Alternatives to Obamacare (Part 3: Comparison of G.O.P. Plans)

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Detailed Version

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Images created March 9th and 10th, 2017

Edited on March 10th, 12th, and 13th, 2017

Alternatives to Obamacare (Part 2: A 12-Point Plan to Replace)

Abstract / Summary

      POINTS #1-5: CHANGES TO OBAMACARE: Repeal the individual and employer mandate, and other mandates. Repeal Obamacare in its totality, and replace it on the same day. Repeal the provision of Obamacare that lets people stay on their parents' insurance plans until they turn 26. Allow total state control over Medicaid and Medicare, advocating significant means-tested tax credits that are refundable for those living in poverty.

     POINTS #6-7: INCREASED ACCESSIBILITY OF INSURANCE: Expand health savings accounts. Make health insurance portable by addressing employer- and location-based discrepancies in coverage. Legalize the interstate sale and purchase of non-group and small-group health insurance. Account for the resulting need to increase policyholders' price leverage by allowing people to join into group insurance pools, including on the basis of profession or trade. De-link employment from insurance by keeping all types of health insurance taxes low, and dismantle health firms' privileges in order to curb cronyism.

      POINTS #8-12: INCREASED AFFORDABILITY OF CARE: Liberalize drug importation by reducing tariffs and patent protections. Repeal taxes on the sales and profits of medical devices to increase affordability and diminish the apparent necessity of tort reform. Repeal the Obamacare provision that prohibits denial of care on the basis of pre-existing conditions. Address the resulting pre-existing conditions coverage gap by encouraging state solutions, incentivizing free care through non-refundable tax credits, and allowing the implementation of professional consequences for breaking promises to never deny care on the basis of inability to pay.

The 12 Points

      1. REPEAL THE MANDATES: Stop playing political games, solve the issue already, and repeal all of the Obamacare mandates. Repeal the individual insurance purchase mandate, the employer-sponsored insurance purchase mandate, the minimum coverage standard mandate, and the benefit mandate in-full. Also address community regulations and the manner in which health insurance plans are categorized.

      2. FULL REPEAL, & REPLACE SAME-DAY: Repeal each of the even key provisions of the Patient Protection and Affordable Care Act. Repeal the entirety of Obamacare, and on the same day, replace the rest of Obamacare with Points #2-12.

      3. REPEAL THE 26-YEAR-OLDS PROVISION: Repeal the provision of Obamacare that requires health insurers offering family coverage to allow young people to stay on their parents' health insurance plans until they turn 26. Oppose Paul Ryan's proposed tax credits that benefit the elderly and married people, providing tax credits on a different basis.

      4. STATE MEDICAID SELF-DIRECTION: Oppose extending the expansion of Medicaid; but choose block-granting Medicaid to the states over reforming Medicaid at the national level. Allow states to reinstate Title 1 of Obamacare, and / or any other provision of the A.C.A. they wish. Allow and urge states to self-direct their own health policy and health plans. Urge states to explore private and non-profit solutions, as well as community-, worker-, and consumer-oriented solutions.

      5. STATE CONTROL AND TAX CREDITS: Allow states to choose whether to replace their Obamacare subsidies to extend Medicaid with state-level tax credits. Urge states to consider means-tested tax credits – deductions for health insurance premium expenses, as well as care-related expenses - refundable up to $5,000 annually for people who are living below the poverty level, regardless of whether they work, earn income, or are required to pay taxes, and regardless of their age or marital status. Federal and state poverty levels should also be raised significantly, so that refundable tax deductions may reach the lower middle class as well as the poor.

      6. EXPAND HEALTH SAVINGS ACCOUNTS: Make contributions to health savings accounts completely tax-free, and remove limits on the amount of money which can be donated to H.S.A.s. Make health savings accounts inheritable, accessible to families, and able to be rolled-over to family members. Make it possible for H.S.A.s to follow people throughout their lives, even from state to state and job to job; and allow people with H.S.A.s to enroll in lower-deductible plans.

