Republican Obamacare Replacement Does All the Wrong Things

Republican House speaker Paul Ryan meets with religious leaders in Washington DC, March 2, 2016
Republican House speaker Paul Ryan meets with religious leaders in Washington DC, March 2, 2016 (Bread for the World)

It’s hard to unite health-care commentators from the left and the right, but that’s what House Republicans have done with their plan to replace Obamacare.

The left is appalled that Republicans would make health care cheaper for Americans who are well-off and leave those who currently depend on Obamacare in the cold.

The right is disappointed that the plan only eliminates the individual mandate but keeps other parts of Obamacare in place, including the principle of federal subsidies and its insurance plan requirements. Read more “Republican Obamacare Replacement Does All the Wrong Things”

Absence of Obamacare Replacement Exposes Republican Deception

Something must be wrong if I’m on the same side as Paul Krugman.

The economist writes in The New York Times that it isn’t just Donald Trump who is incompetent but his entire political party that has been faking it for years.

Its leaders’ rhetoric was empty; they have no idea how to turn their slogans into actual legislation, because they’ve never bothered to understand how anything important works.

That last bit is ungenerous. The reality is that Republicans have put politics over policy, but Krugman — unfortunately — isn’t altogether wrong. Read more “Absence of Obamacare Replacement Exposes Republican Deception”

Clinton’s Plan to Control Drug Prices Seems Like an Overreach

Former American secretary of state Hillary Clinton gives a speech in Iowa, January 23
Former American secretary of state Hillary Clinton gives a speech in Iowa, January 23 (Hillary for America/Barbara Kinney)

Hillary Clinton has a new plan to stop what she considers “unjustified” increases in drug prices.

Slate reports that her plan comes down to European-style price control.

As president, Clinton would create a task force of regulators with the power to decide whether price increases on old, essential medicines and devices were reasonable given product improvements and the amount of competition in the market. If not, the task force would have the power to mete out punishments to companies that were trying to profiteer, potentially with fines.

Fines would still require an act of Congress, where market-friendly Republicans are likely to retain their majority in the House of Representatives and block such penalties.

Nonetheless, as Slate puts it, “Clinton is subtly sending the message that she’s comfortable moving toward a more European system in which regulators have a direct say not just in what drug companies can charge the government, but what they can charge the rest of the public, too.”

It may not happen in the first four years of a Hillary Clinton presidency, but price controls are becoming Democratic Party policy — which means they could happen eventually. Read more “Clinton’s Plan to Control Drug Prices Seems Like an Overreach”

Young and Healthy Americans Spurn Obamacare

Shikha Dalmia writes at The Week that American president Barack Obama’s health reforms are unraveling.

UnitedHealthcare, the country’s largest insurer, has said it may need to pull out of the exchanges next year that were created under Obamacare.

The company expects a $425 million hit to its earnings, primarily due to mounting losses on the exchanges. “We cannot sustain these losses,” said the company’s boss, Stephen Hemsley.

Other insurers could follow. Some have already raised premiums by double digits to try to make end meets, but they still can’t make the numbers work. Read more “Young and Healthy Americans Spurn Obamacare”

Walker’s Sensible Plan to Replace Obamacare

Republican governor Scott Walker of Wisconsin speaks at the Conservative Political Action Conference in National Harbor, Maryland, February 26
Republican governor Scott Walker of Wisconsin speaks at the Conservative Political Action Conference in National Harbor, Maryland, February 26 (Gage Skidmore)

Scott Walker’s campaign for the Republican Party’s 2016 presidential nomination has so far not impressed this blog. The governor of Wisconsin seems to be trying to appeal to every constituency in his party at once and the easiest way to do that is not say anything meaningful.

On Tuesday, he finally took a step toward defining what, if nominated and elected, he would actually do. And it’s not at all bad. Read more “Walker’s Sensible Plan to Replace Obamacare”

Anti-Business Mentality Blinds Labour to Health Improvements

Blinded by its anti-business mentality, Britain’s Labour Party would roll back liberalizations in the National Health Service if it wins the election in May, leader Ed Miliband said on Friday.

Miliband said in London his party would halt the “tide of privatization” he claims has taken place in health care since the Conservatives and Liberal Democrats came to power in 2010. Although it was Labour that brought private contractors into the system in the first place while the rate at which services are outsourced has actually slowed under the current government.

No matter. Under the next Labour government, Miliband said, private firms would have to reimburse the National Health Service if they exceed a 5 percent profit cap on contracts. Read more “Anti-Business Mentality Blinds Labour to Health Improvements”

Britain Refuses to Admit Health Service’s Failure

London England
London, England at night, February 14, 2012 (Warren Chrismas)

There is no denying Britain’s National Health Service (NHS) is in trouble. Fifty years ago, it consumed only 3 percent of economic output. Now it consumes 8 percent and is on track toward claiming almost a fifth of gross domestic product by 2060 if current spending levels are sustained. By then, the NHS would account for half of public spending, crowding out defense, education and welfare.

The current government has done little to reverse this trend. It shielded the NHS from spending reductions while most other departments were forced to make deep cuts. Indeed, health spending is up 3.6 percent since the Conservatives and Liberal Democrats came to power in 2010. The NHS budget is £114 billion this year.

