Senate passes Obamacare partial repeal
In a party line vote last night, the Senate passed an Obamacare repeal bill that ends the law’s tax and financial components.
It must be emphasized that the failure to repeal the law’s regulations is entirely due to the unwillingness of any Democrats to cross party lines, end the filibuster, and allow a vote. The result: we are still stuck with some of the most egregious components of the law. In 2018 many of those same Democrats will be faced with difficult re-elections. It will be time to remove them.
I should add that, just like Obamacare itself, the manner in which this repeal is being written and approved actually appears to be unconstitutional. It is tax policy and it is originating in the Senate. The Constitution however clearly states “All Bills for raising Revenue shall originate in the House of Representatives.” (Article 1, Section 7) The same section also states that the Senate can propose, so I suppose this is how they get around this issue.
On Christmas Eve 1968 three Americans became the first humans to visit another world. What they did to celebrate was unexpected and profound, and will be remembered throughout all human history. Genesis: the Story of Apollo 8, Robert Zimmerman's classic history of humanity's first journey to another world, tells that story, and it is now available as both an ebook and an audiobook, both with a foreword by Valerie Anders and a new introduction by Robert Zimmerman.
The ebook is available everywhere for $5.99 (before discount) at amazon, or direct from my ebook publisher, ebookit. If you buy it from ebookit you don't support the big tech companies and the author gets a bigger cut much sooner.
The audiobook is also available at all these vendors, and is also free with a 30-day trial membership to Audible.
"Not simply about one mission, [Genesis] is also the history of America's quest for the moon... Zimmerman has done a masterful job of tying disparate events together into a solid account of one of America's greatest human triumphs."--San Antonio Express-News
In a party line vote last night, the Senate passed an Obamacare repeal bill that ends the law’s tax and financial components.
It must be emphasized that the failure to repeal the law’s regulations is entirely due to the unwillingness of any Democrats to cross party lines, end the filibuster, and allow a vote. The result: we are still stuck with some of the most egregious components of the law. In 2018 many of those same Democrats will be faced with difficult re-elections. It will be time to remove them.
I should add that, just like Obamacare itself, the manner in which this repeal is being written and approved actually appears to be unconstitutional. It is tax policy and it is originating in the Senate. The Constitution however clearly states “All Bills for raising Revenue shall originate in the House of Representatives.” (Article 1, Section 7) The same section also states that the Senate can propose, so I suppose this is how they get around this issue.
On Christmas Eve 1968 three Americans became the first humans to visit another world. What they did to celebrate was unexpected and profound, and will be remembered throughout all human history. Genesis: the Story of Apollo 8, Robert Zimmerman's classic history of humanity's first journey to another world, tells that story, and it is now available as both an ebook and an audiobook, both with a foreword by Valerie Anders and a new introduction by Robert Zimmerman.
The ebook is available everywhere for $5.99 (before discount) at amazon, or direct from my ebook publisher, ebookit. If you buy it from ebookit you don't support the big tech companies and the author gets a bigger cut much sooner.
The audiobook is also available at all these vendors, and is also free with a 30-day trial membership to Audible.
"Not simply about one mission, [Genesis] is also the history of America's quest for the moon... Zimmerman has done a masterful job of tying disparate events together into a solid account of one of America's greatest human triumphs."--San Antonio Express-News
Oh yeah– they are totally in the weeds on this one; filled with government-speak and referencing other countless other laws & Acts.
While I would agree they are violating the spirit of their own procedures, from a technical standpoint, this sorta stuff happens more often than one might think.
Full Text and the pesky details are at:
https://www.congress.gov/bill/115th-congress/senate-concurrent-resolution/3/text
Interestingly, Rand was the only no vote on the R side.
Without financing, how could anything of it remain? The Supreme Court accepted Obamacare only piece by piece, so the funding part of it can be taken away. But what now? Are the states obliged to fund it? Or the companies in the industry? An unfunded government project, what kind of UFO is that??
LocalFluff–
It’s way more complicated than that. Just in brief (and incomplete)
-The individual mandate says you must be covered, and the penalty is in the form of a Tax and under the IRS enforcement realm.
They need young people & healthy people to buy insurance they don’t need or want, to subsidize other people.
-Majority of people get health insurance through their work. Those policies are subject to mandates, and real money changes hands between business/employees & insurance companies. (They make money, in general ,with these policies & they cross subsidize everything else.)
