Is "Obamacare" really the best idea? Thoughts on my idea?

[Black and Gold]

Currently, the government allows employers to provide health insurance to employees on a tax-free basis. Therefore, employees prefer to be compensated in health insurance rather than wages because otherwise they would have to pay taxes on the money. So there is a built in preference for insurance. The result from that is an over-utilization of health insurance in the United States. This is one of the reasons that insurance and healthcare in general is so expensive.

People use insurance for things they shouldn't be using it for. In general, a person should use insurance for low-probability but high-cost things such as cancer or getting hit by a car. A person should not be using insurance for things such as spraining your ankle or getting the flu. This is routine medical care that people should have ample savings to pay for if the tax code did not favor insurance over cash.

Now we have a whole system where health insurance is coming from an employer. So if you lose your job, you lose your health insurance. It would be better if individuals were able to buy their own health insurance and take it with them regardless of where they happen to work. That would happen if the tax code is changed.

Plus, when an employer is buying the health insurance, they aren't as concerned about the cost because they aren't actually spending their money. They are spending their employee's money. They pass the buck on to the employee. So if an employee offers health insurance, they are taking it out of the wages that they would have paid you if they weren't paying you health insurance.

If insurance was taken out of the employment process, not only would insurance be a lot cheaper, but medical procedures would be a lot cheaper and people would not be over-using the healthcare system because they would perceive a cost. People would then be shopping around to get the best prices they can. This will introduce competition back in to healthcare, and prices will continue to come down over time. Look at areas of medicine that fall outside of insurance coverage, such as Lasik eye surgery. The costs have continued to come down because people have to shop around for the best prices because they are paying out-of-pocket. There is competition, and that is something that is desperately needed in healthcare.

Another way to bring insurance costs down is to allow insurance to be purchased over state lines. This is currently illegal, but it would increase competition even more, which leads to lower prices due to more companies looking to win your business.

Then there are those 46 million Americans who are uninsured. 1/3 of those make more than $50,000 per year and choose not to purchase health insurance, probably because of cost. Health-savings accounts would be a good idea for those Americans, and a change in the tax code would help with that. Another 1/3 are eligible for medicaid, but have not taken advantage of that for whatever reason.

So there are a few things that would make both healthcare costs and insurance costs cheaper for everybody by introducing market forces back into the system. I feel like "Obamacare" is going in the wrong direction and actually exacerbating the problem in the industry.

Thoughts? Constructive criticism?

[Vincardog]

1. Health insurance as we now use it is a "wage" in leu of money. Employers are concerned about the

cost. As they are concerned about all costs. People are not over using the medical system in fact most people do not have enough access to health CARE.
You are correct that competition is the answer to lowering our health care costs.

Allowing insurance companies to sell across state lines would allow them to incorporate in the least regulated state and then compete on price against companies that are required to provide more services (Not a level playing field).
The result would be a race to the bottom for the least expensive policy providing the poorest coverage.

The competition should be between a universal coverage non-profit (Medicare part E for everybody) and everybody else.

The fact hat private insurance companies could not charge a 30% premium and stay in business is the reason that any solution by necessity would eliminate the parasitic insurance companies.

The main problem with "ObamaCare" as you put it is that it started with the premise that the insurance companies were a necessary part of the answer. By including the parasitic companies in the answer it is going in the wrong direction. By eliminating exclusions for pre-existing conditions and requiring a certain percent of income to actually go to patient care is is heading in the correct direction.

[DJ13]

2. Excellent post, thank you

[Vincardog]

4. Any time You are welcome

[Justice wanted]

3. I'll be honest. It could have been A HELL a lot better. I think it is a water down mess BUT it

does give more people more insurance plus it will help people with Pre-existing condictions.


We should have single payer. There should have been a stand and we should have moved closer to it.


For a country to spend 559 BILLION on defense when it's "Greatest Threat" China Spends something like 58 BILLION there is something seriously wrong.

Why is it so wrong for a country to give back to the citizens safety in their health with one thing they don't have to worry about.

[bluestateguy]

5. I find it interesting that now even people on the left call it "Obamacare"

We have bought into their framing, and given the law's stubborn unpopularity, it has not been an effective tactic of discourse.

