Obamacare

What the GOP's Pledge Has in Common With ObamaCare

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“It’s time to do away with the old politics: that much is clear,” say the Republicans behind the new Pledge to America before they go on to propose 135mb worth of mostly old and familiar GOP ideas. (Next time, can they include a promise to learn how to compress a PDF?) Granted, some of those ideas are an improvement on the status quo, but that’s not saying much. And quite a few of them aren’t really any better.

Pledged!

For example, a big chunk of the plan involves reforming (re-reforming?) the health care system. Priority number one, of course, is repealing and replacing the PPACA, a.k.a. ObamaCare, which would be lovely, and probably popular, if they could actually do it. But as long as there’s a Democrat in the White House, that’s an aspirational goal rather than a practical one. Still, as Hollywood proves every year, we’re all suckers for stories featuring The Underdog Who Faces Impossible Odds or The Crazy Dreamer Who Dares to Dream Big, so sure, why not?

Repeal won’t be easy (to put it very mildly), but at least there's plenty of agreement that it would be a nice thing to do. Replacement, though, is where things get tricky. The GOP is also pledging to allow the purchase of health insurance across state lines and expand health savings accounts, both of which are reasonably good ideas. The party is also pledging to pursue federal medical malpractice reform, which is more problematic. For one thing, most common med mal reform proposals, such as caps on noneconomic damages, would harm some patients (those wronged) and help others.  (For a helpful overview, see page 163 of Cato’s Handbook for Policymakers.) Moreover, as the Cato Institute’s Michael Cannon has pointed out repeatedly, it’s not clear that the Constitution actually allows for the federal government to implement such policies. And federalizing such reforms would likely get in the way of state-based experimentation.

Meanwhile, if the GOP was hoping to distance itself from President Obama’s health care overhaul, it’s gone about it in an awfully odd fashion: The Pledge includes a number of promises to follow-through on some of the most problematic ideas in ObamaCare. Here’s a key passage:

Health care should be accessible for all, regardless of pre-existing conditions or past illnesses. We will expand state high-risk pools, reinsurance programs and reduce the cost of coverage. We will make it illegal for an insurance company to deny coverage to someone with prior coverage on the basis of a pre-existing condition, eliminate annual and lifetime spending caps, and prevent insurers from dropping your coverage just because you get sick. We will incentivize states to develop innovative programs that lower premiums and reduce the number of uninsured Americans. [bold added]

If eliminating benefit caps and preventing rescissions is now GOP policy, then they’re with the Democrats; ObamaCare does both of those things. The new health care law also includes a number of state-based pilot programs intended to look for ways to incentivize medical efficiency.

But the larger problem is the requirement that insurance companies be forced to sell anyone with prior coverage a policy regardless of medical history or current ailments (preexisting conditions). It’s a form of what's called “guaranteed issue,” and it’s at the heart of the problem with ObamaCare. Usually paired with another policy called “community rating,” which strictly limits how insurers can charge individuals differently based on their health risk factors (which ends up meaning that individuals with risk factors get charged more), it’s a very popular set of reforms, for obvious reasons: It turns an insurance premium into an all-you-can-eat health care buffet that you only have to pay for when you want it.

But in addition to being popular, it’s also a recipe for a swift insurance death spiral. Knowing that they can get insurance at any time, healthy people leave the pool to save money. That drives up premium prices, which drives more people out of the pool, and so on and so forth until you’re left with a very small, very sick, very expensive insurance pool. The PPACA’s authors decided to solve this problem by including an individual mandate requiring everyone to purchase health insurance or pay a tax/penalty.

But the mandate is among the least popular provisions in the bill. And more to the point, Republicans have campaigned against the mandate, and GOP officials at the state level are leading a multistate lawsuit challenging the mandate on constitutional grounds.

So here’s the question: Are Republicans now in favor of a mandate? Or are they in favor of insurance market regulations that are sure to decimate the country’s health insurance market?

Update: Wonk Room has a chart listing the ways in which the GOP Pledge resembles the new health care law.

Update 2: To clarify, the precise language says that Republicans would make it “illegal for an insurance company to deny coverage to someone with prior coverage.” So technically what they’re calling for is not a blanket ban on coverage denials, but a ban on denying coverage to the previously insured, a policy that would probably have much less effect on the insurance market. But considering the careful the first line in the sectionâ€"“health care should be accessible for all, regardless of pre-existing conditions or past illnesses”â€"it seems relatively clear that Republicans are attempting to address public concern about insurance companies denying coverage based on preexisting conditions. Now, that opening line is also carefully phrased; it says  â€œhealth care” rather than “health insurance.” Still, given that Republicans have traditionally been squeamish about discussing whether insurance companies should be allowed to deny coverage to those with preexisting conditionsâ€"last year, Rep. John Boehner boasted of a GOP plan that “helps Americans with preexisting conditions,” and in the days after the PPACA passed, Sen. Cornyn said that “there is non-controversial stuff here like the preexisting conditions exclusion”â€"it’s pretty easy to imagine how a policy sold with this sort of rhetoric ends up after it goes through the political sausage-making machine.