-The very “poor” are covered under Medicaid. A mixture of Federal monies and State matching money. In general, the budgets of a majority of States, spend upwards of 40% toward Medicaid alone. Its a huge State expense.
-If you are over 65, you must enroll in Medicare, and most people buy supplemental medicare-plans because medicare doesn’t cover everything 100%. If you collect social-security, medicaire premiums are deducted off the top.
–There is also a large group, the individual-market, where people buy insurance for themselves, not part of a group work plan or in medicare/Medicaid.
Those policies in particular, are very expensive and have been targetted, and are used to cross subsidize everything else.
–The insurance companies agreed to go along with this because their is something like $40 billion/year sloshing around from the Feds, and they had a captive customer base They are highly regulated, subsidized in part, and are for all intents and purposes “nationalized,” profits are centralized and losses are subsidized by the feds. Or at least, it started out that way. The money-flows are complicated as hell, and by design.
Some people get rich, the rest of us pay for it all, and more.
(We are being punished for being productive citizens by redistributing our wealth, in the form of healthcare, to people who haven’t earned it. It’s no longer “insurance,” it’s a welfare-program masquerading as a “healthcare market.” (Obama-style.)
Losing my mind… the ACA is 1,200 pages and bakes itself into 16% of our entire economy.
Disengaging and cutting it out, is complicated, and prone to Crony RINO hanky-panky.
something like that…
(I am not, on-a-roll-today! ha)
Wayne’s description of the complication of Obamacare (the ACA as unilaterally modified by Obama) is only part of the complicated mess that it has created.
– Religious factors are no longer considered. The First Amendment has been violated, in that the implementation of the law prohibits certain free exercise thereof. Other violations of the Constitution are embedded in the implementation of the law.
– The US full-time work week has been redefined as 30 hours, so now companies now hire far more part time workers than they used to. The affect on the economy and on the attitudes of the citizenry is also complicated, but generally harmful.
– Health insurance policies work very much like the catastrophic insurance policies that Obama had declared “junk” insurance, except Obamacare compliant policies are more expensive, have larger deductibles, and worse co-pay provisions.
– We the People are no longer free to choose with whom we wish to associate. We are required to associate with an Obamacare compliant health insurance company.
– We the People are no longer free to choose how to spend our own money. We are required to pay for, or get someone else to pay for us, healthcare insurance. Talk about crony capitalism! When the government requires that we enter into contracts with one industry, then our liberty is abridged.
– We the People now live in a tyranny. Government may now direct us as to how to behave, think, speak, or any other aspect of life merely by attaching a tax to the governing law.
– There are many panels, commissions, and councils set up by the law, but an unlimited number may be created at the whim of practically anyone in charge. New rules and regulations can be created.
– Many new companies have been created just to help Americans and their companies comply with Obamacare’s requirements. The cost is more than financial, but our time is taken up trying to comply (or choosing to not comply), and frustration has increased.
– 2015 is the first year in a long time that the US life expectancy declined. Rather than ensuring better health and longer life, the opposite has occurred.
– The advertising for Obamacare was that people could stop working — stop being productive — and pursue their avocations rather than their vocations. This came from Congresscritter Pelosi, a leader in the unethical, unconstitutional ramming through of this unwanted, unpopular, destructive, unsustainable, heinous, tyrannical law.
– Obamacare made healthcare insurance so expensive that even Congress and their staffs had to be included in the Obamacare exchanges because even they could no longer afford healthcare. If these well-paid ruling-class people cannot afford it, what chance do the rest of us pee-ons have?
In essence, the Democrats may complain that if Obamacare were overturned then millions of Americans would lose their healthcare, but by their own definition, tens of millions of us have already effectively lost our healthcare. We still cannot afford to be sick. Each year that we pay our overpriced, prohibitively expensive insurance premiums, an individual policyholder would have to have a $17,000 medical bill in order to break even on the financial cost, after premiums, deductibles, and co-pays.
How many times or years have you ever had such a high medical bill? Would it be worth the half-million dollars paid in premiums over your life expectancy?
I haven’t bought healthcare insurance since Obamacare went into effect, three years and 12 days ago. My break even point is about twice that, at around $34,000. If I get a medical bill for less than that, I will still be better off than if I had bought insurance for these past three years.