[CreekDog]

8. The OP is not on the left

reading the post:

-people overuse their insurance
-says people prefer insurance to wages
-advocates health savings accounts and catastrophic insurance policies
-against Obamacare
-for allowing insurance to be bought across state lines (a Republican talking point --in and of itself might not be a Republican idea, but paired with other Republican talking points --it surely is)
-no mention of the difficulties of buying insurance (preexisting conditions, high cost)
-no mention of any government intervention

[Black and Gold]

9. I just use it

as a nickname... not in a derogatory way.

[CreekDog]

16. does your plan cover everybody?

and provide that nobody would go bankrupt from needing health care?

if it doesn't, i'll take Obamacare.

[noiretextatique]

40. it is total bullshit

and no one remotely to the left of reagan should be using that bs right-wing terminology.

[expatriate2mex]

6. One possible problem I see is the insurance itself.

I have bc/bs federal, the same i believe that will be used for everyone, and it's 400.00 a month premium with a deductible and not a co payment (as it used to be) but a percentage. I'm sure it will help some, but will it help those that need it most? I think the premium will be rough for some.

[FarLeftFist]

7. You are assuming that the insurance companies aren't the biggest part of the problem.

Obamacare does what you are saying, just swap "crossing state lines" with 'joining exchanges' and viola, it's Obamacare. People will have to buy their own insurance and be able to take it from job to job. How about we join the rest of the civilized world and have universal health care. Boom. Problem solved.

[Black and Gold]

13. I want to

limit the use of insurance and incentivise people to use cash except for major illnesses like cancer.

The prupose of any kind of insurance is to pay for major events... not routine things. Stuff like that is what drives the cost of health insurance through the roof.

[FarLeftFist]

17. Uh, it's called health insurance, not cancer insurance.

If you have 3 kids do you know what the medical bills would be like just under regular seasonal colds/allergies and mishaps of childhood? Plus you and your wife?!

[surrealAmerican]

41. That "incentivising" sounds reasonable, but what are you going to do when ...

Last edited Sat Feb 25, 2012, 09:49 PM - Edit history (1)

... you get billed $7,000 for that sprained ankle? An awful lot of people in this country just can't afford care for "routine" medical costs without insurance.


It really isn't a question of people getting too much medical care.

[Skinner]

10. Is it the best idea? C'mon. That is a ridiculously high standard to critique any law.

Of course it wasn't the best idea.

It was the one that could get through the United States Congress. And it's much better than what we had before.

[SunsetDreams]

15. I think at this point, it would be a good time

to review what the other side is saying about health care, particularly the good Dr. Sometimes you just can't say what you want to say

[Dokkie]

31. But it got through congress without

any republican support. Hence this is the best democrats can gives us. That doesnt make me feel good one bit. Then again, the OP made a good point when he pointed out that medical area that mainly use cash for payment such as lasik and plastic surgery has seen a price decrease while general insurance medicine has gone the other ways outpacing inflation rate.

Just think how much a cell phone($700 for iphone) costs compared to a laptop or even an ipad. One purchased via cash by the consumer and the other is purchased via phone companies. Theres a point to limiting use of 3rd party payment method to reduce price of medicine

[northoftheborder]

11. I was very dissatisfied with "Obamacare" for several reasons, and you have very thoughtfully...

...presented some of the problems.

I'm old enough to have lived before the Health Insurance Industry took over the world. We always had hospitalization insurance, and could afford it even on graduate student wages. But we just paid for our routine doctor visits, which were very inexpensive. I remember that my gynecologist charged $6.00 for a routine check up, in the 1960's. Our hospital insurance was either bought individually from a group (Blue Cross, then a non-profit) or as a professional group policy, (but individually paid, no employer part.)

When the Health Insurance Industry started offering the large group insurance, covering all doctor visits and prescriptions, exrays, and all the rest, and the large employers bought in, that's when all hell broke out and prices started going through the roof.

It's much more complicated than this, but the HID can go to Mars and invest, as far as I'm concerned. They have ruined the medical care system in this country. I'm for Single Payer, through non-profit groups, or through the federal gov., or just a Medicare system of insurance for all. Get rid of Medicaid, and all the other systems paid for through local or state taxes. It needs to be national, and fairly administered.

[liberal N proud]

12. Until profit is taken out of the healthcare/insurance industry, there will be no perfect solution.

[CreekDog]

14. Obamacare was what was possible but other systems that are socialized do better for less

So in the absence of better systems like they have in Western Europe and Japan which provide universal health care, do it at lower cost than we do and provide it to their whole population, clearly those systems are doing better than ours. But in the absence of that option here, Obamacare is better than what you're proposing, which actually will take away health care from people.