Lots more on the Pledge from Nick Gillespie here and here.

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NEXT: Pledging to Follow the Constitution

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  1. What the GOP’s Pledge Has in Common With ObamaCare

    Lies and bullshit?

    Ooh, I RTFA and guess what? I’m right again.

  2. The thing was written by political people who think the American public is stupid. Yeah, if you don’t mandate every one buying insurance, you have to let insurance companies exclude people with pre-existing conditions. Life sucks like that sometimes. And I think most people understand that.

    Unless and until we get a political force that is willing to tell the media to go fuck itself and tell the truth, nothing will change.

    1. Yeah, if you don’t mandate every one buying insurance, you have to let insurance companies exclude people with pre-existing conditions. Life sucks like that sometimes. And I think most people understand that.

      The only way out is to permit insurance companies to charge whatever the hell they want. Show up at an insurance company bleeding from the ears and they have to cover you, but they can charge you $100,000 annual premiums.

      Somehow I don’t think the GOP is going to allow that, though.

    2. “”Life sucks like that sometimes. “”

      Words of wisdom? Keep that in mind when we are all paying a higher price because they get their way. I may suck for you too, but life it like that sometimes.

      1. “” I may suck for you too,””

        That’s funny. Should say It my suck for you too.

        1. Geezzz. I really should preview.

          1. Freudian problems?

  3. “But in addition to being popular, it’s also a recipe for a swift insurance death spiral. Knowing that they can get insurance at any time, healthy people leave the pool to save money. That drives up premium prices, which drives more people out of the pool, and so on and so forth until you’re left with a very small, very sick, very expensive insurance pool. The PPACA’s authors decided to solve this problem by including an individual mandate requiring everyone to purchase health insurance or pay a tax/penalty.

    But the mandate is among the least popular provisions in the bill. And more to the point, Republicans have campaigned against the mandate, and GOP officials at the state level are leading a multistate lawsuit challenging the mandate on constitutional grounds.

    So here’s the question: Are Republicans now in favor of a mandate? Or are they in favor of insurance market regulations that are sure to decimate the country’s health insurance market?”

    Exactly. So from a rational perspective, making insures unable to dump people, and keeping the mandate are indivisible to a functional plan.

    Are we going to get rid of auto insurance too? Is it a bad idea? Only until some uninsured drunk hits you….. Is it ok only because its mandated by states, not federal? What if Health care Mandate was enacted by states, not federal, would that be ok?

    While free markets are best for most aspects of economic behavior, Health care to most people is another can of beans. Do you really think people should be excluded and go bankrupt from random illnesses?

    A pragmatic solution would be to admit Health Care is one of very few special cases, that would be ok to allow a mandate, along with full inclusion by insurers.

    Then by all means leave the other economic issues to the market and pursue liberarian ideals.

    Auto insurance is mandated. Does that automatically lead to huge corruption and abuse of the system? No. today’s auto insurance market seems very competitive, so while we all have to have it, market forces help to keep honest, decent, sufficient coverage, within reach for people.

    “Life sucks like that sometimes. And I think most people understand that.”
    Understand what? Your little sister dies because your parent’s coverage lapsed between jobs and couldn’t get treated in time for a treatable cancer? Yeah that might suck, but, oh well, at least political idealogues can sleep well knowing the market is free.

    1. So how would one go about getting treated for a treatable cancer without insurance (b/c they were denied for having a pre-existing condition)?

      -sell assets or use house as an ATM
      -family & friends
      -charity
      -govt programs already in existence

      Then declare BK and hope to get all debts erased in court and start anew ?

      1. So how would one go about getting treated for a treatable cancer without insurance (b/c they were denied for having a pre-existing condition)?

        I defy you to locate one single person in this country who has treatable cancer and has been denied treatment because they don’t have insurance.

        One. Single. Person.

        Don’t waste your time. This mythical cancer patient doesn’t exist.

        Try again.

        1. For free? Not talking about no treatment, talking about having to go bankrupt to pay for it. Are you ok going bankrupt if you by chance have a really terrible disease or accident (If you couldn’t afford/were denied insurance? Do you really just say, “Well, that’s life, sucks…”

          1. Is living worth bankruptcy? I guess we all have to answer that question individually.

            1. This simplistic sophistry weighs on me. Like rampant bankruptcies wouldn’t end up having a societal cost. Might end up equivalent to, oh I don’t know, about the cost of mandatory health care premiums.

              It’s either a combination of higher costs and lesser insurance/medical profits or more dead. Those are the choices.

