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Obamacare Repeal or Obamacare 2.0?

This Thursday, the House of Representatives will vote on a Republican bill that supposedly repeals Obamacare. However, the bill retains Obamacare’s most destructive features.

That is not to say this legislation is entirely without merit. For example, the bill expands the amount individuals can contribute to a health savings account (HSA). HSAs allow individuals to save money tax-free to pay for routine medical expenses. By restoring individuals’ control over healthcare dollars, HSAs remove the distortions introduced in the healthcare market by government policies encouraging over-reliance on third-party payers.

The legislation also contains other positive tax changes, such a provision allowing individuals to use healthcare tax credits to purchase a “catastrophic-only” insurance policy. Ideally, health insurance should only cover major or catastrophic health events. No one expects their auto insurance to cover routine oil changes, so why should they expect health insurance to cover routine checkups?

Unfortunately the bill’s positive aspects are more than outweighed by its failure to repeal Obamacare’s regulations and price controls. Like all price controls, Obamacare distorts the signals that a freely functioning marketplace sends to consumers and producers, thus guaranteeing chaos in the marketplace. The result of this chaos is higher prices, reduced supply, and lowered quality.

Two particularly insidious Obamacare regulations are guaranteed issue and community ratings. As the name suggests, guaranteed issue forces health insurance companies to issue a health insurance policy to anyone who applies for coverage. Community ratings forces health insurance companies to charge an obese couch potato and a physically-fit jogger similar premiums. This forces the jogger to subsidize the couch potato’s unhealthy lifestyle.

Obamacare’s individual mandate was put in place to ensure that guaranteed issue and community ratings would not drive health insurance companies out of business. Rather than repealing guaranteed issue and community ratings, the House Republicans’ plan forces those who go longer than two months without health insurance to pay a penalty to health insurance companies when they purchase new policies.

It is hard to feel sympathy for the insurance companies since they supported Obamacare. These companies were eager to accept government regulations in exchange for a mandate that individuals buy their product. But we should feel sympathy for Americans who are struggling to afford, or even obtain, healthcare because of Obamacare and who will obtain little or no relief from Obamacare 2.0.

The underlying problem with the Republican proposal is philosophical. The plan put forth by the alleged pro-free-market Republicans implicitly accepts the premise that healthcare is a right that must be provided by government. But rights are inalienable aspects of our humanity, not gifts from government.

If government can give us rights, then it can also limit or even take away those rights. Giving government power to enforce a fictitious right to healthcare justifies government theft and coercion. Thievery and violence do not suddenly become moral when carried out by governments.

Treating healthcare as a right leads to government intervention, which, as we have seen, inevitably leads to higher prices and lower quality. This is why, with the exception of those specialties, like plastic surgery, that are still treated as goods, not rights, healthcare is one of the few areas where innovation leads to increased costs.

America’s healthcare system will only be fixed when a critical mass of people rejects the philosophical and economic fallacies justifying government-run healthcare. Those of us who know the truth must continue to work to spread the ideas of, and grow the movement for, liberty.

(Reprinted from The Ron Paul Institute by permission of author or representative)
 
• Category: Ideology • Tags: Health Care, Obamacare 
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  1. We spent $775 on extortionist fees this winter for prescriptions to antibiotics for three of our family members, all with the same sinus infection that would have cost ZERO in many countries that allow pharmacists to prescribe antibiotics.

    Including the cost of the antibiotics themselves, it was over a thousand dollars. It would have been about $30 in at least one country I have visited in the past because the drugs are cheaper too. Just this one restrictive law added over a thousand dollars to our medical expenses. We also had to make five round trips to a doctor almost an hour from our home, then return to our pharmacy for the prescriptions every time. We were sick longer and had to endure hardships that were totally unnecessary. Treated like stupid cattle with no minds of our own when everyone with an IQ over 60 here knows how to treat a sinus infection.

    We don’t need insurance. We don’t need laws either forcing us to buy it or subsidizing it. We need the freedom to choose ourselves whether we want to wait a LOT longer to see a doctor for our prescriptions instead of a pharmacist.

