Obamacare isn't working, the voter suggested. What can be done to bring costs down and improve coverage?
"You're going to have plans that are so good, because we're going to have so much competition in the insurance industry," he said. "We will be able to keep pre-existing."
The answer bordered on incoherence.
He's correct that more insurance competition would drive premiums down. But no insurance company will "compete" for patients with pre-existing conditions -- those patients are too expensive. That's exactly why insurance companies are leaving the Obamacare exchanges: too many sick people are signing up for coverage, while too many healthy people aren't.
The only way insurance works is if healthy people subsidize sick people. It's that simple.
Obamacare tries to solve this problem by forcing everyone to buy health insurance. That's turned out to be a difficult sell, particularly as companies raise premiums and cut benefits to stay profitable. Healthy people prefer to take their chances, and risk a tax penalty, rather than buy something they think they don't need.
The mandate goes away if Obamacare is repealed, which would come as a relief to healthy patients. But repeal makes it much less likely private companies will compete for patients with pre-existing conditions, even across state lines. There isn't enough money.
Interestingly, we already have some experience with a government system that provides insurance coverage for people with pre-existing conditions. More than 50 years ago, growing old was considered a pre-existing condition: the elderly are sicker, and therefore more difficult to insure, than younger people.
Premiums for the elderly were astronomical, if they could get coverage at all. So the government invented
But that isn't entirely
Obamacare did very little to reduce the actual cost of health care, which is one reason the insurance portion is failing now. Clinton never mentioned that in the debate.
The next president and
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