I have seen a few posts that have pointed out that when Paul Ryan said that people shouldn’t expect other people to pay for their health care, that he fundamentally misunderstood the whole concept of insurance. Of course, insurance as defined by the old school, is a pool of everyone’s money to help pay for what is hoped to be fewer people needing than contributing or … other people’s money helping you in your time of need.
But Paul Ryan, of course, fully understands what the modern definition of insurance is. It is a profit driven industry parasitically attached to the provision of medical and pharmaceutical services, that is tasked with taking money in and NOT paying it out. Thus the horridly twisted levels of coverage based on cost, the provisions under which people can be dropped from their coverage, the limits on coverage based on profitability without consideration of the need, plans where you pay in and there are pretty much no chance of anything happening to trigger payment (catastrophic coverage plans) etc.
Insurance companies love the ACA because of the millions of customers it has provided but they are not quite so happy with the fact that it mandates that they actually have to share some of those huge piles of money with people who just happened to get sick.
So there are a basically two options available to the new profit obsessed controllers of the American government.
- Give the people what they want and eliminate the pieces no one seems to like i.e. the mandate, the taxes, the fees etc. or, easier to say, all of the things that pay for it. This will of course destroy the deficit. Republicans have never really cared about the deficit but his would actually bankrupt the government (of course they have been trying to do that for decades as well).
- Go back to what was; where insurance companies were allowed to charge whatever they want and provide little as possible, drop who ever becomes unprofitable etc. (because this is business).
Option 2 is the obvious goal, but how to get there is tricky isn’t it.
The fear that healthcare might actually be treated as something people need is horrifying because in its current form, even under the ACA, a lot of people are getting very, very rich.