    This year they did something incredible, which was to only allow five days of antibiotics when in the past we were always prescribed two weeks. We were always admonished to finish the whole two week prescription even if we felt better. But now – the doctors are clearly wanting us to remain sick so that we have to see them TWICE in order to heal.

    This new bill does not address anything even remotely close to fixing the medical extortion industry for us.

    Read More
    • Replies: @JackOH
    "This new bill does not address anything even remotely close to fixing the medical extortion industry for us."

    Agree 100%. And "extortion" is not too strong a word for a line of work--medicine-- that has put a whole nation into its pocket with extractive actuarial schemes such as group health insurance and Medicare under its original payment formula.

    Between perinatal age and end of life, most people are mostly healthy most of the time. Few people would guess that by the huge moneys that are delivered to the health care industry.

    Of course pharmacists ought to have an independent scope of practice restored to them. Plus, state legislators ought to at least consider the voluntary up-licensing as medical doctors of experienced advanced practice nurses who agree to accept cash patients.

    Ron does his libertarian credentials a disservice with this platitude-filled article that looks like a press release from a medical lobby. Maybe he missed the letter from a hospital administrator in my area that said 70% of its revenues were from Medicare and Medicaid, a figure that likely tops 80% when taxpayer-subsidized government workers' health insurance is added.
    , @jacques sheete
    I am very sorry to hear of your travails. The situation is truly disgusting.

    This new bill does not address anything even remotely close to fixing the medical extortion industry for us.
     
    It never was as I'm sure you know, but what irritates me is that almost no one sees it. We've all been screwed again. , and as Carlin would say,[almost] nobody seems to notice, nobody seems to care...
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  2. @Backwoods Bob
    We spent $775 on extortionist fees this winter for prescriptions to antibiotics for three of our family members, all with the same sinus infection that would have cost ZERO in many countries that allow pharmacists to prescribe antibiotics.

    Including the cost of the antibiotics themselves, it was over a thousand dollars. It would have been about $30 in at least one country I have visited in the past because the drugs are cheaper too. Just this one restrictive law added over a thousand dollars to our medical expenses. We also had to make five round trips to a doctor almost an hour from our home, then return to our pharmacy for the prescriptions every time. We were sick longer and had to endure hardships that were totally unnecessary. Treated like stupid cattle with no minds of our own when everyone with an IQ over 60 here knows how to treat a sinus infection.

    We don't need insurance. We don't need laws either forcing us to buy it or subsidizing it. We need the freedom to choose ourselves whether we want to wait a LOT longer to see a doctor for our prescriptions instead of a pharmacist.

    This year they did something incredible, which was to only allow five days of antibiotics when in the past we were always prescribed two weeks. We were always admonished to finish the whole two week prescription even if we felt better. But now - the doctors are clearly wanting us to remain sick so that we have to see them TWICE in order to heal.

    This new bill does not address anything even remotely close to fixing the medical extortion industry for us.

    “This new bill does not address anything even remotely close to fixing the medical extortion industry for us.”

    Agree 100%. And “extortion” is not too strong a word for a line of work–medicine– that has put a whole nation into its pocket with extractive actuarial schemes such as group health insurance and Medicare under its original payment formula.

    Between perinatal age and end of life, most people are mostly healthy most of the time. Few people would guess that by the huge moneys that are delivered to the health care industry.

    Of course pharmacists ought to have an independent scope of practice restored to them. Plus, state legislators ought to at least consider the voluntary up-licensing as medical doctors of experienced advanced practice nurses who agree to accept cash patients.

    Ron does his libertarian credentials a disservice with this platitude-filled article that looks like a press release from a medical lobby. Maybe he missed the letter from a hospital administrator in my area that said 70% of its revenues were from Medicare and Medicaid, a figure that likely tops 80% when taxpayer-subsidized government workers’ health insurance is added.

    Read More
    • Replies: @jacques sheete

    Plus, state legislators ought to at least consider the voluntary up-licensing as medical doctors of experienced advanced practice nurses who agree to accept cash patients.
     