To put it briefly, we do not get what we pay for. Healthcare insurance has never before been such a lousy deal. Dollar for dollar, it is even a worse deal than earthquake insurance, and that is saying something.
Thanks for the lesson, guys!
What I still don’t understand is how the financing of it can be stopped, without it all ceasing to exist. Is it the federal financing that is ending and that the states or companies will have to cover for that?
“The US full-time work week has been redefined as 30 hours”
One can do 30 hours in a day, if one hurries up a bit. And is onaroll. And has three full time employments like prosecutor, lawyer and judge. Or six part time ones.
US life expectancy declined
That is really very bad, considering the technological progress in saving the newly born and seriously wounded and that the elderly today have had better food and health care throughout their life than previous generations. This number is The basic statistics of the development of a society. Talk about Obama leaving a bad legacy!
Politics and medicine is a very dangerous combination because it kills people. Nazi-Germany was the prime example. But their economics of it was more straight forward, because they didn’t even attempt to hide what they were up to. They actually billed the heirs of the executed for the cost of the execution (which is a kind of “health care”, well, it is somehow medically related anyway, certified by a doctor and all)
LocalFluff wrote: “What I still don’t understand is how the financing of it can be stopped, without it all ceasing to exist.”
The tyranny of the mandatory purchase continues. The religious violations continue. People continue to not get full time employment. Compliance requirements continue, because compliance is enforced by organizations that are funded under other, unaffected, budgets. Because compliance requirements continue, expenses remain high, and so do the types and prices of the policies. Our personal and professional time continues to be taken up attempting to comply.
The lousy service continues (we have to fork out several thousands of dollars before any kind of coverage begins), and life expectancy could continue to fall. Our frustration continues. We continue to not have the types of policies that we want or can afford. We continue to be treated as hermaphrodites (I forgot to include that one, earlier — the good news is that I am covered in case I get pregnant, the bad news is that I am required to pay for that coverage despite my complete inability to get pregnant).
Defunding it may have the effect of eliminating the Death Panels, but then that eliminates the ability to get permission to get life-saving care when the law specifies that you don’t. The Death Equation remains in place. As I recall, if the care costs less than $26,000 for every year of life expectancy that you have for your age, you are allowed to get the care, otherwise you are out of luck and only a Death Panel can rule otherwise. But Obama was clear about that. He said that sometimes you just have to take some pills for the pain then wait for God. This was in response to a question to Obama about taking into account the patient’s quality of life and joy of life.
https://www.youtube.com/watch?v=Z84hTRtSV1U (2 minutes)
So SOMEONE still has to fund it, just not the Federal budget anymore?
“Maybe you are better off not having the surgery, but taking the pain killers!”
-Obama
I hope he follows his own recipe.
No one has to fund Obamacare. However, as with everything else in our lives, we individual people have to fund our healthcare. Traditionally, an insurance industry developed in order to help cover costs, just as with life insurance, homeowner’s insurance, auto insurance, and other insurances. I have heard the insurance industry compared to a bet: we bet that we will need it but hope that we don’t, and the insurance company bets that we won’t need it and hopes that we don’t.
But no one needs insurance. life went on for centuries (hundreds of millions of years, actually) without it.
Going to a doctor is similar to taking your car to a mechanic. In both cases, you are buying a service and may be buying parts — in the case of the doctor, the parts may be prostheses, bandages, needles, medications, etc. This is the part that has to be funded, but it has to be funded by the patient or his insurance company.
However, somehow, we have started thinking of healthcare in a strange way. It seems to be thought of as an entitlement that should be funded by someone else. Why it has become the responsibility of someone else is a mystery that only a socialist can explain — and I’m not sure he can do so to my satisfaction.
Edward, I know you aren’t trying to make a precise comparison between auto insurance and health insurance, but many did when Obamacare was in the works, and there are some important differences that I feel should be pointed out.
Auto insurance just covers repairs, analogous to treatment of illnesses/injuries. Both auto repairs and healthcare include diagnosis. I’m not aware of any auto insurance policy that covers preventive maintenance.
Yet, a big part of health insurance is preventive care, whether we want it or not.
Also, few consumers would choose to have excessive tests for their cars, yet many medical providers push excessive tests (as we’ve discussed elsewhere), and too many consumers are willing to go along. Part of this dynamic is that doctors are much more likely to be sued for failure to properly diagnose than mechanics are.
