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Buy Health Insurance Or.... What?

by David D. Eisenhower (Principles: Military Restraint, Bipartisanship) - 2 year ago

Obamacare failed to convince enough healthy people to buy insurance. Will the proposed Republican replacement do a better job?

Perhaps the best thing about Republicans controlling all three branches of government is that we are finally, FINALLY, going to have a serious discussion about paying for health care. The next time that Republicans pass a bill repealing Obamacare, it will be signed by the President. Therefore, they now need to roll up their sleeves and actually deal with the same issues that Democrats had to address when they first passed Obamacare 6 years ago.

Chief among those issues is what to do about people who are considered “high risk” because they have what the insurance industry refers to as “pre-existing conditions.” Solve that and everything else falls into place.

Prior to Obamacare, the insurance companies were in control. They could refuse coverage to people who they deemed to be too risky or even kick them off their current coverage if they exceeded a lifetime maximum. It fell to state sponsored “high risk” pools to care for these people. The states lost millions of dollars on these pools and the benefits provided were insufficient.  The system was failing.

Obamacare took that power away from the insurance companies. Anyone could get coverage any time. To keep premiums reasonable, however, the law had to encourage healthy people to get insurance. The approach used was the infamous mandate, or penalty, that uninsured people had to pay.  It didn’t work. Healthy people, knowing they could always sign up for health insurance when they needed it, elected to pay the penalty rather than buy the insurance.

So now, along comes the Republican plan which proposes a different incentive. Anyone who currently has insurance cannot be denied coverage for pre-existing conditions. However, if you don’t have coverage, you can be denied. The hope is that healthy people will realize that financial disaster awaits them if and when they become sick, and they will elect to buy insurance now rather than risk being denied later.

It is the ideal Conservative solution. Force people to make responsible choices and, if they don’t, live with the consequences. On paper, it sounds great. The perfect solution.

But can we really rely on healthy young people, with large college loans, to pay significant monthly premiums for health insurance they almost certainly won’t use? Won’t some of them assume that some day the law will change again and they will be able to get coverage?

Much depends on human nature. What’s your view as to whether or not the Republican incentive will be sufficient to get enough healthy people insured to keep the system solvent?  

Comments and Responses (4)

General Comments
By  Facebook Commenter - 2 year ago
You are making statements that may or may not be true. Insurance is betting that you will get sick, the insurance company is betting that you won't. Insurance companies build an account that will cover the problems of all the participants but it is not a socialist program in the true sense of socialism. In socialism all are required to participate, an insurance program that is not the case. ObamaCare tried to force people to participate by fining the none participants. The young took the attitude they were healthy and didn't need insurance. If they were injured or got sick they could go to emergency care and get the needed help. The fines were cheaper than buying insurance. There are too many regulations on the insurance companies, one stupid regulation is you can't buy health insurance across state lines.
Discussion Leader's Response : This comment is relevant to the discussion. (Commenter's rating is increased.)
Discussion Leader's Explanation : You've described the issue very well but have not really proposed a solution. As you say, most healthy people will make the decision to not buy health insurance. Therefore, since most people who buy insurance already have health problems, the insurance companies must raise prices. This, in turn forces more and more healthy people to drop their insurance. There is no question that a socialist program where everyone was required to participate would solve this problem -although it certainly might create other problems. As to the "state line" situation, there is no Federal Regulation preventing it. It's nothing more than a Republican talking point which never worked before and won't work now. The problem is that each state has its' own laws and its own market conditions. Even the insurance companies aren't looking to sell across state lines. (NOTE FROM PWG: Thank you for sharing your views. Please Register as a Member so that in the future you can receive credit for your comments)
Reasoning used for ARGUMENTS presented
By  Dan T - 2 year ago
I wouldn't say that the Obamacare approach didn't work, only that it needed some tweaking that the Republican congress was unwilling to provide. The allowable disparity in premiums based on age was probably too small for example. But a one-time, "buy now or forever hold your peace" approach is not the way to go. A better approach would be to allow insurers to charge more for pre existing conditions in proportion to how many years a person had previously opted out of health insurance. That way, each time a young person opts in they are gaining some tangible benefit in the long term even if they don't get sick in a given year.
Discussion Leader's Response : This comment is relevant to the discussion. (Commenter's rating is increased.)
Discussion Leader's Explanation : Republicans are in a bind. They have to "repeal" Obamacare but if they repeal the "good parts" they're going to be blamed. My guess is that they are going to say that Obamacare has become so entrenched that they now have to fix it and, oh by the way, anything that they can't fix is still Obama's fault. They may well be open to suggestions like yours because what they don't want is to replace the mandate in 2017 and then have all these people develop conditions in 2018, not be able to buy insurance, and start making commercials for Democrats.
General Comments
By  Facebook Commenter - 2 year ago
It all has to do with for profit insurance and hospitals. They don't see people anymore - they just see money bags to be robbed because no one else can provide the service you need, Or, in other words a monopoly. Health insurance companies are not pulling out because of poor people with free insurance because free insurance is Medicaid. They're pulling out because their profiteering wasn't as high as they expected. Obamacare would have worked better if 75% of the population wasn't exempt from having it - like police, fireman, and other public workers.
Discussion Leader's Response : This comment is interesting but not directly relevant. (It might be a good topic for a new discussion)
Discussion Leader's Explanation : It seems that you are arguing for single payer health insurance. That way the insurance companies make no profit and everyone is covered. Unfortunately, that would create a different monopoly - a government monopoly. For now, though, I think we're stuck with insurance companies and with having to find ways to humanize them so that they do see patients as people.
By  Paul Revere - 2 year ago
Trump is in favor of the free market. What if he can introduce more competition into the insurance market. More companies, some with their own clinics geared toward certain conditions, some more general, geared toward "healthy people." What if insurance companies geared toward certain conditions had an r&d branch and a charity fund. The company is a regular insurance company, but people who want to donate could.
Discussion Leader's Response : This comment is relevant to the discussion. (Commenter's rating is increased.)
Discussion Leader's Explanation : Your suggestion would make the health insurance market run more like the life insurance market. There, people who can prove that they are completely healthy, receive the best rates. The sicker you are, the more you pay for the same life insurance, until you become so sick that you are uninsurable. While this would bring healthy people into the market, it wouldn't do anything to bring down the cost for the less healthy people. Your idea of letting insurance companies diversify into being primary caregivers and charitable organizations is interesting but its hard to picture how that might work. Perhaps you could start a separate discussion on that.