2017 Begins with a Swirl of Health Policy Talks in D.C


Yesterday the ‘repeal crowd’ at National Review Online ran two pieces with proposals. I don’t know whether these proposals would work. Economics has never been my strong suit and besides that I don’t know enough about the US health care system.


[quote=“Brian_BSC, post:20, topic:58360, full:true”]

You do realize that this is an inherent contradiction. You cannot transfer resources from rich to poor and share risks across our society without government intervening.[/quote]I fail to realize no such thing.

I look at our current Federal and State spending, and note that there are all sorts of programs that give direct cash to people without telling them how they have to spend it.

For this reason, your (and my) tax dollars are being used directly to purchase heroin, for instance. I’m okay with that, given that the vast majority of the recipients of these cash payments use them as society intends.

Which simply makes the case I’m trying to: Structuring government largesse so that any and all malfeasance is rooted out is chimerical, yet we chase it like the apocryphal Magic Dragon. The result is a much worse experience, and product, for the vast majority of honest, responsible people.[quote]If you just give everyone a “voucher” then only the rich will get good health care.[/quote]No. The rich, the middle class, and the poor will all have access to good care.[quote]The poor will be left with minimal catastrophic insurance and will not have access to health care.[/quote]The poor will be able to choose from a range of low-cost plans that offer different coverages, and can select what best meets their needs.[quote]This is the whole point of major government regulation and programs throughout our society.[/quote]No. Much of the regulation we have today is to protect the interests of trade guilds (like the AMA, Nurses Association, etc.) under the guise of “safety” for a patient.

Just about anyone can learn to stitch a minor laceration. One example of thousands. You don’t need to pay a doctor $100 to stitch a cut, after waiting in the waiting room for 2 hours. An EMT can do that, and likely would happily spend 30 minutes with you for say, $50.[quote]This is why we have Medicare and Medicaid. This is why we require insurance to not “exclude” populations. [/quote]Cannot connect this to the issue being discussed. We don’t have these things because of the voucher concept. We have these to ensure seniors and the poor have Health Care coverage.

If you interpret my writing above to be saying that there should be NO regulation at all, I’m not sure how you get that from, " I think the best results are achieved with the greatest liberty – both for those offering health care products and services, and those consuming them". That doesn’t say “none”.

I certainly agree that there is plenty of need for some regulation. I’m not an anarchist. Regulation that says, “this is health insurance; you must insure people even when they start out sick” seems quite reasonable and directly topical.

On the other hand, regulations that say insurance policies must pay for abortions, for example, which are arguably NOT a matter of being sick (of course, when medically necessary it should be covered), and arguably there is a very real degree of discretion and volitional responsibility on the part of the patient, there is a reasonable argument to say to people they should pay for that themselves.

Just like breast implants.

I am not a rabid pro-lifer. I’m not one who thinks abortion is murder, and should be outlawed entirely (although my ideas regarding gestation, “personhood” lean in the conservative direction, informed by the actual science of the biology of fetal development; I’d be happy to discuss it in a different thread if anyone is interested).

However, I see abortion the same way I see getting a nose job when one thinks their nose is too big. That’s your deal, you don’t have to do it, don’t ask me to pay for it.

Same with birth control.

And lots, and lots, and lots of other stuff.[quote]I hear you complaining about how ACA has harmed “hundreds of millions.” Can you explain what you mean? You seem to have this idea that ACA has raised costs or denied health care to people. What do you mean by this? Do you have studies to back this up?
[/quote]I don’t need studies. I listen to my fellow citizens, compare to my own experiences, and form an educated opinion on that basis.

The ACA has been a financial disaster for my family. My OOP health care costs have tripled since the ACA went into effect. I used to have a great HSA plan via Definity Health (and then whoever bought them out, I can’t remember). I’m not going to get dragged into a debate over all the nuances, but suffice it to say that all sorts of stuff I don’t need is now covered (like birth control), and things I need that used to be covered are not.

I see poll after poll after poll telling us that some 57% hate the ACA and think it makes their care worse and more expensive. Based on my own experience, I believe them.

I’m not sure why you don’t. When you have to search for studies to try and convince people they’re not experiencing what they’re actually experiencing, you’re fighting a losing battle. A Groucho Marx quip comes to mind, “are you going to believe me, or your own lying eyes?”

The near-universal contrary response is, “what about all those people that have health care now that didn’t before?” There are some problems with that generalized assertion, but let’s take it as is for sake of argument.

So what? Are you saying its necessary to drop a giant turd on the majority to solve a problem for a very small minority? I think it’s you that has a lot of convincing to do, not me.

Rather, I want to simply solve problems without creating massive, worse, new ones. We didn’t even try. Instead, the usual political slight of hand, dishonesty, and power-grabbing occurred with the ACA. It’s no wonder that the majority are not happy, and its getting repealed.


Republicans will repeal and replace. But, remember, when it comes to funding they are the party of no. Although they have correctly surmised that to take away preexisting conditions clause and coverage for dependents until age 26 on their parents’ insurance is political suicide, they still want to take away those rights. Or have in the recent past. Price advocates “high risk pools” for people with preexisting conditions without insurance. VERY expensive. VERY. As in, you can’t afford it. Then there is the issue of lifetime caps. Today I tuned in briefly to hear a candidate being grilled about his views on privatizing Medicare and Social Security in order to “save the program.” And asked if he could influence Trump to understand his campaign promise should not be kept. And nominee said I believe that’s why he hired me. It’s going to be a long hard two years. A lot of harm will be done. But if we can win back at least the Senate two years from now, we can render them impotent until the next election. Drain the swamp! I am an Independent, not a Democrat. But the Republican party has turned so far to the right, I don’t recognize it.


I have always had insurance through work but I once had to COBRA myself about 20 years ago. Individual insurance for me was $1,000 a month and 800 for my daughter who was not diabetic at the time. I was 35 years old and no health problems. My cousin had an Obamacare policy and complained about the 900 per month premium but she was 57 (she is now covered by employer once again) and healthy. But a lot older than 35. We live in the New York area. Insurance coverage has never been affordable. The main thing Obamacare did and it is huge is it prevented discrimination because of preexisting conditions and the lifetime cap. Which would mean that when my daughter ages out of coverage under my insurance plan at 26, if she does not have employment with insurance coverage, such as being laid off from a job or maybe wanted to work independently she could get a policy. It would not be inexpensive, it never is. But a lot of these protections will be eliminated. There are countries with wonderful universal coverage such as France, Denmark, Sweden… all the Scandinavian countries and I think Germany and Belgium as well. We could model our health care system on theirs.


The paltry voucher you would be granted would be worthless as health care costs in this country rise exponentially, due to there being no regulation on what pharmaceutical companies charge for drugs. To his credit, I did hear Trump sound off on this, but briefly. Then he abandoned the issue. No political party will touch big pharma because both have deep pockets being filled by the lobbyists.



Well, if only I’d known the paltry voucher would be worthless, I would have rejected such a silly idea immediately. How embarrassing for me that I brought it up.