To me, the biggest difference relates to making insurance mandatory: many pointed out that auto insurance is mandatory, so health insurance should also be mandatory. However, auto insurance is only mandatory for those who own an auto; if you don’t want to pay insurance, don’t buy an auto. There’s no analogous choice in the case of health insurance.
In addition, all drivers must have auto insurance so that they can pay for damage they cause to others, yet no health insurance policy covers treatment for damage one causes to others.
Sorry for the sidetrack, but health insurance has fundamental differences from auto insurance, and all other types for that matter.
Garry–
You bring up many good points. I understand from where you come, but disagree.
I do counter differ on your main premise. All insurance operates in an identical manner, unless it’s been modified, at which point it’s not operating under actuarial modelling and is no longer insurance. (They can call it anything they want and they do, but it’s not insurance.)
Highly recommend checking out this brief definitional entry;
http://www.econlib.org/library/Enc/Insurance.html
Insurance is rightly a commodity product, unless it’s been transformed into social-welfare programming, resource redistribution, and social-policy, by the coercion of the State.
There is literally an unlimited demand for “healthcare,” but there is always a limited supply of it. When markets are not allowed to clear, that manifests in supply and distributional problems.
Obamacare (ACA) is a social-welfare program, it has nothing to do with actual “insurance.”
Medicaid, Medicare, and Social Security, are not insurance programs either, they are all resource-re-allocation and redistribution programs, funded out of general revenues.
“Preventative maintenance,” is the responsibility of the insured. And there are financial incentives for preventative-maintenance, in practically every other area of insurance, except for healthcare, cuz it’s no longer actually insurance.
Referencing “Testing” of all sorts– Reform the tort laws & battle with the trial-lawyers on this one.
There are standard-reference protocols for all diagnostic categories and the associated test(s). However– these have been primarily developed under a 3rd-party payer system.
People just do not actually purchase any of these services with their own money, they have no idea how much they actually cost, nor do they appreciate Type 1 & 2 errors in testing, or the impact of them.
Open up all forms of testing to actual market-pressures of supply and demand, and you’ll see prices drop while tests-performed rise.
Garry wrote: “Yet, a big part of health insurance is preventive care, whether we want it or not.”
Maybe these days, but back in the free market days it depended upon the policies offered and what you were willing to pay for.
“There’s no analogous choice in the case of health insurance.”
Actually, there is. Under Obamacare, health insurance is only mandatory for those who are alive: if you don’t want to pay insurance, don’t breathe.
“health insurance has fundamental differences from auto insurance, and all other types for that matter.”
Correct. No one expects someone else to pay for their other types of insurance. Yet they do when it comes to health insurance.
No other insurance will cover pre-existing conditions, because that would be insane. You can’t get life insurance on Uncle Joe after he has stopped breathing, and you can’t get auto insurance to cover the accident that you just had.
However, since we now expect someone else to pay for our health insurance, we insist that pre-existing conditions must transfer to a new insurance company after the someone else stops paying for our insurance. This does not happen with any other insurance, but that’s insanity for you.
Did I mention that this is insane? That our society has passed over into insanity? That our ruling-class leaders lead this insanity? That they call it the new normal? Quite a fundamental difference. Quite a fundamental transformation of America.
Yeah, I’ll take the ultra-cheap “Yugo” insurance right up until I get sick, because the next morning I’m transferring my pre-existing condition to the “Cadillac” of insurance plans.
To prevent this scam, we all need to be responsible for our own health insurance, so that we can get — or not get — exactly what we want, not merely what our employer offers, just as with our auto insurance, fire/homeowner’s insurance, life insurance, flood insurance, earthquake insurance, or trampled-by-zebras insurance. No more worries that someone else will stop paying for our insurance so that we have to look for another policy that will accept our pre-existing conditions. No more need for COBRA insurance laws.
What is the definition of greed? The desire for undeserved prosperity. It is one thing to have many possessions and wealth that you have earned, but it is another to demand to have unearned benefits that must be paid for or supplied by someone else. This is the problem with Obama’s America: we now expect to receive according to our need, rather than our merit, and many people now think that their need includes more than they need.
