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Thread: Obamacare Replacement - Patient Freedom Act of 2017

  1. #41
    The Republican Agenda HadEnough2's Avatar
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    Quote Originally Posted by Neomalthusian View Post
    Wow, I can't tell you how many times I've read some left wingers whine about how Republicans don't have a plan, what's their plan, oh my God Republicans want to repeal it but don't have a plan.

    No something is brought forth, and.... Fucking crickets.


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    Biff said on the campaign trail that Obamacare would be repealed and replaced immediately. What's the problem?

  2. #42
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    Quote Originally Posted by HadEnough2 View Post
    Biff said on the campaign trail that Obamacare would be repealed and replaced immediately. What's the problem?
    As I said in another thread in this subforum:

    Quote Originally Posted by Neomalthusian View Post
    Quote Originally Posted by Djinn
    Op-Ed from the Chicago Tribune, excerpts:

    This would explain a lot. Republicans want to eliminate Obamacare not because of what it is, but because it's associated with a Democratic President. The only real alternatives are 1) the clusterfuck we had up until Obamacare, which allowed insurers to refuse payouts for "pre-existing conditions," or 2) a single-payer program, which Republicans have fought tooth and nail.

    This is why Republicans can't find a replacement for Obamacare - Chicago Tribune
    This is a cogent brief political analysis, but I want to put a finer point on it, because it's not merely that reverting to the old system would "leave people uninsured," that is a politically soft way to describe what was happening under the old system. Reverting to the old system creates much more fundamental problems than some people being uninsured. The fundamental problems were adverse selection and a domino effect of failures and closures of small hospitals and clinics.

    The current non-Obamacare set of laws and regulations we have concerning health care provision, in addition to the way people actually consume health care services, make health care a public good. That is a fact Republican politicians refuse to accept. We can repeal Obamacare and there will still be all those non-Obamacare laws and regulations that establish health care as a de facto public good. They continue to want to think of it like a private good with price-discipline that responds to seller competition the way virtually every other private good does. It simply doesn't. In my daydream fantasy reality, it would, but it doesn't. Laws passed by Republicans declare it to have public good characteristics, i.e. people are entitled to it regardless of money. And even if those laws didn't exist, when it comes right down to it, people in general, even the most economically and socially conservative people, fundamentally demand that they be entitled to it regardless of cost or money or anything else, when they need it. There is no actual political will among the people for health care to be a private good. Conservatives often want to pretend it is, but ultimately they have no actual will for it to be a private good (something you can buy if you want to and can pay for it, or you don't buy it if you can't).

    The best bet for Republicans might be to say "we were wrong to oppose Single Payer, call us hypocrites all you want, we are hypocrites, but that doesn't matter now, our admitted hypocrisy aside, the nation needs a single payer system now, so here it is." Politically, this would appall everyone who voted for them and risk them being ousted next election, but on the other hand, it would also create a major problem for Democrats because what would be their excuse for opposing it? Democrats passed "the Republican Plan" of a private mandate, so maybe Republicans' only hope is to push the Democrat Plan for single payer.
    Quote Originally Posted by Neomalthusian View Post
    They're lying to themselves, blatantly and obviously. I have never met a conservative who sincerely wanted health care to be a private good. Never. And I'm surrounded by conservatives in my community. They might only say "health care isn't a right," but watch what happens when they get a $35 medical bill in the mail. It's as if someone just stole their pickup truck. I have employees who are staunch Republican conservatives who expect they should have to pay nothing for health care. Most of them are lying to themselves. Some might just not comprehend the true nature of insurance in the slightest, but most are just lying to themselves about whether people should be entitled to health care.

    Recall that I started this thread, mostly for sake of discussion but not entirely unseriously: All private sector insurance is a scam and should be governmentalized

    You seem to forget how obediently most sheep-minded people root for their team. Liberals did it when Democrats passed "the Republican Plan." The GOP can nickname it "RepubliCare" and title the bill "The American Patriotism, Freedom and Soaring Bald Eagle Health Care and Screw Democrats Act" and their base would shout victory from the mountain tops, even if what it actually does is create a single payer system.

