How well is Obamacare working, and will Ted Cruz or Donald Trump fix health care?

Obamacare Bronze plans: and don't forget the $6850 deductibles
Obamacare Bronze plans

Two stories, then we’ll see whether Trump or Cruz is more likely to repeal Obamacare.

The Daily Signal lists 4 problems with Obamacare:

  1. Rising Costs
  2. Higher Taxes
  3. Unstable Enrollment
  4. Hostility to Personal Liberty

Let’s look at the first two:

Rising Costs

Contrary to repeated administration promises, Obamacare has not only failed to lower costs, but has also imposed additional expenses on millions of already over-stretched individuals and families.

Premiums in the government created exchanges were an initially jolting experience for Americans who did not qualify for taxpayer subsidies, and it appears that in 2016 premium increases in the government’s health insurance exchanges will again hit enrollees in the double digit range.

When it comes to average job-based premiums, the Congressional Budget Office (CBO) says that they, too, are climbing, and will rise almost 60 percent between now and 2025. Deductibles in the Affordable Care Act exchanges have also jumped higher than officials anticipated, discouraging the purchase of the Obamacare coverage among the poor and the young.

[…]Today, based on CBO data, the net cost of Obamacare’s coverage provisions—subtracting the taxes and penalties—will amount to over $1.4 trillion over the next ten years.

Higher Taxes

Obama promised he would not raise taxes on the middle-class. But Congressional Budget Office data indicates that Obamacare’s numerous taxes, fees, and penalties will cost about $832 billion over the years 2016 – 2025. And middle-class Americans are going to be hit—directly and indirectly.

Even lower-income workers will get hit by Obamacare taxes, including the so-called Cadillac tax on expensive health plans offered by large firms, as well as the individual mandate tax penalty.

For 2016, that mandate tax penalty for a single adult is $695 and up to $2,085 for a family.

We also need to remember how many companies took their employees off of the full-time work week to keep them below the 30 hours, so that they wouldn’t have to buy them this expensive health care with all the new minimum coverages (drug addiction therapy coverage is mandatory now?) that raised the price of health care insurance premiums.

But there’s more than just more government spending, higher premiums, higher deductibles and higher tax penalties for those who opt out of the individual mandate. There’s also the regulation side of things. Doctors are now being regulated by the government to the point where they are dropping out of the field. And there are fewer people who want to become doctors, because of the regulations.

Primary care doctor shortage
Primary care doctor shortage

So, how do we fix it? Well, one person who will not fix it is Donald Trump. Trump isn’t aware of any of the problems with Obamacare – he wants to expand government control of health care. Make it cover more people, for more mandated coverages (toupees, wigs, Viagra, hair replacement surgery?)

When government pays for all the health care provisioning, we call that a single-payer system. And Trump is for it – that clip is from September 27, 2015. In the Fox News debate in August, he said that single payer health care “works in Canada“.

Do you think more government-control of health care will make things better? Look at how things are going in the single-payer system for our armed forces veterans in the VA single-payer system – they are dying while bureaucrats collect fat bonuses for concealing the waiting lists. Just as in Canada and the UK, the patients are dying on waiting lists while waiting for care. They pay into the Trump health care system their whole lives, then when they are old and of no use to the government, they are denied care and left to die.

Single-payer health care wait times in Canada
Single-payer health care wait times in Canada

How much do Canadians pay in taxes, in order to wait on waiting lists for the government to decide to give them health care?

This Toronto Sun article explains:

Canadians retain just 21% of their income after paying the taxman and covering the cost of necessities, according to a Fraser Institute study.

Taxes gobble up a whopping 42% of the average Canadian family’s income. About 37% of income goes to cover housing, food and clothing.

“We’ve found … that over the last five decades or so, the tax bill for the average Canadian family has grown dramatically,” said study coauthor Charles Lammam.

Well, what about Ted Cruz? Has he got any sort of plan for Obamacare and consumer-centered health care reform?

Ted Cruz

Yes, he’s going to repeal Obamacare on day one, and then work to replace it with this:

Main points:

Ted Cruz's health care plan: choice and competition
Ted Cruz’s health care plan: choice and competition

Cruz explains it himself here:

At the eighth Republican presidential primary debate on February 6, 2016, Ted Cruz discussed repealing Obamacare: “Socialized medicine is a disaster. It does not work. If you look at the countries that have imposed socialized medicine, that have put the government in charge of providing medicine, what inevitably happens is rationing. … If I’m elected president, we will repeal every word of Obamacare. And once we do that, we will adopt common sense reforms, number one, we’ll allow people to purchase health insurance across state lines that will drive down prices and expand the availability of low cost catastrophic insurance. We’ll expand health savings accounts; and we will de-link health insurance from employment so that you don’t lose your health insurance when you lose your job, and that way health insurance can be personal, portable and affordable and we keep government from getting in between us and our doctors.”