We give them a suit so that they look good at the interview in order to get a job, but they never get a job. We give them an Obamaphone so that they can arrange the interview in order to get a job, but they never get a job. We give them a house so that they smell good at the interview in order to get a job, but they never get a job.
We give them a safety net so that they don’t starve while they look for a job, but they never get a job. Instead they turn the net into a comfortable hammock and no longer desire a job, because that is just a lot of work that takes up all their relaxation time drinking mint Juleps served in silver cups all paid for by others, by people who did get a job.
Now they demand that the rest us to work 70-hour work weeks so that they can get free healthcare. What greedy little shi– [ahem!]
wayne,
I think you have it right, especially about the “literally an unlimited demand for ‘healthcare’” From each according to the government’s demand, to each according to the liberals’ unlimited demand, rewarding friends and punishing enemies. Marx’s philosophy has been bastardized but remains unworkable.
Not everyone needs healthcare insurance, but try telling that to the greedy liberals.
I have more words for this topic, but this is a family site, and all the words are profane. Please feel free to sprinkle them, yourself, generously throughout this rant.
Edward–
(Of course, I have it right!)(HA)
>Excellent rant! (I appreciate it takes a bit of time to write it all down in a coherent fashion.)
Remember a day… before Obamacare , when hundreds of thousands of uninsured people were dying in the streets every, single, day?
>I don’t either…. ‘cuz it never happened.
Garry does bring up good points & clearly illustrates how we assign some special status to “health insurance” that it doesn’t inherently posses.
If we want to have a debate on the appropriate level of State-supplied charity healthcare to the indigent, we should have that debate & set those levels.
But we should never confuse social-welfare programs with “insurance.”
Wayne, in your post directly after mine, you seem to be saying that what we have is no longer recognizable as health insurance. You and I (and Edward) are all saying some of the same things in different ways.
Let’s be careful not to look back at the time immediately before Obamacare as “the good old days of health insurance”; as with many, many other aspects of life under Obama, the health insurance world was pretty bad before he made his changes, and his changes made them much worse. but make no mistake, they were bad before he came along.
I was self-employed when I returned to the US 20 years ago, and had never had an interaction with the American health insurance system (my previous time in the US as an adult were spent in the military, or as an obnoxiously healthy, young, unattached adult who didn’t see the need for health insurance). Having a young family, I bought a simple plan when I arrived. If memory serves I had a catastrophic plan for the 6 months, but the details don’t mesh with my understanding of a catastrophic plan.
We made extensive use of that policy, with a few health crises almost immediately after we arrived. With very little income in my first few months, I studied every bill very carefully. I was shocked to find entries such as “emergency room visit – $3000 discount price for insurance company – $350”
In other words, someone with insurance is billed $350, but someone without insurance is billed $3000. They both got the same care, and if anything, (assuming payment is made), the insured patient involves a larger administrative burden. I’m all for negotiations that result in volume discounts, but a 89% discount is ridiculous. Insurance companies will tell you that this is done because many uninsured don’t pay their bills, so to make up for it they charge extra to those who do pay (which smacks of “the beatings will continue until morale improves”). From them on I’ve always had insurance, for that reason alone.
Over the years I found myself switching companies as situations changed. At times our monthly premiums were $1300 for a family, with no major conditions. Over time, fewer and fewer companies offered plans in my state. Part of that was because the state mandated that the plans cover everything under the sun; even if we get rid of every word of Obamacare, if we don’t put a check on state regulators, we will have many of the same problems as we do now.
Clearly, medicine has to have regulations, more so than other areas of the economy. But the regulations have been out of control for at least several decades.
I just want a simple policy that insures that I don’t get bankrupt if I get run over by a bus or get cancer; if I break a bone I’ll go to the walk-in clinic and pay their bill, and if I get strep throat I’ll pay for the doctor visit and prescription.
But I can’t do that, because the health insurance industry, before and during Obamacare, put a stranglehold on the medical industry. I hear of doctors who provide care with set prices, and hope that idea spreads.
Related tangent: my daughter recently told us of her friend, a college student who was sick when her parents were out of the country. It was the first time she had to make her own medical decisions, and she asked her friends for advice. My daughter told her it sounded like she just had a cold, and she didn’t need to go to the doctor. The girl went anyway, and was billed more than $100 for the doctor to tell her she had a cold and recommend some the same over the counter medicines my daughter had recommended she consider taking.
