There's an article out today by liberal super-apologist Krugman, where he says Trump will end at least 5 million of his own supporters' health insurance. Apparently the fact of ending Obamacare equates to ending health care as a whole, is the way he thinks: without "Obamacare" millions of people with pre-existing conditions wouldn't be covered, and the only way to cover them is to force healthy people to buy into insurance markets, as well as provide government subsidies, is how he thinks.
I'll break this down: health insurance companies are scamming the health care system. We don't need "insurance", for the simple reason that all the money currently paid to insurance companies could be paid directly into the healthcare system with no loss and tremendous gain since the obscene profits of insurance companies would be removed. Health insurance companies are a drain and Middle man in the system. They also limit care, restrict access, game markets, and charge up prices, in addition to extracting from the overall healthcare system and for themselves huge profits.
So just disslove the health insurance companies and then take all that money currently paid to health insurance in the form of premiums and split it as follows: 50% goes back to the individual into a healthcare account they can use whenever they need to go to the doctor, and 50% goes into a government fund marked for providing subsidies as needed to people without jobs or with jobs that don't give benefits, or people who are quite poor or have severe enough medical problems that outpace by significant margin the size of their respective healthcare accounts. Then you also remove barriers to health care access and portability, price gouging and lack of competition and lack of transparency, when you throw out the insurance companies.
Bingo, problem solved.
My healthcare premiums in my modest job are around $300 a month, or so, but my employer pays even more. I think the employee pays around $500 a month for me to be insured. So if we go with a plan to dissolve insurance companies and take all that premium money and split it up as I outline above, I would get an annual healthcare account with about $4800 in it, and another $4800 would go into a government account similar to Medicaid (it could just be used to bolster Medicaid directly and expand it).
That's plenty of money. Now, we can retain a small form of insurance for emergencies only, and this could be administered by the government or even by health care systems themselves. Let's say 1 person in 5,000 needs an emergency hospital visit once a year that totals way more than they can pay, let's say average $40,000. Breaking down the numbers:
$40,000/5000= $8 per person per year
Hell, let's up the ante and say one person out of 3000 needs these services twice a year on average and the average emergency hospital stay costs $60,000:
$60,000/3000= $20, x2 for twice a year = $40
So everyone would need to contribute $40 a year into a basic minimal insurance pool, that would cover huge emergency needs only. That amount can just be siphoned off the $4800 a year that I and my employer send to Medicaid.
Now we introduce tiers of healthcare accounts, give people choice how much percentage of their income they want to put toward it. Hell, just let them pic whatever percent they want, like investing in retirement. $40,000 annual salary with a 5% contribution to health care = $2000. Employee marches and were at $4000 a year contributions, half of which I keep and half of which goes into Medicaid. (The ratio can be tweaked of course).
So now we have a four stage system for helping pay for health care:
1) I have a healthcare account with $2000 in it.
2) I can pay out of pocket like any other purchase if I need more healthcare in a year than $2000.
3) I can get Medicaid expanded subsidies if the ratio of my healthcare costs past my healthcare account hits a certain limit of my total income, with progressively increasing subsidies based on income.
4) If I have a suddenly medical crisis and need an emergency room I can draw from the small insurance pool that covers up to $60,000 of costs.
Seems doable to me. And this sort of setup without the insurance companies and all their fuckery would return sane competition and free market into health care, since you could go to any clinic or hospital you want, so they would all be competing for your business and thus have downward pressure on prices. One important point Trump could also help with would be to pass a law forcing health care systems or providers of any kind to display their prices for all products and services before a consumer buys it. Just like any other product or service, you have a right to know what it costs before you buy it.
This is why super-liberals like Krugman are so goddamn irritatingly stupid. They apparently can't come up with anything remotely like this by themselves, and they resist any new ideas beyond their own little pet ideological suckup fuckfest orgy of special interests and politically correct fidelities.
Yeah that's right I just solved America's health care problem. Someone write this up and email it to Trump. Seriously.
Looking at the idea of a basic for emergencies only insurance pool run either by Medicaid or by health systems: this is insane man, we can fucking cover all this shit so easily without the insurance companies:
Upping the ante even more:
Let's say one person in every 1000 needs two emergency room visits a year, each visit costing $100,000. This seems like a very high estimate, but im doing that to prove how doable this is:
$100,000x2= $200,000 a years ER visit cost per 1000 people.
$200,000/1000= $200 a year per person
$200/12= $16.66 per month
So: everyone has $16.60 a month siphoned off their Medicaid contribution amount to fund the emergency only, small insurance pool. Even with the most liberal estimates we only need $16.66 a month to make it work. This covers almost all emergencies, which are part of the massive cost of health care already. And we could have a guideline of "the 5% rule" where it's recommended to put 5% of income into the healthcare accounts, which is way less than the percentage of premiums that we currently pay. My percentage of income I pay to just premiums right now is over 15%, and that doesn't even cover actual healthcare costs if I see a doctor. If I did a 5% plan plus $16.66 a month for the emergency insurance pool, I would pay around $116.66 a month. And most of that is actual money going into an account that I can use on health care when I need it.
And the best part is there is a built in incentive to not overuse health care, because if you have leftover money in your healthcare account you get to get it back in a check as a bonus you pay to yourself a time the end of the year, for being healthy. It's already your money after all.
Eventually health care costs would also go down a lot just by market freedom, and in addition Trump can make some deals with health systems and pharma to get them to reduce costs even more.