    That's a good suggestion. A very definite part of the problem is the issue of licensing which is essentially a way of limiting competition thus keeping fees up under the guise of protecting folks. Besides, it gives the bureaucrats something to do too.
    , @jtgw
    I'm pretty sure Ron would agree with you about letting pharmacists prescribe drugs and letting nurses perform more procedures. He's definitely on record opposing both Medicare and Medicaid.
  3. @Backwoods Bob
    We spent $775 on extortionist fees this winter for prescriptions to antibiotics for three of our family members, all with the same sinus infection that would have cost ZERO in many countries that allow pharmacists to prescribe antibiotics.

    Including the cost of the antibiotics themselves, it was over a thousand dollars. It would have been about $30 in at least one country I have visited in the past because the drugs are cheaper too. Just this one restrictive law added over a thousand dollars to our medical expenses. We also had to make five round trips to a doctor almost an hour from our home, then return to our pharmacy for the prescriptions every time. We were sick longer and had to endure hardships that were totally unnecessary. Treated like stupid cattle with no minds of our own when everyone with an IQ over 60 here knows how to treat a sinus infection.

    We don't need insurance. We don't need laws either forcing us to buy it or subsidizing it. We need the freedom to choose ourselves whether we want to wait a LOT longer to see a doctor for our prescriptions instead of a pharmacist.

    This year they did something incredible, which was to only allow five days of antibiotics when in the past we were always prescribed two weeks. We were always admonished to finish the whole two week prescription even if we felt better. But now - the doctors are clearly wanting us to remain sick so that we have to see them TWICE in order to heal.

    This new bill does not address anything even remotely close to fixing the medical extortion industry for us.

    I am very sorry to hear of your travails. The situation is truly disgusting.

    This new bill does not address anything even remotely close to fixing the medical extortion industry for us.

    It never was as I’m sure you know, but what irritates me is that almost no one sees it. We’ve all been screwed again. , and as Carlin would say,[almost] nobody seems to notice, nobody seems to care…

    Read More
    • Replies: @mtn cur
    I labeled it regurgitated Obama care on 10 Feb.
  4. @JackOH
    "This new bill does not address anything even remotely close to fixing the medical extortion industry for us."

    Agree 100%. And "extortion" is not too strong a word for a line of work--medicine-- that has put a whole nation into its pocket with extractive actuarial schemes such as group health insurance and Medicare under its original payment formula.

    Between perinatal age and end of life, most people are mostly healthy most of the time. Few people would guess that by the huge moneys that are delivered to the health care industry.

    Of course pharmacists ought to have an independent scope of practice restored to them. Plus, state legislators ought to at least consider the voluntary up-licensing as medical doctors of experienced advanced practice nurses who agree to accept cash patients.

    Ron does his libertarian credentials a disservice with this platitude-filled article that looks like a press release from a medical lobby. Maybe he missed the letter from a hospital administrator in my area that said 70% of its revenues were from Medicare and Medicaid, a figure that likely tops 80% when taxpayer-subsidized government workers' health insurance is added.

    Plus, state legislators ought to at least consider the voluntary up-licensing as medical doctors of experienced advanced practice nurses who agree to accept cash patients.

    That’s a good suggestion. A very definite part of the problem is the issue of licensing which is essentially a way of limiting competition thus keeping fees up under the guise of protecting folks. Besides, it gives the bureaucrats something to do too.

    Read More
    • Replies: @JackOH
    js, I'm pretty confident Big Medicine's Iron Pyramid is heading for a political crack-up. It's not a question of whether, but when. Costs of group health insurance are approaching the cost of wages for some workers, the state-licensed physicians' discharge of or refusal to treat cash patients is almost surely a violation of the original terms under which licensure was granted, etc. The list of abuses engaged in by the medical establishment against patients and the political process is pretty ugly.

    Hippocrates knew what the score was with medicine. The doctor-patient relationship is so "asymmetrical" that the potential for abuse is built in to practice. America seems to not understand what the ancients knew about that particular line of work.

    FWIW-my pet theory is that good public health measures in the early 20th century, plus sulfa and penicillin, transformed medical doctors into secular idols. That's going to end.
  5. @JackOH
    "This new bill does not address anything even remotely close to fixing the medical extortion industry for us."