    2. Auto insurance is mandated. Does that automatically lead to huge corruption and abuse of the system? No. today’s auto insurance market seems very competitive, so while we all have to have it, market forces help to keep honest, decent, sufficient coverage, within reach for people.

      You’re in excellent company, Chris: President Obama doesn’t understand how car insurance works, either.

      First, the car-insurance mandate only applies to those to choose to own a car. I have two adult relatives who have never been licensed to drive. They pay no car insurance. But draw breath in America, and Obamacare makes you carry health insurance.

      The law requires drivers to have liability insurance. That way, if you injure an innocent person or damage an innocent person’s property, that innocent person is covered. That person doesn’t have to worry that you don’t have the resources to pay a large personal-injury judgment. That’s not what health insurance is.

      Health insurance is closest to comprehensive car insurance. If your car is damaged in an accident (even if it’s your fault) or by being attacked by hoodlums, or when a tree falls on it, you get paid the cost of repairing your car. But you’re not required to have comprehensive. The state doesn’t care if you’ve insured against flood damage, or your ex-girlfriend breaking out your windows because she’s pissed that you’re banging her sister. The only one getting hurt there is you, and if you don’t want to protect yourself, the state doesn’t care.

      That’s the way it should be with health insurance, but health insurance is a different kettle of fish entirely. You’ll notice that comprehensive insurance doesn’t cover oil changes, new tires, timing belt replacement, towing services, ripped upholstery, or new wiper blades. The difference is the risk profile. Comprehensive insurance covers events that have a low probability of occurring, but when they do occur, are costly to fix. It does not cover high-probability events that are relatively cheap to fix.

      The way we have health insurance set up, we expect insurance companies to pay for maintenance (routine check-ups) and minor damage (colds). That’s not what true “insurance” covers. Everyone gets sick occasionally. The probability of getting a cold over the course of a year is extremely high. And the probability of going to the doctor for a routine checkup is extremely high, particularly if you figure out how to get some chump to pay for it.

      The problem, we’re told, is that medical expenses are bankrupting Americans. I know that some people have hefty bills. But if we’re going to have a mandate for everyone to have health insurance, it should be to pay for low-probability, catastrophic, potentially bankrupting events, not pregnancy and sniffles.

      But Obamacare doesn’t let you do that. Obamacare requires that people have first-dollar “insurance.” No one will actually see the true cost of minor care, because someone else is paying for it. You’re not allowed to bargain with an insurance policy that only kicks in once you reach $1,000 or $10,000 or $50,000 in medical bills for a year. It’s illegal for you to make that bargain. And that’s not right.

      Again, the mandate is unconstitutional. But if we’re going to have a mandate, let’s have one that addresses the real problem: catastrophic, bankrupting illness. Let’s mandate that everyone has to has a policy with a deductible no higher than, say, 25% of last year’s adjusted gross income. You can get a lower deductible if you want. But a one-time $4,000 medical bill isn’t ruinous for someone who makes $20,000. Put it on a credit card, work out a payment plan, get a personal loan, put up your car, etc. A $10,000 medical bill could be ruinous, though, so insure against that.

      That’s real insurance. Obamacare is just dragooning insurance companies to pay for penicillin when you get minor staph infection.

      1. Can we please just go back to Major Medical Coverage and drop this whole “HMO-ish” idea of cradle-to-grave third-party coverage for “maintenance” services.

        I’d gladly cover my $1,000+ per year maintenance prescriptions out of pocket so long as I don’t have to help pay for my neighbors viagra pills out of my insurance premiums.

        1. the problem with that is its in the insurance companies interest to provide low cost maintnence services both for competitive reasons (we cover such and such this plan doesn’t buy ours) and because a lot of services lower the chance of the catastrophic costs.

          1. Is its in the insurance companies interest to provide low cost maintainance services… [because] a lot of services lower the chance of the catastrophic costs.

            Sometimes. One of the issues that got lost in this whole debate is whether screenings and preventive medicine are actually cost-effective. Everyone talks about free annual physicals as if the science is settled that having a doctor look you over for a couple minutes and run some basic blood tests saves money in the long run. But that’s not always the case. From a strict financial standpoint, it’s often cheaper to treat a developed illness than to screen for it.

      2. “But if we’re going to have a mandate for everyone to have health insurance, it should be to pay for low-probability, catastrophic, potentially bankrupting events, not pregnancy and sniffles.”

        “But if we’re going to have a mandate, let’s have one that addresses the real problem: catastrophic, bankrupting illness. Let’s mandate that everyone has to has a policy with a deductible no higher than, say, 25% of last year’s adjusted gross income. You can get a lower deductible if you want. But a one-time $4,000 medical bill isn’t ruinous for someone who makes $20,000. Put it on a credit card, work out a payment plan, get a personal loan, put up your car, etc. A $10,000 medical bill could be ruinous, though, so insure against that.”

        Thanks for the thoughtful reply. I agree with that. I was just throwing out the questions to hear some good answers.

