Obamacare…
✔️ Is not responsible for the rising cost of health care
✔️ Does not affect the quality or extent of health care you receive
✔️ Aggregates insurance plans and provides a choice of plans
✔️ Did allow millions of Americans to obtain health insurance
✔️Did remove restrictions on pre-existing conditions
✔️ Did allow adult children to remain on parents coverage to age 26
✔️ Did require certain health care services (birth control, colonoscopy, etc.) to be reimbursed thereby lowering out-of-pocket costs for individuals – but also adding to the overall cost of premiums because premiums overwhelmingly reflect spending on health care
✔️ Did not automatically save each person $2,000 especially if you see that as premiums alone, but did substantially lower spending for millions thus did save some people that much or more
✔️ Required insurers to spend a minimum percentage of premiums on health care or return the excess
✔️ Did, but no longer does, require a person to have insurance – eliminating that mandate was a mistake as it adds to adverse selection
✔️ Provides an annual period when anyone can obtain coverage
✔️ Subsidizes premiums based on a needs basis. Since ACA did not lower health care spending, this may be construed as artificially making health care somewhat affordable. However, the same principle applies to Medicare and employer plans where the premiums are subsidized
✔️ Expanded benefits by requiring coverage for essential health benefits. This expansion was initially reflected in higher premiums for all plans, but also lowered out-of-pocket costs and encouraged use of preventative services
✔️ Claimed you could keep your doctor. That was essential true, but overstated especially for people enrolled in limited coverage plans. The vast majority of people were unaffected. The issue mainly affected people buying individual coverage on their own, who made up about 5% of Americans at the time. The approximate 60% of Americans under age 65 who have health insurance plus the 60+ million on Medicare were unaffected.
Did Obamacare make healthcare affordable?
That depends on how you look at it. It did nothing do lower premiums beyond subsidies so we can argue over that.
It did lower out-of- pocket spending on healthcare for tens of millions of Americans, even those who do not use the Affordable Care Act.
And that’s the truth‼️
QUINNSCOMMENTARY 
unfortunately your idea is not practical in a population of 340 million with vastly different needs, abilities, intelligence and levels of personal responsibility. Your corporate experience should tell you that.
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Actually, my corporate experience confirms that my solution would work – certainly much better than what is in place today, and absolutely better than some Medicare for All, cost shifting, vote buying crap.
My solution works because every American and individual who is lawfully present must be (or become) individually responsible for the base level of coverage – which they can source from Medicare, Medicaid or the VA – and where not eligible there, from the individual coverage in the exchange, or an employer-sponsored plan … just like today. And every American and every individual who is lawfully present must fund the stop loss coverage.
No free riders, means all Americans are likely to support a process where all who benefit are funding the coverage – with the exception of those who are unable and qualify for Medicaid.
Everyone else who is neither an American citizen and who is not lawfully present as a resident, including those who come here for vacation, and those who come here illegally, are individually responsible for their medical treatment other than emergency stabilization under EMTALA.
No, Americans who are used to politicians pandering and giving stuff to buy votes won’t be happy. As you know, any policy designed to make everyone happy is doomed to failure. My structure is designed to make health coverage affordable by assigning that which is budgetable to the individual and that which is not budgetable to society.
Feel free to suggest a different allocation, and show how it is superior, meets the common sense test such that it would be acceptable to Americans, in general. Frankly, we don’t give a care what others who are not citizens and those who are not lawfully present think.
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Al Lindquist
FROM THE RIGHT WING EDITORIAL BOARD AT WASHINGTON POST–THEIR THOUGHTS FOLLOW
cost is rising on average by 26% annually and that is not affordable.
24 million enrolled 22 million receiving subsidies.
KFF says premiums would double if tax credits established during pandemic expire.
Democrats holding hostage the government so Republicans would extend subsidies.
$350 billion estimated 10-years cost (CBO) of subsidies which were supposed to be a temporary fix.
Milton Friedman; “nothing is as permanent as a “temporary” government program.
system now fragmented–tax-subsidized employer plans and other programs to fill the gap.
system is stupid but politicians fear backlash if they try to rebuild along rational lines.
Americans are satisfied but would be leery of giving it up for an untested scheme like Medicare for All which would require massive new taxes.
Obamacare–grafted patchwork systems onto existing patches–a 3 legged stool of regulations, mandates, and subsidies.
ACA exchanges did not work.
in 2010 CBO projected 21 million would buy exchange policies in 2016–actually 12.7 million did.
under the guise of pandemic exigencies Democrats in 2021 massively boosted subsidies including offering them to families that made 400% of federal poverty line. Enrollment more than doubled as the lavish subsidies increased demand for health care but not the supply.
for Democrats and Republicans the solution is to shovel more tax-payer money into even more subsidies even though the national debt is $38 trillion.
My words now–as usual the big lies now bring us massive costs which add to the debt (who pays for the subsidies?) and the usual loons on the left tell us Medicare for All will pay for itself just like the ACA promises were born of lies and deceit–like almost everything else subsidies seemingly raise the cost of what is being subsidized–another big government program that does not pay for itself. as the debt just keeps on growing.
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Sorry, wrong. But if you don’t like Medicare for All or Obamacare what is your idea?
Why do you think Medicare 4 all would cost more than what individuals, employers, healthcare providers and government are spending now?
Where do you see the additional cost?
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Sorry, wrong. But if you don’t like Medicare for All or Obamacare what is your idea?
I shared my concept of base and stop loss, more than once. I have yet to see anyone offer something better. Instead, every other proposal I see reconfirms pandering. That is, Americans want the best coverage YOUR money will buy. Medical services are an entitlement, a basic right.
My proposal properly assigns liability – what is appropriate for an individual to bear is in the base coverage, and what isn’t appropriate for an individual, isn’t appropriate for their employer either, so that lands in the societal bucket. I arbitrarily say the societal bucket is any expenct > $25,000 per person in a calendar year. There should be point of purchase cost sharing comparable to today, in order to keep the premium cost down. I am open to other suggestions in terms of the dollar limit. However, the cost of a $25,000 health insurance policy is doable for all Americans – where Medicaid, Medicare and VA coverage are capped at $25,000 per person, per year (and can serve as base coverage for low income, older Americans and veterans without coverage alternatives). Every citizen (and lawfully present individual) must be covered automatically. Everyone else, including aliens who are claiming asylum have no coverage other than EMTALA. All costs for aliens are out of pocket. No exceptions. Where a citizen/lawfully present individual fails to pay their premium, treat it as an unpaid income tax. Funding for the stop loss is a per capita tax.
Why do you think Medicare 4 all would cost more than what individuals, employers, healthcare providers and government are spending now? Obvious, look at the change in national health expenditures since Health Reform – when we reduced the percentage of uninsured. We went from spending about $2.5 Trillion a year where today we are spending $5.3 Trillion. So, unless you are going to cap reimbursement rates for everyone at Medicare allowable (essentially placing providers into indentured servitude where they lose a little on every service) or Medicaid/VA allowable, which is only 75% of Medicare allowable, expect to see individuals who have their coverage for free (no premium) use services whenever and however they please. Dick you know this. Medicare 4 all, as pitched today by Bernie and others, has no point of purchase cost sharing. Do you really think utilization won’t spike!?
Where do you see the additional cost? Utilization, Utilization, Utilization. Where patients (and their providers) don’t have any limits, you either get massive tax increases or you get rationing.
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