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Obamacare Finally Dead? 3 Steps Trump Could Take to Make Healthcare Prices Go Down

Obamacare Finally Dead? 3 Steps Trump Could Take to Make Healthcare Prices Go Down

Last week U.S. District Judge Reed O’Connor declared that without the “tax” (disposed of by the Trump administration) the Affordable Care Act, i.e., Obamacare, is unconstitutional. While there is much speculation on how this will play out, it means that all or at least part of the law will be struck down.

This is NOT some trivial suit from some backwater court; this suit was brought by Republican Officials from 20 states led by Texas Attorney General Ken Paxton. This has some real teeth to it.

Anyone who lived through the last election knows there is little chance that Congress will come together to pass anything regarding healthcare.  So how do we proceed?

I believe Trump could fix this through executive action. By that I mean he could pass measures to send prices downward and make America MUCH healthier.

What would it take? A single principle is involved here.

“Prices go down when consumers can buy goods and services in a competitive market based on price and quality.”

Sounds simple right? But NO!

In the current environment, insurance companies and employers separate consumers from the services they buy. You see the result; health costs are spiraling out of control. The patients don’t like it, but then again the patients don’t see the costs directly, they only see insurance rates double every five years. Doctors and insurance companies love it, and have no incentives for change.

How to fix this

1.  Let’s get the consumer closer to the product. A brilliant move from the Trump administration earlier this year, allows small companies to reimburse employees for healthcare that they buy themselves. Hmmm, besides making small companies more competitive, this gets the employer out of the loop right? Once step closer to direct interaction between the consumer and the service provider.

But let’s go a bit further, let’s modify the existing Health Savings Account process, such that business can contribute to this and let employees buy their own insurance from this tax-free account. This means millions of individuals are making choices instead of much fewer employers. In other words, companies should not buy insurance, companies should support individuals in buying their own.

Now the cute part. We can even incentivize good management of these funds by saying if all of your health insurance and deductibles are covered, maybe you can use the remainder of these tax-free funds for your health club, or perhaps an occasional massage. Get the picture? That’s personal management of your own health care — EVERY doctor and psychologist knows that more attention means better health. If you want a GUARANTEED improvement in America’s health, stop trying to take care of all of these people, and enable them to take care of themselves.

2. Let’s separate “insurance” from “maintenance. Insurance is a statistical process that protects you against health problems that are not likely to happen. Maintenance is stuff like checkups, flu shots, stitches for kids, etc., that you know are going to happen, and you have to pay for them no matter what. For some reason, people believe that if their insurance company foots the bill that these are free services. Nothing could be further from the truth.

Insurance companies charge a 40% premium on services. Do you really want to pay for that? If you want a time payment plan for maintenance, why not do this directly with your doctor? It would be cheaper and you could shop around for the best deal. In a free enterprise system, this means prices go down. Buy insurance separately as an insurance product.

Insurance companies love to bundle because it increases their revenue. The more expensive the services, the more they make. So there is never an incentive for prices to go down.

3. Let’s take some of the complexity out of it. Suppose the U.S. Government were to make a “template” of good insurance plan types, the kind that any person would feel secure in having. We don’t wish to force these plans on insurance companies, but we should require them to provide a document that states, clearly, the difference between their plan and the closest USG insurance template.

This provides three nice benefits. First, the USG absorbs the complexity. Since you are only shopping based on differences, knowing that you are getting the right coverage becomes a lot simpler. It’s no longer a mass of uncertainty and gobbledygook that is impossible to comprehend, it’s now a trusted base plan vetted by the USG, plus a short list of differences.

Second, this allows insurance companies to start removing coverage that is not needed. For example, if you are not a traveler and don’t need to be insured against the Tibetan Croup or Somalian Malaria, then maybe your insurance can be cheaper.

Third, since the insurance company has to compare with the USG template, anything not in the exceptions list defaults to the USG template. That means litigation becomes much simpler and cheaper since the bulk of the legal interpretation is on the USG template which is in common to most plans, rather than on a squirrely insurance contract. Think how many lawsuits will not happen or be resolved with clear and basic arguments.  How much money will THAT save!

There are a great many other things that would obviously help bring prices down, for example, the ability to buy insurance across state lines,  or “X-prize” incentives for technologies that reduce health costs, etc.  But the structure has to be right before pressure on costs is downward, instead of upward.

I wrote a book about how to fix healthcare a while back, which you can read here. (Be advised, some of this has been overtaken by events.)  Have a look:

The Opposite of Obamacare

About The Author


  1. Fredrich Clarkson

    You’re forgetting one important factor. LAW SUITS. The number one reason healthcare is so expensive is doctors have to pay huge insurance premiums to protect themselves from blood thirsty lawyers. Let’s pass a law that makes you sign a waiver. If you want to be treated, you agree to take the risk yourself. You cannot sue the doctor, hospital, or drug maker. Healthcare costs would plummet.