        1. My pleasure.

          No analogy is perfect, but comparing auto insurance to health insurance does help as a thought experiment. Imagine, for example, what your life would be like if you had to go through State Farm every time you needed to get a flat fixed or get an oil change.

    3. The true hard luck cases could be covered by a targeted program that would be far cheaper and far less distortionary to the economy than piece by piece socialization of all medicine for everyone.

      But then you know that already.

    4. “Auto insurance is mandated.”

      For people that own cars.

      Would you expect an insurance company to pay out on an home insurance policy that you bought AFTER your house has burned down? Because that’s what pr-existing coverage is.

      Do you believe an auto insurance company should be able to force people who don’t own cars to buy auto insurance? Because that’s what the mandate is.

      Do you think an auto insurance company should be able to force you to buy a $3M colision policy on your 1994 Dodge Caravan? Because that’s what mandating people buy health insurance with all the bells and whistles does.

      1. “For people that own cars.”

        We all own bodies.

        “Would you expect an insurance company to pay out on an home insurance policy that you bought AFTER your house has burned down? Because that’s what pr-existing coverage is.”

        I understand that, which is why a mandate to be insured along with undeniable coverage seems the only rational approach. Of course we should debate/refine issues of “bells and whistles”, and Catastropic-only ideas, etc. I just don’t think rejecting people, and having people uninsured due to circumstance is very civilized. One can sympathize with Libertarian principles, but not to live in Lord of the Flies conditions.

        “Do you believe an auto insurance company should be able to force people who don’t own cars to buy auto insurance? Because that’s what the mandate is.”

        You never get sick and will never get old, or may never get a freak illness?

        “Do you think an auto insurance company should be able to force you to buy a $3M colision policy on your 1994 Dodge Caravan? Because that’s what mandating people buy health insurance with all the bells and whistles does.”

        Seems a fair point.

        1. So in order to breathe and be in America I must buy health insurance by threat of force if I do not?

          Fuck off.

          1. “Fuck off” is a pretty good solution. What a joke. They definitely should not have a total mandate. They should have an option where you opt out of insurance, and agree to pay out of pocket. Then you can tell your brain surgeon to “Fuck off” when he sends you the bill for removing your freak brain tumor.

            1. You don’t appreciate the seven hundred to thousand percent that tertiary means as Rothbard would put it (third party payment) jacks up the price of everything it touches. Thanks to us health insurance policy owners, those who don’t are subjective to sky high cost given the lack of market discipline in the industry. So, who is really being ‘socially’ irresponsible? I have health insurance for purely selfish reasons, not because I give a fuck about the other guy, unlike you I understand the underlying economic dynamic and don’t deny that fundamental truth.

              1. don’t are subjective

                don’t have it are subject

    5. “While free markets are best for most aspects of economic behavior, Health care to most people is another can of beans.”

      No, it’s not. Most people don’t expect to get something for nothing. They just think health care is too expensive – of course that’s do to Government intervention in the market, not free market forces.

      1. Well unless you are very wealthy, good luck paying for open heart, or brain surgery out of pocket.

        Whats so hard to understand about the fact that sometimes people, lots of people, get ill with things that are hugely expensive. So only the wealthy get treated? So naive. You know the facts on social/income mobility in this culture- very hard to move up the income brackets- of course people here and there do it, great, but by and large people don’t. Do you really believe in a limitless pie, that we can all have a giant piece of if we only work hard enough? Of course its not a zero sum game either, but there are tons of people who can’t pay out of pocket. Too bad?

        1. You know the facts on social/income mobility in this culture- very hard to move up the income brackets- of course people here and there do it, great, but by and large people don’t.

          Especially when you incentivize NOT working and moving up that ladder by giving away free housing, health insurance, food, money and whatever the fuck else those on the dole receive in return for voting in thieving bastards.

    6. Yes, insurance companies should be forced to pay for everyone’s medical expenses at a loss, because otherwise people with life-threatening problems would die.

      Hmmm.

    7. Auto insurance is mandated if you CHOOSE to drive. You don’t have to.

      “A pragmatic solution would be to admit Health Care is one of very few special cases, that would be ok to allow a mandate, along with full inclusion by insurers”
      I’m born within the U.S., therefore I must be insured? Nothing reasonable or practical about that. You give out free shit, and people abuse it because they don’t care who writes the checks. You don’t need to go to the ER every time your arm is scraped, you’re running a fever, or your tummy hurts. Once you make it ‘free’, everyone else foots the bill.
      Also, why should I have to pay for someone’s chemotherapy that’s needed from years of smoking, drinking, or staring at the sun? There’s a limited supply of medical devices, supplies, doctors, nurses, radiologists, etc. There’s not enough to go around once everyone abuses the system.

      1. Cancer can hit anyone anytime. Thinking you can assign blame to disease is childish. Do you really think someone of limited means should just die or go bankrupt?

