Obamacare

What Should Republicans Do if the Obamacare Exchange Proves Beyond Repair?

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New York Times columnist Ross Douthat noted last weekend that conservatives should control their schadenfreude over the ongoing catastrophe that is the Obamacare insurance exchange. He wrote:

[While] conservatives think the Obamacare exchanges are overregulated and oversubsidized, they are actually closer to the right-of-center vision for health care reform than the Obamacare Medicaid expansion, which is happening no matter what transpires with Healthcare.gov. So if the exchanges fail and the Medicaid expansion takes effect (and, inevitably, becomes difficult to roll back), we'll be left with an individual market that's completely dysfunctional and a more socialized system over all.

In that scenario, the Democratic Party would probably end up pushing, not for the pipe dream of true single payer, but for a further bottom-up/top-down socialization, in which Medicare is offered to 55- to 65-year-olds and Medicaid is eventually expanded even more.

Meanwhile, the task for serious conservative reformers — already not the most politically effective bunch — might actually become harder, because they would have to explain how their plan to build an effective, exchange-based marketplace differed from the Obama White House's exchange fiasco.

I wrote before the roll out of the exchange that so long as Obama is in the White House, the defund Obamacare

obamacare
rtcosmin

strategy won't work. Hence, the smarter thing for Republicans to do would be to switch tactics and co-opt Obamacare's exchange and turn it into a more market-based system by radically deregulating it and eliminating the individual mandate. Also, they should pare back the tax subsidies that individuals receive from the exchange. Instead, they should push to fix the tax code so that individuals could buy coverage with their pre-tax dollars, just as workers in employer-group plans do.

But if the Obamacare exchange implodes, should free market advocates mourn? Will it make it harder for "conservatives to achieve their public policy objectives," as Douthat claims? Or will it make it easier?

In my view, the second is more plausible.

The implosion of the exchange won't just mean that the country will be able to return to the pre-Obamacare status quo that: priced 45 million Americans out of the health insurance market at any given time; made coverage unportable by tying it to employment; and couldn't put a lid on rising insurance costs because of built-in incentives for overconsumption by those who have coverage. Now that Obamacare has released this genie, there is no putting it back in the bottle, one of the few good things the law has accomplished.

However, the Obamacare debacle will discredit Democrats' Big Government solutions to these problems, creating a political opening for the kinds of reforms that free marketers have been long advocating. Douthat is right that if the exchange fails, Democrats will try and push the two prongs of Medicare and Medicaid to capture more uninsured. However, they'll have a much weaker hand that'll make it harder for them to win, especially if Republicans start putting some of their cards on the table for viable alternatives now.

What would these look like?

Although there are big problems with the American health care system, they are not intractable. Indeed, to the extent that they are a result of lopsided government policies, they can be fixed by reforming these laws—and without resorting to more intrusive government. There are two policies in particular that have prevented individuals who already have employer-group coverage from switching to personal and portable coverage of their choice through a private version of the Obamacare public exchange (like ehealthinsurance), notes Ed Haislmaier of the Heritage Foundation. "We should have fixed them a long time ago," he says.

There is of course the tax code that discriminates against individuals. The other is that, unlike in the group insurance market in which insurance companies are barred from turning away patients with pre-existing conditions when these patients change plans (switch employers, for example) there is no such "guaranteed issue" requirement in the individual insurance market. So covered individuals who develop a medical condition and want (or need) to move from the group insurance market to the individual market (when they start their own company or become unemployed and lose their COBRA coverage) currently have very few options. In most states they can only get new coverage from a designated insurer or the state's high-risk pool.

This has dampened the demand for individual insurance policies, preventing online "marketplaces" (President Obama's new term of art for the exchange) targeted at individuals from emerging. Therefore, maintains Haislmaier, Republicans should push for parity not just between the tax treatment of companies and individuals, but also regulatory treatment between group and individual insurance plans.

This would mean a guaranteed issue requirement for individual plans. However, this guaranteed issue would be more limited and fundamentally different from Obamacare's.

