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(AEI Ideas)   How to turn Obamacare into FreeMarketcare in 4 easy(-ish) steps   (aei-ideas.org) divider line 119
    More: Interesting, FreeMarketcare, obamacare, sliding scale, health savings account  
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2394 clicks; posted to Politics » on 03 Dec 2012 at 11:36 AM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2012-12-03 10:23:01 AM
ObamaCare is already FreeMarketCare. I don't support the idea of putting Medicare into the mix. Leave it alone.
 
vpb [TotalFark]
2012-12-03 10:26:49 AM
Deregulation and cuts and get rid of Medicare. I didn't even need to read it.
 
2012-12-03 10:27:34 AM
1. Deregulate the state exchanges, while capping subsidies.
I understand those words, but what on Earth does that even mean?

2. Slowly shift Medicare patients into the exchanges.
Why? What's wrong with Medicare as it is?

3. Let more people buy insurance on their own rather than through their employer.
Why? Employers can pool insurance and negotiate for much lower rates than an individual can. Part of the reason I still work where I do is because of my awesome benefits package.

4. Move Medicaid patients into the exchanges.

How is this different than #2? Is this idea so novel that it needed mentioned twice?
 
2012-12-03 10:30:30 AM

make me some tea: ObamaCare is already FreeMarketCare. I don't support the idea of putting Medicare into the mix. Leave it alone.


Yeah, if you want universal health care you must pick 1) "a windfall for the insurance companies" via the mandate, 2) competition against a public insurance option or 3) the end of private health insurance as we know it. Obama picked #1.
 
2012-12-03 10:47:11 AM

nekom: 1. Deregulate the state exchanges, while capping subsidies.
I understand those words, but what on Earth does that even mean?



I think it means that the states would be able to offer as many or as few services as they want, and the Federal government would have a hard limit on how much support they would provide. So just imagine what the exchange would look like in places like Alabama and Mississippi.
 
2012-12-03 10:48:32 AM

nekom: 1. Deregulate the state exchanges, while capping subsidies.
I understand those words, but what on Earth does that even mean?


Currently, only insurance packages that meet certain criteria can be included in the exchanges. By deregulating the exchanges, all kinds of crummy insurance packages would become available to lure in unsuspecting customers.

Also "capping subsidies" is a dog-whistle for tax cuts (or preventing a tax increase).

2. Slowly shift Medicare patients into the exchanges.
Why? What's wrong with Medicare as it is?


Government pays for it.

3. Let more people buy insurance on their own rather than through their employer.
Why?


Because then, the employer does not have to pay its employees' insurance. Allowing them to make more profits and cut a few HR employees.

4. Move Medicaid patients into the exchanges.
How is this different than #2? Is this idea so novel that it needed mentioned twice?


It's exactly the same as #2.
 
2012-12-03 10:50:57 AM
Done in one
 
2012-12-03 11:17:11 AM
What's the part where you intentionally hand over control of a state agency to the Federal government because you refuse to carry out optional work?
 
2012-12-03 11:39:56 AM
Only three viable options:

1. Public option.
2. Single payer.
3. F*ck the f*ck off, you lost. Deal.
 
2012-12-03 11:40:08 AM
The boat has a leak. Solution: drill more holes in the bottom of the boat.
 
2012-12-03 11:41:23 AM
Wasn't the whole point to slowly remove health care from the free market? Is there a reason why we are pretending that the free market is going to do good things for health care? (Umm, if it were going to, wouldn't it have done it already?)
 
2012-12-03 11:41:29 AM

Flab: nekom:
4. Move Medicaid patients into the exchanges.
How is this different than #2? Is this idea so novel that it needed mentioned twice?

It's exactly the same as #2.


Actually Medicare and Medicaid are different programs. Medicare is old people, Medicaid is poor people (including poor old people).
 
