Health Insurance | New NY 23rd

Liberals rage against the Trump-Ryan plan for a lot of reasons, but most of it boils down to anger that fewer people will have coverage. Conservatives are raging too, because, as Kentucky Senator Paul put it, Congress’s proposal will “do nothing” to bring health care costs down or to restrict the steady rise of premiums.–Leslie Danks Burke

There is truth in Leslie Danks Burke’s statement, but views on health care are surely more complex. Is it true that liberals are mostly concerned about universal coverage and that conservatives are mostly concerned about rising costs? I have doubts:

Liberals and conservatives–all of us–are and ought to be concerned about rising costs. Those who understand that Obamacare was intended to slow the rise in costs, and may well have done so, are likely to approve of it. Those who blame Obamacare for rising costs are likely to disapprove. Many are confused by the difference between rising costs and the rate of rise. Obamacare was intended to slow the rate of rise rather than to reverse the long term trend of increasing costs; no plan that I can imagine could do that.

Obamacare has many provisions which are important, but less known than “universal coverage:”

  • Covers the cost of the plan with new taxes
  • Offsets the high cost of drugs.
  • Closes the prescription drug benefit loophole.
  • Provides for preventative care.
  • Mandates coverage for certain benefits.
  • Mandates no lifetime limits on coverage.
  • Covers those with preexisting conditions
  • Covers college students to age 26

In my opinion, the Obama Administration did a relatively poor job in promoting Obamacare. Perhaps it wasn’t possible to explain the benefits adequately in face of strident opposition from opponents.

So what’s not to like about Obamacare? Politicians may be motivated by conflicts of interest while many individuals have these objections:

  • Some object to the involvement of for profit insurers, prefer “single payer”
  • Some object to universal coverage (Why should I pay for your health care?)
  • Some object to coverage for women’s health matters
  • Some consider any form of government insurance to be unacceptable (Socialism)
  • Many blame Obamacare for the high cost of health care in America

What’s not to like about the Trump-Ryan plan?

  • Some want any commitment to government subsidized insurance repudiated.
  • Some, now able to afford insurance, fear losing it.
  • Some, particularly seniors, fear unaffordable costs.

If moderate Republicans and Democrats could work together, it might be possible to design a plan based more or less on Obamacare that would work for many. The divisiveness engendered by six years of die-hard opposition to Obamacare together with the reluctance of the GOP to alienate ultra-conservatives make compromise unlikely. The GOP would do well to take care: do they want to be responsible when costs soar?

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