Friday, January 6, 2017

Twelve Things the G.O.P. Should Do to Replace Obamacare

1. Make the federal government adhere to its constitutionally enumerated powers, and simplify and roll back federal involvement in health; by repealing nearly the entirety of the Patient Protection and Affordable Care Act (Obamacare).

2. Reduce limitations on coverage of health insurance subscribers, by keeping the Obamacare provision that allows young adults to stay on their parents' health insurance plans until the age of 26.

3. Put health insurance providers on an equal playing field with consumers, by allowing health insurance providers to deny coverage, and to change the price of coverage, on the basis of pre-existing conditions.

4. End the punitive and unnecessary enforcement of the "individual mandate"; repeal the individual health insurance purchase mandate, and repeal the fine ("tax") on failing to purchase insurance plans.

5. Make it easier for people to keep their health insurance when they move to a new state, by allowing health insurance plans to be bought and sold in any state, as long as the plans fit the requirements set by the state in question.

6. Make it easier for people to keep their health insurance when they lose their job, by ending the tax credit for employer-provided health insurance, or make tax credits equally applicable to all.

7. Allow for long-term planning of health care expenses, by expanding health savings accounts (H.S.A.s); allow people to save unlimited amounts of money in H.S.A.s.

8. Provide income relief for health care workers by repealing taxes on the income of doctors and nurses, and other workers providing health care services, whether they work at hospitals, religious charities, or other enterprises.

9. Make medical devices more affordable for hospitals, by repealing taxes on the sale of medical devices, and by repealing taxes on profits from medical device sales.

10. Help decrease overall federal spending in non-enumerated policy areas; by not only curbing the growth of Medicare and Medicaid, but by refraining from allowing their budgets to grow (in terms of inflation adjusted dollars), at the very least, if not by cutting those programs overall.

11. As soon as possible, cease federal involvement in health when not directly pertinent to the health care and insurance of federal workers; and devolve most (if not all) federal health affairs to state and local governments.

12. Abolish or drastically reduce all taxpayer-supported artificial business privileges, supports, protections, and favors given by government to enterprises providing health insurance and care.

Author's Notes:

     There are probably very few Americans who agree with me on both Point #2 and Point #3. Most Democrats agree with me on Point #2 and disagree with me on Point #3. Most Republicans disagree with me on Point #2 and agree with me on Point #3.
     I support allowing in all cases; that is, allowing young adults to stay on their parents' health insurance plans until they're 26 years old, and allowing health insurance companies to deny or charge for coverage on the basis of pre-existing conditions.
     The position I take is non-ideological, I take my position without regard to its effect, and with my position I intend to benefit no particular class or type of people. If Obamacare required young adults to stay on their parents' plans, or required insurance companies to offer plans that 25-year-olds can be on, I would oppose that measure, even though the effect of my position would bring about the opposite state of affairs.
     The point is to oppose more requirements and more force in health, and to support more freedom. As a parallel to what I explained above, since Obamacare requires health insurance companies to insure people with pre-existing conditions, I oppose it, because I know more freedom means more choices. Moreover, people with pre-existing conditions need care, not insurance, and you can't insure against something that has already happened.

     Additional taxes that should be reduced and repealed, in addition to those mentioned in Point #8 and Point #9, include the following: 1) sales taxes on medications; 2) taxes on profits from sales of medications; 3) taxes on sales made by hospitals; 4) tariffs and duties on imported medications; 5) taxes on the sales of ordinary non-health consumer goods that health workers and patients buy every day; and 6) the "inflation tax on savings" that dilutes the value of health savings accounts.
     Lowering taxes on health employee income and purchases, medication importation, and savings, will help increase affordability of health care and medications, improve the free flow of medicine across international borders, and increase affordability of ordinary goods by the people who provide health services, helping ensure that nurses are not struggling to make ends meet.
     Monetary reform will be necessary to "repeal" the "inflation tax" mentioned in Tax #6 above. An additional tax measure pertinent to health is to allow people to deduct health care expenses from their taxes, perhaps in addition to elder care and child care expenses. This would help return more of the taxpayers' money back to them, while increasing affordability of health care for anyone and everyone who generates income (or is dependent upon someone who generates income for health insurance).

   Point #12 should be construed to recommend the repeal of laws limiting the importation of prescription drugs from foreign countries; these laws show favoritism towards domestically produced American pharmaceuticals, and the result is that American patients pay higher prices.
   Another example of taxpayer-supported artificial business privileges is the overly lengthy intellectual property protections on pharmaceutical drugs. Government enforcement of drug patents helps give domestic pharmaceutical companies security on the taxpayer's dime; this aggravates the problems of few choices and high prices.

Final Author's Note:

     On March 9th, 2017, I changed my position on Point #2. I supported the provision of Obamacare that allows young people to stay on their parents' plans until they turn 26, because I misunderstood what the provision does. I oppose federal laws that require insurers who issue family health insurance plans to allow 26-year-olds to stay on their parents' plans until they turn 26. I oppose this provision of Obamacare, and I oppose the pre-existing conditions provision as well. I now oppose full repeal of the A.C.A.; full repeal of both of these provisions, and the five other major provisions of Obamacare, including the individual and employer insurance purchase mandates.

Written on January 6th, 2017

Author's Note on Point #12 Added on January 25th

Author's Notes on Points #2 & #3, and #8 & #9, Added on February 18th, 2017, based on notes from February 8th

Final Author's Note Added on March 9th, 2017

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