    Agree 100%. And "extortion" is not too strong a word for a line of work--medicine-- that has put a whole nation into its pocket with extractive actuarial schemes such as group health insurance and Medicare under its original payment formula.

    Between perinatal age and end of life, most people are mostly healthy most of the time. Few people would guess that by the huge moneys that are delivered to the health care industry.

    Of course pharmacists ought to have an independent scope of practice restored to them. Plus, state legislators ought to at least consider the voluntary up-licensing as medical doctors of experienced advanced practice nurses who agree to accept cash patients.

    Ron does his libertarian credentials a disservice with this platitude-filled article that looks like a press release from a medical lobby. Maybe he missed the letter from a hospital administrator in my area that said 70% of its revenues were from Medicare and Medicaid, a figure that likely tops 80% when taxpayer-subsidized government workers' health insurance is added.

    I’m pretty sure Ron would agree with you about letting pharmacists prescribe drugs and letting nurses perform more procedures. He’s definitely on record opposing both Medicare and Medicaid.

    Read More
  6. Driving Democrats back to the Democratic Party by taking away healthcare will just give McCain more leverage. Let’s not forget what created demand for government healthcare in the 1st place. Outsourcing all of those jobs through NAFTA and GATT created that demand. Those jobs had healthcare attached to them. I’m afraid Ron Paul can’t have it both ways. Either he is for free trade and government healthcare or he is for tariffs and American jobs.

    Read More
    • Replies: @jtgw
    There's no reason why healthcare needs to be linked to employment. I don't care if my job doesn't come with health insurance, as long as I can afford to pay for my routine expenses out of pocket and for catastrophic insurance for myself. Getting that, of course, is another matter, but I think it's a mistake to focus on the lack of employer-provided insurance as the core of the problem.
  7. @jacques sheete
    I am very sorry to hear of your travails. The situation is truly disgusting.

    This new bill does not address anything even remotely close to fixing the medical extortion industry for us.
     
    It never was as I'm sure you know, but what irritates me is that almost no one sees it. We've all been screwed again. , and as Carlin would say,[almost] nobody seems to notice, nobody seems to care...

    I labeled it regurgitated Obama care on 10 Feb.

    Read More
  8. @Louis
    Driving Democrats back to the Democratic Party by taking away healthcare will just give McCain more leverage. Let's not forget what created demand for government healthcare in the 1st place. Outsourcing all of those jobs through NAFTA and GATT created that demand. Those jobs had healthcare attached to them. I'm afraid Ron Paul can't have it both ways. Either he is for free trade and government healthcare or he is for tariffs and American jobs.

    There’s no reason why healthcare needs to be linked to employment. I don’t care if my job doesn’t come with health insurance, as long as I can afford to pay for my routine expenses out of pocket and for catastrophic insurance for myself. Getting that, of course, is another matter, but I think it’s a mistake to focus on the lack of employer-provided insurance as the core of the problem.

    Read More
    • Replies: @Louis
    If there are 94,000,000 unemployed or underemployed as Paul Craig Roberts has pointed out, then people cannot afford to buy healthcare insurance. If outsourcing jobs created this number then that drove up demand for government healthcare. I don’t think most Americans cared whether it was provided through employment or through the government, but after they lost their jobs they looked to the government. Free Trade helped drive up demand for Obamacare!
  9. @jacques sheete

    Plus, state legislators ought to at least consider the voluntary up-licensing as medical doctors of experienced advanced practice nurses who agree to accept cash patients.
     
    That's a good suggestion. A very definite part of the problem is the issue of licensing which is essentially a way of limiting competition thus keeping fees up under the guise of protecting folks. Besides, it gives the bureaucrats something to do too.

    js, I’m pretty confident Big Medicine’s Iron Pyramid is heading for a political crack-up. It’s not a question of whether, but when. Costs of group health insurance are approaching the cost of wages for some workers, the state-licensed physicians’ discharge of or refusal to treat cash patients is almost surely a violation of the original terms under which licensure was granted, etc. The list of abuses engaged in by the medical establishment against patients and the political process is pretty ugly.