Your post says nothing about chronic conditions, preexisting conditions, preventative care, people with low incomes, etc.

It also says that people prefer to be paid less to get health care --no, that's your ill-founded conclusion.

And the rest of it is Republican talking points without the most obvious Republican buzz words.

--heath savings accounts instead of low cost routine care
--buying insurance across state lines as panacea
--not getting health care through work but not saying how people will afford it or even be offered a decent policy apart from employer group rates
--you say that people making above 50k/year (and you act like that's a lot of money) are turning down insurance --when they may not qualify, or may not be able to afford it, or may be choosing between paying rent and eating and having insurance

Again, Republican talking points. And for what it's worth, the Republicans had 6 years to put these things into effect if they wanted to, but they didn't. See these ideas aren't intended to become law, they are just intended to get people to not support what did become law.

A head fake really.

[Black and Gold]

19. Because I don't

think socialized medicine is the way to go it is nothing more than Republican talking points?

I never said people preferred to be paid less in order to get health care... because they aren't being paid less. They are getting more from their employer when he is offering health insurance because it is tax-free. If the employer would pay cash, the employee would have to pay tax on it.

Which is why I'd want to change that so that there isn't an incentive of insurance over cash.

[FarLeftFist]

20. Do you know how much a doctors visit is?!

[CreekDog]

21. Universal care only happens in *more* socialized systems

if you go less socialized than ours, you will end up with less people getting needed health care.

and that is a Republican talking point.

[Black and Gold]

27. That is...

not true.

The government has only gotten more involved in healthcare over the years, and (not surprisingly) the costs have gone up and up and up with less people getting care.

And that is a fact, not a talking point.

[FarLeftFist]

28. Yet, here you are complaining about Obamacare, which gives the PRIVATE SECTOR millions of new

customers. Make up your mind. You are thinking in terms of putting profits over peoples lives, but let me guess, you're "pro-life".

[CreekDog]

29. You're ignoring the rest of the world's health care systems --which is why you're wrong

and government single payer systems even in the USA are the most efficient in this country.

furthermore, among the best deal in health insurance is the largest health insurance policy in the world --the Blue Cross/ Blue Shield plan offered to Federal Employees. it is arguably more like the health insurance exchanges will offer than any other plan and is a bargain compared to most health insurance policies.

also, the reason you are incorrect is because your ideology is where you're getting your information rather than actual information about health care systems.

[Black and Gold]

30. Please tell me...

what is my ideology?

[CreekDog]

36. you're against Obamacare, you're against socialized medicine of any kind

you don't want employers paying for health care.

you prefer health savings account for routine care.

i don't know what your ideology is, but those tenets are those of a Republican/conservative in the US.

outside the US, even conservatives support socialized, universal health care, so you actually seem to be to the right of mainstream conservatives in other western nations.

[ProSense]

22. Pretty

"Because I don't think socialized medicine is the way to go it is nothing more than Republican talking points? "

...much! I agree wholeheartedly with the comment you responded to, and would add: You are offering a scheme, not a solution. In fact, the scheme's intent is to reject the ACA and "socialized medicine." It's an unworkable scheme being used to challenge what works, and everyone knows single payer (Medicare, VA health care, etc.) works much better than private insurance schemes.

[CreekDog]

24. I'd also argue that the scheme isn't intended to be implemented, just used to undermine Obamacare

and/or any socialized system that is part of our current system or any effort towards expanding health care exchanges and single payer aspects of our health care system.

and in several years of Republican rule, despite hyping of these talking points, there was no effort to pass these into law.

it's just a way to get us to kill Obamacare and be left with nothing in its place.

[subterranean]

44. Exactly. The previous Republican talking point was "repeal and replace."

Now it's just "repeal."

[DCBob]

18. RWingers think attacking Obamacare is winning political tactic.

It might work because the issue is complex and there is plenty not to like about the program but I admire the President for sticking his neck out trying to solve this huge problem. If you never take a risk you will never get anything signficant done.

[MineralMan]

23. Well, I have some thoughts, but I

won't express them.

[SunsetDreams]

25. I know the feeling,

I want to rip it off, but I'm afraid it might hurt in some way or other.

[loyalsister]

26. There is definitely a better system

Obama himself said that if we were starting from scratch he would advocate a single payer system. But, there are people who have built a profession (I'm talking about insurance agents not executives) as insurance agents. Vile as the insurance industry is, I don't feel comfortable complaining about corporations shipping manufacturing overseas while being more than happy to put people who have built their professional lives as insurance agents out of business.