Obamacare requires participating insurance companies to issue coverage without pricing for risk regardless of when an individual decides to obtain it. So individuals have a very strong incentive to wait till they get seriously sick. (Theoretically, individuals are confined to buying coverage during the open enrollment period each year under Obamacare, but there are so many exceptions to this rule that it is likely to be fairly toothless.) But the more limited approach to guaranteed issue would only apply to those who have maintained continuous coverage for some years and then need to switch plans. This would create a powerful incentive for individuals to always maintain coverage without an individual mandate. That more limited and balanced approach has operated successfully in the group market for the past 15 years.

The other big reason why the concept of private insurance exchanges is likely to catch on is that they are succeeding even as the Obamacare exchange is failing.

Even though these private exchanges have limited appeal for individuals and small companies for the reasons mentioned above, big companies are turning to them because they are switching from a defined benefit to defined contribution health coverage model in order to control rising employee medical costs. Indeed, notes Haislmaier, Obamacare itself has accelerating this switch to defined contribution (and hence private exchanges) by jacking up corporate health care costs through its diktats (removing annual lifetime limits on coverage and requiring coverage of dependents up to age 26, among other things).

More importantly, Obamacare's mandate that small companies with over 50 employees provide lavish coverage means that the limitless health benefits that corporations offered no longer gives them a competitive edge in the labor market. So they'd rather give employees a fixed sum to pick their own coverage from a wide array of choices.

Indeed, at the same time that Obamacare's exchange debacle was unfolding, The Detroit's News' Henry Payne reports, Walgreen moved 160,000 of its employees to a private exchange run by Aon Hewitt, a consulting company, without a hitch. Interestingly, in contrast to the Obamacare exchange that was launched even though it crashed during a test run, Hewitt made its exchange available to its corporate customers only after first successfully beta testing it on its own employees in 2011. Walgreen's employees now get to pick a plan from 25 options on the Hewitt exchange instead of the previous two to four on the company's menu.

It is premature to write the obituary of the Obamacare exchange. Time is running out, but it is possible that the administration will be able to fix the problems before the death spiral of adverse selection destabilizes the entire insurance market. This means pumping likely hundreds of millions more on something that has already cost taxpayers $635 million. If, despite all this, the exchange still collapses, Americans won't be in the mood for more Big Government solutions. There will never be a politically more opportune moment to put sensible market-based alternatives — with an established track record — on the table.

So Republicans shouldn't waste the Obamacare crisis — they should start thinking of ways to capitalize on it now.

NEXT: Detroit Bankruptcy Trial Opens

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  1. What should they do?

    My suggestion is “point and laugh.”

    1. My suggestion is, “Hey, we tried to repeal it, you refused, now you try to fix this turkey. Good luck with that.”

      1. The two aren’t mutually exclusive.

      2. And then they’ll be accused of not moving on and helping to fix the problem the Democrats created.

    2. Prior to 2017, I don’t see any other course.

      Oh sure we can TALK about deregulation, paring back subsidies, tax reform, repeal of the individual mandate, parity between group and individual insurance plans in terms of guaranteed issue — to which Pelosi, Reid, Obama, and Jarrett will point and scream “Terrorists!”

      1. Natch. Health comes from healthcare. And the payment for health care comes from insurers. Therefore health comes from insurers. And so if people don’t have insurance, they won’t have health.

        Ergo, only evil people would suggest that people shouldn’t be forced to purchase insurance. Quad erat Democratum.

        Until that soft-brained nonsense is cured there’s no hope about discussing any of the important things.

        1. Government regulation of health care providers.
        2. Government regulation of provisioning emergency care.
        3. Government regulation of insurance.
        4. Government breathing taxes.
        5. Refunding taxes for purchase of politically preferred goods.

  2. This means pumping likely hundreds of billions more on something that has already cost taxpayers $635 billion.

    I think you are confusing “millions” with “billions”. They sound the same, but one is a THOUSAND times bigger than the other.

    1. Millions, billions, trillions – at this point what difference does it make?

      1. As Everett Dirksen used to say, “A billion here, a billion there, and before you know it, you’re talking about real money.”

    2. What is a million billion?

      1. Whatever it is, it’s something Obama wants to spend.

      2. Janet Yellen will be by shortly to ignore your question.

      3. The level of the new debt ceiling?

  3. priced 45 million Americans out of the health insurance market at any given time

    Not all of those 45 million without insurance were priced out. Included in that number were illegal immigrants and people who opted out of buying insurance but could otherwise afford it.

