Author: Cathy Wentz
Despite recent failures in at least three states over the last few years, to establish some kind of single payer “health care” system, that Senator Bernie Sanders so fondly refers to as “Medicare for All,” Sanders has once again proposed it for the entire United States. This seems to be a rather irrational idea because even when a strong effort was made in Bernie’s home state of Vermont to get such a system established, it failed abjectly.
Sanders, an Independent from Vermont, introduced a bill Wednesday (9/13) that would basically cover all American citizens (and, from what I have been hearing on the news, some non-citizens). By the way, how did Bernie manage to run for President as a Democrat when he has been an Independent? Politifact answers the question by saying that because his home state of Vermont does not require voters to be registered with a political party, Bernie can remain officially unaffiliated while calling himself a Democrat for the sake of his presidential bid. How convenient!
According to a Washington Post article entitled “Sanders Introduces Universal Health Care, Backed by 15 Democrats,” dated September 13, “the bill would revolutionize America’s health care system, replacing it with a public system that would be paid for by higher taxes.” Standard care such as emergency surgery, prescription drugs, mental health and eye care, would be covered, and there would be no copayments.
The Post article also reports that Americans younger than 18 years of age would be covered immediately and would receive universal Medicare cards. Then Americans who are not currently covered by Medicare would be phased into the program over a four-year period.”
Just a little editorializing here – I am sure that any bill by Bernie will revolutionize anything in America. Think Russian Revolution. No thanks! Then what about those of us adults not currently covered by Medicare that refuse to accept Bernie’s socialized medicine scheme? Are we going to have to build our own underground medical system?
Now this is where the real cluelessness of the loony left starts. The Post article states that private insurance would remain, only it would have fewer customers, and would only be used for elective procedures such as cosmetic surgery.
Here is a hint, oh clueless ones. Cosmetic surgery is not currently covered by most insurances. When it is an elective procedure, it is a cash pay proposition, and that market is functioning very well in terms of price competition and affordability. If cosmetic surgery is covered at all, it is for reconstructive surgery resulting from injuries or conditions that may have drastically disfigured people. So what is it, oh clueless Bernie and company? Is elective cosmetic surgery going to be taken over a third party that will only succeed in making it more expensive?
In this post and the next two, I will do a rundown of the three most recent (and resounding) failures of single payer coverage to take hold in single states. Let’s start with Bernie’s home state of Vermont.
An article by Politico entitled “Why Single Payer Died in Vermont,” dated December 20, 2014 examines the collapse of the single payer ideology in Vermont (for now). It states that Governor Pete Shumlin put the kaibosh on single payer health “coverage” in Vermont, saying that the state couldn’t pay for it. Politico reports that Shumlin said it is not the right time for Vermont to pass a single payer health care system.
His reasoning? He realized that the 11.5 percent payroll assessments on business and sliding premiums that could go as high as 9.5 percent of individuals’ income could hurt the state’s economy. So when would such tax increases NOT hurt the economy, may I ask?
The Politico article quotes Jack Mozloom, spokesman for the National Federation of Independent Business, as saying, “If cobalt blue Vermont could not find a way to make single-payer happen, then it’s very unlikely that any other state will.” He added, “There will never be a good time for a massive tax increase on employers and consumers in Vermont, so they should abandon that silly idea and get serious.” Bernie and his leftist Democrat cronies are always big fans of silly ideas, not to mention government central planning because, of course, no one is as intelligent as our government leaders, right? I guess us peons who are not in government are just too stupid to make our own health care decisions, at least according to Bernie and his cohorts. Oh yes, and according to Jonathan Gruber, one of the architects of Obamacare.
I think I will tackle Colorado’s epic fail to pass single payer “health care” during last November’s election in my next post.
Sources for further reading:
After I wrote my previous blog post about two important principles expressed during the Free Market Medical Association conference, the truth of those principles have continued to be confirmed in my mind throughout the past week, and will, no doubt, continue to be.
