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President Obama and health care in America
29 Jul 2017 (23 views)

President Obama sent a lot of effort to get Congress to pass the Affordable Care Act. The Act helped to get a few million people to be insured, but it was quite unpopular with a large section of the population. It caused many Democrat senators and representatives to lose their seat in the subsequent elections.

The Act, which is given the name of Obamacare, had many flaws. It did not help to control the inflation of medical costs. Many insurers had to increase the premium rates sharply. The consumers do not like these high increases.

A DIFFERENT APPROACH
What could Obama had done differently?

Obama made the mistake of revamping the system. It is never easy to change a system that affect tens of million people.

A better approach would be to keep the existing system of health insurance and create an alternative, low cost system to cover the uninsured people.

TKL APPROACH
Here is the alternative approach - called the TKL approach.

Prior to Obamacare, there were about 40 million uninsured people. Many were in poor health with pre-existing conditions. They were not working for a large insurer who has health insurance for their employees. 

These uninsured people neglected their health care until they became critically ill. They were treated in hospitals and the expenses were mainly charged to Emergency Medicaid.

Many states already have a Medicaid to cover families and individuals with limited resources. Obama could have given more Federal funding for the state Medicaid programs. 

Another approach is to create a Federal Medicaid program to cover people the uninsured people. One important feature of this program is to control the medical expense. Doctors and hospitals participating in this program should be required to accept the negotiated schedule of fees and caps. The Federal government should provide a subsidy for each person that is insured, with the amount varying according to age. The subsidy should represent about 50% of the total cost.

If the Federal Medicaid program is successful, more people who are now covered by private insurance through their employers may move to this new program, due to its lower cost. Over time, this program can have more people insured. It could achieve the goal of keeping the cost low.

An important feature of the TKL approach is to allow the existing people to continue with their private insurance purchased through their employers and to insure the uninsured people under a state of Federal Medicaid scheme with a subsidy from the Federal government to cover half of the cost. 

If the Medicaid scheme is successful, more people will move from the private insurance to the Medicaid scheme, but this has to be achieved gradually and voluntarily.

MEDICARE FOR ALL
Senator Bernie Sanders advocate a single payer system under his slogan "Medicare For All". If Sanders adopt the approach of revamping the system, he will face the same problems that were faced by Obama. He should adopt the TKL approach and create the "Medicare for All" program to be an alternative program to cover the uninsured and to attract existing people to move from the private insurance.

Tan Kin Lian









 
 



 


President Obama and health care in America
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President Obama sent a lot of effort to get Congress to pass the Affordable Care Act. The Act helped to get a few million people to be insured, but it was quite unpopular with a large section of the population. It caused many Democrat senators and representatives to lose their seat in the subsequent elections.

The Act, which is given the name of Obamacare, had many flaws. It did not help to control the inflation of medical costs. Many insurers had to increase the premium rates sharply. The consumers do not like these high increases.

A DIFFERENT APPROACH
What could Obama had done differently?

Obama made the mistake of revamping the system. It is never easy to change a system that affect tens of million people.

A better approach would be to keep the existing system of health insurance and create an alternative, low cost system to cover the uninsured people.

TKL APPROACH
Here is the alternative approach - called the TKL approach.

Prior to Obamacare, there were about 40 million uninsured people. Many were in poor health with pre-existing conditions. They were not working for a large insurer who has health insurance for their employees. 

These uninsured people neglected their health care until they became critically ill. They were treated in hospitals and the expenses were mainly charged to Emergency Medicaid.

Many states already have a Medicaid to cover families and individuals with limited resources. Obama could have given more Federal funding for the state Medicaid programs. 

Another approach is to create a Federal Medicaid program to cover people the uninsured people. One important feature of this program is to control the medical expense. Doctors and hospitals participating in this program should be required to accept the negotiated schedule of fees and caps. The Federal government should provide a subsidy for each person that is insured, with the amount varying according to age. The subsidy should represent about 50% of the total cost.

If the Federal Medicaid program is successful, more people who are now covered by private insurance through their employers may move to this new program, due to its lower cost. Over time, this program can have more people insured. It could achieve the goal of keeping the cost low.

An important feature of the TKL approach is to allow the existing people to continue with their private insurance purchased through their employers and to insure the uninsured people under a state of Federal Medicaid scheme with a subsidy from the Federal government to cover half of the cost. 

If the Medicaid scheme is successful, more people will move from the private insurance to the Medicaid scheme, but this has to be achieved gradually and voluntarily.

MEDICARE FOR ALL
Senator Bernie Sanders advocate a single payer system under his slogan "Medicare For All". If Sanders adopt the approach of revamping the system, he will face the same problems that were faced by Obama. He should adopt the TKL approach and create the "Medicare for All" program to be an alternative program to cover the uninsured and to attract existing people to move from the private insurance.

Tan Kin Lian