How would you replace/fix ObamaCare?

[Free Bird]

. Get rid of everything and rebuild except the exchange. Too many people have insurance from it now.
. Pass tort reform and preexisting conditions as their own thing
. Open markets across State borders
. Most importantly of the first point, get rid of the individual mandate and MD tax

[Sumner 1868]

Replace the law by eliminating all age restrictions on Medicare.

[Free Bird]

Replace the law by eliminating all age restrictions on Medicare.

Ooo good. Didn't think of that. How will they build up funds for it if the individual can tap into it at any point?

[🦀🎂🦀🎂]

* put all funds currently spent on Medicaid etc into researching medication for immortality
* no need to spend any more on medicine after we all live forever

[Antonio the Sixth]

Create a National Health Service, ban private insurance.

[King]

1. I would get rid of state legislatures and Governors refusing to expand Medicaid and set up insurance exchanges

2. Nothing. It's perfect.

[Lief 🗽]

1. I would get rid of state legislatures and Governors refusing to expand Medicaid and set up insurance exchanges

2. Nothing. It's perfect.

Yes, King is correct. Like most problems in this country, Obamacare's can be completely solved by simply abolishing federalism.

[King]

Also, the "across state lines" reform is the dumbest idea ever and there is absolutely zero cost saving opportunity involved. Nobody wants it except really huge insurers looking to bankrupt smaller ones.

All that would happen is all the insurance companies would merge together immediately and relocate to the state with the most lax regulations. Our once oppressive credit card system (no longer the case thanks to federal consumer protections passed in 2009) was created by a similar lie that out of state banking would lower interest rates for the consumer.  All of the credit companies just used it as a loophole to move to Wilmington, DE where the law said they didn't have to give too damns about the consumer.

You would get the same expensive plans by the same expensive companies only instead of your doctor network decisions being made in state, their work will be even more distant and bureaucratic.

[Antonio the Sixth]

1. I would get rid of state legislatures and Governors refusing to expand Medicaid and set up insurance exchanges

2. Nothing. It's perfect.

Yes, King is correct. Like most problems in this country, Obamacare's can be completely solved by simply abolishing federalism.

You forgot getting rid of the Supreme Court. They are the ones responsible for the Medicaid expansion mess.

[TNF]

1. Nationalize the insurance sector, all hospital chains, the pharmaceutical sector, and the medical technology sector and place them under the control of elected committees of employees of the medical sector as a whole, community members, and patients.
2. Provide all medical care (including dental, mental, etc.) for free at the point of use. No charges for prescriptions, no medical bills, and no mandatory insurance contributions from anyone other than employers.
3. Provide incentives for private practitioners to convert their businesses into workers self-directed enterprises, and prohibit the formation of all new private practices that are not sole proprietorships.

[Starbucks Union Thug HokeyPuck]

Create a National Health Service, ban private insurance.

Spot on here, Tony.

[Cory]

Replace the law by eliminating all age restrictions on Medicare.

[IceSpear]

Replace the law by eliminating all age restrictions on Medicare.

[Frodo]

-federalize Medicaid (thus stripping states of that responsibility)
-have one national insurance exchange instead of states having their own
-strengthen the cost-savings aspects of Obamacare

[Deus Naturae]

1) Make it legal for group health insurers to discriminate against fat people (and people with unhealthy lifestyles generally). Currently this is prohibited. The result is that both fat and healthy people pay the same premiums into the same pools, despite the fact that fat people are objectively more likely to make claims and withdraw money from the pool. Essentially, this amounts to subsidizing the overweight and irresponsible at the expense of the healthy and fit. Obviously, this constitutes moral hazard and has an explosive impact on costs. Legalizing discrimination in this area is simply common sense and would prevent the further ballooning of insurance costs.

2) Legalize all drugs and abolish FDA restrictions on pharmaceuticals. It makes no sense to say that a drug is "too risky" or "too unproven"  since every individual's risk assessment is different. Many people may wish to use potentially dangerous or unproven drugs if such offered even the chance that their condition would heal or be significantly improved, rather than being condemned to their diseased state with no chance of escape. In addition, there are plenty of safe drugs that cost more because the company that produced them has to subject them to expensive and lengthy FDA trials. Getting rid of the restrictive FDA bureaucracy would increase the supply of drugs while decreasing costs associated with developing new drugs, thus driving down costs while allowing individuals to select drugs based on their own risk assessment rather than the arbitrary decision of an FDA bureaucrat.