    1. I think “priced out” means they decided it wasn’t worth the cost, given other potential uses of their money and the benefits of insurance. Not that they would be starving in the streets if they bought it.

      1. Exactly. Insurance is not some holy grail. It is an economic decision. It is rational for some and not for others.

        1. No assets == no insurance. Its the myth of medical bankruptcies killing people. Medical bankruptcies are a part of a healthy economic system. Much like nobody expects a zero foreclosure rate. Sometimes people, despite doing everything “right” experience financial misfortune. If you get $220k in cancer treatments but lose your house, you know what? that sucks, but it isn’t a bad trade. Neither the doctors nor the hospital nor the mortgage-holder screwed you. You experienced more bad luck than you could afford.

          1. Exactly. And getting people to buy insurance is not going to reduce overall costs. It will just shift them and probably increase cost as people who now have insurance rationally use it to consume health care.

            But people also need to understand that health care is always going to be more expensive than a perfect market would produce because it will never be an ideal market. First, health care costs at the individual level are totally unpredictable. My healthcare costs could be 0 or they could be in the millions over the next few years. I have no way of knowing. So I can’t effectively plan for them. So I have to either chance it or buy insurance so I can pool my risk and thus quantify my costs so I can plan. We will for that reason never have a pure fee for service healthcare industry. People are always going to want to buy insurance. And people, being risk adverse, are always or in most cases by more insurance than is strictly efficient.

            1. You and I have assets. I would prefer child continue to be able to live in our house if my wife or I get a million-dollar disease. So I pay $3300/year to know that I’m only out $13.3k/year absolute worst case. Thus, protecting any assets above that threshold. If you don’t have $13,000 or even $3000 in assets, why bother?

              1. Duh. Cause otherwise you’re a freeloader (or victim, depending on the argument needed).

            2. That is true. I’d like to see a few more clinics and practices give discounts for patients who offer cash up front, no subsidies AT ALL for treatment/testing.

  4. We had a software developer where I work who was very vocal in his opposition to the decision to bring in “Cognos” as an enterprise-wide reporting tool.

    Every chance he got – at a meeting, walking down the hallway, going out for drinks – he would hammer on how bad an idea Cognos was. “Good morning, Matt, how are you?” “Ok. Say, has everyone realized what a piece of shit Cognos is, yet?”

    I pulled him aside at one point and tried to give him advice. “Look, everyone knows you oppose this. Nobody has any doubt as to your opinion. But we’ve already spent the money and are rolling it out as we speak. You need to step back. If this fails the way you think it will, everyone will remember that you warned us. But if you keep hammering on it every day, you just alienate people and give them an excuse to point fingers at you for blocking the project.”

    He gave me that “Good advice, if I was rational. But I’m not, i’m crazy and obsessed and I won’t listen to advice.” look.

    I think he was a Republican, is what I’m getting at.

    1. “If this fails the way you think it will, everyone will remember that you warned us.”

      Given that the democrats are already blaming the republicans for the obamacare problems, I don’t think this applies in the political world.

    2. Does your company have a corporate media arm that will lie and spew out propaganda to ensure that no one knows Congos fails or if it does to obscure the cause as much as possible? If not, your developer is not in the same position as the Republicans.

    3. I can say that after a dozen years as a software guy, nobody has ever told me, “you were right, this is a giant piece of shit, we’re going to listen to you next time.” Not even over drinks after I left a previous company. So I understand why he didn’t believe you. His experience doesn’t match your words.

      OTOH, about 3 times a year, I’d be asked for a memo about something technical that I would spend 3 weeks researching and then it would be promptly be ignored. Maybe your shop is different.

      1. You must have missed the part of obama’s speech yesterday where he said:

        “I apologize to Senator Cruz for calling him a terrorist and hostage-taker, because he was right that these exchanges were not ready for prime time and we should have delayed them and the mandate for a years.”

      2. Its even worse when you are a consultant.

        Im trying to get you to not spend money with me, but you wont listen, and you wont acknowledge the problem when you are later paying me to unfuck the situation.

