Bob Laszewski on GOPCare

Eli,

I've found Bob Laszewski to be one of the more reliable commenters on health care. He isn't supportive of the GOP health care plan introduced. I always appreciate essays that have a strong opinion, started immediately and clearly. Laszewski starts out with:

It won't work.

And he doesn't get nicer.

The House Republicans are also proposing an individual health insurance market scheme that may even be worse than Obamacare itself.

As bad as the Obamacare individual mandate was for consumers––and as ineffective as it was for insurers––it did cause those not buying health insurance some pain. The Republicans now want to create a scheme that doesn't require anyone to sign up. But when they get sick enough that they need insurance, they will be able to quickly do so by paying a paltry 12-month 30% premium surcharge.

For example, a person paying $5,000 for health insurance would pay a one-time total $1,500 penalty! A family paying $10,000 in annual premium would pay only a $3,000 penalty for any late enrollment!

Obamacare is so poorly constructed it is literally an anti-selection machine. The Republican proposal is worse.

He gets to the nub of the problem with both Obamacare and GOPcare:

What the market needs to be viable are not subsidies but a market that works efficiently in the first place.

The Democrats, for reasons I don't understand, hate the market and want to remove the market from health care entirely. Despite thousands of years of evidence that markets work across geographies, cultures, industries, they have somehow come to the conclusion the markets and health care can not intermarry. Oh well. Nothing I say will convince them otherwise.

 Laszewski concludes:

The Republicans are trying to create something they can sell to enough Republicans to pass it.

What they need to create is a program that they can sell to enough consumers to make it financially viable and that will meet the needs of a consensus of voters to make it politically viable.

The amazing thing to me about Obamacare, (and pretty much every other government mandate), is the refusal to acknowledge there is a group called consumers that will, mostly, rationally evaluate their health care choices, and since they refuse to acknowledge this they create a Rube Goldberg contraption that ultimately collapses and needs to be replaced. Unfortunately the politicians fixing the collapsed machinery build on the ruined remains of the last bad plan.

What will probably happen is Medicare for all. Medicare, of course, is a financial disaster in the making. Extending a financially unsustainable plan to the entire population strikes me as irresponsible to the extreme, but who cares. My children and grandchildren will pay the bills, not me.

Bill