A plurality of Americans want the Affordable Care Act repealed and replaced. The Republican Study Committee has worked on a replacement and come up with a proposal that has the support of a majority of House Republicans.


The plan combines all the old GOP ideas for health care in one package. Its major features are as follows. Specifically, H.R. 3121, the RSC's American Health Care Reform Act:

  • Fully repeals President Obama's health care law, eliminating billions in taxes and thousands of pages of unworkable regulations and mandates that are driving up health care costs. 
  • Spurs competition to lower health care costs by allowing Americans to purchase health insurance across state lines and enabling small businesses to pool together and get the same buying power as large corporations.
  • Reforms medical malpractice laws in a commonsense way that limits trial lawyer fees and non-economic damages while maintaining strong protections for patients.
  • Provides tax reform that allows families and individuals to deduct health care costs, just like companies, leveling the playing field and providing all Americans with a standard deduction for health insurance.
  • Expands access to Health Savings Accounts (HSAs), increasing the amount of pre-tax dollars individuals can deposit into portable savings accounts to be used for health care expenses.
  • Safeguards individuals with pre-existing conditions from being discriminated against purchasing health insurance by bolstering state-based high risk pools and extending HIPAA guaranteed availability protections.
  • Protects the unborn by ensuring no federal funding of abortions.

As might be expected, the emphasis here is on tax cuts in the form of actual deductions and in the form of Health Savings Accounts, which favor the rich. Smaller insurance companies in some states will be wiped out as the large insurance companies are allowed to come in. People with pre-existing conditions will be placed in high risk pools, guaranteeing them insurance coverage, but at much higher costs. Meanwhile all this competition will reduce costs in a business that is labor intensive and technologically sophisticated. Who wouldn't want their quadruple bypass performed by the surgeon who offers the lowest rates?

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Why doesn't the government just give it up and make our health care a single payer system like the rest of the world. I guess there's just to much money to be had by the very wealthy who now use our government for their own private amusements.

It's a good question. I think the answer is that healthcare is a business like any other and must make a profit for those involved. A single payer system would take away the opportunity to make a profit.

Obamacare certainly needs a lot of work.  If they are going to force people to buy health insurance, that health insurance had BETTER cover people's actual medical expenses - not what the insurance feels like covering. 

I signed up for one of the state-run plans, then found out they refuse to cover almost all of my actual medical expenses.  They refused to cover the drugs I have made for me by a compounding pharmacy, to avoid fillers I'm allergic to.  Also they almost certainly wouldn't cover the expensive Xolair I'm getting. 

There are good medical justifications for both - so any government-mandated health insurance should pay for them. 

Lawmakers have been tweaking Obamacare to make the coverage better.  I contacted my senators and wrote a letter to my representative about the problem of not covering compounded medications. 

If the government-mandated insurance is going to keep on being shitty insurance, I sure hope they repeal Obamacare. 

Look at where you would be with the GOP plan. As someone with a pre-existing condition you would be put into a high-risk pool and assigned to an insurance company on a random basis as is now done with high-risk drivers who have had lots of accidents. If the auto insurance is any guide, that insurance would be extremely expensive.

It seems like a good idea that insurance co's shouldn't discriminate against people based on pre-existing conditions.  I think that particular provision is actually a popular part of Obamacare.   

Insurance companies survive by accurately assessing risk and pricing their policies to reflect that risk. There is no question that people with pre-existing conditions are greater risks than those without, but few make it to middle age without some medical condition.

The choice is between making insurance a little more expensive for everyone and guaranteeing that pre-existing conditions are no obstacle to coverage or making insurance much more expensive for people with conditions that put them at greater risk.

For most of my life I was denied life insurance because of a benign heart arrhythmia. Then the insurance companies decided it was no great risk and I was deluged with offers of (very expensive) life insurance when I no longer needed it.

Obamacare has problems Luara but at least it's care. There is no system in existence that doesn't have problems. The people who want it repealed are the ones looking for the pot of gold at the end of the rainbow. It doesn't exist.
At least Obamacare makes sure people can have some kind of insurance. It beats the hell out of the last insurance my family had that cost 350 a month and came with a 6500 deductible. Paying for nothing is what it amounted to. Provided by my employer. Take it or leave it was the option. And no pre-existing conditions need apply.

For me, Obamacare is NOT care, because it doesn't pay for almost all my medical expenses.

So it should be repealed because ONE person gets shafted?

You would call the NHS in the UK a single-payer system?  I've heard it has a lot of problems, and the quality of care in the UK is lower than in the USA in many ways.  

There are many facets to the difference between healthcare in the US and the UK that do not get discussed.

The basic difference is that the UK has a well-designed system that has been chronically underfunded due to government austerity while the US has a badly designed system that is very well funded from private sources and wastes tons of resources—and overall achieves worse results than it could.

In this country we are wedded to the notion that competition in a free market will lower healthcare costs despite all evidence to the contrary. That will prevent any real progress in healthcare beyond our present position.

So your contention is that a single-payer system would look different in the USA.  Why do you think it would escape the many problems with the NHS? 

Why wouldn't the USA be plagued with similar quality problems?  I have heard a lot about low-quality care dictated by bureaucrats in the NHS. 

How do you get a single-payer system without the care being dictated by bureaucrats? 

One thing that bothers me a lot about the high healthcare costs in the USA is that so much of them are self-inflicted - the culture that promotes obesity, people eating themselves into heart attacks, people not getting enough exercise, etc.  We need a more health-promoting society, and encouraging competition among healthcare providers will certainly not address that. 




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