I’m just glad that she learned her lesson and probably won’t do that again; by and large, people with more extensive policies don’t get that lesson, because there is no direct penalty for useless visits, other than a very small co-pay in some cases.
This is even worse under Obamacare, where the very poor get better coverage than those of us who pay more for our policies.
Garry–
Good stuff. (You always have good-stuff!)
You are absolutely correct, in that the ‘good-old-days’ were far from optimal. (In comparison with today, it’s looks great, but I know it wasn’t, and that is not the point to which I wish to return.)
I as well, have had experience buying (individual) health insurance (pre Obama), which was not part of a group-plan; my monthly premiums were almost 2X’s my home mortgage.
(and tangentially– I distinctly recall when my (then) teenage-daughter was added to our auto-insurance, yowza! It was a great day indeed, when she became an independent citizen.)
I would put forth, briefly, the entire “market” for healthcare & health-insurance, has been horribly influenced by the rise of the State as the 3rd-party payer, in most instances.
I trace this back to Medicare and later on, Medicaid.
Government has completely distorted the entire economy of the “medical industry.”
The Government, in most respects, is the largest “customer,” and predictable so, they have distorted the market beyond recognition.
Off the top of my head, I’d compare it with the rise in costs to attend College.
Nobody really pays what the “actual cost” is for healthcare or higher education; Government increases Aid, Colleges raise prices, and so on & so forth, ad infinitum.
And when it comes to pharmaceuticals– the Government is THE largest purchaser.
(And…it costs upward of a Billion dollars, to bring a new entity to market.)
-That is a complex subject I’m not prepared to delve into right now.
Anyway— “good stuff!”
Wayne, you are absolutely correct about how government involvement distorts markets, and they seem to pick the most important markets.
Eisenhower warned of the “military industrial complex,” and since his time we have seen the rise of “the higher education/research complex,” “the healthcare complex,” and others.
I’m afraid we’re past the point of no return on these and others, but if they’re going to be dismantled, it would probably start with a wildcard like Trump.
Garry–
excellent.. reference the “military-industrial complex.”
Any time you have billions of dollars floating around for any Program, the devious always belly up to the trough, and unholy alliances develop & become institutionalized.
VISA has the contract in Michigan, to provide our EBT cards. (“electronic benefits.”)
Walmart receives 10% of their gross sales, from the SNAP Program.
Colleges are subsidized by Financial-Aid & Student Loans.
“Housing,” is distorted greatly by the whole government-sponsored mortgage labyrinth .
Our auto industry– CAFE standard’s & defacto nationalization.
Blah-Blah-Blah…. the list is endless.
Highly recommend this episode of Econ-Talk.
“Bootleggers & Baptists”
http://www.econtalk.org/archives/2007/01/bruce_yandle_on.html
(1:08:46)
We do have extensive historical experience with waste, fraud, graft, corruption, and pure Cronyism, on a grand scale… but we never seem to learn our lesson’s (or rather fail to effectively transfer them across generations.)
“The American Economy and the end of laisse faire: 1870-WW-2.”
Murray Rothbard
2 of 13. (whole series is great & in Rothbards own voice.)
“-The Railroading of the American People”
https://mises.org/library/2-railroading-american-people
Garry wrote: “Let’s be careful not to look back at the time immediately before Obamacare as ‘the good old days of health insurance’”
Not to worry, I consider health insurance of around 1960 as the good old days. Actually, the overall healthcare of that era was done mostly right. The problems that later developed are twofold.
1) Litigation
2) Expensive treatments
The problem of litigation likely came from unrealistic expectations. Two hundred years ago, a doctor’s main purpose was to inform the family whether or not they needed a coffin. He had very few cures or tricks in his medical bag, he mostly practiced the art of medicine, where the better doctors were better at guessing about the need for a coffin.
During the 19th century, medicine started becoming a real science. Pasteur, John Snow, those who pioneered anesthetics, Florence Nightingale, and many other unsung early pioneers in modern medicine created actual hope that many diseases and injuries were survivable and even preventable.
After the horrors of the US Civil war, doctors became obsessed with anesthetics. After WWI, doctors turned even more to science for finding cures and treatments. If only they had had a way to cure, treat, or prevent the Spanish Flu then millions of people would have survived.
