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I’m not a healthcare policy expert. Not by a long shot. The challenges facing healthcare in this country are enormous. While I may not have answers, there is no downside to generating discussion on alternatives. Feel free to comment on anything you feel is wrong with my suggestion.
The problem legislators are facing in their attempts to “Repeal and Replace” or even modify Obamacare in a manner that will make their constituents happy is that they can’t answer one very important question-
“Who takes less ?”
The stakeholders in Obamacare are the Insurance Companies, Health Care Providers and Consumers.
Will Insurance Companies be willing to take lower profits ?
Will Health Care Providers be willing to charge less for the services they are providing or take less reimbursement ?
Will Consumers have to accept fewer services and lesser quality of care ?
No stakeholder is willing to take less. Which is why it will be near impossible to “fix Obamacare” in a way that makes consumers, also known as voters, insurers and healthcare providers happy.
Politicians can deflect and promote the benefits of a free market, but the free market shows itself every day in the profits of insurers and healthcare providers. I have yet to see a single public company in these spaces make an announcement that they are willing to or expect to take less because of changes to Obamacare. Have you ?
So what should happen ?
There are 2 risks that every single citizen of the United States shares:
1. We all can lose the genetic lottery and find ourselves getting seriously ill or worse.
2. We all can lose the “wrong place, wrong time” lottery and find ourselves facing a significant or life threatening injury.
We all can take steps to reduce those risks, but it is literally impossible to eliminate them. On any given morning, every single person can wake up, feel a little off and soon come to find they are sick.
At any given moment we can be in the wrong place and something catastrophic happens. A car. A bus. A baseball bat. A knife. A bullet. etc. All of the sudden our loved ones are praying for us.
Today, we deal with those fears by doing our own versions of risk management. Most of us try to get a job that offers health insurance. Even if its a job we don’t like, we realize that if we lose in either of these lotteries we won’t be able to afford the health care we need.
Some of us do our best to afford the least expensive health care insurance with high deductibles and lie to ourselves that we will be able to save enough to cover the deductible or we can keep enough open on our credit cards to survive a disaster. Unfortunately,when disaster hits, we rarely have enough.
Some of us, like I did in my 20s feel invincible and think it won’t happen to us. Until it does.
Which leads to my suggestion.
Not one single person in this country is immune to losing the Genetic or Randomness of Life Lottery. Not one. Doesn’t matter if you are rich, poor, white, black or whatever religion you are, if any. We all have close to the same odds of getting ill or being in the wrong place at the wrong time.
It’s time we recognize these facts and deal with them accordingly.
Whether its Medicaid or a new program, every single person in this country should be covered 100pct for chronic physical or mental illness and for any life threatening injury.
The premiums that we are paying to insurance companies as individuals or as company coverage for these significant risks would go from the insurance companies to the IRS. Only the cost of covering the what’s left would continue being paid to the insurance companies.
It would not be hard to do the math. Every insurance company does this analysis already. The government does this analysis already. We all would end up paying more in taxes, but less in insurance and healthcare costs over time.
There would be no mandates. There would be no individual penalties. No Tax Credits. No subsidies. No Offsets or deductions for buying higher end insurance. This will be single payer (yes i know its a dirty phrase in this country) for chronic physical or mental illness and for any life threatening injury.
Everything not covered by the above can be covered by insurance sold on the Free Market, managed by the states, sold across state lines, without government interference.
There will be unique opportunities for insurance companies to innovate knowing they wont have to face the most expensive healthcare problems and they can have the cushion of knowing that illnesses and injuries that they covered that transition to those covered by Single Payer Advanced will be reimbursed.
We all share the same risks, we all can share the costs of our greatest risks.
The peace of mind this would bring to every family would make our country stronger. I know with certainty it won’t reduce innovation in healthcare. Technology is going to continue to boom and change our future.
There is something for everyone to hate in this. It doesn’t cover as wide a range of healthcare options as Obamacare, but it covers everyone. Immediately. No paperwork required. It is more humane, cost effective and fair than what the Republicans have proposed so far.
Which means everyone can rip it to pieces. Which is exactly what I want everyone to try to do in the comments so we can see how to make the concept better
PS – On the issue of drug prices, I would include an MFN for pricing for this government pricing. Whatever the best price is you give to anyone, you have to give to this program.
I happen to be a fan of the government investing money into what is commonly called infrastructure projects. I strongly believe that any reasonable businessperson, even one who works for the government, should be able to invest money at 1% interest rates and get a better than 2% return on taxpayer money. But I think its time to rethink how we spend a big chunk of that money.
