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Saturday, June 25, 2016

Republican Plan--NOT A Better Way

Summary: Republicans have unveiled their Better Way replacement for Obamacare, but it isn't, underscoring that they weren't duped into Obamacare but were complicit in the governmental plan to save government money by imposing Obamacare on non-government citizens while preserving the carveout exception that allow government employees to retain benefits that include none of the draconian policies that put our health both physical and financial in peril.

The Republican plan not only preserves this approach, but would worsen the current healthcare environment for non-government employee individuals by resorting to false language of "free market," which assumes we're too stupid to know that lobbyists have dictated the laws and therefore the healthcare market, by using the strategy of prevention instead of treatment priorities for health services catering to the health insurer dream of collecting premiums and only paying out finite costs of checkups, by providing back-door mechanisms for higher premium charges by allowing for SURCHARGES (penalties) to be imposed on individuals who decline FORCED WELLNESS, and by PENALIZING those without health insurance coverage just like the individual mandate calling it "continuous coverage."

Look it up: http://abetterway.speaker.gov/_assets/pdf/ABetterWay-HealthCare-PolicyPaper.pdf. Read it and speak up--the Republican "A BETTER WAY," plan is anything but. It's hard to believe that they could come up with something worse for consumers than Obamacare, but they have. Here's my first take (more to come).

But this time, we're in a better position to squash the legislative detritus if we speak up because we've learned from the governmental trick of Obamacare what to look for.

Start with what we were sold on Obamacare--No denials for pre-existing conditions. This was a good thing, but Obamacare went too far, failing to include any increased premiums for those with pre-existing conditions while authorizing charging more in premiums to THREE GROUPS ONLY: The old, (and thereby the young whose rates are hinged in a ratio of three to one based on what's charged to older people), and smokers. The same type of ratio should be included for those with pre-existing conditions, those who are obese, those who have chemical dependencies to legal or non-legal drugs, those of child-bearing age, because they too statistically have more expensive health needs. Using such a ratio LIMITS the amount that can be charged WHILE acknowledging the increased POTENTIAL costs of specific groups.

REPUBLICAN non-BETTER WAY: Republicans do plan to restore the 5:1 pre-Obamacare ratio, rather than 3:1 ratio of old:young and premiums, meaning that young people would POTENTIALLY be charged less than they are under Obamacare. Note, no one is going to pay less because health insurance premiums don't go down. Further, in an effort to save money, the reason young people didn't flock to "better" insurance plans, catastrophic plans and HSAs, the cheaper, worse coverage plans will continue to appeal to younger people.

OK, so back to pre-existing conditions.

Republicans state "No American should ever be denied coverage or face a coverage exclusion on the basis of a pre-existing condition," BUT my first read doesn't show any prohibition against such denial. "SHOULD" is not a guaranteed protection.

The Republicans instead specifically prohibit rescissions, where insurers drop people who become sick BUT do NOT prohibit the denial of insurance for pre-existing conditions UNLESS an individual has had NO BREAK in coverage (CONTINUOUS COVERAGE). This brings back the risk of denial of insurance policies or charging unlimited amounts more in premiums to those with pre-existing conditions if there is a break in coverage.

"Our plan also proposes a new patient protection for those Americans who maintain continuous coverage."

Medicaid Expansion--Even for Obamacare haters, let's face it, providing near free health insurance coverage and near free medical services by expanding the already existent Medicaid DOES reduce the number of uninsured. Under Obamacare, naturally, this too was perverted into a scam because the government has a CONFLICT OF INTEREST, trying to save itself money while "providing" this protection to individuals.

Under Obamacare we saw that this resulted in expanded bureaucracy and costs that instead of inspiring streamlining and auditing government, prompted the government to change how it calculates costs and leave out what it spends on itself and decide instead to save money ONLY on individuals, per capita spending (Congressional Budget Office 2015).. We are not too dumb to figure out that saving money per capita on those with insurance means paying out less for their care which in the absence of cost controls on what's charged means that individuals get less care.

REPUBLICAN non-BETTER WAY: The Republicans intend to make things worse, omitting common sense solutions to the problem of providers not accepting health insurance which would mean taking on the powerful lobbyist of the AMA and pushing for REQUIREMENTS that physicians accept specific numbers or types of health insurance, discouraging Medicaid (and Medicare) fraud by changing the standards as a strict liability standard--if there's overcharging by providers to Medicaid/Medicare then maximum fines are paid instead of the difficult-to-prove and currently ineffective method of trying to "prove" fraudulent INTENT, (all providers claim billing errors are "mistakes," and let's face it, if they're too stupid to do the paperwork, they should hire someone who can or face fines.)

But no, Republicans ignore that and instead intend to FURTHER jeopardize the health of citizens by REDUCING how much the federal government contributes with a PER CAPITA ALLOTMENT, lowering still how much is spent on patients AND by reducing the Federal government's contribution to 83 percent from current levels of over 90 percent AND only providing this much contribution for states that have already expanded Medicaid, forever terminating the choice of non-Medicaid expansion states to choose such expansion for their populations.

Out of Pocket Maximum: Obamacare has failed in terms of affordability for many Americans because the amount of money we have to lay out before obtaining maximum health insurance coverage under our plans has skyrocketed to $7,150 for individual coverage and $14,300 for family.

REPUBLICAN non-BETTER WAY: Does NOTHING for this number. This number should be hinged to health insurance policy prices--if those prices go up, the out of pocket maximum should go down by an equivalent percentage. But Republicans are mute on that.

As far as the most burdensome part of Obamacare--the ransom paid to insurers to cover people in exchange for requiring everyone to buy health insurance, the individual mandate by any other name is still a mandate. For Republicans they call it CONTINUOUS COVERAGE, meaning if you have a break in coverage you can be charged more--with NO LIMITS ON HOW MUCH MORE that I can find meaning you HAVE TO KEEP BUYING HEALTH INSURANCE or be PENALIZED, sounds like an individual mandate…According to Republicans, the "…safeguard applies to everyone who remains enrolled in a health insurance plan."

As far as Obamacare's ransom paid to insurers that prevention is more important than covering needed medical services, the dumbest part of the plan because it raises the costs of "checkups," encourages defensive medicine making healthy people permanent patients being sent for tests (covered by insurance) and exposes people to the significant risk of medical error, the third leading cause of death in the US, naturally the Republicans go along with that too legalizing not only wellness incentives but wellness SURCHARGES, meaning if you don't comply you'll pay more.

"Our plan ensures employers may offer wellness programs that are tied to a financial reward or surcharge so long as those programs do not exceed the limits under current law."

The plan also reintroduces the scam of physicians owning hospitals, nursing homes and other facilities they push their patients towards by re-legalizing this practice: "Repeal of the Ban on Physician-Owned Hospitals"

The Republican plan also pushes for HSAs, the darling of the insurance industry that began as the healthy-wealthy plans, providing high-deductible coverage for cheaper premiums making them attractive to younger and healthier people and for wealthier people looking for a tax shelter. These plans are ONLY useful as a secondary insurance in the case of a couple, they are a financial peril for everyone else. Of course, Obamacare too pushes these plans, part of the ransom paid to insurers, but the Republican plan is supposed to be a BETTER WAY not the same way.

Upon preliminary reading it's more of the same from the Republicans, devoid of needed consumer protections, committed to Obamacare's reduce government spending scam--the real meaning of Affordable, tied to the interests of unfettered provider charges and unfettered insurance company charges.