2012-12-03 11:43:59 AM
Like, really embrace it. To the max.

ct.fra.bz
 
M-G
2012-12-03 11:45:11 AM

iccky: Actually Medicare and Medicaid are different programs. Medicare is old people, Medicaid is poor people (including poor old people).


And Medicare is run at the federal level, while Medicare is handled by the states, with federal support.
 
2012-12-03 11:45:44 AM

Lumpmoose: make me some tea: ObamaCare is already FreeMarketCare. I don't support the idea of putting Medicare into the mix. Leave it alone.

Yeah, if you want universal health care you must pick 1) "a windfall for the insurance companies" via the mandate, 2) competition against a public insurance option or 3) the end of private health insurance as we know it. Obama picked #1.


A windfall for the insurance companies like the budget negotiations were 98% of what the GOP wanted back in 2010?

Be careful with Obama, that man is wily. It's awesome to watch.
 
2012-12-03 11:45:54 AM

M-G: iccky: Actually Medicare and Medicaid are different programs. Medicare is old people, Medicaid is poor people (including poor old people).

And Medicare is run at the federal level, while Medicare is handled by the states, with federal support.


OK, fine. But what about Medicare?
 
2012-12-03 11:47:04 AM
yes, i want my 80 year old mother to have to decide amongst various insurance coverages she should buy, that sounds like a brilliant plan. somebody give that CEO a bonus
 
2012-12-03 11:47:42 AM
Let more people buy insurance on their own rather than through their employer.

I was unaware that people were not allowed to buy private insurance. Not able to afford it, sure - but unless this guy has a plan upping the wages of everyone in the country by 25% or so, I don't see how you 'let' more people do this.
 
2012-12-03 11:48:38 AM
3. Let more people buy insurance on their own rather than through their employer.

I didn't realize people were being prevented from buying their own insurance? Damn Obama.
 
2012-12-03 11:50:46 AM
i.imgur.com
 
2012-12-03 11:50:57 AM
As long as the "decision makers" and "job creators" can skim a dollar or two off the top, times 300 million, then it's ok.
 
2012-12-03 11:51:43 AM
Answer one question. Who benefits from adding a profit motive?
 
2012-12-03 11:51:46 AM
The problem with the approach outlined is that it doesn't really address where the costs are coming from:

1) none of the participants other than insurance companies have any incentive to control costs (i.e., buyer isn't paying)

2) Insurance companies do have incentive to control costs to themselves, but not costs to the patient. And in addition they have a profit motive which incentivizes them to retain any savings they force from the providers rather than pass it on to the buyers.

Insurance should be used only for catastrophic heath needs -- sudden onset of rare disease, car accident, complications at childbirth, etc... Not for eldercare or preventative care. Everyone needs those things and insurance for something everyone needs only adds overhead.
 
2012-12-03 11:52:45 AM

Lumpmoose: make me some tea: ObamaCare is already FreeMarketCare. I don't support the idea of putting Medicare into the mix. Leave it alone.

Yeah, if you want universal health care you must pick 1) "a windfall for the insurance companies" via the mandate, 2) competition against a public insurance option or 3) the end of private health insurance as we know it. Obama picked #1.


Obama picked #2. The "IF THAT DAGBURN DIMMYCRAT VARMINT IS FER IT, AAAAAAAHHHHH'M AGIN IT!' crowd picked #1, and then blamed the dagburn Dimmycrat varmint.
 
2012-12-03 11:54:08 AM
So, basically "Obamacare" becomes 'free market' if we end Medicare and Medicaid. Got it.
 
2012-12-03 11:54:40 AM
3. Let more people buy insurance on their own rather than through their employer.

Wow. So, just LET people buy insurance on their own. It's that easy, is it? Well, how about that whole middle ground where health insurance is so ridiculously expensive that most people in this country can't afford it? THAT is the whole problem here--the lack of affordability of health care. The problem is I don't think "Obamacare" goes far enough to alleviate the problem.
 