I will review those two principles just in case anyone is viewing this blog for the first time (but feel free to read my previous posts, of course). They are:
- Washington can’t fix health care.
- We have to fix health care.
Where do I start when it comes to confirmations of these two principles? A New York Times article written by Marc Santora from November, 2016 entitled, “Many Insured Children Lack Essential Health Care, Study Finds” states the following:
“A new study to be released on Monday by the Children’s Health Fund, a nonprofit based in New York City that expands access to health care for disadvantaged children, found that one in four children in the United States did not have access to essential health care, though a record number of young people now have health insurance.”
In the previous paragraph, the article uses the story of Margo Solomon who has “insurance” for herself and her four children, and yet getting treatment is another matter entirely. Solomon has trouble finding a doctor that accepts her insurance and she has the challenge of finding a specialist for three of her children who suffer from asthma and other medical conditions. The article also says, “And once in the door, she cannot afford the costs, including for deductibles and medications.”
Clearly, this “coverage” is the result of the Patient Protection and Affordable (?) Care Act. Wasn’t this insurance supposed to be for those struggling with health problems and lack of insurance coverage? But what good is insurance coverage if those who have it are still struggling to obtain and pay for the care they actually need? This is something Washington did, but what good is it? I am willing to bet that Solomon would say “Not much” if she is struggling to pay for the out-of-pocket costs such as deductibles and medications.
Who knows? Maybe those brilliant Obamacare “navigators” didn’t bother to tell her she might qualify for some of the cost-sharing subsidies as well as a premium subsidy for low-income people. But maybe she doesn’t qualify for those anyway. I don’t know the woman’s income situation or the levels of income required for those cost-sharing subsidies to apply. However, as challenging as health care is for her right now with her Obamacare “coverage,” (I assume that’s what it is), I would contend that she is much better off without any more government intervention in her personal business. I don’t see that it has helped her all that much.
I am willing to bet that this woman and her children would be much better served by a low-cost Direct Primary Practice, although I don’t know if there are any in her area. Or perhaps, if she could have a Health Savings Account coupled with a low-cost High Deductible Health Plan (a truly catastrophic plan) that would cover the bigger (and hopefully rarer) expenses. With such an arrangement, she could find the doctors she needed at a price she could afford because she could go into a doctor’s office WITHOUT an insurance card and find out how much they may charge for an cash-paying patient (often less than the insured patient) and pay cash for the service with her HSA. However, as I learned a couple of years ago, such a payment strategy for medical services is close to impossible now under Obamacare because of the essential benefits mandates that force insurance companies to cover services for which a health insurance buyer may have no use. I found that the high deductible insurance was very high even if coupled with an HSA when I was trying very hard to escape Obamacare.
This situation, and many similar ones, has been brought on by Washington’s meddling in the delivery of medical and surgical care. During the failed “effort” for the repeal and replacement of Obamacare, we saw that most of Congress only focused on the issues of how many people would be “covered” by health insurance. Yet, in so many cases like the aforementioned scenario, this “coverage” proves to be more and more worthless every day. Yet Washington and the media babble endlessly about “coverage.” Under Obamacare, my coverage stinks! The deductible for my husband and me is $11,500 this year.
So while Washington continues to babble cluelessly about “coverage,” the point made at the FMMA conference, that “we the people” must fix health care remains very solidly at the center of my thoughts. How do we do it? I contend that we start in little personal ways. I am making it a point to become a more educated consumer in my health care choices. I admit to making a few missteps, but I keep making it a point to learn more.
Once again, the doctors, nurses, and other providers of medical and surgical care cannot change health care by themselves. We, as patients, have to go find high-quality physicians and facilities that offer transparent and better pricing for services and use those services. I believe these actions can encourage a free market in health care.
Sources for further reading:
*If you would like to join me in my individual journey to fix health care in the United States, I encourage you to sign up for my email list at the top right hand of this post so that I can share my thoughts and strategies for creating and even better system of delivering medical and surgical care.
