What will happen if health care is repealed?

[Darth Executor]

Healthcare for profit is immoral and on the brink of extinction.

You're not very bright, are you? Becoming a doctor is hard. It's a difficult (probably the most difficult "mainstream job" out there) path most people are not capable of following, and if people don't get paid a lot for going through all that trouble, they'll stop becoming doctors, at which point you will get no health care, for profit or otherwise.

[Challenger Grim]

You're not very bright, are you? Becoming a doctor is hard. It's a difficult (probably the most difficult "mainstream job" out there) path most people are not capable of following, and if people don't get paid a lot for going through all that trouble, they'll stop becoming doctors, at which point you will get no health care, for profit or otherwise.

A dozen amens to this.

And while I have all sympathy to those with preexisting conditions well... see it's part of why health care is such a thorny debate - it's impossible to not take personally because we all know someone within our "monkeysphere" who it would apply to and nobody wants to drag "the other" into their monkeysphere. So they shove everything that's the problem into their mental category of "the system" and then proceed to blame it for all ills. Remember: even insurance companies are filled with people trying to make a living and provide for themselves and family. Remember that insurance is like a bet/wager. You bet the insurance company that you'll get sick, the insurance company bets that you won't. If you "win", they pay you, if they "win" you pay. Showing up with a preexisting condition is rigging the bet - you cannot lose.

Remember that the money and resources for health care have to come from somewhere. And when we discuss resource division... well we have to avoid letting emotion into it and look at things logically and rationally.

The free market is (currently) our best system for allocating resources with the most freedom to each individual. Consider carefully the implication of allowing someone else to start deciding what resources you get.

[Epoetker]

DrRich had the right of it:

Method One: Make all healthcare spending the responsibility of the individual.

Method Two: Make all healthcare spending the responsibility of a Central Authority.

Method Three: Provide strictly limited public support for basic healthcare services, with individuals responsible for the remainder.

What about Method Four?

There is little reason to spend much time discussing the fourth and final method for controlling healthcare expenditures. Nobody is a proponent of this method, so nobody discusses it. However, Method Four, at this moment, seems to be the most likely outcome. Indeed, at this moment it is our default method of choice.

Method Four is formulated as follows: Our skyrocketing healthcare expenditures are the chief driver of our national debt. Our national debt burden, unless we get control of it by controlling healthcare expenditures, will inevitably destroy our civil society. At the same time, our modern, sophisticated and very expensive healthcare system utterly requires a complex, modern, organized, high-tech society in which to function.

Therefore, our skyrocketing healthcare expenditures ultimately provides its own cure. Once society collapses, “healthcare services” will revert back to the roots-and-poultices methodologies that served mankind so well for millions of years. And healthcare, as well as other modern geegaws like cable TV and the Internet, will no longer be a fundamental human right, but will become a mere afterthought (if a thought at all) in a more primitive kind of society where life is nasty, brutish and short.

So, not to worry.

Simple, forthright, and easy to remember. And if you haven't added The Covert Rationing Blog to your favorites yet, why are you still not favoriting?

[Soyeong]

Healthcare for profit is immoral and on the brink of extinction. The best alternative is Everybody In, Nobody Out.

I think what's immoral is demanding that other people pay for your health care. When everybody is in, whether they want to be or not, everybody loses.

[SarahB]

You're not very bright, are you? Becoming a doctor is hard. It's a difficult (probably the most difficult "mainstream job" out there) path most people are not capable of following, and if people don't get paid a lot for going through all that trouble, they'll stop becoming doctors, at which point you will get no health care, for profit or otherwise.

I stopped reading after the bold sentence. There really does seem to be an entrenched insult culture in this place. Not terribly inspiring.

[SarahB]

I think what's immoral is demanding that other people pay for your health care. When everybody is in, whether they want to be or not, everybody loses.

