Trumpcare Triumphs over Obamacare!
The reasons for the recent jubilation of Trump’s healthcare initiative are simple. It’s not that Obamacare is “dead” as Trump claims, it’s just that the Republicans have killed it. Obamacare is simply legislation requiring mainly:
1. Government subsidies to private health insurance companies.
2. A mandate to increase the pool of healthy versus sick.
Without these two primary elements Obamacare is gradually dying. The private insurance companies are pulling out of the insurance markets (exchanges) where the subsidies are drying up as well as the healthy insurance buyers. The uncertainty of the marketplace has led the insurance companies to pull out before they are left without subsidies for the sick and poor and without the needed healthy pool to counter balance the costs. Plus there was never a law requiring private insurance to enter the Obamacare exchanges, one may then wonder why they did.
They did only because:
1. The mandate; they expected the actuarial pool would improve with healthy people mandated to buy insurance versus the sick and poor.
2. The Government would help pay for insurance for the needy.
The underlying premise for Obamacare was that the private insurance companies would drive down healthcare costs by competing with each other and negotiation down the true healthcare costs; medicine, doctors and hospital costs. There was never BIG government regulating the costs of the underlying costs of healthcare nor “death panels.” Obamacare was relying on market forces (private insurance companies) to curtail the costs and in no way was it capping doctors fees or drug costs; it was not creating laws that says a doctor must charge only $X and a drug can only cost $X like in Europe. Europe instead has a very regulated market of costs, a drug cannot be introduced into it’s national formulary unless it costs $X. I would venture to say that the European state functions as the most capitalistic rational and efficient machine to control costs. Of course, in Europe you can get additional supplementary insurance to cover non-formulary procedures and medicine and it almost constitutes a system for the rich and one for the general populace, but that is reality.
“Trumpcare” will easily nullify Obamacare because it is getting rid of the mandate and decreasing subsidies. There will be few insurance companies left in any exchange. You will be able to buy insurance but the cost of insurance will just revert to America’s old system, the previous logic of all insurance companies. The insurance costs will reflect the current pool of healthy versus sick and the underlying costs of healthcare negotiated by each respective insurance companies with doctors, drugs and hospitals accepting their reimbursements.
The Republicans are very happy with this because they believe that healthcare is really a matter of choice, and it is your bad lifestyle choice if you have diabetes or Parkinsons. You should shop around for the best drugs and treatments and pick your own doctor. Everyone knows, unless you are a moron, that healthcare is not like shopping at a marketplace like going to Target, Amazon or Walmart. It would be very difficult to setup ten appointments for my colonoscopy and pick the cheapest (and that is not even an emergency procedure), nor will I be able to bring in my own anesthetics I purchased from India or from the “dark web” into the operating room and give them to the anesthesiologist to administer. In a true marketplace I should be able to bring in my own IV solutions instead of using the expensive ones the hospital uses. There are no websites that lists which equipment will be used for my procedure in the hospital and where in the world I could purchase them cheaper. Amazon, where are you?
The problem with Obamacare was that Obama never used his “golden tongue” to explain to his Democrat followers that Obamacare was just a government program that was relying on insurance companies controlling costs (the marketplace not the government) and that it depended on government to pitch in money for insurance costs. The Republicans loved the subsidies to the insurance companies but not the subsidies to help the poor pay for their insurance. Obama’s Affordable Healthcare Act (ACA), was not a program of affordable healthcare it was for affordable health insurance, it really should have been called AIA, Affordable Insurance Act. Ultimately unless the government does not control the underlying cost of insurance which is based on the actual healthcare costs, the price of your insurance will just correlate and increase proportionally to the costs of our country’s healthcare: drugs, doctors and hospitals.
In summary, this is as simply as I can describe the gradual and apparent coming death of “Obamacare.” I hope this does not sound like I am explaining the theory of Quantum mechanics here.