I packed up and headed off last Thursday for a conference called “Be a Beacon” being put on by the Free Market Medical Association in good old Oklahoma City, and I have come back with a renewed sense of mission for promoting the free market in medical care along with a great arsenal of information to use on my mission.
Thursday was my traveling day, which turned out to be pretty crazy (more about that later). Then the main part of the conference got started bright and early Friday morning. To begin with, there was a session about Direct Primary Care that I sat in on briefly while I ate breakfast. I was very interested in the way doctors who were involved in their own DPC practices were living, breathing testaments to the benefits of that primary care practice model and to the benefits their patients experienced by being members of such practices.
I am not going to give you a play-by-play of the conference because you can actually get that just by going to the FMMA website, but in this and future posts, I will describe some of the ways that the conference presenters impressed me and my takeaways from those insights.
Something said by the presenters for Texas Free Market Surgery, Dr. Patrick Kelley and his brother Sean Kelley, hit me hard, although it should be quite obvious. Wait for it …
- Washington can’t fix health care.
- We have to fix health care.
(Both these statements were on the Power Point in very large letters.)
Considering what happened in the failed effort to repeal (and possibly replace) the Patient Protection and Affordable Care Act (not so fondly know as Obamacare), I am sure that these two statements are no great revelation. After all, look at all the chicanery that took place around the discussions about various degrees of repealing Obamacare. The country witnessed a lot of wrangling back and forth between Democrats who clearly had no interest in really participating, just spreading unfounded panic, and Republicans (only a handful of which really understood the actual problems with the way health care is delivered). The end result last month was a defeated “skinny repeal” that was meant to reverse the worst aspects of the disastrous legislation and regulations attached to it.
I kept thinking during the entire debate about the cluelessness of many involved, as well as the media, because the entire conversation was about “coverage,” and rarely about lowering the cost of care itself, although Senator Rand Paul did speak up for that. So, back to those two very pivotal statements …
It does certainly appear to be a very correct diagnosis of our current health care woes – that Washington can’t fix health care. I agree with that statement 100 percent. The only thing Washington could do that would be right would be release all of its control of health care, and let the free market totally work its magic. The way Washington is right now – fat chance of that!
Then this week I read an online column by Craig M. Wax, DO in Medical Economics entitled “Both Political Parties Are Responsible for Healthcare Disaster.” This was actually written in the midst of the Senate discussion regarding the repeal of Obamacare. Here is a quote that very much demonstrates why Washington cannot fix health care.
” … It is clear that both major parties in power are conflicted and unduly influenced by major political contributors. It is clear that both parties are bought and sold to big industrial corporate interests compromising their philosophy and stated goals. The Democrats want to increase taxes and borrow money to keep the poor dependent on government and voting for them. The Republicans want to maintain big government and give preferential treatment to corporate interests to gain their votes. It is both sides crushing the taxpayers in the middle.”
Wow, that was well said! It certainly hammers home the statement that Washington can’t fix health care.
So that leads us to the next statement they made – “We have to fix health care.”
Who is “we?”
It is everybody who believes that the only real salvation for the delivery and costs of health care comes from principles of the free market – the freedom of doctors, nurses, third party administrators of self-funded insurance plans, and so many other providers in the delivery chain for medical and surgical care to create and implement innovative ways to drive down the cost of that care to make it available to everyone. The people in health-related careers cannot do it all though. They need the support of their patients who believe in what they are doing to spread the word about how free market health care works for them, and how it can benefit many more people if those people give it an honest chance.
I know I am committed to that. How about you?
For further reading:
The last couple of weeks have been extremely busy, and this resulted in my being unable to get a complete blog post written last week and the week before for the first time since I launched my blog in mid-January of this year. I actually started two posts, which I will complete very soon.
However, I want to pause a moment and think about my “journey” in advocating affordable medical and surgical care, especially in the midst of some potential local controversy in my little world of Iron County, Utah.