      7. LEGALIZE INTERSTATE INSURANCE: Make health insurance portable for people who move to new states, lose their job, travel for a living, and are unemployed and non-employed. Legalize the interstate purchase and sale of small-group and non-group non-employer-sponsored health insurance, as well as small-workplace employer-sponsored insurance. Account for the resulting need to increase policyholders' price leverage by allowing people to join into group insurance pools, including on the basis of profession or trade. De-link / de-couple employment from insurance not by beginning to tax employer-sponsored insurance, but instead through lowering taxes on non-employer-sponsored insurance through means-tested refundable individual tax credits for health care and insurance expenses. Additionally, dismantle taxpayer-funded privileges and supports for health care and insurance companies, and restore the Enumerated Powers, in order to remove the temptation to pass mandates that let companies get away with high prices.

      8. LIBERALIZE DRUG IMPORTATION: Remove tariffs on, and barriers to, the importation of pharmaceutical drugs; lower importation fees will mean lower drug prices for patients. Give the Food and Drug Administration thirty days to approve Rx drugs that have been approved in other industrialized countries. Reduce the duration of time for which medication and medical device patents are enforced; this will help swiftly end prohibition on cheap knock-offs that may be safe alternatives to expensive name-brands. Oppose any and all measures which would aim to establish price transparency through compulsory means; instead, urge insurers to be more transparent about their prices and rates, and allow states to enact price transparency laws.

      9. REPEAL MEDICAL DEVICE TAXES: Repeal taxes on income, sales, etc.; replacing them with Land Value Taxation, in order to reduce tax burdens on ordinary people, including health care workers and patients. Most importantly, on hospitals that are trying to affordably purchase medical devices. Repeal taxes on the sales of medical devices and equipment, and repeal taxes on profits therefrom, in order to decrease prices. When hospitals can afford up-to-date equipment, they can diagnose diseases earlier. Oppose efforts to enact tort reform (medical malpractice reform); do not limit juries' abilities to award damages for non-medical traumas through legislative means. Instead, repeal medical device taxes, in order to help hospitals avoid medical negligence lawsuits brought on grounds that a practitioner's lack of up-to-date equipment impaired or hindered a proper diagnosis.

      10. REPEAL PRE-EXISTING CONDITIONS: Sick people primarily need care, not insurance coverage. Repeal the “consumer protections” provisions of Obamacare that prohibit health insurance companies from denying coverage on the basis of pre-existing conditions, and prohibits insurers from “overcharging” policyholders. Allow states to consider providing uninsured sick people with an 18- or 24-month transition period in which they can obtain coverage, or to consider prohibiting denial of coverage of afflictions which a health insurance customer does not already have. Don't prohibit denial of coverage; instead, increase sick people's ability to access care affordably by enacting Points #11 and #12.

      11. INCENTIVIZE FREE CARE: Health care workers don't show up at work because they look forward to denying people care; they want to do their job, and they want to help people. Allow doctors and nurses to decide whether to donate care for free, and enact non-refundable tax credits for health care workers who decide to donate care. Government doesn't get to tax or regulate a hospital if it doesn't generate any revenue. Let hospitals choose whether to operate on not-for-profit bases by refraining from charging people for, and profiting from, care. Do not subject non-profit hospitals to the same taxes and regulations that come with the territory of for-profit health care models.

      12: ADDRESS HIPPOCRATIC OATHS: If health care were free, then health insurance would be unnecessary. Make the health insurance industry obsolete, and health insurance coverage unnecessary, by allowing doctors and nurses to choose whether to submit to their Hippocratic Oaths. Urge health care network to implement guidelines that require the termination of health care workers who voluntarily vow not to withhold care on the grounds of inability to pay, but who then break their oaths by turning away people in need of treatment.