Even so, care is lacking and the money remains tight. Three million patients are waiting to be treated. The health service itself expects to post a £30 billion shortfall by the end of the next parliament.

Yet the ruling parties are backing away from their own reforms which were meant to rein in costs. The coalition gave health officials more autonomy and handed control of purchasing care to local doctors. This modicum of competition and decentralization was slammed by the opposition Labour Party as tantamount to undermining the whole system where it actually built on cautious liberalizations brought in under the previous Labour government. Read more “Britain Refuses to Admit Health Service’s Failure”

British Health Service Politically Sensitive for Conservatives

David Cameron
British prime minister David Cameron attends a meeting of the European Council in Brussels, March 20 (The Prime Minister’s Office)

For anyone who watched the opening ceremony of the 2012 Summer Olympics in London, the pride Britain takes in its National Health Service (NHS) is clear. Far from the apathy that most Americans feel toward government-provided services, the NHS has been a popular feature of British life since it emerged during the late 1940s as part of the Labour Party’s postwar government. That makes the debate about how to prepare the system for an expected rise in demand at a time of austerity politically sensitive.

The NHS is a public health provider that offers treatment “free at the point of use” and gets the majority of its operating income from taxes. But like health-care providers across the developed world, the organization is coping with strain as it balances Britain’s aging population against the country’s generally lower economic activity and rising health-care costs.

The Conservative Party-led coalition government has tried to improve the situation by privatizing an array of NHS services, creating a hybrid model in which most of the services that patients interact with are government-provided but many of the auxiliary services no longer are.

This has generally not been received well. The breakdowns in service provision directly attributable to this health-care delivery method have been documented in a number of recent studies. Polls show voters trust the opposition Labour Party more to improve the NHS than they do the Conservatives. This is not in itself new but alarming to Conservative Party strategists nonetheless. In response, George Osborne, the chancellor of the exchequer, announced a £2 billion funding increase for the NHS last week. Read more “British Health Service Politically Sensitive for Conservatives”

Obamacare Was Never Going to Create Jobs

Barack Obama
American president Barack Obama meets with advisors in the Oval Office of the White House in Washington DC, December 30, 2012 (White House/Pete Souza)

The Wall Street Journal had a great interview with University of Chicago economist Casey Mulligan this weekend whose research proved instrumental in getting the Congressional Budget Office to revise its estimates of the employment effects of the Democrats’ health reforms.

In 2010, the CBO predicted the equivalent of 800,000 jobs would be lost as a consequence of enacting “Obamacare”. In its most recent fiscal outlook, the budget office puts the number at two million by 2017 and 2.5 million jobs by 2024.

Mulligan believes the number will turn out to be even higher. The reason is fairly straightforward: Obamacare gives subsidies to low-income Americans to buy health insurance. If they work more hours or get a promotion and their wages rise, those subsidies are gradually phased out. As The Wall Street Journal puts it, “some people will have the incentive to remain poorer in order to continue capturing higher benefits.”

This is not exactly rocket science yet many economists denied the law would incentivize Americans to work less than might otherwise have. In January 2011, dozens of economists wrote to Congress (PDF), warning that repeal of the reforms could cost between 250,000 and 400,000 jobs — per year! Read more “Obamacare Was Never Going to Create Jobs”

Obama Lied: Not All Americans Can Keep Their Health Insurance

President Barack Obama delivers a speech in Milwaukee, Wisconsin, September 22, 2012
President Barack Obama delivers a speech in Milwaukee, Wisconsin, September 22, 2012 (Obama for America/Josh Burstein)

When President Barack Obama promised in June 2009, while his signature health reforms were being written, and again in April 2010, after he had signed them into law, that Americans who liked their insurance would be able to “keep it” — adding, for good measure, on the last occasion, “No one will be able to take that away from you.” — it was clear to critics he was lying.

More than three years later and just a month after “Obamacare” went into effect, it should be clear to the whole country.

CBS News reports that up to two million Americans might have to find new health insurance as the coverage they have now doesn’t meet the law’s criteria.

I hinted at this in a blog post last year when I pointed out that one of the reasons medical insurance is so expensive across the United States is that many state governments mandate that insurance companies cover all sorts of treatments that consumers may not require or wish to buy, including prenatal and psychiatric care. In most states, it was already impossible for a person to insure himself again medical catastrophe alone.

“With Obamacare, it will be impossible across the country,” I warned, “because it, too, forces insurers to offer a basic plan that covers ambulatory services, hospitalization, maternity and mental health care as well as rehabilitative services.” And added, “Health insurance costs can only rise as a consequence.”

When insurers are forced to cover more types of health care, and cannot discriminate anymore against customers who are already ill, insurance becomes more expensive. Companies pass those costs onto their customers. There is, after all, no competition anymore from companies that offer leaner plans — or “substandard plans,” as Obama’s spokesman Jay Carney put it this week. The government now dictates what sort of health insurance Americans ought to have and it ought to be the same for everyone. Read more “Obama Lied: Not All Americans Can Keep Their Health Insurance”