My View: GOP shot at Obamacare is DOA
March 19, 2013
Last week Rep. Paul Ryan kicked off budget discussions by inserting a poison pill into any compromise with Democrats: making repeal of Obamacare part of budget negotiations.
With Democrats holding the Senate and the presidency, the GOP’s attempt to repeal Obamacare is DOA.
The GOP has always argued for a status quo, which is neither free market, cheap, nor successful. Worse, last week House Budget Chair Ryan proposed keeping Obamacare’s tax increases and ending Medicare Advantage while eliminating the benefits and cost savings of Obamacare.
With Ryan’s plan, the uninsured would remain uninsured. The rest of us would still pay for insurance that continues to screw consumers with lifetime caps, no coverage of pre-existing conditions, and kids over 18 kicked off their parents’ insurance.
Like a bad penny arguments for and against Obamacare keep turning up long after the Supreme Court upheld it and Congressional attempts to repeal it withstood more than 30 attempts.
The arguments the GOP has used against Obamacare is that it is government control that overturns the free market health care system and runs up the deficit so let the free market take care of the problem.
What free market? I know a free market when I see it. Our family imports and distributes an over the counter pharmaceutical in a market with 2,000 competitors. Consumers have the opportunity to buy it if they like the product and the price. Not so with health care. A very small handful of insurers control the market across state boundaries through their wholly owned subsidiaries and they are not subject to anti-trust laws. Those employed by small businesses or self-employed have a choice of either buying unaffordable insurance or going without. Their physician, insurer, or ambulance choose hospitals for them – hardly free markets at work.
The Obamacare exchanges from which the uninsured get their affordable policies are comprised of private insurers openly competing against one another that offer required minimum benefits and more. Subscribers get access to a freer private sector market than we have now.
The GOP’s newest approach speculates most employers will stop providing insurance, opting to pay the fine instead, even though the Congressional Budget Office predicts that will not happen to any significant extent. This would be expensive, Republicans claim, because the exchanges subsidize the insurance policies. That point is deceptive. Consumers using exchanges will pay per their income levels and employed consumers would be less likely to get subsidies than the unemployed.
Cheap? Our costs per-capita are two and a half times more than any other industrialized country. The U.S. ranks in the bottom 40s in the list of any measure of outcome when compared to the rest of the industrialized world, mostly because the lack of access to health care of so many drags down the average. Why? Those who have insurance get preventative care; the rest who rely on high priced emergency rooms do not.
Private health providers get away with markups that are many times what even the government Medicare and Medicaid reimburses, per an investigative report in Time Magazine, March 4. One reason Medicare Advantage was scrapped was that insurers charged 12 percent more than government spends doing it itself.
Our system now pays providers fees for each service. The more tests given; the more re-admissions into hospitals, the more providers get paid. Outdated record-keeping cannot keep track of duplicative tests. Obamacare reduces charity care costs shifts by providing health insurance for the 30 million uninsured, changing the payment basis, and modernizing record keeping. The Congressional Budget Office estimates a $700 billion-plus savings to Medicare over 10 years and still Obamacare is deficit neutral. These are the cost savings to the health care system Ryan’s budget would eliminate.