If it was me spending the money, I would take 100 billion of the proposed $ 1 Trillion dollars in infrastructure investment and invest it in Robotics.
I would invest it in the companies that do R&D, software, and design for robots and every other facet of the Robotics Industry.
Unfortunately, none of the companies that actually make the robotics are based here in the USA. That’s a problem that needs to be solved. We need to help develop domestic companies much like we did the electric car and wind and solar industries. Even if it means trying to help pick winners.
We have to win the robotics race. We are not even close right now.
A new report says China is spending far more on Robotics than we are. China, Korea, EU are offering billions in credits to support their robotics industry. We spend about $100mm . That ain’t gonna work.
The good news, if there is any, is that according to the report China is only spending $ 3B dollars a year on robotics. We need to quickly pass them by.
Why is this so important ? Because technological change always accelerates. It never stagnates over time. Which means we are going to face the fact that if nothing in the States changes, we will find ourselves dependent on other countries for almost everything that can and will be manufactured in a quickly approaching future.
We have to face the fact that countries are going to lose jobs to robotics. The only question that needs to be answered is which country will create and own the best robotic technology and have the infrastructure necessary to enable it.
Right now it’s not the USA and that needs to change.
Our “infrastructure” spending should look forwards, not backwards so that we can be the robotics hub of the world.
Peter Thiel was right when he said that Trump supporters take him seriously, but not literally.
When it comes to reporting the news, a presidential campaign and election is obviously news, the MSM (Main Stream Media) takes everything literally and seriously. That is the definition of reporting isn’t it ?
There are 10s of millions of voters who probably preferred to consume literal information from MSM sources they trust and processed it before they decided which Presidential candidate they voted for.
There are 10s of millions of voters who probably preferred to consume other, non MSM sources of information. It’s not that they don’t want literal information. It’s that they don’t trust traditional reporting sources, aka, MSM, aka Main Stream Media.
I don’t know how or why they developed this distrust of the MSM. But they certainly did and still do. They not only distrust the MSM, they seem to feel strongly that the MSM is controlled by forces that are intentionally trying to discredit the things they believe strongly in.
Who do they trust for their information ? Pretty much anyone and any outlet that recognizes and reveals the impurity of MSM outlets and reinforces the purity of their beliefs. It can be a neighbor, friend, relative, talk show host, website or information source, real or otherwise. It certainly was all the people who were at the rallys. You talk about creating a word of mouth network of support. The rallys certainly succeeded there.
For the MSM literals, its “us vs them”, for the MSM haters , its “us vs them”
In this election there were more MSM “literals”, but the Trump campaign was a lot smarter and able to rally the MSM haters and turn them into Trump believers and voters in the states they needed them.
President Elect Trump won not because the media failed at their job or didn’t recognize something. Donald Trump won precisely because the MSM did their job exactly as they expected they would and they used it to their advantage.
Every chance Donald got he would say things that his campaign knew would get the MSM all riled up. They knew exactly what they were doing. The more the media and people like me criticized Donald, the more it played right into their hands. We were the bad guys. We didn’t get it. We represented everything they wanted to change. We were the forces behind the corrupt media. The elites. The establishment. The suckers getting paid off by George Soros and foreign corrupt interests.
I was dumb enough to think I would be able to talk people out of voting for Donald Trump by detailing what I thought were his weaknesses. The Trump campaign had to be laughing at me and thanking me at the same time. I approached my choice of candidates by consuming information literally. That was my hammer and I tried to use it to make everything else look like a nail. I obviously was wrong.
Where Donald Trump was challenged, it wasn’t because of something he said on the campaign trail. It was something he said or did years ago. When there was hard evidence, it created question marks for even his staunchest supporters. But for every hit he took, he was able to communicate to his followers that his opponent was far far worse than he ever could be.
She was a threat to their lives, their livelihood, their country. It was clear to his supporters that he understood them and she was a threat. It was an easy choice to make. They both had issues. He could learn from his. She was a lying traitor that couldn’t be trusted and neither could anyone who supported her. She would never be able to wash that off and be trusted and neither could the elites or special interests that wanted to help her take away his supporter’s liberties.
So here we are. We are going through a transition after which Donald Trump will be our President. Have I changed my mind about him ? Not yet. I’m willing to give him a chance. But I still don’t trust his temperament. His tweets are risky in so many ways. That still concerns me. Bigly.
But he will be our President and I want him to succeed. But that isn’t the end of the story. Recent history is repeating itself . As we speak.
The Trump team is once again brilliantly using MSM to their advantage. They know that MSM will continue to be literal in their reporting, and the Trump transition team is grateful for it.