    Hippocrates knew what the score was with medicine. The doctor-patient relationship is so “asymmetrical” that the potential for abuse is built in to practice. America seems to not understand what the ancients knew about that particular line of work.

    FWIW-my pet theory is that good public health measures in the early 20th century, plus sulfa and penicillin, transformed medical doctors into secular idols. That’s going to end.

    Read More
    • Replies: @jtgw
    There's potential for abuse, by which I think you mean fraud, in all commercial relationships. At some point you have to trust that your provider is selling you the genuine article and is not trying to take advantage of you. But I can see how consequences of fraud become particularly egregious where health is concerned. As you noted above, it would help if the law didn't give doctors as much extra unearned power as it currently does by e.g. forbidding experienced nurses from providing certain services and thereby introducing more competition and accountability for doctors.
  10. Technology will wring most of the inefficiencies out of the medical field in the next couple of decades.

    I think that government will somehow use that transition to take over all health care.

    Read More
  11. @JackOH
    js, I'm pretty confident Big Medicine's Iron Pyramid is heading for a political crack-up. It's not a question of whether, but when. Costs of group health insurance are approaching the cost of wages for some workers, the state-licensed physicians' discharge of or refusal to treat cash patients is almost surely a violation of the original terms under which licensure was granted, etc. The list of abuses engaged in by the medical establishment against patients and the political process is pretty ugly.

    Hippocrates knew what the score was with medicine. The doctor-patient relationship is so "asymmetrical" that the potential for abuse is built in to practice. America seems to not understand what the ancients knew about that particular line of work.

    FWIW-my pet theory is that good public health measures in the early 20th century, plus sulfa and penicillin, transformed medical doctors into secular idols. That's going to end.

    There’s potential for abuse, by which I think you mean fraud, in all commercial relationships. At some point you have to trust that your provider is selling you the genuine article and is not trying to take advantage of you. But I can see how consequences of fraud become particularly egregious where health is concerned. As you noted above, it would help if the law didn’t give doctors as much extra unearned power as it currently does by e.g. forbidding experienced nurses from providing certain services and thereby introducing more competition and accountability for doctors.

    Read More
  12. I am utter surprised that I’ve finally stumbled upon a site where the comments reflect an informed minority who openly disparage the medical arts community as an extortion scheme. Bravo.

    I liken the tactics used by the medical arts community today to extract and extort money from the citizens to a very similar situation where a highwayman robs a stage coach in the wild west. “Your money of your life” is the operative principle.

    In opposition to what Congressman Paul says above, health care in America is failing the citizens of America because THE MEDICAL ARTS PROVIDERS ARE ALLOWED TO EGREGIOUSLY GOUGE THE CITIZENS WITH THEIR HIGH AND EVER-INCREASING GREEDY PRICES FOR SERVICES and because the Congress will not take on the medical arts community and enact and enforce price controls on them.

    Yes, it really is that simple.

    LF

    Read More
    • Replies: @jtgw
    You don't need price controls. You simply need to open up medical licensing. The AMA currently keeps a tight lid on the supply of doctors through their monopoly of licensing requirements, which means doctors can charge cartel prices. Why not have several competing licensing organizations? I don't think RP would object to any of these measures, since they comport perfectly with his free market views. I think several commenters are seriously misconstruing RP's positions on healthcare.
  13. Part of the problem with “health care” is that costs for those who do not (or will not) pay for their health care are shifted on to those with insurance. This is why an aspirin, administered in a hospital, can cost $30.00. Someone has to pay the bills. Those who receive “uncompensated care” are the problem. It turns out that those who use “uncompensated care” utilize hospital emergency rooms for colds, flu, and other minor ailments much more than those of us who PAY for our health insurance.
    Insurance companies DO make “deals” with hospitals and physician group practices, where the hospitals and doctors agree to a set amount, much less than the “usual and normal” amount.
    For those who gush about Canadian “health care”, it can take weeks or months to get procedures that, in the United States, can be done almost immediately.
    A number of years ago, some Canadian hospitals opened up their CAT scan facilities to veterinarians. It turns out that these hospitals could make more money opening up their facilities to pets, while humans were forced to wait. Another aspect of Canadian “health care” is that, when hospitals run out of money for operating expenses before the end of the fiscal year, they merely close their doors, until the beginning of the new fiscal year.
    Canadian health care is good for routine cuts and bruises, but when it comes to complicated, (expensive) procedures, the wait can be interminable.
    Canadian medical professionals are world-class; it is the conditions that they are forced to work under; their health care system drags them down.
    It is a loosely-guarded secret that in Canadian border towns such as Windsor, Canadians flock to the United States (Detroit, which has major medical centers) because they can get procedures done in hours and days, rather than waiting weeks and months for the Canadian system to work.
    The Canadian system works as well as it does, because the population of Canada is much smaller…
    The only solution is to scrap the present American health care (insurance) system entirely and go to a catastrophic coverage model. You would see prices for routine care decrease.
    One major problem is the HMO (Health Maintenance Organizations) model, in which routine care is covered by insurance. If car insurance were modeled on our HMO system, insurance would pay for routine maintenance such as oil changes and other repairs.
    Scrapping the HMO model would help.