Healthcare isn't a luxury; it's a necessity. Spreading the risk over the entire population over the entire lifetime reduces costs for everyone; it allows availability to everyone. With not-for-profit Everybody In, Nobody Out, the level of care improves across the board---you can be assured those with power will see to it.

If you haven't taken the time, here again is the link to Physicians for a National Health Plan. http://www.pnhp.org/
-

[seanD]

Healthcare isn't a luxury; it's a necessity. Spreading the risk over the entire population over the entire lifetime reduces costs for everyone; it allows availability to everyone. With not-for-profit Everybody In, Nobody Out, the level of care improves across the board---you can be assured those with power will see to it.

If you haven't taken the time, here again is the link to Physicians for a National Health Plan. http://www.pnhp.org/
-

Only the risk doesn't seem to be consistently "spread over the entire population." Apparently if you're a corporation that what's to opt out, it just takes a generous bribe thrown towards Obama's compaign...

http://www.foxnews.com/politics/2010...-care-waivers/

[joel]

Healthcare isn't a luxury; it's a necessity.

So is food, water, shelter, clothing, transportation, communication, etc. I don't want their production socialized either.

But even still there is degree. Some things are elective. Some things are being over-cautious, there are tradeoffs, etc. Not all of it is a "necessity."
And think about any given advance in modern health care. What happened to mankind before that advance was made? They all died out?

And one does not have or have a rightful claim to something merely by needing it.

Spreading the risk over the entire population over the entire lifetime reduces costs for everyone;

No. In fact, the separation between the payer and consumer is one of the things that has been driving costs up in general by increasing demand.
Costs are further increased due to the overhead that doesn't exist with simple direct payment. For things that have a probability of 100%, insurance (or something like it) will necessarily cost more than direct payment.
Also forcing low-risk people to pay for high-risk people necessarily increases the cost for the low-risk. It cannot reduce costs for everyone, because it entails systematic wealth redistribution.

Also when risks are thought to be covered (i.e., by someone else) then that tends to increase risky behavior, so risk (and cost) likely increases. People with the risk won't see the true cost of the risk. The benefit of a market for risk is to make it easier to factor risk rationally into decision-making. Forced universal coverage prevents that, tending to result in everyone not rationally factoring risk into decision-making.

With not-for-profit Everybody In, Nobody Out, the level of care improves across the board

That seems really unlikely. The profit motive is incentive to please the consumer. Without it, providers will instead be motivated by seeking for tax money from bureaucrats/politicians. It will be the political interests, instead of the patients' interests, that will guide things.

you can be assured those with power will see to it.

This is really naive, and counter to human nature.

Have you read 1984? :-)

[Contreras]

Well, seeing the highly-socialistic healthcare plan that was passed under the Obama administration (The fact that he got this plan passed is pretty surprising, often, when a president tries passing a healthcare plan, he will be willing to offer a fair amount of partisan compromise. Obama didn't, he went straight through with his socialized healthcare plan.) a major reduction would be quite nice, but I personally don't know if I'd advocate complete abolition of government-mandated healthcare. While totally repealing healthcare might sound a bit worrying at first, you should take in mind that it's elimination would have some positive impacts as well. With the current Obamacare system, everyone is essentially forced into buying an expansive healthcare package that provides coverage in many areas which are just unnecessary. This results on excessive taxation being infringed on the vast majority of people, who don't need a substantial amount of the coverage in the plan. In the complete absence of healthcare, the citizens would re-gain a great amount of choice in their healthcare decision and have the option of only purchasing what insurance they need. With the government interference out of the picture, the healthcare system would have the ability to be more competitive with it's pricing. A more free-market style pricing system would prove to be very beneficial to people of many different income levels.

[Ted]

Einstein defined insanity as doing the same thing a second time and expecting a different result. We should look at the history of medical care.

Prior to WW2, there was basically little health insurance. During the war, wage controls prevented the increase of pay. To get around this, employers were allowed to provide medical insurance as an untaxed benefit. This became a subsidy to the medical profession (from which I just retired). If you subsidize something you will get more of it.