3) Abolish mandatory government licensing of medical professionals. Medical licensing requirements are simply protectionist entry barriers designed to ensure high salaries and fee for existing doctors (many of whom are little more than highly-trained technicians) at the expense of consumers. Private accreditation boards would still exist to indicate quality, but the supply of physicians would no longer be artificially restricted as it is currently.

4) Abolish "certificate-of-need" restrictions on the construction of new medical facilities. If a hospital is truly "unneeded", it will fail on its own. These regulations are simply a way for incumbent providers to restrict competitors from entering the market and keep costs artificially high.

5) Repeal the HMO Act of 1973. HMO's increase costs by severely restricting consumer choices, which prevents patients from comparing prices between competing providers. There's no reason for the government to promote and mandate them.

[Sumner 1868]

1) Make it legal for group health insurers to discriminate against fat people (and people with unhealthy lifestyles generally). Currently this is prohibited. The result is that both fat and healthy people pay the same premiums into the same pools, despite the fact that fat people are objectively more likely to make claims and withdraw money from the pool. Essentially, this amounts to subsidizing the overweight and irresponsible at the expense of the healthy and fit. Obviously, this constitutes moral hazard and has an explosive impact on costs. Legalizing discrimination in this area is simply common sense and would prevent the further ballooning of insurance costs.

2) Legalize all drugs and abolish FDA restrictions on pharmaceuticals. It makes no sense to say that a drug is "too risky" or "too unproven"  since every individual's risk assessment is different. Many people may wish to use potentially dangerous or unproven drugs if such offered even the chance that their condition would heal or be significantly improved, rather than being condemned to their diseased state with no chance of escape. In addition, there are plenty of safe drugs that cost more because the company that produced them has to subject them to expensive and lengthy FDA trials. Getting rid of the restrictive FDA bureaucracy would increase the supply of drugs while decreasing costs associated with developing new drugs, thus driving down costs while allowing individuals to select drugs based on their own risk assessment rather than the arbitrary decision of an FDA bureaucrat.

3) Abolish mandatory government licensing of medical professionals. Medical licensing requirements are simply protectionist entry barriers designed to ensure high salaries and fee for existing doctors (many of whom are little more than highly-trained technicians) at the expense of consumers. Private accreditation boards would still exist to indicate quality, but the supply of physicians would no longer be artificially restricted as it is currently.

4) Abolish "certificate-of-need" restrictions on the construction of new medical facilities. If a hospital is truly "unneeded", it will fail on its own. These regulations are simply a way for incumbent providers to restrict competitors from entering the market and keep costs artificially high.

5) Repeal the HMO Act of 1973. HMO's increase costs by severely restricting consumer choices, which prevents patients from comparing prices between competing providers. There's no reason for the government to promote and mandate them.

Basically Sierra Leone health care.

[Amenhotep Bakari-Sellers]

Create a National Health Service, ban private insurance.

Too many overweight, healthy people not going to doctor, due the high cost of insurance.  And the decline of pernament work and replacing it with staffing or part time jobs is taking the incentive of health care away from those people.

If we can create some type of network, where everyone gets involved, just maybe, those castastrophic cases, where overweight healthy people will go to doctor.

Meanwhile create more incentives for Health saving accounts for the lower income people. And get rid of tax penalty for those individuals, who can't meet financial income.

[Deus Naturae]

1) Make it legal for group health insurers to discriminate against fat people (and people with unhealthy lifestyles generally). Currently this is prohibited. The result is that both fat and healthy people pay the same premiums into the same pools, despite the fact that fat people are objectively more likely to make claims and withdraw money from the pool. Essentially, this amounts to subsidizing the overweight and irresponsible at the expense of the healthy and fit. Obviously, this constitutes moral hazard and has an explosive impact on costs. Legalizing discrimination in this area is simply common sense and would prevent the further ballooning of insurance costs.