        1. Yes, I have that conversation occasionally now that I’m a consultant: “Listen, I like you on a personal level, but if you will just listen to me, we can exchange Christmas cards and keep up on LinkedIn and you won’t have to pay me to come back here again. You pay me good money, but I would rather you listen and have something that works, and I go on to help someone else.”

        2. I’ve twice had customers who responded to me saying basically “We don’t do that type of work very well. We should find you a firm that specializes in web development, and we’ll do the backend number crunching” with “Nah, just do everything yourself”.

        3. It’s worst when you’re a consultant for a government agency:

          I’m trying to get you to not spend money with me, but you wont listen, and you won’t acknowledge the problem when you later blame me for the situation and make me fix it at my own cost.

      3. Same experience here. That would require people to admit that they were wrong and cost the company a whole lot of money, and upper management is just plain not going to admit that. Usually, the project is just declared to be a success regardless of what actually happened. If it’s actually bad enough to require acknowledging, it’s always the economy, problems with vendors, uncooperative elements in the company, or just “unforeseen factors”, never the plan itself.

        1. This.

          I have watched VP’s get up and address all hands meetings touting the success of endeavors that EVERYONE knew were abject failures, and they did it with a straight face.

          Basically being a VP means never having to admit you were wrong.

          This is also why they myth of outsourcing persists. It’s not cheaper and does not save money EVER (the best scenarios I’ve encountered were basically break even) but no one in a corporate environment has any incentive to point out it’s failures.

      4. Sounds like my shop.

        Also sounds like Coolidge is deserving of the earful he is getting.

  5. Strictly, they should probably harp on the fact that they tried to stop the train wreck. A year’s delay probably would have been enough time to think through the issues a little more thoroughly.

  6. Uh, what’s with the big lips on Obama?

    1. Those are big teeth, not big lips. Racist.

      1. And what’s Bush doing – yes, he’s extracting the tooth of Obamacare. What about extracting Medicare Part D?

  7. How about instead of running into a brick wall they legislate some changes to improve the situation. Two quick thoughts are to allow states to set different minimum coverage if they manage their own exchange. The libs get preasure off the federal system and we allow states to define what the minimum coverage should be (not ideal, but better than the feds dictating it universally). After that, allow individuals to buy insurance across state lines. Those two changes would make a big difference immediately. You know, states rights, functioning (kind of at least) market and all that crazy, racist stuff.

    1. Well, I was going to post in response to the question:

      How about working toward a solution and fixing what we have?

      But what a quaint notion…chipping in and solving problems. But of course, that is the crux of the matter, is it not? Chipping in and trying to work together. Like I said, a quaint notion not in play these days.

      I would point out, however, that the state exchanges SEEM to be off to a decent start…Kentucky, Washington, New York. Does not seem like much tweeking will be needed there.

      1. The problem is that they all have to offer the same coverage. Let states decide what minimum coverage consists of and then let users buy across state lines. Simple changes really.

        1. Let states decide what minimum coverage consists of and then let users buy across state lines.

          Which is it? If states are setting minimum coverage requirements, that means you can’t buy across state lines, because what you buy has to be approved by the state as meeting minimum coverage requirements.

          1. Both. Let states determine what a policy sold in their state looks like (they already have these on the books) but let customer’s buy a policy in the state of their choosing, not residence.

        2. two problems:

          1) Letting states have different things is the prior way and that is what the Obamacare people thought was THE biggest problem

          2) A federal penaltax seems like an unfair/illegal way to enforce what would essentially be state laws.

          3) Allowing people to buy across state lines means you essentially invalidate the state laws which means the states wouldn’t set up ANYTHING. Not a bad idea in and of itself, but that would have meant almost everyone would have abandoned the systems in MA, CA and some other states for insurance purchases in states not run by complete morons. Keeping morons in charge was at the very least the #2 problem Obamacare was trying to solve: try to make the Massachusetts system not like look like a total disaster by making it the de facto standard.

          1. 1) IDGAF what they think the problem was. They were and are wrong.
            2) Yep, unfair, but we are stuck with it for now. The requirement is still a federal law, it would just let states that run their own exchange define what “coverage” looks like.
            3) If Wyoming ends up with all health insurance business because it offers the policies people want, IDGAF if CA and NY run exchanges. Likely to be undesirable options, so what does it matter?