By 1970, Americans had expectations of perfection in medicine and an attitude any adverse outcome meant that a doctor or hospital should be sued. It was a better alternate for the lottery (which wasn’t popular/legal until the 1980s). We have already discussed the costly results of lawsuits in American medicine.
The 1960s also introduced treatments for cancer and for heart disease. Although chemical treatments, chemotherapy, is older than 1970, it was well known and popular by then. Open heart surgery and heart transplants became fairly common. But these things were expensive.
Medicines have become very expensive to develop (wayne says it can be around $1 billion) and since their patents are short lived, after approval for general use, their prices are tremendous, depending upon the number of patients using the new drug. Since the generic brands are so cheap, people believe that the high prices for the non-generic form are unreasonable. However, the high cost of development for any drug, and the low rate of successful development require high prices in order to pay for the development of the next drug.
The high cost of medical care has made even the simple and common treatments more expensive than they had been in 1960. FDR’s Stabilization Act of 1942 resulted in a dramatic increase in fringe benefits in business to attract new workers and better talent. Without the ability to use wage increases to attract workers, businesses needed something, and the fringe benefit was the legal answer to get around the limits imposed by the law, especially for the military-industrial complex, which seriously needed good talent in order to win the war.
Healthcare and its insurance became a popular benefit for employers. It didn’t cost the employer much, but families felt more secure that they could afford to take the kids to the doctor as often as kids seem to need the doctor. Thus began the expectation that someone else would pay for healthcare – that healthcare should be free. And the basic foundation of Obamacare was born.
So maybe I should consider health insurance of around 1940 as the good old days, since the family, not the company, chose it and paid for it.
Bad as it was, however, the time immediately before Obamacare was pretty darned good when compared to Obamacare.
Now, however, government tells insurance companies, hospitals and offices, and doctors and nurses exactly how to do their work. Innovations and improvements are discouraged or outright illegal. How is healthcare supposed to improve under Obamacare?
Garry wrote: “even if we get rid of every word of Obamacare, if we don’t put a check on state regulators, we will have many of the same problems as we do now.”
This is why I believe that a free market system would be better than what we had before Obamacare. The insurance companies would be free to offer policies that customers want, not what the government wants (recall my rant about getting only what government wants when government is in control, but getting what we want when we are in control). As noted, the more government gets involved, the more the market is distorted. Also, the more that the care itself is distorted.
Garry wrote: “ “because the health insurance industry, before and during Obamacare, put a stranglehold on the medical industry”
Not quite. As you noted before, it was the government regulators who put the stranglehold on the industry, even the health-insurance industry. Your desired policy became prohibited, just as it is under Obamacare.
Your daughter’s friend’s experience is exactly what the free market should provide. $100 for a doctor visit is not much at all, considering all that is involved, and with the patient making the payment, she quickly learns when she should not bother the doctor. New parents are similar, in that they often panic with their first child and take the baby to the doctor over something that turns out to be minor, but by the second baby they have figured out what is minor.
Edward–
Great stuff!
Average cost to develop a new molecule is roughly $900 million & I (believe) the time involved, is approaching a decade. I do know that is up from approximately 400 million & 7 years, in the late 80’s & 90’s.
“Pharmaceutical’s” are somewhat unique as consumer products. But that’s primarily a cultural & Administrative State overlay, there is no inherent reason they should be “special.”
-They can’t be sold without FDA approval, if they are psychoactive the DEA gets a vote. A prescription from a Doctor is required for all non over-the-counter medications. And much like airline tickets, not everybody pays the same price for the identical drug.
As far as pharmaceuticals are concerned– I’d go back to circa 1905 or so, before the Pure Food and Drug Act(s).
[Everything in The Jungle, was made up wholesale & sold retail.]
>They all had little to do with “purity” or “safety,” and everything to do with State control & cartelization of pharmaceutical producers & who was allowed to sell what to whom.
(It took a Constitutional Amendment to outlaw alcohol. Currently, any molecule on Earth can be regulated by the FDA, DEA, and EPA. That is insane and wholly counterproductive.)
>Interesting topic.
I still maintain, if they don’t kill the ACA, asap, we’ll have it forever.
let me start by congratulating for managing such a huge blog. You always provide updated content. On the issue of Obama care, the obama care was a plan that was meant to help many, but its full implementation and realization of benefits was not achieved.
Great article as always and great audience. Waiting for the next release.
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