    You also seem to overlook the fact that Republican administrations and politicians have consistently expanded the entitlement to health care when power was theirs to do so, going back to at least Reagan. The Emergency Medical Treatment and Active Labor Act, the Medicare Prescription Drug, Improvement, and Modernization Act, the Rare Diseases Act, the Orphan Drug Act, the Combating Autism Act, and others that were either passed with significant Republican support and signed into law by Republican presidents, and countless others still that were proposed by Republicans but maybe died in committee or did not advance, all of which contributed to the expansion, not reduction, of health care as a public good -- something government is and should be involved in funding, expanding, and improving. Republican politicians have consistently done this, and even staunch conservatives, deep down, want to be entitled to health care regardless of whether they can pay for what they need or not.

    It's funny when I suggest Republicans should consider pushing single payer -- the ones who freak out tend to be liberal-leaning people, which is strange, but I think it's because, like I said, it would do what Democrats did to Republicans, which was steal their idea in its entirety, pass it, and then take credit for fixing our health care problems.

  3. #43
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    Quote Originally Posted by Zephyr View Post
    How is the commercial insurance industry sexist? I really do not know and wanted to understand your point.
    If he were able to opt out of coverage for female functions like childbearing, he would be benefiting from a system that is sexist in its design.

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    Quote Originally Posted by Rasselas View Post
    If he were able to opt out of coverage for female functions like childbearing, he would be benefiting from a system that is sexist in its design.
    An insurance system isn't "sexist" if it varies the price of its coverage according to the likelihood of payouts to the covered individual. That's just what insurance is supposed to do. Women cost approximately 20% more than men in health care (controlling for longer life expectancy). That fact isn't "sexist," it's just a fact.

    And under current law this issue is entirely irrelevant and inapplicable. The fact that health insurers aren't allowed to do these types of things is one of the reasons health insurance isn't really "insurance" anymore.

  5. #45
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    Quote Originally Posted by Neomalthusian View Post
    An insurance system isn't "sexist" if it varies the price of its coverage according to the likelihood of payouts to the covered individual. That's just what insurance is supposed to do. Women cost approximately 20% more than men in health care (controlling for longer life expectancy). That fact isn't "sexist," it's just a fact.
    It is sexist to limit risk pools to one sex. It just is. Per se.

    And under current law this issue is entirely irrelevant and inapplicable. The fact that health insurers aren't allowed to do these types of things is one of the reasons health insurance isn't really "insurance" anymore.
    The whole point of insurance is to spread risk out among a large group of risks. If you force everyone into different risk groups and charge accordingly, that defeats the purposes of "insurance" as well.

  6. #46
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    Obamacare Replacement - Patient Freedom Act of 2017

    Quote Originally Posted by Rasselas View Post
    It is sexist to limit risk pools to one sex. It just is. Per se.
    Insisting that any gender-based actuarial differentiation must be described as "sexist" forces an otherwise rational, objective, actuarial understanding of insurance into the a subjective socially progressive framework. Counterproductive.

    Is it useful to characterize the fact that insurance companies charge double or triple to 50-60 yr olds what they charge 26 year olds as "ageist"? No. Young people don't drive the costs.

    Your attitude, and not just yours but I think a majority of the country, about how private sector health insurance "should" work is antithetical to the fundamentals of how private sector insurance actually does work.

    As a result, our country now plays make-believe with the notion that it still has a private sector health insurance industry. When what it really is at the end of the day is an EXTREMELY complicated and convoluted publicly financed healthcare system.

    The whole point of insurance is to spread risk out among a large group of risks. If you force everyone into different risk groups and charge accordingly, that defeats the purposes of "insurance" as well.
    Only if taken to the extreme, which isn't what I'm suggesting. People don't want to purchase (and won't unless coerced) insurance protection against events that have a 0.000% chance of ever happening to them. Currently we're quite a bit closer to the latter extreme than the former.
    Thanks from bmanmcfly

  7. #47
    Veteran Member Isalexi's Avatar
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    Quote Originally Posted by Neomalthusian View Post
    As I said earlier today in another thread:
    Nothing could make trump happier than to have his name on something someone else inspired

  8. #48
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    Quote Originally Posted by Neomalthusian View Post
    Insisting that any gender-based actuarial differentiation must be described as "sexist" forces an otherwise rational, objective, actuarial understanding of insurance into the a subjective socially progressive framework. Counterproductive.
    It's not counter-productive. It's the only logical option. Allowing people to self-select into risk groups ruins the whole point of insurance. There's no difference between opting out of treatments for female issues because one is not female than it does for me to opt out of cancer treatments because I have no history of cancer in my family, on either side. We all die of cardiovascular illness in my family. Should I be able to opt for a plan that covers only things for which I feel myself at risk? That's crazy and would push many people into incredibly expensive plans.