The message of how a truly free market in health care can make its costs so much more affordable is certainly a difficult message to get across to many people. From what I have read in writings by doctors I follow on Twitter and on other platforms, I believe one of the main problems is that government meddling in the delivery of health care has become such a norm, especially after Medicare and Medicaid were voted into existence by Congress in 1965, that way too many people have come to expect that if they do not like the way the delivery of medical/surgical care is working, the government will solve the problem. The government tends TO BE THE PROBLEM!
Over the years, government has increased its involvement in the way medical and surgical care is delivered with a plethora of regulation. Of course, the two most recent heavy-handed interventions by government are the Patient Protection and Affordable Care Act (better known as Obamacare) and the Medicare and Chip Reauthorization Act of 2015 (known very unaffectionately as MACRA).
It cannot have escaped anyone’s notice that Obamacare really IS IMPLODING. There are already areas in the country that have been reduced to a choice of only one insurance carrier. One of those areas is mine!
Worse yet, the insurance I have been stuck with the last two years is a monopoly in the state of Utah, and especially in my somewhat rural area. I will call this monopoly out by name because it is important for people to understand how such “health care systems” keep prices high by limiting the facilities and physicians people are able to use.
The culprit in my area, and I am sure many other areas of the country have their own similar culprits, is Intermountain Health Care, which is a “not-for-profit” organization. When I frequently reported on the activities of this much-revered “health care system” in my days working for a couple of weekly papers and one daily paper, I had no idea how Intermountain was operating to CONTROL its competition.
However, I learned that from my orthopaedic surgeon (and eventual employer), Randy G. Delcore, M.D.
One issue with Intermountain is that it is affiliated with a subsidiary insurance company known as SelectHealth. This insurance company has refused to contract with Dr. Delcore’s surgery center, Cedar Orthopaedic Surgery Center, even though the surgery center offers much lower pricing for orthopaedic surgeries than our local hospital does. Therefore surgical patients with SelectHealth are herded to the hospital for orthopaedic surgery procedures where it is guaranteed they will pay more just in deductibles and co-insurance because some of Dr. Delcore’s costs for procedures are well below the average deductible under Obamacare. I have explained in previous posts how hospitals and insurance companies collude to play a game of phony discounts that make people THINK they are getting a good deal, when they are not.
Not only does Intermountain refuse to contract with Dr. Delcore’s surgery center, but it also essentially bribes other insurers and third party administrators to refuse to contract with COSC. This situation is coming to a head even as I write this because the public schools in Utah are self-funded, and yet they have a third-party administrator known as Educators Mutual Insurance that broke off its contract with COSC about four years ago because the TPA was offered a larger “across-the-board” discount for medical and surgical procedures from Intermountain for canceling its contract with COSC than it would get if it continued to renew its contract.
After four years of remaining a physician on contract with EMI, but not being able to offer patients the real savings of procedures at COSC, Dr. Delcore made the very difficult decision to break off his physician contract with EMI. Then EMI did not waste any time in sending emails to those whose insurance it manages that they would have to find another orthopaedic surgeon … and isn’t it so convenient that Intermountain just happens to have two employed orthopaedic surgeons in our area to which patients can be herded?
If this is not monopolistic behavior on the part of Intermountain, I don’t know what is. I feel I can be open about this controversy because I submitted a “letter to the editor” on behalf of Dr. Delcore to our weekly paper, Iron County Today, and it should actually be in today’s edition. So the cat’s out of the bag. I have also been working at mailing out this same letter directed to public school insurance holders who are also Dr. Delcore’s patients. So if you’ve been wondering where I have been, this is what I have been up to while being a little delinquent from my blog, but I feel it is a worthy cause because it is an issue very close to my heart in terms of health care costs.
I don’t know, at this time, how publishing this letter will work out, but I hope we can wake people up to the harm that hospital and insurance company monopolies can cause to patients and society as a whole. I will keep you all posted on what happens next.
Just as little note here – when President Obama was promoting his signature “health care plan,” he praised Intermountain. This alone should tell you something about that company – control issues!