"A person should not be using insurance for things such as spraining your ankle or getting the flu. This is routine medical care that people should have ample savings to pay for if the tax code did not favor insurance over cash."


What???? I certainly envy anyone who has any savings at all. Aside from that, untreated injuries and illnesses have put a strain on the health care system. The sprained ankle (which actually turns out to be a fracture. - This happened to me, BTW. Fortunately I caught it) that a person can't afford to see a dr. about turns into a major injury that leads to a significant disability.

Then there is the flu that leads to pneumonia.

All either of the above took was a flu shot and a good xray. Part of Obamacare is a focus on preventative care. It saves money, because for a long time people with the conditions listed above would put off going to the doctor because of the cost. By the time they get there the condition is worse and way more expensive than it would have been in the first place.

Among other things, single payer essentially wraps it all up into one payment and brings costs down. The HCR that is gradually going into effect with more regulation and embracing preventative medicine is a start toward reducing costs. It was the best Obama could get for now. The best thing that could happen would be for Insurance companies to get pissed about regs and bail out of the business. As they drop off, non profits and government funded agencies have to pick it up.

[TheKentuckian]

32. The best idea??? It isn't even a good one.

It was a bad idea when the Heritage Foundation hatched it.

It was a bad idea when Gingrich and Dole were selling it.

It was a bad idea when Rmoney put it into place.

It is a bad idea now.

It will be a bad idea in ten years.

It will be a bad idea in ten thousand years.

I'm not sure it is better than the absurd idea we live out now, we slightly increased access to the predatory system we have in exchange for mandated "subscribership" and a key to the national trasury for the wicked cartel.

I don't see the value for endorsing and accepting the marriage of our state with this predatory cartel in exchange for a few pay to play features that should be automatic and a little increase in coverage at full cost.

[Quantess]

33. We need single payer. Socialized health care.

Anything else is a band-aid solution. The US health care system is a colossal failure for the people.

[noiretextatique]

34. your "over-utilization" premise is questionable, at best

and possibly disingenuous. in fact, people forego preventative care because they cannot afford it, and need more intensive care after they are ill. "market forces" are the problem, not the solution. take the profit out of healthcare...that is the only solution.

[Black and Gold]

35. What do you mean

the premise is questionable?

What do you think insurance is?

Insurance is only supposed to be used for major events. Car wrecks, fires, cancer, etc. It should not be used for all of your medical visits.

That is what is meant by "over-utilization" of insurance. It drives up costs.

[noiretextatique]

38. and therein lies the problem

health care is not a commodity...it is a necessity. insurance is nothing but gambling on people's lives, and it is not necessary. as a breast cancer survivor, i challenge you to tell me which of my treatments were optional, as my insurance company tried to do. do you understand that "major events" might be prevented by routine medical care, which we humans need?

[SunsetDreams]

39. I'm sorry but

Elvis has left the building

[renie408]

42. I am not sure I either understand or agree with your premise

that insurance is ONLY for catastrophic events.

My husband got a tiny speck of metal in his eye about two years ago. After about 24 hours of having a painful watery eye that no amount of eyewash could get the speck out, I drove him to the doctor's office. He never even saw an actual doctor, the nurse took a big fat Q-tip with some ophthalmic ointment on it and dabbed it on the speck and out it came. Literally, he was back in the room for MAYBE fifteen minutes. And the bill?

$740.

Yep. I am not lying. They charged us $300 while we were there, which we almost fainted over and we got ANOTHER bill in the mail for another $440. For a Q-tip. I refused to pay the second amount and raised holy hell. After a few months of argument, they backed off the second bill. But not until they had sent to collections and we were harassed and threatened and treated like criminals.

Right now we are one of those families that makes more than $50,000 (barely) and don't have health coverage. Since both my husband and I are self-employed, we have no coverage through work unless we pay for it ourselves. The cheapest, crappiest policy we can get for all four of us runs $546 a month. And we just don't have it. My son is covered through insurance he gets from the college he attends and my daughter is covered under a state health initiative. My husband and I just keep our fingers crossed.

[DevonRex]

37. Aww. You were so young, too.

[Enrique]

43. you are ignoring the reasons why it's employer-based

group insurance results in lower premiums. Your system would make insurance cost more for everyone.