What are the worst things about Obamacare

US healthcare reform : Obamacare: Always the same mistakes

People find it difficult to learn from their own mistakes. They learn from the mistakes of others even less often. The Republicans were masters at opposing Obama's health care reform. Now they want to wind it up, but run the risk of failing - because they don't want to learn from Obama's mishaps.

The basic idea is popular, the concrete reform is not

The basic problem for Obama was in 2009 and is now for Republicans: the idea they put forward - Obama for universal health insurance, Republicans for cost reduction - has widespread support. However, as soon as a specific bill is available, a majority is suddenly against it. Because in addition to the people who reject the proposal on principle, there are those who want more than what is proposed in the draft, as well as those who want less.

In 2009, many citizens and politicians were in favor of every American having health insurance. However, when Obama presented his bill on how this could be achieved in practice, it became a majority against it. In 2017 the basic idea is that the health insurance that actually exists has become too expensive as a result of Obama's reform; so a majority supports the Republicans' plan to at least partially wind them down. But as soon as it becomes known what exactly is to be abolished, a majority is against the reform of the reform.

Just no compulsion! But it's also not voluntary

Major opponents of the Obama reform in 2009 included those who generally opposed the state requiring its citizens to take out health insurance; they should do this voluntarily. But how do you get the young and healthy into the system who calculate that they will drive cheaper without insurance?

Others feared that the reform would cost too much and that insurance premiums would rise. That's how it turned out. Not all insurers, but many used the reform to raise their premiums sharply. And not all companies and citizens are flexible enough to react with a change of insurance so that the competition on the market has a cost-cutting effect.

Obama's calculation: Citizens will learn to appreciate the benefits

Obama was betting on a long-term effect: even if his reform was initially unpopular, the Americans would slowly come to appreciate its practical advantages. Three things are particularly popular with citizens: First, parents can now insure their children in education up to the age of 26 through their contract. Second, the so-called "preexisting condition" has been abolished. This clause stated that an illness that was already known when the contract was signed is not included in the insurance. For example, if a woman with health insurance was diagnosed with breast cancer at 52, she could no longer change jobs or move to another state. Because then she would have had to take out new insurance; and the cancer would no longer have been insured because it was already known. This clause was banned by Obama's reform.

Third, the "Lifetime Maximum" has been abolished. This clause stated that an insurance company would have to pay a maximum of $ 1.5 million for an insured person over the course of their life. After that it is no longer even for the insured. That too was banned by Obamacare.

The fourth was added: Obama's reform gave the individual states money for the health care of the socially disadvantaged who cannot afford adequate insurance from their own resources and who fall under the "Medicaid" emergency program. This relief is good for the individual states. Some republican-ruled states do not want to abolish this provision either.

The Republicans promise: it will be cheaper

In 2017 Republicans say: Obamacare has increased the contribution burden. The liquidation of Obamacare will make things cheaper and better at the same time. This promise is popular. But to cut costs, Republicans would also need to access the popular elements of the reform. They don't want that.

The proposal that the Republicans brought to Congress on Tuesday night cannot resolve these contradictions. On the one hand, the penalties for the uninsured, with which Obama wanted all citizens to take out insurance, will be abolished. Now they are cheering: the compulsion is gone. But since Republicans also understand that they have to offer the young and healthy an incentive (or threaten with a penalty) in order for them to insure themselves, they are reintroducing the penalty in a different form: Insurance companies are allowed to apply to those who are underinsured, 30 Request percent surcharge.

The reform of the reform is full of contradictions

The popular elements of Obamacare are retained: Co-insurance of children in education up to the age of 26 and the abolition of the "preexisting condition". The Republicans do not say how they will then achieve the promised savings.

In place of the direct grants for low-wage earners so that they can afford health insurance, there are tax deduction options. But they are of little use to low-wage earners, as they hardly pay any taxes. The bottom line is that millions who got health insurance for the first time through Obama will fall out of the system again. The same is true of the ten million Americans who received basic health care through federal government grants for Medicaid in the states.

Republican Senators reject the draft

What the Republicans are proposing is sham. That is why public as well as political support for their reform is in question.

In the House of Representatives, the Republicans may find a majority in favor of "Repeal and Replace": their project to replace Obamacare with this new health care reform. But in the Senate, which is also subject to approval, there is currently no foreseeable majority in favor. Republicans make up 52 of the 100 senators. Four of them have announced written concerns because citizens of their states are losing coverage: Rob Portman from Ohio, Shelley Moore Capito from West Virginia, Cory Gardner from Colorado and Lisa Murkowski from Alaska.

Three other senators object because the reform bill does not go far enough and differs too little from Obama's approach: Mike Lee from Utah, Rand Paul from Kentucky and Ted Cruz from Texas. "We don't want Obamacare-Lite," they write.

Obama had brought his health care reform through Congress with a bang and with the help of rules of procedure tricks. Corrections, which already seemed necessary at that time, were omitted in the legislative process because the reform would then never have come about. The Republicans have brought a poorly prepared reform of reform into Congress, which their party has not supported from the start. They refuse to learn from Obama's mishaps. Nothing good can come of it.

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