        Isn’t the whole insurance concept the idea the anyone could have a need anytime, so we all just pay in enough to keep the scheme going and pay out the services? Of course you have to adress costs of medical services and rates of use, but do you suggest rationing? what do you suggest?

        How many people talk this (people want free shit…) nonsense, but without insurance would never be able to personally finance a major surgery or disease?

        1. Cancer can hit anyone anytime.

          So can meteorites. The difference is that I can take care of my health and shouldn’t have to be penalized because some parasite didn’t.

        2. “How many people talk this (people want free shit…) nonsense, but without insurance would never be able to personally finance a major surgery or disease?”

          Because insurance isn’t free and we choose to pay for it?

  4. Apparently the Republicans didn’t read the bill either.

    “So here’s the question: Are Republicans now in favor of a mandate? Or are they in favor of insurance market regulations that are sure to decimate the country’s health insurance market?”

    The Republican are in favor demagoguing this issue into a midterm election victory.

    1. Republicans didn’t read the bill

      They didn’t read this pledge thing either.

      1. It is pretty long

        1. That’s NOT what I said.

  5. ObamaCare is here to stay until we’re so far in debt that the annual interest payments on our debt exceed revenue, and maybe longer.

    Republicans aren’t going to do anything that can be demagogued as hurting kids or giving insurance companies the right to deny coverage or treatment. The scary-music, grainy-black-and-white-photo TV ads practically write themselves.

    Team Red is just going to do what Team Blue does, but slower. And we’re all fuck-diddly-ucked.

    1. Look, the HCR bill, if implemented, will actually cut the deficit by a pretty large amount (The excise tax is basically a gradual repeal of the tax-deductibility of employer-given health-care. This was a massively distorting and expensive tax-break)

      Other things might bankrupt us, but Obama care is one of the things that push back the day of reckoning.

      1. You should really lay off the kool-aid.

      2. Look, the HCR bill, if implemented, will actually cut the deficit by a pretty large amount …

        psst! Wanna buy a bridge?

    2. ObamaCare is here to stay until we’re so far in debt that the annual interest payments on our debt exceed revenue, and maybe longer.

      That could happen before ObamaCare is even fully implemented.

      For years, we have been shortening up our debt, which increases rollover risk. When the market for short-term debt is saturated and/or when inflation kicks in again, our rollover risk is huge and our debt payments will skyrocket.

    3. HCR is fiscally do-able we’d just have to reprioritize our spending- if we slashed defense spending by 50% (say gave up all but 1 European base, withdrew from Japan and Iraq, etc) we could cover a lot of things.

      1. This only works if you believe the government has a right to the money people make. We could just let people keep their money and decide for themselves what they need to buy.

        1. Agree on cutting defense though.

  6. I didn’t think it was possible, but the new idea for a health care plan is worse than Obamacare. Obamacare forces you to buy health insurance, which sucks and is, or should be, unconstitutional. The new plan with no caps, guaranteed issue and no requirement to buy will make it impossible to buy insurance because they’ll all shut down, cost a zillion dollars or go out of business, like the Kids Only plans.

    1. The fine print seems to be “We will make it illegal for an insurance company to deny coverage to someone with prior coverage on the basis of a pre-existing condition.” That’s more or less the law pre-Obama care, I think.

      1. Really? That is totally different than what is being portrayed here. If you actually have insurance, they shouldn’t be able to dump you just because you get sick. That is just as bad as buying insurance after you are sick and expecting the company to pay for your illness.

        1. they really can’t dump you after you get sick… thats a lie thats been thrown out there by the dems. They can onyl dump you, if you misrepresented info on your application (ie. you’re a smoker but said you weren’t). Or because of some technical thing that your plan didnt cover. Is there some abuse here ont he part of insurance companies finding a technicallity like you filled in a line wrong? Probably. But as a rule, insurance companies can’t just dump you for getting sick. That would violate the contract they signed.

          1. Not some- recission was one of the few things that wasn’t demagogued enough- it was a major portion of the personnel department at any large insurer you can name- frankly I think recision could be allowed if upon cancellation all payments ever made to the insurer are also refunded- it’d still be skeevy but it wouldn’t be as skeevy.

        2. It’s their health-insurance policy-nobody should have the right to force them to sell it to anybody!

    2. “I didn’t think it was possible, but the new idea for a health care plan is worse than Obamacare.”

      Didn’t think it was possible? With all those Republican rocket scientists?

  7. I always knew I would hate the 112th Congressional Republicans, but I just didn’t expect to do it so soon.

    1. Yep. ‘GOP: The Other Dems’ That’s what we’ll be getting this season.

  8. Oh, Jesus, we musn’t decimate the nation’s insurance market. Why that would mean millions of Americans without health insurance…oh.