2012-12-03 11:54:51 AM
1. Deregulate the state exchanges, while capping subsidies.
2. Slowly shift Medicare patients into the exchanges.
3. Let more people buy insurance on their own rather than through their employer.
4. Move Medicaid patients into the exchanges.


It's actually 3 steps, as 2 and 4 are the same. Also, steps 2 and 4 have nothing to do with Obamacare. Medicare existed before Obamacare.

As for #3, does the author think people are prevented from purchasing insurance on their own? Of course not, what the author really meant was "don't force employers to give their workers health insurance." It seems the author thinks an employer who saves $10,000 a year on health insurance costs is just going to pay that person $10,000 more a year. They won't. They'll keep it for themselves.
 
2012-12-03 11:55:05 AM

Zasteva: Insurance should be used only for catastrophic heath needs -- sudden onset of rare disease, car accident, complications at childbirth, etc... Not for eldercare or preventative care. Everyone needs those things and insurance for something everyone needs only adds overhead.


So you propose a massive increase in worker pay and Social security payments so that individual can afford all non-catastrophic medical costs out of pocket?
 
2012-12-03 11:55:17 AM
Why would we want to do that? Free market isn't compatible with "everyone has access", and we've decided pretty clearly as a nation that everyone having access is the more important part.

Unless there's been some massive popular movement against free emergency rooms that no one told me about.
 
2012-12-03 11:56:39 AM
I really don't farking get Americans. You rather have a for-profit pooling system, than a not-for-profit one that cost less and covers all...it's like you are all a bunch of morons.
 
2012-12-03 11:56:42 AM

nekom: 1. Deregulate the state exchanges, while capping subsidies.
I understand those words, but what on Earth does that even mean?

2. Slowly shift Medicare patients into the exchanges.
Why? What's wrong with Medicare as it is?

3. Let more people buy insurance on their own rather than through their employer.
Why? Employers can pool insurance and negotiate for much lower rates than an individual can. Part of the reason I still work where I do is because of my awesome benefits package.

4. Move Medicaid patients into the exchanges.
How is this different than #2? Is this idea so novel that it needed mentioned twice?


I thought the whole point of exchanges was to make it easier to buy insurance by yourself instead of through your employer.

The issue with #2 and #4 is that the elderly and poor are uninsurable. If you were an insurance company, would you offer insurance to somebody who was old and frail? Of course not. It would be like offering flood insurance on a house that was already being submerged.
 
2012-12-03 11:57:04 AM
All Obama needs to do now is allow Medicare/Medicaid to be sold 'at cost' on the exchanges. It is a back door into single payer.

All insurance companies add is hundreds of thousands of middle men who do nothing but add costs and deny care.
 
2012-12-03 11:58:13 AM

make me some tea: ObamaCare is already FreeMarketCare


Done in one.

No click

No reading rest of thread.
 
2012-12-03 11:59:05 AM

TomMalory: 3. Let more people buy insurance on their own rather than through their employer.

Wow. So, just LET people buy insurance on their own. It's that easy, is it? Well, how about that whole middle ground where health insurance is so ridiculously expensive that most people in this country can't afford it? THAT is the whole problem here--the lack of affordability of health care. The problem is I don't think "Obamacare" goes far enough to alleviate the problem.


This idea might be workable if the employers actually paid their employees the extra amount that they would have used for their health insurance, but I don't see either TFA or the link in TFA talk about that.
 
2012-12-03 11:59:37 AM
This is one of those cognitive dissonance bombs that goes off when you have someone's who's been theorizing all this stuff for years sees it enacted by his 'enemy'.

He's suggesting, as many pre-Obama conservatives did, that we "follow Switzerland and Singapore". While not getting into the *extremely-heavy* regulation of both the insurers markup and doctor/hospital allowable fees that are part of the Swiss or Singaporean model. Those two systems have a veneer of consumer choice at the front end, which is why the Heritage/Cato/AEI guys grasp at them, but at their core, the strict regulation is the bigger part and puts them closer to the Beveridge states than to the US pre-PPACA.
 
