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The Trump Health Care Disaster

Category: Health Care
Posted: 10/13/17 12:09

by Dave Mindeman

Who is most affected by Trump's decision to suspend ACA subsidies....

States with the highest average monthly tax credit for premiums:

AK - NC -WV - OK - AZ - TN - AL - NE - WY - CT - SD - MN - LA - PA - SC

If it looks a little red to you, you are right. 13 of 15 are Trump states.

States with total dollars received from ACA premium credits:

FL -CA -TX -NC -VA -PA - GA - IL - MI - NJ - MO - WI - TN - MA - OH

Again, fairly red. Ten of top fifteen are Trump states.

Total number of people receiving tax credits by state:

FL - CA - TX - NC - GA - PA - IL - TN - VA - MO -AL - WI - SC - NJ - AZ

Red again. Eleven of top 15 are Trump states.

It is worth noting that New York does not appear on any of the top 15 lists even though they are a high population state. While North Carolina is in the top five for all three. Minnesota will get hurt disproportionately because they have had one of the highest average credits and in addition, MinnesotaCare will take a big hit as well.

This is a direct assault on the poor. It takes a system that was working with a few problems...to a system that gets completely unraveled.

Trump is destroying our health care system singlehandedly.

And Congress, once again, stands by and watches.
comments (1) permalink
Ford
10/13/17 18:38
Busted since WWII...

Dave, while I can only admire your attempt to push blame on our current President, the truth is this has been broken since the 1940s. Some basic history is in order...

Employer provided healthcare has been around since the Post WWII wage and price controls. Near riots demanding higher wages delivered a concession to labor that said employer provided healthcare was exempt from the artificial controls on inflation. The practice became near universal by the mid-1960s when this relatively inexpensive employee benefit was demanded by all. After all, very sick people don't work. Healthy people work. So covering healthy people was a pretty cheap benefit.

The ACA coverage limits (or lack of limits) creates, in effect, a tax on healthcare to facilitate premium sharing between healthy working people with the (largely) non working sick. The ritual of involving the employer in this process is really quite stupid.

Some experts (Zane Benefits for one) in the industry are predicting that 60% of the population will be in the individual market by 2025. Wow! Small employers are giving up--and big employers will exit at first opportunity.

In part, the actuarial facts buried in the ACA is that companies (largely healthy people) can now self-insure and effectively isolate their overhead from the general public, which is disproportionately sicker.

The smart money is advocating doing with health care exactly what they did with retirement plans years ago. Although public unions have managed to maintain defined benefit plans, the rest of the population is stuck in the defined contribution model (IRA, 401K, etc). The model is textbook strategy for modern healthcare.

Essentially 60% of the public will get a credit of some sort from their employer to go out and buy their own insurance plan. It may take the form of what we come to know as "Flex Spending" accounts. Expect to see associations develop that allow people to share risk with others. There are, after all, many ways to finance health care needs. Expect to see the ability for the employer and employee to enter into an agreement to "Flex" their wages to pay for their premiums.

America has thrived in an environment where people are allowed (and expected) to choose a path that optimizes their ability to satisfy their own needs. Insurance is one way to finance their needs and minimize their risk of significant losses due to health emergencies--if reasonably priced, a smart way to do it. If said premium is loaded with (essentially) a burdensome tax (additional needless premium) then other methods exist to assist minimizing the financing costs. Expect to see memberships in association that are contractually obligated to care for you and your family. Expect to see associations that share a similar risk pool.

There will always be a role for welfare...a suitable safety net to protect our health care providers...yes providers...from significant losses. There will always be a role for charity as well. The socialized medicine approach eliminates the need for charity, which is a shameful public approach as a matter of policy.
 

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