Under Lyndon Johnson, Medicare was created. Up till then, we had spent 5% of GDP on medical care, with no great increases over decades. With Medicare, a great subsidy to the profession was created, and costs began a linear rise to our current levels. If you subsidize it, it will grow!

The problem now is that all products and services are rationed. They are either rationed by price or by fiat. Since we have removed the patient from the status of direct payor, we have de-coupled supply and demand. This leaves only fiat as a means of rationing. Welcome to ObamaCare.

The proper answer is also the least likely: Get the government out of the business of paying for medical care. The politically rational steps with a chance of success are:
1. Repeal ObamaCare. Do not replace it.
2. Deny states the right to bar insurance companies from selling their products across state lines.
3. Make Health Savings Accounts universally available.
4. Give Medicaid recipients HSA's.
5. Fix the economy by getting the Government out of it. Then people will have the resources to pay for what they need.

Libertarianism is the best system, not because it is the most free, but because it works the best.

[Seasanctuary]

Well, seeing the highly-socialistic healthcare plan that was passed under the Obama administration

Are you from some alternative universe where a "highly-socialistic" bill passed?

Can I move there?

[Durthorin]

I have a friend who is a Doctor and works PICU/NICU, according to her one of the largest if not the largest expense most doctors have is split between paying off their education loans and malpractice insurance. One reason you hear that Tort reform needs to be part of any kind of health reform.

As far as insurance companies go, their not corrupt and their not thieves. They're the "House". Your gambling when you take out insurance as someone earlier said your betting on getting sick, their betting on you staying healthy and like the House in Vegas, they do not like to loos and they prefer to pay the minimum when they do loss. Its how they stay in business. People seem to think of insurance companies as on "their" side. So they get annoyed when the people you have paid for years and years are suddenly not cooperating. Just remember they are not your friend, their the guy your playing poker against and he wants you to lose.

[Ted]

I forgot to mention that I'm a doctor, my brother is a doctor, and my daughter is a doctor. I think that gives me a bit of knowledge of what is happening in medicine.

Put bluntly, the practice of medicine has nearly been outlawed. You must make sure that you fill in all the blanks properly. Most of medicine is not practicing paper, which is exactly what bureaucrats want.

Now let's get down to the basic issue: Medical care (not health care!) is a service that is sold. All goods and services are rationed, without exception. They are either rationed by price or by fiat. Insurance was originally a way of dealing with catastrophic risk only. It was cheap and readily available. Because catastrophic risk is rare, it did not act as a subsidy. But when the modern form of insurance developed in WWII, a subsidy was created, since it extended to ordinary risk. Medicare added to this subsidy in 1967. And since then, price has risen linearly from 5% of GDP to >16%. Does anyone think that we'd be having this discussion if medical care dropped back to 1/3 of its current price? And can there be any question that the subsidy is the cause of the price rise? After all, when you subsidize something, you get more of it and the price goes up.

As the price has risen, it has become necessary to ration by fiat, not price. Thus, we have Medicare as the insurance company that denies more claims per capita than any other. ObamaCare will be worse. But they have no choice. The subsidy has raised prices so high that price would bankrupt payors who have committed to full coverage.

The answer must be to eliminate subsidies. This means that health insurance must be completely deregulated and removed from tax preference status. This also means that Health Savings Accounts must be liberalized to allow anyone the right (not the means!) to purchase them. And the medical device and drug industry must be removed from the umbrella of government regulation and allowed to operate in a truly free market. That means that the FDA must be abolished as it stands and replaced with an online registry that publishes all relevant data on drugs and devices. Lay language executive summaries must be available in standard form. And the user is presumed to have read the released information and assumed the underlying risk. Only concealed risks would be legitimate subject for suit. Similarly, medical liability must have the standard of proof changed to a "clear and convincing cause and effect".

If all these changes take place, medical innovation will boom, and the price will come way down. The concerns for drug prices will be eliminated, since it won't take $5 billion to get the next drug to market.