    1. Wait, so Max just admitted that Obamacare will decimate the insurance market?

      So Max just admitted that Obamacare will lead to very few people having insurance, instead of the vast majority of people that do now?

      So Max is a fucking retard who just proved our point while trying to ridicule it?

      1. You do get that the difference between Obamacare as flawed as it is and this proposal is that since Obamacare has a mandate it doesn’t essentially destroy insurance as a concept.

        1. If the mandate was actually a mandate instead of a fee that will be cheaper than insurance for years, then yes, insurance would still exist as a government puppet industry. But since it isn’t actually mandated that everyone must get insurance, the question of whether the insurance industry will be able to sustain itself in those first years is unanswered. But I’m sure the government will be there to subsidize and stimulate insurance companies that they made too big to fail.

  9. How do you fucking party-line libertarians are very amusing.

  10. Oops. I started to write “How do you swallow this party-line libertairan shit without choking?” and changed mid-sentence.

    1. ARFARFARFARFARFARFARFARFARFARFARF!!!!!!!!!!

      1. ARF!?

  11. Maybe the Republicans are actually brilliant limited government activists*.

    Consider: Obamacare – Mandate = rapid collapse of present healthcare system. After the present employer provided insurance system collapses, everyone is forced onto HSAs, which lead to greater individual choice and responsibility in health-care spending, ultimately solving our health care crises.

    *Lol, no they’re fucking idiot demagogues.

    1. Sadly it would probably lead to Democrats wailing that Republicans dismantled the health care system an that now is the time to implement single payer.

      1. Sadly? After countless people suffer or die due to Republicans disingenuously passing a law they knew would cause wide-spread havoc?

        Any movement so craven deserves to be kept out of power.

        1. Uh, David, its the ObamaCare plan that will lead to the collapse of private insurance, so that, according to you”countless people suffer or die due to Republicans Democrats disingenuously passing a law they knew would cause wide-spread havoc.”

          Some of them were quite open about their long-term plan to crater private health insurance to pave the way for single-payer.

          I agree that “Any movement so craven deserves to be kept out of power.”

        2. David Shor|9.23.10 @ 3:17PM|#

          Sadly? After countless people suffer or die due to Republicans disingenuously passing a law they knew would cause wide-spread havoc?

          Any movement so craven deserves to be kept out of power.

          Holy shit progs bring the dumb.

    2. The solution to failed regulation is more regulation.

      That’s a corollary to Masturbatin’ Pete’s First Law of Regulation:

      All problems arising out of a regulated industry will always be successfully blamed on the unregulated portions of that industry.

      1. This was definitely predicted with any government healthcare overhaul.

        You could have an island atoll of capitalism in a sea of government control and regulation, and any problems which occur will naturally be placed on the island of capitalism.

        1. They’re a bunch of capitalist wreckers and saboteurs.

          1. Don’t forget about the spies, saboteurs, and speculators.

            BTW, with recent Fed moves, you can bet that Congress will be investigating the disruptive activities of the latter in the next six months or so.

            1. Now Congress investigating Congress would be a sight to see.

        2. Alternatively, if there were no island atoll of capitalism, you could blame unpurged capitalist thoughts.

          1. Capitalists are incurably diseased animals. Like rabid dogs, they must be shot lest they infect others.

            1. I would have hung the last capitalist, but unfortunately I had to eat the rope. Can you sell me more rope. How’s my credit?

      2. Its the eternal dilema over regulation stifles growth and innovation- under regulation leads to a market place that is essentially rigged in favor of the established interests.

      3. I dare you to find one segment of health care that wasn’t regulated before HCR.

        Just one.

  12. Meanwhile, if the GOP was hoping to distance itself from President Obama’s health care overhaul, it’s gone about it in an awfully odd fashion: The Pledge includes a number of promises to follow-through on some of the most problematic ideas in ObamaCare.

    This was my complaint over a year ago with the GOP dimwits and their so-called opposition to Obamacare. They’re not opposed to it, anymore than they’re opposed to Social Security, Corporate Welfare, or any other cornerstones of the Democratic party. They just argue details. Fuck them.

    1. Actually the sad thing is the GOPs in favor of worse corporate Welfare- at least in the case of Medicare- witness the uproar when HCR proposed cuts to medicare plan D which essentially paid private health care providers more money for little to no increase in services.

  13. There is a difference between preventing rescission and denying for a pre-existing coverage. I don’t see how the former causes an insurance death spiral.

    If you pre-existing conditions are covered, sure healthy people will leave the pool. But that is not what the Pledge is advocating. It is stopping rescission, which is different. Rescission is where the insurance company denies you existing coverage after you are sick. Banning that doesn’t give you coverage for pre-existing conditions. And further, banning rescission doesn’t create a motive for healthy people to leave the system. Yeah, I can drop my healthcare coverage and go buy more when I am sick. But that new coverage isn’t going to cover the costs associated with my existing illness. So what good would it do me?