2) Legalize all drugs and abolish FDA restrictions on pharmaceuticals. It makes no sense to say that a drug is "too risky" or "too unproven"  since every individual's risk assessment is different. Many people may wish to use potentially dangerous or unproven drugs if such offered even the chance that their condition would heal or be significantly improved, rather than being condemned to their diseased state with no chance of escape. In addition, there are plenty of safe drugs that cost more because the company that produced them has to subject them to expensive and lengthy FDA trials. Getting rid of the restrictive FDA bureaucracy would increase the supply of drugs while decreasing costs associated with developing new drugs, thus driving down costs while allowing individuals to select drugs based on their own risk assessment rather than the arbitrary decision of an FDA bureaucrat.

3) Abolish mandatory government licensing of medical professionals. Medical licensing requirements are simply protectionist entry barriers designed to ensure high salaries and fee for existing doctors (many of whom are little more than highly-trained technicians) at the expense of consumers. Private accreditation boards would still exist to indicate quality, but the supply of physicians would no longer be artificially restricted as it is currently.

4) Abolish "certificate-of-need" restrictions on the construction of new medical facilities. If a hospital is truly "unneeded", it will fail on its own. These regulations are simply a way for incumbent providers to restrict competitors from entering the market and keep costs artificially high.

5) Repeal the HMO Act of 1973. HMO's increase costs by severely restricting consumer choices, which prevents patients from comparing prices between competing providers. There's no reason for the government to promote and mandate them.

Basically Sierra Leone health care.

Somehow I doubt that fat people are a problem for their health care system.

But seriously, no. I don't even get what point you're trying to make. Do you think that the reason that health care in Sierra Leone would be better if they required pharmaceuticals to be approved by the government or restricted the number of hospitals?

[Chancellor Tanterterg]

Create a National Health Service, ban private insurance.

[Attorney General, LGC Speaker, and Former PPT Dwarven Dragon]

-  40 hours, not 30 hours, should be considered full-time
-  allow a small number of health insurance companies that provide most but not all 'Obamacare-mandated' benefits to still exist for people that legitimately don't need full coverage (ex. people that don't need maternity-related services shouldn't be required to pay for them anyways as the law currently forces them to do so)
- keep the exchanges open year-round, just having these two month periods each year and then closing it off for 10 months just doesn't make any sense at all.
- repeal the medical device tax
- forbid business owners from laying off or firing people solely because of Obamacare-related costs
- require all hospitals and  all doctors to accept insurance policies purchased on the website, no exceptions.
- discriminate against fat people ( 1) in Deus's post above)
- cover birth control like any other prescription, don't insist that it's completely free.

[DC Al Fine]

I'm reasonably happy with Obamacare. My only criticism is that it relies too much on employer provided health insurance, which can cause problems with job loss, tying employees down etc. Therefore I'd make the following changes.

1) Remove the requirement for employer provided insurance for companies over X employees
2) Remove corporate tax credits for health insurance
3) Encourage employers to provide health benefits by subsidizing insurance bought individually on exchanges rather than providing their own policies.

[AggregateDemand]

Phase-out the income exclusion for health insurance premiums. The exclusion started this mess, and our problems won't go away until we eliminate the cause. Insurance cannot function like insurance, when the federal government tells employers to treat insurance as tax-free compensation.

The US is full of people who make $60,000 in Box 1, and $20,000 in Box 12 Code DD. We are ridiculously over-insured, which creates absurdly overpriced medical services.

After the exclusion is phased-out, eliminate flat-rate copay for non-catastrohpic services.

[AggregateDemand]

Create a National Health Service, ban private insurance.

This is laughable.

[Attorney General, LGC Speaker, and Former PPT Dwarven Dragon]

2. Nothing. It's perfect.

[King]

2. Nothing. It's perfect.

Democrats ITT are very clearly not saying it's perfect because they want single payer garbage. Any clear independent mind knows this is a series of great ideas; better than single payer and better than our insurance system prior. The more I examine it the more I am convinced. I can't think of one bad thing about the Affordable Care Act.