Photo by Daron Pealock, R.N., Nurse/Administrator at COSC- Post Acute Care Unit at Cedar Orthopaedic Surgery Center.
The Senate Republicans finally managed to do it! … Kind of, but not really.
“Do What?” you might ask, but only if you didn’t hear Tuesday’s news.
They managed to actually get a majority vote in favor of moving the repeal of Obamacare to the debate stage. Unfortunately, that is as far as they got. So, as far as I can keep track of after that, one comprehensive bill to repeal and replace Obamacare was voted down with a vote count of 43 to 57, according to an article by the New York Times (1).
It appears that the vote came not too many hours after the vote to approve moving the issue of repealing and replacing Obamacare to the debate stage. I wonder how much debate actually took place before the comprehensive repeal and replacement bill failed. Sometimes I get nervous about hearing the actual debate for fear that I will get so mad at something someone says that I will start foaming at the mouth.
Then the Senate went on to the strategy of trying to pass something called a “skinny repeal.” According to an article on the website CNN Money (2), the main tenets of the “skinny repeal” included the following:
- Elimination of the individual mandate to buy insurance. The bill set the tax penalty at zero, which basically means the mandate would be history.
- Get rid of the employer mandate for eight years. I have to ask here, “Why eight years?” It’s probably just another instance of our “leaders” in government thinking they might have severe withdrawal symptoms if they cannot keep some sort of stranglehold on the people in the country.
- Provide a lot more flexibility to states regarding Obamacare insurance regulations through waivers. However, the overall effect of those waivers appear to be unclear … more about that later.
- De-fund Planned Parenthood and divert that money to Community Health Clinics that would care for a woman’s total health and is not involved in providing abortions.
- Eliminate the medical device tax for three years. Here’s another one that is very tentative in letting go of government control.
- Then finally, increase the contribution limit for Health Savings Accounts.
However, according to a Fox News Politics story (3), in the wee hours of Friday morning (around 2 a.m.), the “skinny repeal” failed to pass by a vote of 51 to 49. I regret to say, and I am sure that those of you reading this already know and may be spitting nails over it, Senator John McCain cast the final vote against it. I am looking into his “reasons.”
I am bitterly disappointed in the Republicans right now, and I agree with much of what Sean Hannity was saying on the radio this afternoon – that the Republicans seem to have abandoned all the vision that we thought they stood for. Now it’s hard to tell what they stand for unless it’s election time and they want votes to stay in power. I was going easy on the Republicans a few months ago when people were attacking them for not having an actual Obamacare Repeal or Repeal and Replacement plan ready to get voted on and go to President Trump’s desk to be signed. However, I am agreeing with many pundits that the blasted Republicans really had seven years to pull a doable plan to repeal and replace Obamacare together, and they really squandered it.
Are they just incompetent … or have they lost all their “guiding principles?”
Sources for further reading:
For a little while now, I have been giving most of the Republican senators the benefit of the doubt (huge doubt) as they convened and tried to work out a good solution for repealing and replacing the Patient Protection and Affordable Care Act although I feared a lot of high payout deal-making, which always stinks to high heaven.
I think that now I am totally with both Sean Hannity and President Donald Trump in my frustration about the Senate Republicans’ deep, and apparently irreconcilable differences in how this repeal is supposed to work.
In my opinion, one of the biggest problems I see is some Republicans, that could really fit the description of Republicans in Name Only, are trying to “bring home the bacon” in their states. The repeal and replacement of Obamacare should not be something that senators are supposed to be paid off to accomplish. This is something desperately needed by the American people – those people who wanted this change so badly that they could not stomach four more years of the “same ‘ol, same ‘ol” top-down government control, so they voted for Trump instead of Clinton. Of course that is not the only reason they voted for Trump, but it was certainly high up on many Americans’ priority list.
One of the RINO “villains” in this repeal and replacement drama is Senator Lisa Murkowski. According to a July 13 article on Business Insider (1), the most recent version of the Senate repeal and replacement bill contains a provision that holdout Murkowski can take home to her home state of Alaska. Of course, right now there are several different versions of a Senate bill running around that are basically unsatisfactory in one way or another, and the main effort now may be just a clean repeal.