Those of you who like to read consumer-centered health care policy scholars like me (Sally C. Pipes, Regina Herzlinger, Michael D. Tanner, Michael F. Cannon, John C. Goodman, Ilya Shapiro, Avik Roy, etc.) will recognize a lot of what he is proposing – he stole it all from the conservative and libertarian policy experts.

To me, that sounds better than Trump’s plan of expanding government-run health care into universal government-run health care. If I wanted that, I’d go to Canada or the UK, and just die on a waiting list after paying 42% of my salary into the system for my whole working life.

One thought on “How well is Obamacare working, and will Ted Cruz or Donald Trump fix health care?”

  1. Many of my Canadian buddies were cheering when the ACA/PPACA was passed in 2010, thinking this was Universal Healthcare. Unfortunately many of them failed to read the bill… not realizing there were a number of things thrown in, including:
    1. Increasing year-over-year tax penalties for those who don’t purchase insurance,
    2. If there was no state-wide healthcare exchange, it called for one (otherwise it was no change),
    3. Some of the ACA compliant insurance programs had rather confusing aspects that made it difficult for the average consumer to analyze (e.g., low vs. high deductible, coinsurance, copays, maximum out of pockets, in-network vs. out-of-network, etc.)
    4. It increased a number of czar positions

    This is certainly not Universal Healthcare. Better to call it universal penalty for failure to have health insurance. I live in a state which had a healthcare exchange prior to the ACA so it wasn’t affected (translation: ACA was useless legislation). I also mentioned to a coworker who considered himself a strong Democrat about these above items, and asked him what he thought of the czar positions, since we already have plenty of hospitals (e.g., Mayo Clinic), health providers (e.g.,, and private companies (webmd) that provide a ton of excellent information. Do we really need redundancy in the public sector? My coworker snarled and said, “OBAMA! He said he wouldn’t reward his cronies!”

    And to boot, were you aware that most to all Canadian companies that provide healthcare insurance for traveling Canadian citizens refuse to provide healthcare to people traveling to the United States?

    In any case, health care needed true reform. For instance,
    1. Mandating that hospitals provide line items of charges before care is given — “cafeteria plan”. For instance, if you took your car into the autobody shop and the mechanic said you owed $3000 or you wouldn’t get your car back — my state has outlawed this behavior. Nowadays, the mechanic has to tell you everything he (or she) plans to do, line item the cost(s), and have you approve before you get your car fixed. Why isn’t healthcare any different?

    Shouldn’t I know how much a CAT scan or a nurse visit is before I get hit for a bill? E.g., shouldn’t I be told that, under my employer healthcare plan, a 20 minute nurse visit such that my 11 month old who had an ear infection will run me to the tune of $175 (before I see the bill)?

    2. Patient and consumer advocacy — obviously some of the bills are overly inflated for those who can pay, since they are effectively subsidizing those who can’t.

    Of course this should be the case for everything. Artificial hips, canes, prescriptions — there should be patient advocacy groups that will go to bat for the consumer to get the best price (and also the best care).

    3. Ben Carson has also advocated increasing the HSA program. Many people are not aware of this. I’ve only had to use this more over the last few years. My employer has three programs: 1) Dependent Care (as long as both parents work to some degree, even if one works one day a week and/or part time), up to $5000; 2) HSA, $6750, the 2016 maximum with $1000 55 and over catch up; 3) Health-related (medical, dental, vision, prescription, etc.) FSA. All three of these use pre-tax money. (One could ask the question why are there three accounts, rather than two … or even one.)

    Unfortunately the older one gets, the more one has to deal with medical and dental issues. Under my company’s high deductible healthcare plan, the maximum deductible (= the amount I can be charged) is $5000 for in-network. But that only deals with medical and in-network costs. Having some kind of pre-tax account — even just one — that covers dependent care, health, dental, vision, prescription, etc. would be great.

    4. Since Obama (and Ted Cruz) were lawyers and Obama was even a law professor, Tort Reform could have been useful.

    Case in point:
    Shirie Leng, who is a practicing physician, reviewed this case.


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