    Read More
  14. @Longfisher
    I am utter surprised that I've finally stumbled upon a site where the comments reflect an informed minority who openly disparage the medical arts community as an extortion scheme. Bravo.

    I liken the tactics used by the medical arts community today to extract and extort money from the citizens to a very similar situation where a highwayman robs a stage coach in the wild west. "Your money of your life" is the operative principle.

    In opposition to what Congressman Paul says above, health care in America is failing the citizens of America because THE MEDICAL ARTS PROVIDERS ARE ALLOWED TO EGREGIOUSLY GOUGE THE CITIZENS WITH THEIR HIGH AND EVER-INCREASING GREEDY PRICES FOR SERVICES and because the Congress will not take on the medical arts community and enact and enforce price controls on them.

    Yes, it really is that simple.

    LF

    You don’t need price controls. You simply need to open up medical licensing. The AMA currently keeps a tight lid on the supply of doctors through their monopoly of licensing requirements, which means doctors can charge cartel prices. Why not have several competing licensing organizations? I don’t think RP would object to any of these measures, since they comport perfectly with his free market views. I think several commenters are seriously misconstruing RP’s positions on healthcare.

    Read More
  15. There’s no mechanism to prevent illegal aliens from getting health care under this bill. I believe insurance companies are disallowed from seeking proof of immigration status. If Trump is aware of this yet still supporting the bill then he should be ashamed of himself since he said Americans come first and low income illegals would be getting taxpayer dollars in the form of health care subsidies.

    If Trump becomes just another business as usual Republican then he’ll likely be a one termer.

    Read More
  16. @jtgw
    There's no reason why healthcare needs to be linked to employment. I don't care if my job doesn't come with health insurance, as long as I can afford to pay for my routine expenses out of pocket and for catastrophic insurance for myself. Getting that, of course, is another matter, but I think it's a mistake to focus on the lack of employer-provided insurance as the core of the problem.

    If there are 94,000,000 unemployed or underemployed as Paul Craig Roberts has pointed out, then people cannot afford to buy healthcare insurance. If outsourcing jobs created this number then that drove up demand for government healthcare. I don’t think most Americans cared whether it was provided through employment or through the government, but after they lost their jobs they looked to the government. Free Trade helped drive up demand for Obamacare!

    Read More
  17. Obamacare Repeal or Obamacare 2.0?

    It would appear the answer is neither. Health care is now an albatross around the GOP’s neck. What is needed is single payer. The Democrats couldn’t do it because corruption. The Republicans can’t do it because communism.

    Read More
  18. This is the first fiction which we must repudiate:
    “If an employer pays the cost of an accident or health insurance plan for his/her employees, including an employee’s spouse and dependents, the employer’s payments are not wages and are not subject to Social Security, Medicare, and FUTA taxes, or federal income tax withholding.”

    Obamacare is flat-out unconstitutional. There are enumerated Federal powers in the Constitution, see sample below. There is nothing in there about a Federal role in medicine.

    “•To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;
    •To borrow Money on the credit of the United States;
    •To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes;”

    Read More
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