What is that provision?
The provision provides a pot of money to the state stability fund that would be given to states to help them offset high insurance premiums and encourage people to sign up for coverage. I’m sorry, but this sounds like warmed-over Obamacare to me because Obamacare was all about pushing people to sign up for insurance coverage.
Now here’s a novel idea, why not create a truly free market in both health care and health insurance? There are many ways to do this, and yet somehow this senator feels that her state must be paid off to make any move to repeal and replace Obamacare. In fact, the whole idea of repealing and replacing Obamacare is to allow people more choices in the way they personally manage their health care – it is not about delivering goodies to certain states to bribe a senator from that state to “come along.” I thought that one of Trump’s principles around his election was to “drain the swamp” in Washington. I would characterize any unusual amount of money Murkowski might get set aside for Alaska as pretty swampy.
Business Insider quotes the provision pertaining to Alaska as follows:
“The Administrator shall determine an appropriate procedure for dividing and distributing funds under this subsection that includes reserving an amount equal to 1 percent of the amount appropriated under paragraph (1) for a calendar year for providing and distributing funds to health insurers in States where the cost of insurance premiums are at least 75 percent higher than the national average.”
It just so happens, according to a report (cited by Business Insider) from the Department of Health and Human Services, that Alaska is the only state that qualifies for that provision.
The Business Insider article states the following: “Based on the amount of money set aside through the state stability fund, Alaska would likely end up with hundreds of millions of dollars annually toward its health insurance markets.”
So this is something offered to the state of Alaska by way of Senator Murkowski to basically bribe her to go along with repealing and replacing Obamacare. FOR CRYING OUT LOUD! Murkowski is supposedly a Republican senator, but with spend-crazy Republicans like her, who needs Democrats to run this country into the ground financially? Does she have any conscience whatsoever?
If I could have a crack at talking to her, I would tell her to talk to people who really understand what is going on in the health care sector of our economy (I could refer her to a few) and the fact that the high cost of health insurance premiums is the symptom behind the country’s “health care” woes, not the main problem (although insurance companies are complicit in the scam). I have written about this before, but more about this in a future post.
Murkowski is just creating continued dependence on the government by the people of Alaska and insurance companies that do business in Alaska. Instead, she should be getting an education concerning the true drivers of high health care costs and working to solve those problems, which would drive down health care costs, and in turn, the cost of health insurance.
In an editorial in USA Today (2), Senator Rand Paul wrote that the previous Senate bill (one that was roundly rejected by all sides in the Republican party for a variety of reasons) kept a majority of the Obamacare taxes and spending. It also contained a $200 BILLION bailout for insurance companies. Clearly, a good chunk of this would be going to Murkowski’s home state.
Not only that, Murkowski has a few other very “leftist-oriented” demands. She has also opposed cuts to Medicaid and freezing the funding for Planned Parenthood, even with the knowledge of those horrific videos in which abortionists talked casually about selling the body parts of unborn babies while eating and drinking. I question why Murkowski hangs with the Republican party; I don’t see an ounce of conservatism in her. She really needs to be more honest and just switch to being a Democrat (or at least go unaffiliated) because she is clearly a traitor to any true conservative principles. Of course, she’s not the only one I could say that about.
I, like my husband, am growing more and more frustrated with the Republican party. My husband finally ended his membership in the party and is now registered to vote as an independent. I am headed there, yet I have held out hope for a while that I could positively contribute to the Republican party by choosing people in primaries and caucuses who truly reflect its principles. However, that hope is growing dimmer and dimmer in the face of Republican antics like Murkowski’s.
Sources for further reading:
*As I have said before, I am just getting warmed up on the the subject of repealing and replacing Obamacare as well as encouraging a much freer market in medical and surgical care that could really decrease costs for everyone and make that care much more accessible. If you are curious to know what I have to say next about all this, I encourage you to sign up for my email list, which is at the top right hand side of this post.