Written between March 7^th and 9^th, 2017

Edited March 10^th, 2017

Comments on the Obama-Trump Transition

Written on January 8^th, 11^th through 13^th, and 17^th and 18th, 2017

 

 

 

            On the evening of January 10^th, 2017 - the same night that Obama gave his farewell address from McCormick Place in Chicago - I attended a Steve Earle concert elsewhere in the same city.

Guitarist and vocalist Earle told the audience that he was sad to see Obama go. Earle dedicated a song to Obama, said "I don't mind the drones", and added that he thinks Hillary Clinton is smart.

I've never seen so many people pat themselves on the back for helping to elect "the first black president" as I did last night. Do they do that all the time? Have they ever stopped to consider that to call a mixed-race person "black" - when he does have white heritage - could be perceived as labeling Obama a non-white "other"?

 

            On the way out of Earle's show, I heard someone who attended the concert tell his friend that Obama dropped 26,000 bombs within some time frame or another. Remember, Barack Obama renewed the same kind of steadily increasing Israeli aid package that George W. Bush signed, expanded troop presence in 40 countries in Africa, and failed to end the wars in Iraq and Afghanistan.

            As confident as I am that Trump will destroy the lives of Palestinians (and undocumented immigrants) more than President Obama has, I'm still not sad to see Obama go. Obama's true legacy will be remembered as electing Trump, and making him look good by comparison; just as Hillary Clinton's legacy is making Nixon look good by comparison.

Obama was able to replace U.S. soldiers in Iraq with mercenaries (also called private security contractors), as well as with U.S. soldiers working for private security contracting firms. This allowed liberal media to skew the numbers about U.S. troop levels in Iraq, because the number of U.S. soldiers had technically drastically declined, while the level of total Western security agents remained more numerous than the public was aware several years into the Obama Administration.

Additionally, failed to close Guantanamo like he pledged, failed to reverse the growth of executive power and reverse the damage done to due process in the wake of 9/11. Obama didn't reverse the attack on civil liberties as he promised; he continued to detain alleged enemy combatants who were found not guilty, and his orders resulted in the deaths of American citizens abroad - adult and of minor age alike - without charges and without due process.

Barack Obama's drone strike orders have resulted in the deaths of children; in Yemen, Pakistan, Iraq, Afghanistan, and other countries. During the Obama Administration, military experts complained about the high number of civilian casualties the military was prepared to risk in order to take out medium-value targets.

 

Trump says he likes Obama, although they have some disagreements. On the health policy front, Trump has said that he wants universal health care. But he has also stated that he wants to get rid of the lines around the states, that make it impossible for people to purchase health insurance policies across state lines, even when those policies comply with the regulations of the state of the policy buyer's residence. Trump has also said that he wants to keep the provision of Obamacare that prohibits insurance companies from denying people based on pre-existing conditions.

To recap, Trump has stated a desire for universal health care, said Big Pharma is "getting away with murder", and wants to keep the Pre-Existing Conditions provision. This is not a right-wing position on health insurance; it is a welfare-warfare-statist one. So, people with pre-existing conditions, despite my objections to Trump's and Obama's shared position on this, have no fear about being denied coverage.

But to those of you who support Obama more than Trump on health: are you going to attribute every treatment you receive over the next four years to Donald Trump, the same way you did with Obama? You've heard that Trump might just keep most of Obamacare but change it slightly and call it Trumpcare, right? Obama isn't Imhotep (the Egyptian god of medicine), and Trump isn't either. Appreciate the doctors who help you; not the politicians who say they want to help you but can do nothing but get in the way.

Obamacare did as much to hurt health insurance companies and young insurance subscribers as it did to help them. It bound all citizens together into territorially determined health insurance pools, and makes a mockery of what the federal role ought to be in ensuring that free enterprise in the medical industries survives.

