Know what’s an even better deal than new biologic drugs? Over-the-counter (OTC) drugs. If the FDA had a policy to seek out drugs that are safe enough for patients to self-administer and move them OTC Americans would save on drug prices and doctor visits. This should be the policy whether the patent holders like it or not. Of course, most would be off-patent by the time there is enough history to deem them safe enough for self-medication.
Thanks for posting the Obamacare’s Not Working website. There are a lot of good observations in the collected articles.
Sometimes the author does take a wide swing and tends to over-simplify problems. He pounds hard on the increasing premiums of Obamacare, for example. The hard fact is that guaranteed-issue health plans always have increasing premiums. Mark Pauly and Thomas Miller wrote a good article a few years ago on high-risk pools a few years ago that made this point in detail.
The author is appalled that persons making $200,000 a year can get subsidies. Well, the subsidy kicks in when health insurance costs more than about 8% of income. When this $200,000 family with no employer coverage faces a health insurance premium of $26,000 a year, this exceeds 8% of income and triggers a subsidy of about $10,000.
This hypothetical family may have health conditions, so short term insurance is not an option.
I don’t have a perfect solution, but a federal subsidy in this case is understandable.
John Goodman has been a strong, fact-based critic of Obamacare since before it was passed. In recounting its flaws, however, he and many others focus on fake goals rather than real goals. Marketplace plans were sold to the public as insurance products that would revitalize the individual market for health insurance. This was always unlikely, and by this standard, they have certainly failed. However, growing actuarially sound insurance products was not the real goal underlying passage of the ACA. Many of the architects of the legislation designed these plans to be a transition to universal taxpayer-supported health insurance. If you accept this as the real goal of Obamacare, it has been pretty successful. In 2020, over 80% of Exchange enrollees were getting some level of federal subsidy, and the federal government’s cost per enrollee was about $5,800 per member, more than the cost of Medicaid. Federal projections show total enrollment flat or declining through 2030, but the subsidy per enrollee is expected to grow 3% per year, to $8,600 by 2030. As this subsidy grows and employer-sponsored insurance becomes more and more expensive (because employers are cross-subsidizing Medicare and Medicaid), the pressure will build on small businesses to drop employer-sponsored health insurance and tell their employees to purchase coverage on the exchange. As a vehicle for growing taxpayer-supported healthcare, this may not be as efficient as increasing the eligibility thresholds for Medicaid enrollees, but every little bit helps.
Know what’s an even better deal than new biologic drugs? Over-the-counter (OTC) drugs. If the FDA had a policy to seek out drugs that are safe enough for patients to self-administer and move them OTC Americans would save on drug prices and doctor visits. This should be the policy whether the patent holders like it or not. Of course, most would be off-patent by the time there is enough history to deem them safe enough for self-medication.
Thanks for posting the Obamacare’s Not Working website. There are a lot of good observations in the collected articles.
Sometimes the author does take a wide swing and tends to over-simplify problems. He pounds hard on the increasing premiums of Obamacare, for example. The hard fact is that guaranteed-issue health plans always have increasing premiums. Mark Pauly and Thomas Miller wrote a good article a few years ago on high-risk pools a few years ago that made this point in detail.
The author is appalled that persons making $200,000 a year can get subsidies. Well, the subsidy kicks in when health insurance costs more than about 8% of income. When this $200,000 family with no employer coverage faces a health insurance premium of $26,000 a year, this exceeds 8% of income and triggers a subsidy of about $10,000.
This hypothetical family may have health conditions, so short term insurance is not an option.
I don’t have a perfect solution, but a federal subsidy in this case is understandable.
John Goodman has been a strong, fact-based critic of Obamacare since before it was passed. In recounting its flaws, however, he and many others focus on fake goals rather than real goals. Marketplace plans were sold to the public as insurance products that would revitalize the individual market for health insurance. This was always unlikely, and by this standard, they have certainly failed. However, growing actuarially sound insurance products was not the real goal underlying passage of the ACA. Many of the architects of the legislation designed these plans to be a transition to universal taxpayer-supported health insurance. If you accept this as the real goal of Obamacare, it has been pretty successful. In 2020, over 80% of Exchange enrollees were getting some level of federal subsidy, and the federal government’s cost per enrollee was about $5,800 per member, more than the cost of Medicaid. Federal projections show total enrollment flat or declining through 2030, but the subsidy per enrollee is expected to grow 3% per year, to $8,600 by 2030. As this subsidy grows and employer-sponsored insurance becomes more and more expensive (because employers are cross-subsidizing Medicare and Medicaid), the pressure will build on small businesses to drop employer-sponsored health insurance and tell their employees to purchase coverage on the exchange. As a vehicle for growing taxpayer-supported healthcare, this may not be as efficient as increasing the eligibility thresholds for Medicaid enrollees, but every little bit helps.