Lost in the din surrounding the ongoing outrage about Donald Trump and the shock that ensued after the Brits voted to leave the European Union, the House Republicans released a position paper on the contours of the plan with which they’d like to replace the PPACA:
House Republicans led by Speaker Paul Ryan (R-Wisc.) on Wednesday released the most comprehensive GOP health plan to date. The plan is the fifth of six agenda items that comprise the House GOP’s “A Better Way†agenda for 2017 and beyond. Evan Smith of Opportunity Lives and Avik Roy at Forbes have good summaries of the plan.
The proposal repeals and replaces Obamacare, but it does more than that. It is an ambitious effort to reform our health system more broadly by updating laws that are quite literally stuck in the 1940s and 1960s. The proposed changes to our $3 trillion healthcare economy (which is one-fifth of our entire economy) will have profound impacts on patients’ lives, jobs, wages, the future of American politics and the character and direction of the Republican Party.
which would seem to address the often-heard complaint that the House Republicans have no plan of their own. I haven’t looked around for commentary but I presume there will be continuing complaints about their not having completely fleshed-out legislation.
In producing an election year position paper, they’re following the Democrats’ lead. In 2008 the Democrats hadn’t drafted a piece of legislation, either, but they did produce a position paper and their position paper included many of the features that eventually became ObamaCare.
I assume that Democrats will reject the Republicans’ plan out of hand. Here’s my question. Is that the right reaction? Based on the analyses I’ve read the Republicans’ plan isn’t all bad. As it stands the PPACA will continue to stagger upright as long as the Congress is willing to toss money to insurance companies.
I should show my own cards. I’m skeptical of any plan including the PPACA that doesn’t confront the rising cost of healthcare head on. I don’t think that any market-based approach can work because there is no market in healthcare and can’t be one as long as we restrict the supply of healthcare services without restricting the demand for healthcare services and, frankly, it makes pretty good sense to restrict the supplyu of healthcare services.
But I’d like to get more reactions.
No market in medical care? How about laser eye surgery and contact lenses?
https://www.google.com/webhp?sourceid=chrome-instant&rlz=1C1MSNA_enUS690US690&ion=1&espv=2&ie=UTF-8#q=laser%20eye%20surgery
https://www.google.com/search?q=contact+lenses&rlz=1C1MSNA_enUS690US690&espvd=2&biw=1536&bih=764&source=univ&tbm=shop&tbo=u&sa=X&ved=0ahUKEwi-z–U_sjNAhVEdj4KHYPGAssQsxgI5gE
There are niches but there is no market across healthcare.
Try to open a hospital. Or put out a shingle as a physician.
And why are they niches? Perhaps because they are much less dependent on 3rd party payers and generally less subject to medical needs boards?
1) The plan needs to fix its typos. It claims premiums, because of Obama care, have been increasing $17,000 annually since 2010. Pretty sure the average health care plan in the US does not cost over 100k.
2) This is a vague, aspirational paper. Half of it is just complaints about Obamacare and how the GOP is going to make government smaller. (I will assume that I am the only way to read the original paper BTW, but then I have a stake in these things.) Almost no details. IOW, this plan will make Health Care in America Great Again! (This may lead to a lawsuit so they might want to be careful about using this.) So really, the GOP DOES NOT have a plan.
3) Since this is not a detailed paper it does not deserve a detailed critique, but I guess I should point out the irony of a paper complaining about the high deductibles of Obamacare and then promoting HSAs. Are they just assuming no one will know what an HSA is? High risk pools failed before. Why will they work just because the GOP now likes them? Purchasing across state lines? LOL Lordy, I always love that one.
4) So what are the odds that the GOP will come out with a plan if Trump wins the election? I would place it at less than 5%. We might get another one or two vague position papers, but not much more. They just aren’t interested in the topic. What they will pass, if they can, is block grants to Medicaid, meaning they will just cut Medicaid spending.
5) At least they are going to repeal the ban on physician owned hospitals. My surgical buddies can go back to skimming off the patients with good insurance for their privately owned hospitals.
Steve
Roy-Because it is not really medicine.
Steve
Aren’t we bound to end up with what no one wants to say, that is you can live if you can pay, if not, you may or may not see another sunrise.
I don’t think so. I think we’re bound to end up with what everyone else in the world has: a system in which healthcare workers earn decent enough livings but very few are in the top 1% of income earners.
Haven’t read the plan and I don’t intend to because it will be DOA. At best, assuming the GoP keeps the House and Senate majorities, they might be able to get a few things passed assuming they are willing to pay whatever price the Democrats will take for not blocking it – assuming is there is any price at all.