      2. How about working toward a solution and fixing what we have?

        Because we don’t buy the premise that what we how have (OCare) can or should be saved.

        1. It can’t be scrapped either. At least not now. Sneak in a couple of market-ish based reforms and take it from there.

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  9. My fear is that Ted Cruz screwed up their chance at this. By taking the defund Obamacare and government shutdown tact, the public in general will still prefer this over anything a Republican has to say, especially if they align with the Tea Party.

  10. This alt-text is beyond repair!

    1. This is one time where alt-text would be a let down.

  11. This is the benefit of divided government. Republicans try to make things worse one way, Democrats try to make things worse another way, and they trip over each other and fail to make things worse.

  12. “pare back” the subsidies? does that mean get rid of them altogether, or just reduce them? I hate subsidies, especially when they’re compensating for drastically overpriced products to begin with.

    It’s the radical deregulation of insurance that I want, especially under its new, improved Obamacare design. I won’t pay for your prostatitis, you don’t have to pay for my endometriosis.

  13. The real problems are the results of the operation of Obamacare, web site or not. Republicans ought to concentrate on pointing out the screw ups and, more importantly, offer solutions to those being screwed over.

    If we can believe analysis and anecdotes:
    (1)Many people will see their premiums rise significantly, and deductibles will increase for many as well.
    (2)Doctors will opt out of the system, meaning that people will lose the providers they have been satisfied with and must find others.
    (3)The employer mandate is delayed, so working people who should have been covered, won’t be and will have to go to the exchanges for mandatory insurance.
    (4)The IRS will certainly make errors and needlessly harass many people.
    (5)Budget breaking costs, hence premiums, will increase markedly because of the death spiral effect. “Young people” older than 26 or orphans younger than 26, healthy but financially strapped, won’t sign up in anywhere near the numbers needed to make the “young and healthy support the old and sick” model work.

    Among these affected folks will be many potential voters who never before thought they had any reason to pay serious attention to voting.

    Should the Republicans be capable of wising up, they will identify the people screwed in the above categories and concentrate on reaching them with specific proposals to alleviate their distress.

  14. WHAT is realistic before 2017? On both sides?

    How will Obama react to unmitigated failure? Will he bail for “single-payer”? Wave his executive wand and open up Medicare to everyone?

    I have no idea, but I think Obama’s probable responses to failure are the contingencies around which we should be strategizing.

  15. There are private “exchanges” such as eHealthInsurance.com that function perfectly well. So who gives a fuck if the federal exchange doesn’t work?

    1. People who want to buy coverage that they know meet the mandatory minimums, and how much of a subsidy they may get?

  16. Obamacare requires participating insurance companies to issue coverage without pricing for risk regardless of when an individual decides to obtain it. So individuals have a very strong incentive to wait till they get seriously sick. (Theoretically, individuals are confined to buying coverage during the open enrollment period each year under Obamacare, but there are so many exceptions to this rule that it is likely to be fairly toothless.) But the more limited approach to guaranteed issue would only apply to those who have maintained continuous coverage for some years and then need to switch plans. This would create a powerful incentive for individuals to always maintain coverage without an individual mandate. That more limited and balanced approach has operated successfully in the group market for the past 15 years.

    Or, you could just say that insurance companies must be liable for ongoing treatment for existing conditions. So when you switch companies, your prior insurance company has to pay the next company for the expected cost to them of your treatment. They can negotiate over how much. That would counteract the disincentives against taking people with pre-existing conditions, because insurance companies get compensated for covering them. Some of them might be able to turn a profit by specializing in specific chronic conditions.

    1. Or, you could just say that insurance companies must be liable for ongoing treatment for existing conditions.

      Which is current law, provided that you continue paying your premiums.

      1. The problem that is that once you develop X condition, the probability of future payouts becomes 1. Insurance is meant to deal with unexpected future events, not certainties. Once there is a certainty of having to pay for something the insurance company should be liable for that if you were current on your payments at the time the event realized itself. The fact that the payout actually happens next month or next year or ten years from now should have nothing to do with it.

  17. The Dems (who control the WH and senate) are firmly behind Obama, who won’t accept a SINGLE change to ACA. They didn’t even agree to repeal the unpopular medical device tax. They’re unlikely to accept free market solutions advanced by the GOP even as public’s opinion on Obamacare continues to sour.

