voyager-doctor
 
Republicans don’t want to repeal all of Obamacare, only portions of the bill. Specifically, the individual mandate. While I personally believe that forcing the public to buy any product is a disgusting overreach of government authority, it is the lynch pin that holds the whole thing together.
 
Obamacare is not an insurance program, it is a subsidy program for the sick and elderly. Insurance is something you buy to protect you against future damages, not to fix something that is already broken. You can’t hit a deer with your car and sign up for insurance the next day and expect them to fix it for you.
 
If we are going to subsidize individuals who can’t afford their medical costs, then we should do it directly, ideally through charities. Instead, we have Obamacare, which forces companies to subsidize people who are already sick. They are not allowed to charge these people high premiums, and all plans have to meet a minimum standard of care.
 
Most of the people who want Obamacare are a net loss for insurance companies. They pay out more than they collect in premiums. Because there are so many of these people, and the insurance companies can only increase their premiums so much, they have to pass the cost on to other, healthier customers.
 
The individual mandate forced young healthy people onto the insurance rolls, and into much more expensive plans than they would normally buy. Most people my age just want a catastrophic plan. In this way, Obamacare transfered wealth from a lower income group (the young) to a more wealthy group (the old).
 
If companies are still forced to cover pre-existing conditions, but there is no individual mandate, people will drop their insurance coverage. With fewer young healthy people on the insurance rolls, the cost of caring for the old and sick will be spread among fewer people. Each individual will have a bigger burden, and their premiums will rise.
 
So what is the solution? Repeal the whole bill, and address the problems that actually lead to high health care costs. One of the unintended positive consequences of Obamacare has been the rise of direct primary care “cash clinics” and medical cost sharing services. These are more like “the good ‘ol days” before health care became a massive bureaucracy. Some of these clinics only offer basic services, but some offer more advanced care, even chemotherapy.
 
“An unpublished study performed by the University of North Carolina School of Medicine and North Carolina State University MBA students demonstrated that the group’s DPC patients spend 85% less out of pocket for their total cost of care compared with the same level and amount of care in a traditional setting. Patients receive an average of 35 minutes per visit (compared with 8 minutes in the traditional model).20”
 

http://www.jabfm.org/content/28/6/793.full