    • Joe Gilbertson

      I mentioned that, just in passing. Imagine if you could go online to a government site and say “I have such and such condition, am I covered”. The government site says yes, your list of exceptions doesn’t mention it, so there is no doubt that you are covered. So fewer lawsuits about what is and is not covered. As for doctors, sometimes they truly screw up. But we do need to manage expectations and risk better. I agree we need a disclaimer for when a procedure is risky.

  2. Yadja

    The Constitution does not say any citizen is to be given healthcare or education. We know that government education is nothing but indoctrination and what makes people think that having government insurance is going to work? Get the government out of our insurance, open up competition and allow people to get insurance that fits their pocket books and needs.

    Trump needs to say that and get out of the insurance business.

  3. David Sharp

    The removal of the Commerce Act would allow the across State line competition and make insurers have to compete. That is an excellent concept. Obama Care was the same model which failed in England and Canada. The problem I see is this entire “Triad” of Medical-Pharma-Legal conspiracy began with Hillary in the early 1990s, and, the Clinton Dynasty has been making quite a profit off of it so others in Congress must also be participating in the manufacturing. Lot’s of money is going to be hard to turn and individuals must take charge of themselves. I wish much luck to Pres. Trump and hope his policies succeed.

    • Craig Michael Vandertie

      That is the same reason why our government has been working against competition in the business community for decades because the wealthiest businesses lobby for laws that allow them to buy out all smaller less wealthy businesses and once you are the only show in town it is corporate tyranny, consider what has happened in the Broadband communications field in the case of Comcast, TWC and Charter are now defunct now Spectrum, that was not enough for them then they had to toss their hat into the 4 and 5G-LTE field, even have phones with the Spectrum name on them, the FTC, SEC, and FCC are so corrupt they make me sick to my stomach.

      My point politicians are paid to eliminate competition among businesses.

  4. Jeffrey Risden

    It all sounds good , however I’m 61 done paid into this system all my life , will since I was 15 years old I’ve been paying social security taxes and when they first started Medicare they got their very first payment from me . Now if they change it now ; how is that going to effect me my wife and millions of people my age ? During the past 20 years it has taken every dime you can earn just to survive let a lone save for a rainy day ! I know my problem for not saving right , personal responsibility even when the government has been the one screwing you or letting someone else take advantage of the American people . What health savings accounts and at the end of the year if you haven’t used the money you loose it , who in their right mind is going to put money into such an account ? However I do agree something needs to be done . Before Obamacare my daughter could buy health insurance from farm bureau insurance company for 250 a month only restrictions were she had to have her insurance in effect for a year before it would pay for a pregnancy 200 dollar deductible. Now with Obamacare the same exact insurance is 1500 dollars a month with 2000 dollar deductibles and higher co-pays and our elected officials gave us Obamacare now they are going to run single payer down our throats ! Yes something needs to be done , but what another book to make more money off of poor people trying to survive ?

    • Craig Michael Vandertie

      Just like those corrupt FISA judges you need to place partial blame for ACA on John Roberts.

  5. Guy Rivoli

    Great ideas your right Dems Aren’t going g to pass any successful legistration because they are willing to hurt this country and this president to stop him from being successful.they will obstruct forever this is why the people must join together to overcome the radical liberals.GOd bless president Trump and God bless America

    • Joe Gilbertson

      Most of this Trump can do by executive order, but they could be undone by Democrats in the years to come.

      • Craig Michael Vandertie

        Even laws can be repealed, my guess is that much of the 1952 McCarren-Walters act was rendered null and void by that Communist ideological act of the 1965 Immigration act, that evil LBJ’s and Teddy Kennedy’s brainchild to flood our nation with the most worthless people on the planet.

    • Craig Michael Vandertie

      Robert’s., but the true enemies are the way too many psychotic Progressives, how do you prevent them from voting.

      Did you not see the video of that obese ugly most likely a Dyke bitch freaking out when she found out the Hildabeast had lost?, she should have had a bullet put right between her eyes, major disgrace to the human race is what such people are.

  6. Craig Michael Vandertie

    I got completely disgusted and frustrated after reading the first possible solution that clearly applies to people still within the labor force which by the way many healthcare providers will not accept employer’s insurance plans, Shopko optical is one such place, I think Target optical will not accept employer’s insurance either, fact healthcare providers do not appreciate having to employ and train the clerical people required to fill out and submit the claims forms, if they had their way all the money they expect would be paid off a Check/Debit or Credit card, greedy people are lazy people.