Tuesday, January 3, 2017

What to do about Obamacare?

Obamacare is a disaster.  The costs it lays on business has stalled hiring, stalled expansion, and generally slowed the economy.  Obamacare is one of the reasons for the miserable 1% growth of GNP in the Obama years.  GNP growth used to be 3.5% back before Obama.  Obamacare along with some other misguided Obama policies knocked it down to 1%.  That's not enough growth to offer employment to match our population growth let along reduce unemployment and raise wages.
   And, the US spends too darn much on healthcare.  We spend 19% of GNP on healthcare, where as all the other countries in the world only spend half that.  And US health is no better than many other countries who spend much much less.  This means that US exports have to be priced 19% higher than direct manufacturing cost, just to pay for the workers healthcare.  Whereas our international competitors, places like Japan, the EU, South Korea, even Canada, only have to mark their products up 9.5%   That's a crippling price disadvantage in the marketplace.  And it drives US companies to move operations overseas to avoid US healthcare costs. 
    The Obamacare law is some 10,000 pages long.  Nobody can read 10,000 pages of legal gobble-de-gook and understand it, even if it doesn't drive them mad.  Trump needs to repeal all 10,000 pages just to eliminate surprise clauses springing to life and doing badness.  Modifications or amendments are a slippery slope that open the door to all sorts of crookedness.  Trump needs to kill the whole thing, root and branch.  If there are parts of Obamacare that people want to keep,  pass them as new laws and Trump will sign them.
   Most Americans (say 80%)get their healthcare insurance thru their employers, or from Medicare after they retire.  Obamacare only helped the self-employed, and the medium poor, the extremely poor get Medicaid.  First thing to do is to increase competition by allowing interstate sale of health insurance.  Any insurance company, based in any state, should have the right to sell insurance in all 50 states, WITHOUT doing any paperwork anywhere except in their home state.  Right now, to sell insurance in any state, the insurance company is required to do a couple of tons of paperwork for the state "regulators".  For small rural states (like NH) most insurers just don't bother, the market ain't that worthwhile.  Which is why we only have two companies offering insurance up here.  Allow interstate sales and we would get more choices and better prices.
   Then to curb drug price ripoffs, $800 Epipens and $100 pills,  we need to allow duty free import of drugs from any first world country, Canada, the EU, Japan and places like that.  Any drug the authorities of a first world country have approved can be imported, even if the US FDA hasn't approved them yet.  FDA will scream and cry, and so will big Pharma, but too bad. 

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