The GOP's best solution on health care

[pbrower2a]

The worst for Americans is to simply push Health Savings Accounts which simply allow people to prepay for medical expenses twenty or more years down the line. Of course, inflation will devour the attempt, and at most the savings effort will allow people to live a few more days tan without such accounts... and when the money is gone, people simply get medical care cut off. 

[Fuzzy Bear]

What are actual, serious GOP proposals to replace the ACA? I'm primarily asking the Republican posters on this forum. And how will they ensure affordable coverage for the 30 million Americans who could lose their healthcare as a result of repealing the ACA?

"Health savings accounts."

Which is a fancy word for "nothing."

I'm not sure how HSAs would even cover medical costs unless you were rich.

They would cut costs because it would be people, themselves, paying the bill, with THEIR money. 

Health Insurance is OPM.  Other People's Money.  It's taking money from people who are well and giving it to people who are sick, is it not?  When it's the government's money, or Other People's Money that enables one to pay for a good or service, it increases the price of that service not so much due to the increased demand as the fact that it feels like it's free to the person who gets the service.

I'm not anti-Obamacare.  I do think that its viability is in question due to (A) the SCOTUS striking down the expansion of Medicaid and (B) Republicans selfishly wanting to destroy it for political gain, rather than fixing a plan which was, originally, a REPUBLICAN idea that Obama borrowed to get something done.  But Americans need to be honest with themselves.  The goal of cutting costs is directly at odds with the goal of universal coverage.

[Mr. Morden]

What are actual, serious GOP proposals to replace the ACA? I'm primarily asking the Republican posters on this forum. And how will they ensure affordable coverage for the 30 million Americans who could lose their healthcare as a result of repealing the ACA?

Are there no Republicans here able or willing to answer my questions?

I'm not a Republican, but the ideas that have been floating around as options for the Republican plan are described here:

http://money.cnn.com/2017/01/12/news/economy/obamacare-republicans-health-care/

Also, on how to handle pre-existing conditions if there's no longer an individual mandate:

http://time.com/money/4632898/obamacare-affordable-care-act-repeal-what-happens-preexisting-conditions/

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[ag]

What are actual, serious GOP proposals to replace the ACA? I'm primarily asking the Republican posters on this forum. And how will they ensure affordable coverage for the 30 million Americans who could lose their healthcare as a result of repealing the ACA?

Are there no Republicans here able or willing to answer my questions?

I'm not a Republican, but the ideas that have been floating around as options for the Republican plan are described here:

http://money.cnn.com/2017/01/12/news/economy/obamacare-republicans-health-care/

Also, on how to handle pre-existing conditions if there's no longer an individual mandate:

http://time.com/money/4632898/obamacare-affordable-care-act-repeal-what-happens-preexisting-conditions/

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Just think what this will do to the premiums (with the government subsidies withdrawn)

[True Federalist (진정한 연방 주의자)]

The problem with the idea of "shopping for care" is two-fold. First and foremost, a significant portion of care, especially the more expensive types of care, become needed suddenly and unexpectedly, so there is little to no chance for comparison shopping. Secondly, individuals just don't have the economic clout needed to extract price concessions from the oligarchic hospital industry. Personally, I think the best reform one could make in restructuring how our health-care system works would be to require that health insurance be run on a non-profit model. That would insure that insurance works on behalf of the insured and provide the needed counterweight to the hospital industry.

[The_Doctor]

Once again - as I've said - let's be honest with ourselves.

ObamaCare isn't being repealed. It's being "modified" and called a win. Otherwise? Big Pharma will need a massive bribe to STFU and these fine folks in the states where Medicare expansion took root will most definitely want to have a word with the GOP Congress and White House. Particularly those states that voted for Trump in the Midwest.

The GOP knows this. They can't agree on a replacement because a) any replacement will be crappier than ObamaCare b) ObamaCare needed to be killed in 2012, not 2016 and c) they don't want to deal with angry constituents that discover suddenly that their healthcare is related to ObamaCare. Believe me, the Congresscritters know this. They aren't happy about it, but they know about the political math. Just see how Capito from West Virginia behaves. Trust me, her constituents depend on Medicare and if the GOP repeals the expansion, West Virginia is going to be royally ticked.

The GOP base, facing the possibility of the team losing, will start "discovering" the virtues of ObamaCare. Hey, if they could do it on Russia, they can suddenly shift on ObamaCare.  Long and short of it: ObamaCare is permanent. After much hemming, hawing, and huffing and puffing, this will be the outcome.

Still not convinced? Let me put it this way, very gently. Tens of millions of people are on some sort of market plan facilitated by ObamaCare. Including with subsidies. The law has ingrained itself into the fabric of American economic life to the point that repealing it will cause a massive clustercrap. And the alternative is a stronger public option ... so ... the GOP will STFU and take ObamaCare.

[anvi]

The problem with the idea of "shopping for care" is two-fold. First and foremost, a significant portion of care, especially the more expensive types of care, become needed suddenly and unexpectedly, so there is little to no chance for comparison shopping. Secondly, individuals just don't have the economic clout needed to extract price concessions from the oligarchic hospital industry. Personally, I think the best reform one could make in restructuring how our health-care system works would be to require that health insurance be run on a non-profit model. That would insure that insurance works on behalf of the insured and provide the needed counterweight to the hospital industry.

Agreed. 

I also think one of the major ironies of the ACA was the way in which the "mandate" was made a lightning rod.  The problem with the mandate was not that it was too onerous but that it was too toothless.  If young folks didn't buy insurance, and didn't pay the fee for not buying insurance, the IRS had no authority to take them to court for the delinquency.  So, young people didn't buy in and the state exchange markets suffered as a result because the coverage in many cases could no longer be financed, and insurance companies pulled their particiaption in many places, or raised their premiums and increase the amounts of subsidies customers required.  In the '94 Senate Republican bill that was the basic origin of most of the ACA, the individual and employer mandates were stronger than in the ACA, which would make the whole framework easier to finance.

But, in the big picture, I agree; having insurance run by people who are trying to satisfy investors skews the motivations that go onto health insurance specifically.  Non-profit private insurers work much better, I think.