Friday, March 10, 2017

Surviving Obamacare...

As this is written, literally, the so-called "repair and replace" Obamacare fight is going on in the halls of Congress.

It's not going well, by my reckoning.  Republicans are of the opinion that the best health care program is one the Gummint has nothing to do with at all.  That's because Republicans know that the Declaration of Independence guarantees us all the right to "life, liberty and the pursuit of happiness," with no suffix continuing on adding "...and the right to lots of really good, cheap, or even free health care."  

The Democrats, on the other hand, believe the only good health care program is one that's owned, operated, managed and paid-for by the Federal Government.  Ummm, that would be you and me.  Single-payor, universal, socialist-style, everybody-covered, everything covered, taxpayer-paid health care like that offered in the U.K. and Canada is their primo model.  Like where you have to wait 7 or 8 months to see a doctor and a year or more to see a specialist.  Rigggggttt.

And the lawmakers in Foggy Bottom these days seem to be trying to come up with something approximating degrees of both. 

I believe that's a prescription for disaster.

Those of us who study this stuff, like me, who spent an entire professional career in health care, know that Obamacare was a deeply flawed law that should never have been passed. 

We know that it was rammed through Congress late on Christmas Eve of 2009 without a single Republican vote, using an arcane parliamentary trick called "reconciliation." That allowed the Democrats, who were in control of the House, the Senate and the Presidency, the "hat trick," to take hostage one-sixth of the entire U.S. economy on a strict, Party-line, simple majority vote.  Bad way to do business, by my reckoning.

And this is what they wound up with:  Those who had employer-paid health insurance lost it.  Many of those who had no insurance got it, and it was paid for by those who had lost it, along with taxpayer-paid subsidies to insurance companies who were assembled into co-ops to cover them. Those who had lost it were given the opportunity to buy it back at three or four times what they'd previously paid, along with a deductible of four or five or six times what had been the case. The excess fees for this much worse coverage were used to pay for some of the insurance of those who never had it. And those who lost it and bought it back, and those who hadn't had it and wound up with it, discovered that they had health insurance, but little or no health care. That's because physicians wanted no part of this crappy health insurance that paid bupkus for their services.  And so, most weren't accepting it.  Most likely you wouldn't have either.

A poll taken of the American Medical Association right after passage of O'Care showed that fully 83% of all physicians were planning to retire early.  With no plan whatsoever to replace them.

Got it?  Good.

And what's the current state of Obamacare?  18 of the 23 insurance company co-op exchanges that were created by the Obamacare administrators, using taxpayer-paid subsidies, $Two Billion Dollars so far, have already failed. They've lost so many hundreds of millions of dollars on this failed experiment that they've dropped out.  

Pay attention to this fact:  Of the 3,000 counties in America, 1,023 of them have only one insurance company still offering coverage, or none at all. If that's "competition," I want none of it.  

Those in the know, know that Obamacare is on its last legs. It will fall apart like a K-Mart watch in less than a year. This is what happens when a bunch of bureaucrats get together and hammer out a law to do something they don't understand and know nothing about, but are too damn dumb to know it.  And all of this was done so that the Democrats could count on their newly-insured young and poor constituents voting for them in perpetuity.

And we should also know that the Republicans, if they take charge of this mess and try and fix it, will be blamed by all those who lose their Obamacare, and also by those now unseated-from-power Democrats who breathed life into it in the first place.  And they'll likely suffer for it in the 2018 elections.  In short, they'll be shown the door, and with their leaving, the Republican majority will be threatened.

So, what's the Chuckmeister's Rx?    

Republicans would be wise to sit back, relax and observe Obamacare circle the drain. When it fails, they should step in like a superhero and offer up some minimal conservative solutions to help those who need health insurance to afford it. 

Once its gone they should enable the sale of health insurance across state lines, like car and life insurance, finally fostering true economic competition. They should toss in tort reform, removing the incentive from "slip and fall" lawyers to sue for gargantuan, multi-million dollar sums due to medical malpractice claims. They should establish risk pools for preexisting illnesses so that younger folks won't have to pay the exorbitant price for the huge premiums of the elderly and the really sick.  They should enable HSA's, Health Savings Accounts, so that citizens have a choice as to what sort of care to seek, because they'll be paying for some of it.  They should establish incentives for educating physicians and other health professionals in exchange for a negotiated number of years of service from them in community health centers, relieving the cost burdens from hospitals of having to treat people for "free," with the true cost of such care passed along to those with health insurance.  After all, the only thing really needed is what's called "catastrophic coverage," so that true emergency situations, cancer, broken limbs, etc., are taken care of. Everything else has already been underwritten by the various states' Medical/caid insurance programs. And block Medical/caid grants to the states could help to insure this level of care continues, insuring that no one loses their coverage.  Simply stated, Republicans need to let the whole thing to go back to exactly where it was when the Democrats unfortunately chose to take a little trip down this road, and then put it back together the way it ought to have been in the first place.

The Republicans have been preparing for this moment since Obamacare was rammed through Congress 7 years ago, without a single Republican vote.  And now, after having voted to dump O'Care more than 50 times, without success, Republicans, who now control all three aspects of power in D.C., that same "hat trick," are flailing about wildly, mired in the throes of indecision.  What to do, what to do...

I know what to do.  Do nothing...

But before concluding this little rant, allow me, The Chuckmeister, your humble scribe, to back up a bit and provide you one of President Ronnie Reagan's better quotations:

     "The nine scariest words in the all of creation is, "I'm from the Government and I'm here to help."

How prophetic.  O'Care cratered the job market, put a multi-year damper on economic growth, put tens of thousands of business owners out of business, increased the cost of health insurance by huge percentages (Arizona's premiums will increase 113% this year!), brought us breast exams for men and prostate exams for women, and inserted Gummint into virtually every aspect of our lives.  And it gave Democrats the bums rush out of Washington, D.C.  I guess we'll all find out whether Republicans can successfully unwind this Democrat mess without having the window of opportunity close on their fingers.

Really, really hard...

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