    I think this is a bullshit post. I didn’t read it closely at first. But Suderman or Mr. McArdle or whatever he goes by these days is not being honest here.

    1. I find your occasional reference to Peter as “Mr. McArdle whatever he goes by these days ” to be unnecessarily disrespectful. It’s pretty clear from the by-line what name he goes by.

      1. Too bad. My point still stands. I don’t think this was an honest post. I don’t see how ending rescission puts the insurance industry into a death spiral. Suderman wrongfully equates banning rescission with banning pre-existing condition exclusions.

    2. There is a difference between preventing rescission and denying for a pre-existing coverage.

      Rescission is the remedy for somebody who lies about their pre-existing conditions. So I don’t think you can allow denial for pre-ex without also allowing rescission.

      1. If it is fraud that is different. Truthfully, I can’t tell what this sentence means

        “We will make it illegal for an insurance company to deny coverage to someone with prior coverage on the basis of a pre-existing condition”

        That could mean once you are in you are in even if you lied. But it also could be a really poorly written attempt to say “they can’t take away your insurance if you get sick”, which is pretty meaningless since they can’t do that anyway.

        You tell me what that sentence is supposed to mean.

    3. I knew John would get around to gargling the Republicans’ jizz.

      If you sign a contract with an insurance company that says “if so and so occurs we can deny coverage,” then who are the Republicans to say that they can’t?

      Also, it would be basically equivalent to making insurance companies cover everyone because you could simply lie about having a pre-existing condition, and then once you have coverage the insurance company can’t take it away when they realize you lied in the contract.

      1. “Also, it would be basically equivalent to making insurance companies cover everyone because you could simply lie about having a pre-existing condition, and then once you have coverage the insurance company can’t take it away when they realize you lied in the contract.”

        Couldn’t the insurance companies solve that problem by requiring you to get a physical before they give you insurance? That is what life insurance companies do.

        You guys act like you can just lie and the insurance company has to take your word for it. If they don’t give you a physical, why should I care if they get screwed?

        “If you sign a contract with an insurance company that says “if so and so occurs we can deny coverage,” then who are the Republicans to say that they can’t?”

        If you do that is good for you. But I am unaware that such contracts even exist. I have never seen one that says we cover you but not for this or that. There are ones with big deductibles. But none that say “we don’t cover cancer”.

        So go back think of some better arguments. And if you are lucky I will let you gurgle on some of my jizz dickhead.

        1. The problem is the GOP plan removes the mandate but keeps the guaranteed issuance- recission should have been removed years ago- it should only be allowed in extraordinary cases of fraud not as it was pre-HCR as a cost savings measure whereby insurance companies would take premium money, provide overage adn then in the vent of a major cost- go back and investigate a persons initial application looking for even minor and/or unwitting errors that could be used to cancel coverage while still pocketing all the accumulated payments.

        2. There are plenty of insurance contracts that will stipulate that they will cover you for everything except for illnesses related to a preexisting condition. My friend who had major reconstructive knee surgery can’t get a reasonably priced insurance policy that covers his knee*.

          * Not that he needs it since the injury happened at his old employer and part of the settlement was they would cover all of his knee related medical bills and surgeries.

        3. “If you do that is good for you. But I am unaware that such contracts even exist. I have never seen one that says we cover you but not for this or that. There are ones with big deductibles. But none that say “we don’t cover cancer”.”

          Every damn plan has a list of things it doesn’t cover. Here’s one example:
          http://www.opm.gov/insure/heal…..71-005.pdf
          Section 6. General Exclusions- Things we don’t cover

        4. Couldn’t the insurance companies solve that problem by requiring you to get a physical before they give you insurance? That is what life insurance companies do.

          You guys act like you can just lie and the insurance company has to take your word for it. If they don’t give you a physical, why should I care if they get screwed?

          So it’s OK to lie in a contract if the other person signing the contract doesn’t take the time to make sure you are telling the truth? It’s the insurance companies fault when you defraud them? OK, John, way to miss the point.

          If you do that is good for you. But I am unaware that such contracts even exist. I have never seen one that says we cover you but not for this or that. There are ones with big deductibles. But none that say “we don’t cover cancer”.

          Again, John proves he has no idea what he is talking about. Rescission occurs when a person lies about not having pre-existing conditions. If it is found out later that you lied in the contract, your coverage will be taken away. That is exactly what this Republican plan would prohibit companies from doing.

          So go back think of some better arguments. And if you are lucky I will let you gurgle on some of my jizz dickhead.

          Why do I need better arguments? They worked fine against you, you hack.

  14. How is that I have all these pre-existing conditions and yet managed to have insurance?

    Oh, that’s right… I got a fucking job.