2012-12-03 12:00:29 PM

madgonad: All insurance companies add is hundreds of thousands of middle men who do nothing but add costs and deny care.

 

Won't somebody think of the middle managers?!

What is the ratio of positive to negative experiences when it comes to dealing with a private health insurer versus Medicare?
 
2012-12-03 12:00:45 PM
Anyone who says "deregulate" without specifying what they mean is either trolling or willfully ignorant.
 
2012-12-03 12:02:04 PM
More Americans would be acting as involved consumers.

Thanks for the laugh.
 
2012-12-03 12:02:27 PM
1) Fark it up
2) Fark it up
3) Fark it up
4) Fark it up
 
2012-12-03 12:04:12 PM

make me some tea: ObamaCare is already FreeMarketCare.


Not in the least.
 
2012-12-03 12:05:03 PM

ex0du5: Anyone who says "deregulate" without specifying what they mean is either trolling or willfully ignorant.


Words don't have meanings to these people, they have emotions. "Deregulate", "job creators", "tax cuts" - these things have good connotations. "Regulations", "government oversight", "socialism"...these are bad. You use good words to describe what you're doing, and bad words to describe what other people are doing. It's delightfully Orwellian and they don't even realize that they're doing it.
 
2012-12-03 12:05:42 PM

nekom: 1. Deregulate the state exchanges, while capping subsidies.
I understand those words, but what on Earth does that even mean?


It means a state can decide the "subsidy" is capped at 0% of your income, and that to qualify for the exchange, a policy need only be issued by a company with a license to do business in the state.

Or are they saying that the Feds can cap that subsidy at 0%? Not that the next Randian Free Marketist Compassionate Conservative would ever think of doing that...

2. Slowly shift Medicare patients into the exchanges.
Why? What's wrong with Medicare as it is?


As someone else said, "we pay for it." The GOP has totally forgotten (or worse, not forgotten) why Medicare was created in the first place - because "old people" could not afford health insurance - they were priced out of the market, much the same way "all people" are now. They seem to think that old people can just conjure up some affordable coverage the same way they could magically withstand communism.

(NB: An ad this morning, I think sponsored by AARP, ended with the message "Tell Congress that guaranteed coverage for seniors is too important to cut." I nearly flipped my shiat - WHAT THE FARK ABOUT EVERYONE ELSE, whose coverage is far cheaper? But AARP sez: "Fark you youngsters. No single-payer for you.")

3. Let more people buy insurance on their own rather than through their employer.
Why? Employers can pool insurance and negotiate for much lower rates than an individual can. Part of the reason I still work where I do is because of my awesome benefits package.


I actually support this one. However, I don't think TFA realizes he's calling for unionization of a slightly different kind.

4. Move Medicaid patients into the exchanges.
How is this different than #2? Is this idea so novel that it needed to be mentioned twice?


Infinitive pet peeve. Yinz needa learn some English in b'twynn all'ose Ahrnsitty burs.
 
2012-12-03 12:07:25 PM

nekom: 1. Deregulate the state exchanges, while capping subsidies.
I understand those words, but what on Earth does that even mean?

2. Slowly shift Medicare patients into the exchanges.
Why? What's wrong with Medicare as it is?

3. Let more people buy insurance on their own rather than through their employer.
Why? Employers can pool insurance and negotiate for much lower rates than an individual can. Part of the reason I still work where I do is because of my awesome benefits package.

4. Move Medicaid patients into the exchanges.
How is this different than #2? Is this idea so novel that it needed mentioned twice?


1) How does deregulation address the cost issue that was agree by both parties to be the underlying problem that needed fixing by healthcare reform?

2) How does shifting costs to consumers from Medicare address medical care cost issues from #1 when Medicare has a lower per-patient cost than most or all private insurance? Also, how does it address the issue of cost of elder care making many older people uninsurable at a profit, especially when coupled with suggestion 1?