Photo courtesy of canstockphoto.com.
Last week I pointed out clear flaws in the way the Congressional Budget Office analyzed the effect of the Better Care Reconciliation Act, otherwise known as the Senate bill to repeal and replace the Patient Protection and Affordable Care Act. In analyzing three of the most recent legislative efforts to repeal and replace the ACA (otherwise known as Obamacare), the CBO has come out with estimates that are difficult to fathom considering the vast differences in assumptions each estimate makes.
There is apparently another plan that has come out that is really no better than the other plans from what I am hearing from Senator Rand Paul’s objections on the news, and no doubt, the CBO will get around to weighing in on that one too. Why bother though? I don’t doubt that the agency will pick a number, any number, somewhere between 22 and 24 million as their estimate on how many people will “lose” coverage if that particular Senate bill were to pass.
Then that “dire” number will be trumpeted all over the media as those who will be “losing” coverage as a result of that bill. As Avik Roy pointed out in the Forbes article to which I referred in my last blog post, approximately 15 million of those people are not “losing” their insurance, but REJECTING their insurance. The sad aspect of that is, there will still be no insurance to which they can flee, because the only plans allowed will still be Obamacare-type plans. The Senate rejected Senator Ted Cruz’s Consumer Freedom Amendment – more about that in a future blog post.
I would like to once again, demonstrate how faulty the CBO estimates are concerning any issue of coverage or non-coverage whether Obamacare is in effect or not.
Let’s start with the CBO’s estimates in a 2012 report of how many people it predicted would sign up for Obamacare in advance of the sign-ups.
Here is a quote from that March 2012 report by the CBO entitled, “Updated Estimates for The Insurance Coverage Provisions of the Affordable Care Act,” (1) regarding how many people would gain coverage through the Obamacare exchanges.
“According to the current estimates, from 2016 on, between 20 million and 23 million people will receive coverage through the new insurance exchanges and 16 million to 17 million people will be enrolled in Medicaid and CHIP.”
So let’s look at how the numbers have actually shaken out so far.
An editorial in The Hill (2) about an early 2017 meeting of the House Budget Committee regarding the failures of Obamacare, says that Ed Haislmaier, senior research fellow with the Heritage Foundation, estimated that only 14 million people gained insurance through the Obamacare exchanges between 2014 and 2015. He added that early estimates of those receiving health insurance through the individual market for 2016 were another 842,028.
Other figures Haislmaier reported were as follows:
- A decline of 1,128,597 individuals enrolled in fully insured employer health insurance plans.
- Enrollment in self-insured employer plans increased by 776,780 people.
- Individuals enrolled in Medicaid and CHIP (Children’s Health Insurance Program) increased by 2,044,809.
So, according to this editorial in The Hill, the approximated number of people that actually gained some form of health coverage in 2016 was 16.5. This number does not even come close to the 20 million to 23 million people the CBO estimated would gain “insurance” through the exchanges.
Clearly, there are no totals for 2017 yet as we are in the middle of the year. However, if the CBO did such a woeful job so far of predicting how many people would be covered from 2016 on, how can we possibly expect that office to provide any believable estimates for how many people might “lose” their insurance as the result of an Obamacare repeal with or without a replacement? Don’t forget that in its estimations of the people that would “lose” their insurance are an approximate 15 million who would not be losing it, but canceling it of their own free will and saying “Good riddance!”
My theory: the numbers that the CBO has been putting out regarding the number of people who would be without “coverage” are merely something the Democrat left and Republicans in Name Only (RINOS) can use as scare tactics – nothing more, just a useful propaganda tool.
Sources for further reading:
As the Senate is now in the heat of discussions regarding the changes it wants to make to the Republican repeal and replacement of the Patient Protection and Affordable Care Act (more like Unaffordable Care Act), the Congressional Budget Office came out with its estimation a couple of weeks ago of the effect the Senate Bill, which bears the name the Better Care Reconciliation Act, COULD have on the United States overall.
