more than 10 years and when I looked into private plans before ACA was implemented the cost of insurance was undoable for us.

Ditto for me also. Both DH and I were considered uninsurable in the old days.

 

[MRG]

Ditto for me also. Both DH and I were considered uninsurable in the old days.

+1.

I'll be starting a new j*b if insurance goes back to underwriting. :thumbdown:

 

[audreyh1]

I just find going back to medical underwriting unimaginable.

 

[ejman]

I just find going back to medical underwriting unimaginable.

+1000. Medical underwriting almost derailed my ER 12+ years ago after I found out I could not buy any health insurance because I had a history of high BP (controlled with medication) and my wife had carpal tunnel. Finally in desperation I had to go to all kinds of contortions and create a business just so I could get a group health plan (FOR TWO PEOPLE!) so I could buy very high deductible health insurance for an astronomical price. What a nightmare!