    Is it useful to characterize the fact that insurance companies charge double or triple to 50-60 yr olds what they charge 26 year olds as "ageist"? No. Young people don't drive the costs.
    But young people MUST be in the risk pool, or the costs to others will be prohibitive.
    Your attitude, and not just yours but I think a majority of the country, about how private sector health insurance "should" work is antithetical to the fundamentals of how private sector insurance actually does work.
    But private sector insurance doesn't work very well, does it? We spend more on health care as a portion of GDP than pretty much anyone else, with worse health outcomes.

    As a result, our country now plays make-believe with the notion that it still has a private sector health insurance industry. When what it really is at the end of the day is an EXTREMELY complicated and convoluted publicly financed healthcare system.
    Maybe that's because private sector health insurance only works for a small portion of the population.
    Only if taken to the extreme, which isn't what I'm suggesting. People don't want to purchase (and won't unless coerced) insurance protection against events that have a 0.000% chance of ever happening to them. Currently we're quite a bit closer to the latter extreme than the former.
    It's wrong to charge women more for health insurance than men. It's simply wrong.

  9. #49
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    Quote Originally Posted by Rasselas View Post
    It's not counter-productive. It's the only logical option. Allowing people to self-select into risk groups ruins the whole point of insurance.
    Only if taken to the absolute extreme, and even then, people can't predict the medical conditions they'll get, so foregoing insurance coverage a la carte does not necessarily create adverse selection. In the case of sex, at least half the population is female so for men to "self-select" into gender based insurance pools, or even if the pools were completely separated, it wouldn't risk any adverse selection, all it would mean is women would then pay roughly 20% more than men for health insurance. And that would make quite a bit of logical sense given the stats show them consuming about 20% more health care dollars than men (even after accounting for lifespan differences). That's a fact that we know. There's no prejudice inherent to an observed fact.

    There's no difference between opting out of treatments for female issues because one is not female than it does for me to opt out of cancer treatments because I have no history of cancer in my family, on either side.
    There's a big difference. People with no familial cancer history do get cancer, and if you opted out, you'd save money and the insurance company would have less risk, quid pro quo, because there is a chance of you getting cancer.

    We all die of cardiovascular illness in my family. Should I be able to opt for a plan that covers only things for which I feel myself at risk?
    In theory, yes, assuming of course that an insurer was willing to design an a la carte plan like that for you. You'd be saving some money in premiums in exchange for the insurance company saving on actuarial risk regarding the things you assumed wouldn't happen to you (but still could).

    That's crazy and would push many people into incredibly expensive plans.
    The extremely expensive plans would be a result of adverse selection and the group of unlucky souls left over after adverse selection whose health care costs are already known to be immense on an ongoing basis. These types of people are uninsurable, from a private sector actuarial standpoint. They aren't in need of "insurance" in the first place, i.e. they aren't looking to protect against unknown, relatively unlikely possible future events, they're looking for someone to pay for their health care now. The entire private sector insurance model falls apart for people like this. No system of private insurance works for those who would be left holding the bag and have no choice other than "incredibly expensive plans." There is no actuarial math that fixes their situation or causes any private sector insurance plan to work for these people.

    But young people MUST be in the risk pool, or the costs to others will be prohibitive.
    Then the private for-profit insurance model falls apart.

    But private sector insurance doesn't work very well, does it?
    No, for fundamental reasons related to what you and most Americans believe health insurance should do, which run counter to the way insurance actually works.

  10. #50
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    Quote Originally Posted by libertariat720 View Post
    A good start I suppose.
    Look up how many states went nearly bankrupt trying to run their own Medicaid programs and employee pensions.

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