tag:blogger.com,1999:blog-10833510.post641361717471032178..comments2023-09-27T01:44:56.585-07:00Comments on Clark County Politics: Its a tough day to be a GOP Congressman... or Congresswoman.Unknownnoreply@blogger.comBlogger1125tag:blogger.com,1999:blog-10833510.post-40417626168287544552017-03-23T17:36:30.671-07:002017-03-23T17:36:30.671-07:00The most practical solution is to cut out the taxe...The most practical solution is to cut out the taxes and mandates in Obamacare ... and set an ending date 2 to 3 years in the future. Let Obamacare die of it's own weight (with its existing rules). No one who "likes" Obamacare would be "forced" to leave it, at least without 3 years of notice. <br /><br />At the same time (the replace) is to establish a true, free market in health insurance. Let those who qualify for for whatever policy they desire to buy the coverage they want. For those who have pre-existing conditions, set up "assigned risk pools" much like is done in many states for bad drivers for auto insurance. Subsidies can be established for those who have medical expenses beyond some threshold (such as $30,000 per year or (better) a sliding scale based on family income). <br /><br />Finally, to get rid of the disadvantage of the individual policy holder vs. those covered by "company group plans" by adding a line on page 1 of the 1040 that allows the total cost of individual insurance to be deducted from gross income before the Adjusted Gross Income is calculated. (That is the same deal that workers get from company-paid plans...) <br /><br />If in their wisdom, the elected folks think we can't afford the "tax expenditure" that would involve --- THEN make company paid insurance plans taxable as income to those covered by such plans. That would also balance the two systems -- AND it would make recipients of company paid group health plans actually take a look at the benefits they're being given and to decide if it is worthwhile to have a highly comprehensive plan that might increase their taxes more than they might prefer. (This would also have the impact of reducing demand for health services that previously appeared to be "free.") <br /><br />Finally, create a rule that workers, who previously had an individual plan can keep it even if they qualify for a company paid plan ... and encourage the company to give the employee in that situation additional pay equal to the amount the company would have paid for their health insurance. Ultimately, we'd likely see a movement away from one-size-fits-all group plans and instead would find a robust individual plan market develop. <br /><br />Finally, for those under age 30, establish a rule that those who begin coverage on individual plans (before age 30) and who maintain such coverage for 3 years, (with no gap greater than a total of 90 days), then the insurance companies should allow continued coverage (or transfer to a different company/policy) without regard to pre-existing conditions. That will encourage people to begin some level of coverage early in their working career, and then continue it over time. <br /><br />Of course various "protections" for older individual policy holders might be necessary during the transition to a true free market in insurance coverage and medical care. <br /><br />For medical care, it is necessary to eliminate the "public necessity" type requirements for building hospitals or acquiring major diagnostic equipment (such as MRI machines). Currently, governments (at various levels) interfere in the market for insurance and medical carer AND they interfere in the supply of medical services. (e.g. a group of doctors try to set up a cancer clinic, but are restricted from owning such a clinic -- or from owing a pharmacy associated with such a clinic. Finally, hospitals and doctors should be required to post "list prices" of their various services, so comparisons can be made. It may be necessary for some public or private entity to create a "standard set of definitions of each service that is priced." (e.g. a cataract surgery should spell out if an implant lens is or is not included, and if it is included, what its cost is relative to the total price.)Anonymoushttps://www.blogger.com/profile/12570014965381941530noreply@blogger.com