    1. You have insurance. But that insurance doesn’t cover all of your pre-existing conditions. Maybe I am totally missing something. But I don’t see how banning rescission is a bad thing. If I have insurance, they shouldn’t be able to cancel it just because I got sick. They took the risk that I would some day get sick when they took my money. Isn’t that the point of insurance?

      1. I had no health insurance for about 10 years. Nothing. Paid out of pocket. Came in to my current insurance with Type I and Type II diabetes, hypertension, a reconstructed hip, and an unruptured cranial aneurysm (or so they thought at the time.) I got treatment for every one of those things within the first month of working here. I sucked it up and took a fairly low-paying job with good benefits.

        1. That is some kick ass insurance.

          1. Yes, but the take home pay sucks. I’d be living in a tiny apartment and pinching pennies if I was single.

            1. I take it your job doesn’t require knowledge of the subjunctive mood.

            2. You should have been a teacher.

      2. The pre-existing conditions rules only apply in the individual and small group markets. If you have a big corporate or government job, you can get insurance that covers pre-existing conditions. One more reason the problem was blown out of proportion.

  15. Make employer provided health insurance taxable like all other compensation?

    Nah, that would piss off too many people. Hell, if you did that employers might just start paying the folks the cash instead of providing health insurance and people would do what they wish with the money.

    And as all good statists know, GOP or Dem, we cannot have people doing what they wish with their own money. That way lies anarchy. Tax incentives, mandates and penalties, both civil and criminal, are the key elements in keeping the people free from excessive government interference in their lives.

    As noted libertarian Republican Rudy Giuliani once said Freedom Is About Authority.

    1. Libertarian Republican?

      Where’s barfman when you need him?

  16. Actually from a fiscal perspective the GOPs Healthcare plan is worse- you can’t have guaranteed issuance without mandating coverage- otherwise your basically creating a massive free rider problem where none previously existed- essentially the GOP wants to keep the popular part of HCR while removing the unpopular part that makes the popular part anywhere near possible.

  17. Next time, can they include a promise to learn how to compress a PDF?

    The oil spill had a web site within a week…

    Why the fuck did they not make a web site for this thing?

    Republicans really are the stupidest animals on the planet.

    1. The oil spill also had a fake and real twitter feed too.

      http://twitter.com/BPGlobalPR

  18. The reason the republicans hate Obama care is because Obama is democrat. If a republican President offered the same plan, they would like it.

    1. SPEW!

    2. Probably, I’d argue the GOP (and the Dems) have moved right over the last decade but yeah you’re probably right- after all it was Bush who passed Medicare Part D- and did so on a straight party-line vote.

      1. The man that brought universal health care to MA is a republican contender for the President race.

  19. Threadjack but our friends in Britain have officially lost it:

    http://www.bbc.co.uk/news/uk-england-tyne-11396980

  20. Meh. The UK dropped the ball on freedom of speech a long time ago. That is, if they ever had possession of it.

  21. The Real Democratic Strategy is not the single payer that many rightfully fear as a dead end. It is something equally insidious but less ideologically driven. This is it: once per generation they would like to take the credit for rearranging the regulatory rules that everyone has to follow and call it ‘sweeping change for progress’ though it is a mere reshuffle of their previous fuck ups coinciding with the crises those fuckups create. Also, the moral traction of ‘tackling the issue of health care out of ‘social concern’ is soothing to their misaligned souls. Not ideology, just stupid sentiments, and all too typical bureaucratic driven thinking. There is not much else to it. God do I hate them, but you are giving them too much credit when you focus on the ideology as that would be principled even if it is off kilter. They are not principled. Neither are Republicans which is why I suggest doubling your stock of ammo for the lean years to come, members of both parties are equally edible.

  22. Couple of non-libertarian heretical thoughts:
    1) While pre-existing condition bullshit is sheer nuttery, maybe an amnesty would be an acceptable compromise? Basically, prohibit insurers from discriminating based on any condition that occurs before one year from now or so, and after that people are SOL. Would make more sense than the mandate, practically speaking.

    2) Now that that government has been given the power to decide what kind of insurance contracts are legit and which ones are not, could we push a less spineless GOP to ban everything but high-deductible HSAs?

  23. How about some heretical libertarianish thoughts:

    1) End all mandates and medical related regulations. Drive down the prices, Medicare suddenly becomes solvent again.
    2) No one is going to invade us to any significant extent. Get rid of the standing army.
    2) One last highway bill push to cover the current infrastructure in materials that last at least as long as those used by the Romans, say a thousand years or so. After that, no more money spent on it for the next thousand years. You want to develop off of it, fine, build your own. Private parking lot spaces rival the public roadways in size and scope but you don’t see the owners charging the customers. Why? Externalities are one million times more efficiently handled in a pure private market.

    1. externalities are one million times more efficiently handled in a pure private market.

      citation please

      1. Even if the best studies show that the market is only nine hundred and sixty seven thousand times more efficient than the government, don’t you think it would still be worth a try?

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