It's not where they disagree that the national consumer fleecing comes into health insurance legislation, it's where they agree that consumers are being exploited by our government. Here are four areas where our lawmakers agree.
Where Republicans and Democrats in Congress agree: Taxpayers pay 72 percent of Congress and designated public employees' health premiums (https://fas.org/sgp/crs/misc/R43194.pdf). That's right, the government uses our money and then calls itself the "employer" and pays 72 percent of public worker premiums. THIS IS AN ENTITLEMENT, and this is where healthcare reform should start. But it's one of those no arguments between Democrats and Republicans issues, NONE of them require that these "representatives" and public employees join the taxpayers they're robbing AND then they talk about cutting "entitlements" like Medicare that we PAID for and Medicaid which is the entitlement health insurance available to non-public employees.
Where's the entitlement cuts on taxpayer funding of public employee benefits? Not only would this protect us from lawmakers slashing benefits in order to keep more of our money for themselves, but it would lessen the burden of having to justify "entitlements" and take that nonsense off the table unless first and foremost public employee entitlements even up with the rest of the country.
Where Republicans and Democrats Agree: Punish people financially who choose to NOT purchase the consumer financial product of health insurance. The individual mandate, the tax created by Obamacare as part of a deal with insurance companies to "cover" those with pre-existing conditions is merely being substituted with a privatized version of this forced purchase attitude under Republicans which will be noted with the words CONTINUOUS COVERAGE. This means that if there's a lapse in coverage, insurers will charge you more, just like under Obamacare. For consumers the result is the same--buy the insurance company product or be penalized.
Where Republicans and Democrats Agree: Insurance fraud costs at least billions of dollars but government is lazy and it's easier to simply cut something else for consumers, maybe food stamps, or Medicaid per capita spending, or Medicare coverages than it is to actively prosecute fraud. Though Donald Trump mentioned going after fraud in his campaign, sadly, he seemed to forget those billions when he spoke this week (Feb. 28, 2017).
For government, fraud is unimportant when you're spending taxpayer money. Obamacare was beset with fraudulent overpayments and accounting wizardry that simply chose not to calculate what the government was spending. Yes, this was an official policy statement by the CBO in January, 2015: CBO Publication 49892, 1/15/15, page 1, “…estimates address only the insurance coverage provisions of the ACA and do not reflect all of the act’s budgetary effects… "
Under Obama the government overpaid and forgave, each time fraudulent payments came to light.
How do you stop fraud? You prosecute fraud so that it's too expensive to risk. But from HIPAA to Obamacare, to private insurers, fraud requires work because you have to prove that the entity intended to deceive. Today that standard is what they call toothless because of the bureaucracy of medical payments that allow each player to say they weren't aware of the fraud.
Obamacare actually DEINCENTIVIZED insurers and payers from prosecuting fraud with the 80-20 (85-15) rule which required insurers to spend 80 percent of the money they take from premiums on health care and "quality improvement" instead of administrative costs and overhead. Prosecuting fraud would eat into their 20 percent "free money" and like the government, insurers merely cutting coverage to insureds and raising prices to cover these losses is easier.
Finally regarding fraud, whistleblower statutes should allow citizens to have a 10 percent share in the recovery of amounts for fraud, just like employee whistleblowers get. Instead of threatening citizens about how fraud raises prices for all of us, pay us like they pay themselves for the JOB of uncovering and documenting fraud.
Where Republicans and Democrats Agree: Medicaid enrollment has exploded, especially since Medicaid expansion under Obamacare. Trump wants to wash the federal government's hands of it to a large extent by paying out block grants, states want to wash their hands of it by keeping Obamacare expansion under which the federal government pays around 90 percent of the costs.
Here's the issue: If so many people are eligible for Medicaid it is a sign that TOO MANY PEOPLE ARE LIVING IN POVERTY IN A STATE. Immediately, implementing the Obamacare "punishment" style of the individual mandate, STATES must be penalized. Public employee hiring and raises should be gone for states that fail to keep the number of eligible Medicaid recipients at reasonable levels. States must be required to fix their problems or be "punished" financially for their incompetence. This regional approach would also apply pressure to insurers and overcharging health industrial complex entities in specific regions as states enact laws to protect their own wallets which will make them fight for consumers not continue the Obamacare government-insurance company partnership.
Where Republicans and Democrats Agree: Preventive Care Hyperfocus. Preventive care coverage is the low-hanging fruit of money-making stakeholders in the health industrial and governmental process. Checkups galore, diagnostic testing galore, meanwhile unhappily if you reach the end of the "free" stuff and actually NEED medical services, prices go through the roof. This is idiotic. Covering preventive services RAISES the price for those services as every Dr. Tom, Provider Dick, and Insurer Harry gets money for the easy stuff. We don't need a society of WELL patients getting the best care, we need a society that cares for its sick. This is why everything from pre-existing conditions, where medical expenses are a given to prescription drugs expose SICK patients to price gouging, yes, under Obamacare too. This is why CMS started paying doctors to advise people that the cost of possibly life-saving procedures, etc. weren't worth it based on their odds. It's also why doctors will refer you for other tests and further exams, because now you're out of the free stuff and into the pay stuff.
This is the Forced Wellness Model (Obamacare's Forced Wellness, 1/27/2016) and it not only weakens consumer choice in deciding on their care and expands incentives for the obscene practice of defensive medicine, but it is coupled with a REDUCTION in options for the sick.
Obamacare and Obama boldly told young people that they were the tools to make Obamacare work because they would buy insurance and likely not need it, and for some reason people bought in. This was the "single risk pool" fantasy of getting everyone in and having them balance out those who need medical care. A system that doesn't provide access to meaningful care that doesn't wipe you out financially when YOU NEED MEDICAL CARE is not healthcare, it's a money-making scheme for the health industrial complex.
