Privatized plans offer less choice

ACA Republican Replacement Plan

canada goose outlet boston The recent first step by the Republicans for repeal of the ACA (by a vote of 51 48 in the Senate and 227 198 in the House) (1) opens up an intense debate among Republicans as to how and when to replace it. President elect Donald Trump is pressing Congress to replace it concurrently, or nearly so, with its actual repeal, with which House Speaker Paul Ryan Canada Goose Parka now seems to agree. Recent talk of a two to four year delay is quickly fading away. Having embarked on the budget reconciliation process, the GOP can expect to pass repeal with just canada goose black friday sale a bare majority vote in Congress, thereby avoiding filibuster by Democrats, but knows it will need 60 votes in the Senate to pass any real replacement package, thus requiring uk canada goose outlet some help from the Democrats. canada goose outlet boston

canada goose outlet woodbury Some say the GOP still has no replacement plan, after almost seven years contesting the ACA, But they actually have published their principles, and have somewhat similar competing plans on the shelf, with some variation as to details. Republicans now realize the political dangers of a two to four year delay after repeal, and are Canada Goose Jackets now trying to gain consensus among these plans as two House committees report out by the end of this month. The question of Tom Price’s role in the outcome lingers as his committee hearings canada goose clearance are delayed Canada Goose sale into February, when we will learn if he is to be confirmed as incoming head of canada goose coats on sale the Department of Health and Human Services (DHHS). canada goose outlet woodbury

canada goose outlet store quebec In the meantime, Canada Goose online we already know a lot Canada Goose Online about what to expect in the final Republican post ACA replacement plan. First, these are the principles upon which it will be based: canada goose outlet store quebec

canada goose outlet usa States, not the federal government, should have primary responsibility for health policy; canada goose outlet usa

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canada goose uk site Small business should have more discretion and flexibility to configure health benefits for their employees. (2 canada goose uk site

canada goose outlet edmonton Released last summer, Paul Ryan’s 37 page white paper, A Better Way, includes continuation of consumer directed health care (CDHC) (with patients having “more skin in the game”), health savings accounts, high risk pools, selling insurance across state lines, association health plans among businesses, and further privatization of Medicare and Medicaid (3) Tom Price (R GA), as leader of the House Budget Committee, proposed in 2015 the complete repeal of the ACA, as well as privatization of canada goose store Medicare, sharp cuts in Medicaid funding, and defunding of Planned Parenthood. (4) canada goose outlet edmonton

canada goose clothing uk The problem with all of these proposals is they won’t work. Each of these directions has been used for years, and have all failed to assure Americans with better access to affordable health care. They have been discredited by long experience. Here are four fatal flaws to these proposals: canada goose clothing uk

canada goose parka outlet Market failure. Like the ACA, any of their replacement plans are still based mainly on canada goose coats the private canada goose uk outlet for profit market place. Insurers, the drug industry, and other parts cheap canada goose uk of the medical industrial complex, including their shareholders, have enjoyed bonanza years on Wall Street under the ACA without any significant cost containment. Most people are unaware of how extremely privatized and for profit the current health care system is, as these examples show: free standing laboratory and canadian goose jacket imaging centers (100 %), surgical centers (95 %), dialysis centers (90 %), home care (76 %), nursing homes (65 %), and hospice (63 %) (1) (2016 Annual Survey by the Commerce Department or most recent available data for share of establishments.) Instead of increased competition, we have seen increasing Canada Goose Coats On Sale consolidation and less competition under the Canada Goose Outlet ACA. canada goose parka outlet

canada goose outlet in chicago Failure to learn from past canada goose uk black friday failed health care policies. Republicans conveniently forget that the ACA was modeled on a health plan brought forward by the Heritage Foundation and enacted as the Massachusetts Health Plan by Governor Romney in 2006. Three years later, a study comparing safety net hospitals with non safety net hospitals found that the former played a disproportionately large role in caring for disadvantaged patients and were hurting financially. (5) Many reasons canadagooseuk.net for the ACA’s failure have been discussed elsewhere, including its reliance on a failing multi payer financing system with some 1,300 private insurers, mostly dedicated to profits rather than coverage of patients’ health needs. How they continue to discriminate against the sick, profiteer, and inflate their overhead has been described elsewhere, to the point where the industry is not sustainable without taxpayer support. (6) canada goose outlet in chicago

canada goose outlet new york Further canada goose privatization. Contrary to experience, evidence and GOP ideology, privatization is less competitive, less efficient, and canada goose uk shop more expensive for patients than the public sector, as already demonstrated by private Medicare and Medicaid plans. Privatized plans offer less choice, are more volatile and less accountable than their public counterparts. more than173 billion to Medicare Advantage between 2008 and 2016 (7) All that amounts to corporate welfare at taxpayer expense. canada goose outlet new york

canada goose jacket outlet store Dependence on larger role of states. There are already wide variations in states’ definitions of eligibility and coverage, which are likely to increase further as more restrictive federal block grants to states become widespread. Safety net resources will be hit hard, seriously impacting the most vulnerable among us. canada goose jacket outlet store

canada goose outlet london The GOP is taking us over a cliff, not yet realizing it may well be political suicide for the party. www.canadagooseuk.net We can expect that any GOP replacement plan will cost patients, families, and taxpayers more, and that canada goose clearance sale we will all get less. This is all so foolish since there is a real buy canada goose jacket cheap solution in plain sight single payer national health insurance (NHI) if Republicans were not so blinded by ideology and unaware of the failed policies already proven cheap Canada Goose by the last 25 plus years’ experience, including those of the ACA, much of which are still baked into canada goose factory sale their supposed “better way.” They also seem to be unaware of the most recent public polls strongly favoring NHI, regardless of political party. As just one example, a Gallup poll in May 2016 found that 41 percent of Republicans and leaners favored replacing the ACA with NHI. (8) canada goose outlet london

canada goose jacket outlet sale Defying experience and reason, we can anticipate that the GOP’s principles and approaches will make an imploding ACA system even worse. We can then expect a huge backlash from the public and even the private insurance industry when it doesn’t get all that it wants. Reality and What Comes Next and uk canada goose How Obamacare is Unsustainable: Why We Need a Single Payer Solution For All AmericansMohan, A, Grant, J, Batalden, M et al. The health of safety net hospitals following Massachusetts health care reform: buy canada goose jacket Changes in volume, revenue, costs, and operating margins from 2006 to 2009 canada goose jacket outlet sale.

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