I don't drink alcohol, and yet I have to be in the same health insurance pool as people who drink alcohol. I have to pay for retirees and seniors who drink, to stay alive on Medicare and Social Security, while I probably won't get mine. I have to work to pay for them to live forever, when I can't even manage to convince them that living forever will soon be medically possible. So as a result, they're demanding to live forever, while insisting on living as if they're dying.

They consume diet sodas and artificial sweeteners, and sulfites in cheap subsidized pork and in wines. They drive drunk on the nice, smooth roads we have - that the alcohol sales taxes probably pay for - putting myself, themselves, and their loved ones and neighbors in danger in the process. They get to live irresponsibly, while my generation gets stuck with the bill, deprived of our entitlements, payment still forced on those who don't even want those benefits, while the Baby Boomers deride Millennials as lazy and entitled.

I did not give Baby Boomers heart disease and cancer; their ignorance and naïveté about F.D.A. standards is their own fault. They ignore what our generation has to say about food safety, they rub elbows with well-paid yes-men who tell managers who poison our foods, and they have difficulty conceiving of the way future technologies will affect the economy and regulations. I already have to listen to them give me unsolicited advice that only made sense in 1979; I shouldn't have to help take care of them.

But that's not to say I don't want to be in the same insurance pool as people with pre-existing conditions; I do, I just want to be in the same pool as sick people whom I know and trust, not people who live thousands of miles away from me, whom I will never meet.

 

I won't miss Obama, and you shouldn't either. When politicians can sweep future expenses under the rug, and delay payments to our creditors, the deficit will look smaller. All the statistics about Obama improving the budget deficit and the employment rate are deliberately distorted, and the importance of the strength of the Dow Jones to the needs of average Americans is overblown. If you don't know what Major Fiscal Exposure is – or don't know the difference between unemployment and non-employment, and how they're measured - then you've been deceived.

Labor force participation and home ownership are down since 2009, and although the deficit is the lowest it's been under Obama, it's higher than it was under Bush in 2008, and the national debt is higher than ever (having almost doubled since Obama entered office).

The dichotomy used to characterize the Obama-Trump transition has been overblown. Trump is not far-right; and Obama is not far-left. Neither of them offer a perfect world, nor anything close to it; they each only offer trade-offs. The best that either of them can do is move their food around their plate; shuffle our nation's problems around, so that the set of problems becomes 50% different every four years.

I gave Obama a chance, he failed to live up to his promises, so I won't miss him. I'll give Trump a chance, most of his promises are ridiculous so I don't care whether he lives up to his promises, he'll solve a few problems but start a whole bunch of new ones, and I won't miss him when he goes either. So I say good riddance to Barack Obama, and "don't let Mrs. o'Leary's cow set you on fire on your way out of the city".

 

It's the new year, and we have a new president. That's not to say that we're obligated to give Trump a chance, nor are we obligated to obey his orders; I will never stop believing in the rights of non-violent resistance and conscientious objection.

What we do have an obligation to do, is to be intellectually honest and responsible with the information we take in and put out. Regardless of our political affiliation, each of us has a responsibility to one another to say what we think, and to use science and research to back it up. We should also make it clear when we're only speculating about something, versus whether our conclusions are based on said research. We must also remember that we're not responsible for what other people do, based on what we state might be true (unless we intend to incite a riot with our speech).

It's time to stop mincing words. It's time to stop blowing racist dog-whistles, and stop virtue-signaling. You can't emote your way out of a rational political discussion; nor use fear about racism and xenophobia to manipulate people, without offering substantial evidence thereof.

Trump's interactions with the media, and comments on political correctness - in addition to the rising tide of throngs of students pulling fire alarms and blocking entrances to ensure that other students can't attend conferences by persons criticizing immigration or the transgender community - mean that we simply can't do that anymore. It's dishonest, it only shows that you've stooped to the level of your political rivals, and it only opens you up to criticism, which will enhance the feeling of victimization which you would not have if you bothered to do some research.