    If Rand Paul suggests that HSA be part of the exchange, the dems will scream that the GOP is in favor of plans that skimp on coverage. Remember, their excuse for rising premium is that “the product is better”.

    The GOP isn’t going to mount as serious challenge to ACA since they made little to no gain in the shutdown theater. They kinda have no choice but to sit back and watch this thing burn. Score some political points with some timely “I told you so”. When Obama delays ACA, they should sing in unison that “If you did this months ago like we wanted, then the shutdown doesn’t happen”

  18. Gimme a break. Even with a full melt-down, the average low info voter doesn’t understand the nuances between the GOP and Dem plans. So when the blame contest begins, the dems will simply blame the obstructionist GOP for the implosion and everyone will continue on the path they’ve been on. We are way overestimating the damage that ACA will do to the dems

    1. If that is true, then the country is headed for full on communism and will richly deserve everything it gets.

    2. This debacle is being picked apart and exposed in real time: no testing, no competent oversight, no realistic scheduling or budgeting, and then the sticker shock. I don’t think the Republican blame-theme is gonna stick. Even my lurkings at Daily Kos show that people just aren’t buying that.

      My big fear is that Hillary will succeed in pitching total government control as the cheap, easy, fair solution that Obama aimed at but fell short of.

  19. The idea that the Repubs should try to co-opt the exchange and make it better is idiocy of the highest order.

    First, of course, is that the exchange serves no real purpose except to allocate subsidies and track compliance. There’s no reason at all to have it unless you think the feds should be allocating subsidies and tracking compliance. If that’s what you want, well, then you have no problem with Obamacare except that you wish it worked better. And if that’s where you are, well, fuck you.

    Leaving aside the principled and policy arguments, though, the exchange cannot work, period, from a purely technical standpoint. The Repubs would be idiots to buy into “mend it, don’t end it” now that we know it can’t be mended, period, full stop.

    Which, of course, is exactly what I expect them to do.

    1. There’s nothing inherently wrong with a one-stop exchange marketplace for health insurance; the employer-based system we have now is simply horrible if you’re not a W-2 employee of a company that has a health plan. Before the exchanges, finding and effectively comparing health insurance plans was nearly impossible.

      Whether it should be nationally managed by the federal government is a completely different story.

      And exchanges DO work from a technical standpoint; just because healthcare.gov was poorly designed doesn’t mean the concept won’t work. Some state-run and privately-run exchanges work fine.

      1. the employer-based system we have now is simply horrible if you’re not a W-2 employee of a company that has a health plan.

        Why is it horrible? Mostly because when you buy alone you are not pooling your risk with other people. That sucks and all. But why is it the government’s responsibility to fix that? Buying in bulk is always going to offer advantages.

        1. “pooling risk” sounds a lot like “socialism”

          Again, pooling risk makes sense when risks are somewhat equal, and we had mutual societies set up for that. Then government began its never-ending “equality of outcomes” kick and essentially killed mutual societies as we knew them. (Part of that was an attempt to get a larger share of that insurance company investment money – government gets more buyers of its debt when insurance companies have more customers than shareholders.)

        2. Here is a significant problem I can think of with the employer-based system.

          If you get health insurance from your employer, then you are getting a tax break on it, as is your employer. Neither of you get that if your money goes to you first and then to your health insurance provider.

          This creates an artificial incentive for people to get health insurance through their employers, and for employers to prefer paying employees in health benefits as opposed to cash.

          This system was conceived of by people who expected to work for the same company for their whole careers (i.e. the WWII generation).

          If you wind up changing jobs every few years, which is pretty normal nowadays, you may well have to apply for a new health plan every time you do that.

          Given that something might happen to you in there, at some point something that was once covered is now a pre-existing condition and you’re fucked.

          1. f you wind up changing jobs every few years, which is pretty normal nowadays, you may well have to apply for a new health plan every time you do that.

            Given that something might happen to you in there, at some point something that was once covered is now a pre-existing condition and you’re fucked.

            And this is where the idea that if you were covered at the time you developed the condition, you should be covered if you want to apply for a new insurance plan.