3) How does reducing customer bargaining power by limiting grouping address cost issues as stated previously?

4) How does pushing the poor off the cheapest per patient healthcare (private and government) option address cost issues and coverage issues?

Answer? None of those suggestions do anything but result in more expensive insurance that covers fewer people for fewer issues.
 
2012-12-03 12:08:15 PM
I only skimmed through it... but it seems that the individual mandate wasn't even addressed by AEI. I thought that for all (non-rino) republicans, the individual mandate was the most evil of all things in the health reform because then people would have to eat brocolli. Why does AEI want all americans to be oppressed and forced to eat their veggies!
 
2012-12-03 12:10:05 PM
The republican spin machine would make INGSOC jealous.
 
2012-12-03 12:11:59 PM

The Jami Turman Fan Club: The issue with #2 and #4 is that the elderly and poor are uninsurable. If you were an insurance company, would you offer insurance to somebody who was old and frail? Of course not. It would be like offering flood insurance on a house that was already being submerged.


Actually I would. It is impossible to lose money in the insurance industry. You would simply have to offer the insurance at an amazingly high premium. You can absolutely offer flood insurance on a house that was already submerged. Those premiums are sure gonna suck though. That's the real issue. Not that no one would offer the insurance but rather the premiums would make insurance unaffordable.
 
2012-12-03 12:13:36 PM

ex0du5: Anyone who says "deregulate" without specifying what they mean is either trolling or willfully ignorant.


Corollary: Anyone who says "deregulate" while simultaneously extolling the virtue of emulating a decidedly highly-regulated system (Switzerland) is certainly trolling.
 
2012-12-03 12:17:02 PM
1. Deregulate the state exchanges, while capping subsidies.

2. Slowly shift Medicare patients into the exchanges.

3. Let more people buy insurance on their own rather than through their employer.

4. Move Medicaid patients into the exchanges.

5. Sell the peasants to China and India for cents on the dollar.

6. Profit.
 
2012-12-03 12:19:39 PM

Pincy: 3. Let more people buy insurance on their own rather than through their employer.

I didn't realize people were being prevented from buying their own insurance? Damn Obama.


Woooaaa... I just bought insurance for my family because it was too expensive through work, I didn't know it was illegal to do that!
 
2012-12-03 12:24:12 PM

Lumpmoose: make me some tea: ObamaCare is already FreeMarketCare. I don't support the idea of putting Medicare into the mix. Leave it alone.

Yeah, if you want universal health care you must pick 1) "a windfall for the insurance companies" via the mandate, 2) competition against a public insurance option or 3) the end of private health insurance as we know it. Obama picked #1.


The Swiss system that they compare to in the article (I'm not sure the author of TFA really understands the Swiss-model, since deregulation isn't in line with how the Swiss do it) doesn't fit any of those three groups and is considered Universal coverage. Residents are mandated to buy insurance by law, the kicker is that in order to provide health insurance a company has to be registered with the proper Swiss authorities, and by law the "basic" coverage, which they must offer, can not have a profit. So many of the insurance companies are actually non-profits in Switzerland. You are allowed to build "premium" packages that offer more amenities, etc. And those can make a profit.

Lawnchair: ex0du5: Anyone who says "deregulate" without specifying what they mean is either trolling or willfully ignorant.

Corollary: Anyone who says "deregulate" while simultaneously extolling the virtue of emulating a decidedly highly-regulated system (Switzerland) is certainly trolling.


Or stupid. I'm going to generally go with stupid.

The Swiss system does work quite well, they do still spend slightly more per capita than other Universal systems (France, the UK, Canada, Australia, Japan) but it is much closer to those than it is the US. Also, the real kicker is the average income and standard of living in Switzerland is WAAAAY higher than it is in the US. Things are expensive there but even with that factored in they tend to be much better off on average.
 
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