 

It is no better to be ashamed of your race (or ethnicity) for bad things that other people did, than it is to be proud of your race for the good things that other people belonging to your race did. To say otherwise is to hold millions (or billions) of people collectively guilty, or collectively responsible.

We must remember that not every action called "a terrorist attack" by media are terrorist attacks. Nor is burning down a Holocaust museum "an act of free speech". We should look at recent terror attacks, but also some historical atrocities, as crimes; committed by particular individual persons, against particular individual persons, sometimes with hatred or racism as a motivator, sometimes not.

 

We must be intellectually honest with one another. We must not shy away from using certain words that we feel are appropriate, simply because some people out there would like to intimidate us into not using them, or into using different words.

Being privileged is not bad; everybody should have privilege. It's being spoiled - and having unequal privilege (especially when the privilege is institutional, and not meritocratic) that's the problem. We must stop calling for privileged white kids to be punished more, simply because non-white, non-privileged kids are punished so harshly. Especially if it's a victimless crime, like non-violent possession and trade of illicit drugs.

As a way to diminish the disparity in sentencing across race, Barack Obama pledged to make powder cocaine and crack cocaine offenses equally punishable. He did so, not by decreasing punishments for crack cocaine, but by increasing penalties for powder cocaine. This accomplishes nothing, aside from teaching non-violent offenders how to become violent people in order to survive in prison.

Additionally, please stop saying "mansplaining" when you mean to say "condescension". There is no need to bring someone's sex into it, when you intend to call them out for being disrespectful, because they're explaining something as if the person they're talking to is stupid. Men do that, women do that. Using the word "mansplaining" is sexist. Sorry if I'm mansplaining.

Lastly, as I explained above, don't let anyone tell you which words to use, and which words not to use; including myself. Say "mansplaining" and "privileged" all you want, just don't expect me to take you as seriously as I would someone whose diction makes sense.

I guess this has just been my little way of saying "Happy New Year".
Lastly: please quit wearing shit on your lapels. I don't need to send a visible virtue-signal to prove that I'm easy to talk to. Every time I hear people bickering about whether Obama is wearing his American flag pin, or see people wearing safety pins, all I can think about is Nazi armbands and yellow stars of David. Remember, the Jews in Germany wore those stars willingly, because they chose to see being compelled to wear them as honorific. Check out a little movie from 1981 called The Wave.
I close with the immortal words of Huey Freeman (a character on Aaron McGruder's animated show The Boondocks), who said, "Act like you've got some goddamn sense, people!"

In Defense of Allowing Denial of Coverage on the Basis of Pre-Existing Conditions

Written on January 11th, 2017

Edited on January 25th, 2017

          Health insurance companies should be free to deny subscribers coverage, and raise the prices of premiums, on the basis of pre-existing medical conditions.
     It may sound inhumane to advance this position, but it only seems cruel when we forget that insurance is supposed to insure against things that haven't happened yet; it is irrational to insure against getting a disease that you already have. If you have a pre-existing condition; what you need isn't health insurance; it's health care.

Taking this position seems even more inhumane when we forget that the provision of Obamacare that opposes that pre-existing conditions policy, by design, rests (in terms of implementation) on the completely illogical Individual Insurance Purchase Mandate, which was somehow found by the majority of the Supreme Court to be the most appropriate part of Obamacare. This means that once the Mandate falls, most of the rest of Obamacare falls. Moreover, the health insurance industry might not even need to exist.

It's not necessary to compel anyone to purchase health insurance, especially with people they may not want to be in the same pool with; whether that's because they have expensive conditions, or because they're older (and therefore more prone to disease), or simply because their political values - and their ideas about what health policy should look like - are different from other subscribers'. It is not only unnecessary to compel anyone to be in the same health insurance pool as any other particular person, for whatever reason; it is a violation of our constitutionally recognized freedom of, to, and from association.