            Of course, my version of that is hold the original insurance company liable and then Coase.

      2. I know several self-employed people that had no trouble finding satisfactory health insurance coverage years ago. The problem depended on which state you lived in – some states had such idiotic laws you weren’t allowed to tailor insurance plans because everybody was supposed to be treated as “equal risk”.

        We could take this back to the Nixon-era “demutualization” which was government’s first attempt at ripping off consumers disguised as helping them.

      3. My personal experience is drastically the opposite of what you assert in your post. Before Ocare I paid $240 a month with 3K total out of pocket and then had 100% coverage on a catastrophic type plan. I purchased the plan I chose after a very pleasant experience online with einsurance and the BCBS website. After Ocare was passed I had two price increases up to $360 for the same plan. After checking on an Ocare calculator My premiums are to be around $900 a month with about $300 subsidy netting a new premium of $600 +/-, with a $ 9,750 deductible and 85% coverage after that. But, at least I now have maternity care even though it is unlikely that a 57 year old male will be needing it.

    2. Perfectly said.

  20. Speaking of the Obamacare Exchange, here a parody clip of the German movie Downfall talking about Obamacare exchange http://www.youtube.com/watch?v=W-ajt5dk__M

  21. Who knows what Republicans or Democrats will do if ACA fails — No one.

    Regardless, there is not doubt that the US is headed towards a single payer system.

  22. Conservatives and other thinking people should simply sit back and shut up. Let the MugabeCare people flap around for months and months. It is too much to hope by now but what the GOP should have done beginning last year was to oppose all the waivers handed out to Democratic Party cronies as well as the slipping of the employer mandate. Then the imbecile party would have had to vote in public on the waivers. Vote to keep it, then explain why it is needed since the PPACA is so wonderful. Vote to rescind the waiver, then lose support from the unions and corp cronies. Perfect judo move.

    1. Ever wondered why there was no Congressional hearings for accountability for the Iraq war with over 4400 military dead, and why Tea Party Republicans are calling for Congressional hearings for the failure to launch of the Affordable Health Care law? One reason and reason only, Tea Party Republicans just can’t accept a Black man living in the White House.

      1. Derp on troll, piss off and head back to fluffpo with the other children.

      2. Bush did it ! Bush sent a suxnet virus into the “online market place and derailed the glory that should be Ocare.

  23. Reading the comments on this site let me know why our children are close to the bottom when they’re compared to industrialized countries when it comes to education; the parents are dumber than the children they’re trying to raise. It’s like listening to people calling in to the Washington Journal on cspan; one out of ten callers might make some sense.

    1. You apparently don’t have much of a basis for comparison for the low quality of political debate in other countries.

    2. What are you saying? You want more government control?

  24. As long as government is so deeply involved in health care, any attempt at fixing or improving this through legislation will simply be used for more rent seeking. Legislators simply don’t have the resources, motivation, or ability to outwit thousands of large and clever profit-maximizing businesses and their lobbyists. And it’s not going to result in a more workable system either. There simply is no way to win.

    For now, the only thing to do is to quietly oppose any change and wait until the system becomes so unworkable that we can start over. I expect Democrats will try to turn the system into something single payer. I’m not even sure that’s worse, actually: a partially free market system seems like we have now seems to be the worst of all possibilities, since it combines private rent seeking with governmental inefficiencies. Nationalized single payer with completely regulated physician salaries, drug prices, treatments, etc. limits the rent seeking better. And it’s either going to give rise to a healthy supplementary market in private insurance (because it’s so awful), or it’s going to collapse financially sooner or later.

  25. my roomate’s mom makes $73 an hour on the computer. She has been unemployed for seven months but last month her pay was $18333 just working on the computer for a few hours. pop over to this website

    http://WWW.Works23.com

  26. like Walter explained I am taken by surprise that a single mom able to profit $5487 in four weeks on the internet. visit their website
    http://WWW.JOBS72.COM

  27. Counting on republicans to highlight the ineptness of big government isn’t a winning strategy. Since the republicans were smart enough to vote against this fiasco en masse, its best to sit back and let the magic of big government do what it does best…………fail.

  28. Obamacare: The biggest fraud perpetrated on the U.S. in history!

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