Ever since that publication of the CBO estimates, the Democrats and some Republicans In Name Only, lovingly called RINOS by true conservatives, have been shrieking that somewhere between 22 and 24 million people will lose coverage, depending on with whom one is talking. The Democrats and RINOS throw that number out with the express purpose of making people panic and call their Senators with impassioned pleas not to take away their “health care.”
A Forbes article entitled “CBO Predictions About the Senate Health Care Bill Are Deeply Flawed,” written by Avik Roy (1) explains that the absurdity of the CBO predictions can be demonstrated by the various predictions this “august” government agency has thrown out in reference to three different bills meant to repeal the Unaffordable Care Act in one way or another.
Those three bills include:
- The Restoring Americans’ Freedom Reconciliation Act (H.R. 3762 – 2016)
- The American Health Care Act (2017)
- The Better Care Reconciliation Act (Senate version of the AHCA – 2017)
According to this article, the RAFRA bill, which was intended as a repeal of Obamacare with no replacement, was analyzed by the CBO to cause 22 million Americans to be uninsured by 2026 with no subsidy provisions for coverage.
The article then states that the American Health Care Act, which is the House of Representatives’ version of repealing and replacing Obamacare this year, contains a system of flat tax credits that are not dependent on income. This system of tax credits proposed to spend approximately $375 million over the next 10 years to subsidize the purchase of health insurance. Yet the CBO estimates that, even with that $375 billion in subsidies, there will be 23 million more people without insurance than are currently covered under Obamacare over that 10-year period.
Roy describes the final kicker in these rather strange CBO calculations: the Senate bill that rejected the flat tax credits offered in the AHCA and spends $616 billion for means-tested tax credits over 10 years (which means that these tax credits/subsidies are directed toward low-income people), still results in a coverage loss for 22 million people in comparison to the number that are presently covered. Ironically, it appears that no matter how much money the federal government coughs up to make sure that as many people as possible are covered, there is very little improvement on the numbers of those who would ostensibly “lose” their coverage, at least according to the CBO.
The explanation Roy offers for these rather strange calculations is the individual mandate imposed by Obamacare that requires all U.S. citizens (with few exceptions) to consistently buy health insurance. So the CBO estimates that if the individual mandate is repealed, 15 million people will cancel their health insurance (or that which they are currently stuck with) in 2018. Clearly this is not a case of people being “thrown off” their insurance, but of reveling in the freedom of not being forced to buy insurance that they despise anymore. By my own calculations, this 15 million people is slightly short of 70% of the total amount of people who might be expected to be without health insurance coverage by 2026, and that would be immediately in 2018.
There are some other aspects of these suspect CBO calculations to be considered such as the question of whether 15 million people celebrating their freedom might not acquire some other form of coverage as a substitute for the burdensome Obamacare. What if all the essential benefit mandates were removed as a result of the repeal and replacement of Obamacare and people are free to buy the insurance of their choice?
According to an article by Justin Haskins in “theblaze” (2), Senator Ted Cruz (R-Texas) has proposed an amendment to the Senate bill since the CBO estimates that could provide many people with the flexibility they are looking for. This amendment would allow insurers to offer a wide variety of plan types as long as they offered at least one plan with all the required Obamacare mandates. This is intended to create the ability for insurance companies to offer much more flexible plans and benefits than Obamacare provides. This newly acquired freedom could result in many of those 15 million canceling their expensive plans in favor of lower-cost plans being made available without all the required bells and whistles.
I would conclude, from all I have read so far, that the CBO is making some very loose assumptions with very little qualification that are being used by leftist groups to spread misinformation and panic about the real intent of the Republican proposals to repeal and replace Obamacare.
Sources for further reading:
*I plan on using the next few posts, at least, to analyze the various facets of the debate regarding the proposed repeal and replacement of Obamacare. If you would like to be notified of future posts on the subject, please sign on to my email list to the upper right side of this post, and you will receive any new posts every Thursday morning. I am also planning a new offer in the near future.
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