In looking at his actual and proposed appointments, every one in the MSM, everyone who consumes their literal information from the MSM is freaking the fuck out.
Once again his voters are taking him seriously, but not literally. After all, he hasn’t taken office yet. How in the world does the MSM even know what is going to happen ? It’s just more confirmation that the MSM doesn’t get it. They don’t get us. They are still out to get him and make him look bad. And when the MSM makes our President look bad, they make all of us that voted for him look bad. Which in turn makes his support from his voters even stronger.
When his transition team picked Flynn, Bannon, Sessions, they knew exactly how the MSM would react. They knew every single past issue each faced would surface. From tweets to not being confirmed to breitbart news. They could have picked any number of qualified candidates that didn’t carry that “baggage”. But they chose them precisely because they had that baggage and of course because they were loyal to President Elect Trump.
Every bit of their histories was going to be taken literally and reported literally by the MSM. And like in the campaign, I’m pretty sure that his supporters won’t care, a minority of his supporters will think of those issues as positives, and the Trump team will continue to be thankful for the MSM doing their jobs exactly how they expected them to.
It’s the perfect long-term setup for the new President and all those around him. No matter what he does in office, unless it is demonstrably and verifiably dangerous to their way of life, the MSM media reporting on his Presidency is always going to be a plot against him.
They trust President Trump far, far more than they could ever trust anything the MSM says about him. And they trust all the non MSM sources of information that again, unless there is something disastrous and undeniable, will say and write positive things about his Presidency. What doesn’t work and isn’t disastrous is the fault of his predecessor and the establishment who continue to fill the swamp of DC and fight his every move. In fact, I would guess that they use all the negative articles during the transition as a way to convince those who didn’t vote for Trump, but may have been on the fence,as support for why they should support their new President.
The MSM doing their job is going to make President Donald Trump stronger than he was the day he was elected.
A couple more guesses and presumptions from my personal swamp:
1: My guess is that all the meetings with non-supporters are` “kiss the ring and kiss my ass meetings” and not true job interviews. Yes, there will be an exception or two. Or at least ones that look like they are a hiring of someone who didn’t support President Elect Trump’s campaign. But the reality of the situation is that it’s not about hiring those folks. They give the President Elect and his organization the chance to say “see, I was open minded. I talked to everyone. Whether I agreed with them or not. But even when you try to take the establishment out of the Swamp, you can’t take the swamp out of the establishment.
More importantly, they give President Elect Trump the satisfaction of watching those like me who campaigned vocally against him, bend over, and kiss his ring. Touche’ President Elect Trump. Touche’
2: As I said, I am very, very nervous about what he might say or tweet. But I do have some confidence that like everyone before him, the office will change him. The non stop onslaught of challenges will focus him. He won’t have the time, energy or inclination to tweet simply because he is too busy. That is my hope.
3: I do understand the fear the uncertainty is causing minorities. They are rightfully terrified. I know I would be. My suggestion is to use the fear so many are feeling as a way to raise money for groups that protect those minorities. Hopefully those funds and groups won’t be necessary and the fears will end up unfounded.
4: In supporting Sec Clinton, there were policies of hers I agreed with and policies I disagreed with. The same will apply to what appears to be his expected policies. Socially, there is plenty I disagree vehemently with the far right about. I’m not yet convinced that all of our President Elect’s NY Values are gone. We will see.
Economically, there are positives in his plan to borrow at hopefully what will still be effectively less than 0 percent interest. I think if they can take this approach rather than an infrastructure bank, it will pay off nicely in growth for the economy. I also believe that reducing corporate income taxes is good. But I’m a believer that they should be closer to the 22 – 25pct range. That makes us globally competitive and hopefully allows for more re-investment by companies.
Finally I hope he takes a page from Sec Clinton’s small business agenda. All the paperwork required, along with the many different fees that every different level of local government charges a new company, makes starting a business too difficult and stupidly expensive. All of which combined to crush the incentive for an individual to start their own business.
If you are good at a trade, its ridiculously expensive to go out on your own. Every start up should be as easy as starting up a lemonade stand and cheap, if not free. Sec Clinton proposed that federal funds be used to buy out the many local, county and state fees that crushed small startups and to work to unify and simplify the paperwork required. Hopefully the Trump administration will take a close look at this.
5: I’m tired. So apologize for the typos and whatever else. I’ll circle back tomorrow and fix the many grammatical and spelling errors I’m sure I left behind
6. Feel free to hate on me in the comments. I learn from the thought out disagreements and improve my temper from the over the top hate.