Single-payer systems and public options can be made obsolete through the focused pooling of assets into voluntary health insurance cooperative plans. This idea replaces competition-destroying monopsonies (one-buyer systems; i.e., single-payer systems) with consumer-cooperative purchasing societies; market actors that can grow as large as necessary (in terms of purchasing power) in order to affect prices in a way that obtains low premium prices for all members of the pool.

The only way to justify continuing the Pre-Existing Conditions provision of Obamacare on grounds of freeing and opening people's access to trade in health insurance, is to absurdly argue that ordering someone to purchase something, is the same thing as allowing them to purchase it.

The blatantly unconstitutional Individual Insurance Purchase Mandate flies in the face of the Fifth Amendment Takings Clause, and the Supreme Court opinion that upheld it undermines everything that a logical and fiscally responsible society ought to understand about what the difference should be between fees and fines, and between taxation and theft.

The government regulates people for refraining to engage in commerce by buying health insurance. Next it tries to address the problem of people being uninsured because they can't afford it, by requiring people to spend money they can't afford to buy the insurance. It passes this off as helping the poor.

Finally, it regulates the commerce (buying the policy) because it's commerce now, even though you wouldn't have engaged in commerce unless they ordered you to buy it. Still, you're theirs to regulate, even if they only have federal jurisdiction but you can't even buy policies from other states.

None of this is necessary. Doctors' Hippocratic Oaths include pledges to help patients regardless of their ability to pay. If Hippocratic Oaths were enforceable (whether by government, or by non-state-actor contract enforcement agencies), then doctors who agree to abide by that oath would not legally be free to decide whether to turn patients away.

If that happened, and if the parts of Obamacare that violate the Constitution were repealed, then patients wouldn't need health insurance companies. Not only that, but our supposedly caring government wouldn't even force patients to trade with health insurance companies. Without the Individual Mandate, government couldn't force us to buy from these companies; and without the Individual Mandate, there would be no need for government to force companies to accept us.

          Remember, this is the same government that is limiting people's choices about what kind of medications they can try to save their own lives, taxing profits and sales of medical devices (raising prices and increasing malpractice lawsuits in the process), and enforcing medical patents for overly lengthy time periods in order to benefit Big Pharma (which makes the problem of availability of medical devices worse).

Meanwhile, the Third World suffers from disease, and Americans aren't allowed to buy cheaper drugs that imitate the patented ones, from Canada or Mexico. Figures in liberal media that "open borders is a Koch brothers proposal" so that we won't become aware of the hazardous effects that state and national borders have on the affordability and variety of consumer goods (medications and medical devices included). There are plenty of changes to health policy that would be more appropriate than six of the seven major provisions of P.P.A.C.A..

          I oppose the Pre-Existing Conditions provision because it takes away a valuable freedom - the right of the insurance company to deny coverage - without compensating them for this takings, and without allowing individual insurance companies to refuse or opt-out. If the Supreme Court had ruled the other way, this takings would be seen as the extrajudicial theft that it constitutionally is.

            Barack Obama's signature piece of legislation was a failure and a waste of public attention and money. In my opinion, about eighty-five percent of the Patient Protection and Affordable Care Act has absolutely no constitutional or economic merit to it. I believe that it has only served to make the health care and insurance industries more complicated (both for its employees and for patients); more plagued with financial and procedural problems; and less compatible with civil liberties, due process of law, the right of private property, and a federal government that enforces strictly limited intellectual property rights laws, and obeys suggestions by the framers about what kind of taxes are permissible and why.

           We should be allowing more people to buy insurance, not forcing people to do so. If young people are allowed to stay on their parents' insurance until they're 26, that's fine, because that's freedom. It would not be freedom if they were ordered to stay on their parents' plans. For the same reason, government allowing denial of coverage is a freedom, while government forcing you to be covered by compelling you to buy, is the opposite of freedom; it is command-and-control economics.

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