Trump Promises "Insurance For Everybody" In Obamacare Repeal

Tyler Durden's picture

Just two days after both the House and Senate passed a budget resolution clearing the way to repeal and replace Obamacare, the President-elect has told the Washington Post that his replacement bill is nearly complete and envisions "insurance for everybody."  Although no specific timeline was given for the announcement of legislation, the CR passed by Congress last week gives the various committees until January 27th to present a bill.  Per Reuters:

"It’s very much formulated down to the final strokes. We haven’t put it in quite yet but we’re going to be doing it soon," Trump told the Post, adding he was waiting for his nominee for health and human services secretary, Tom Price, to be confirmed.

 

The plan, he said, would include "lower numbers, much lower deductibles," without elaborating.

 

“We’re going to have insurance for everybody,” Trump said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”

 

“It’ll be another plan. But they’ll be beautifully covered. I don’t want single-payer. What I do want is to be able to take care of people,” he added.

Meanwhile, taking a similar approach to his efforts with Boeing and Lockheed Martin to lower costs, Trump vowed to bring down drug prices by forcing big Pharma companies to negotiate directly with the government for Medicare and Medicaid pricing.

Moving ahead, Trump said that lowering drug prices is central to reducing health-care costs nationally — and that he will make it a priority as he uses his bully pulpit to shape policy. When asked how exactly he would force drug manufacturers to comply, Trump said that part of his approach would be public pressure “just like on the airplane,” a nod to his tweets about Lockheed Martin’s F-35 fighter jet, which Trump said was too costly.

 

Trump waved away the suggestion that such activity could lead to market volatility on Wall Street. “Stock drops and America goes up,” he said. “I don’t care. I want to do it right or not at all.” He added that drug companies “should produce” more products in the United States.

 

The question of whether the government should start negotiating how much it pays drugmakers for older Americans on Medicare has long been a partisan dispute, ever since the 2003 law that created Medicare drug benefits prohibited such negotiations.

 

"They’re politically protected but not anymore,” he said.

Of course, as we mentioned last week, Kellyanne Conway hinted that the Pharma industry would be in the crosshairs of Trump's new healthcare law, telling Bloomberg that "to repeal and replace Obamacare without having a conversation about drug pricing seems like not a reasonable prospect."

 

Without giving a timeline, Trump said that he expects Republicans in Congress to work quickly to pass his new healthcare legislation and threatened that any splintering of the Republican party would be met with an aggressive appeal directly to the American people to put pressure on their Congressmen.

Trump said he expects Republicans in Congress to move quickly and in unison in the coming weeks on other priorities as well, including enacting sweeping tax cuts and beginning the building of a wall along the Mexican border.

 

Trump warned Republicans that if the party splinters or slows his agenda, he is ready to use the power of the presidency — and Twitter — to usher his legislation to passage.

 

“The Congress can’t get cold feet because the people will not let that happen,” Trump said during the interview with The Post.

Of course, as we've said before, while Democrats and some Republicans will certainly fight it, whatever bill is introduced by the Trump administration will almost certainly be better than the status quo.

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OfAllElaboratePlans's picture
OfAllElaboratePlans (not verified) Jan 16, 2017 11:24 AM

Even for those who are moving to Canada?

FreezeThese's picture
FreezeThese (not verified) OfAllElaboratePlans Jan 16, 2017 11:25 AM

Not exactly conservative is he ... 

OfAllElaboratePlans's picture
OfAllElaboratePlans (not verified) FreezeThese Jan 16, 2017 11:27 AM

So let me think about this. We 'lower' the cost of drugs by importing knockoffs from Canada. But then I still have to subsidize the cost for asshats who are moving TO Canada because Trump got elected?

 

What kind of snowflake crap is that?

InjectTheVenom's picture

hey Donald...just a little reminder...the people (you know, those people that voted you IN) want LESS Federal Government in our lives.  We want the STATES to make most decisions, not D.C. 

the phantom's picture

This is where Trump loses me.  Insurance is not a constitutional right.  If you are uninsured, you can always go to the emergency room... and they must treat you.  Not optimal, as preventative medicine is cheaper that "treatment" medicine, but we cannot afford it.  End the foreign wars and close the majority of useless bases around the world.  With that savings, THEN we can begin the conversation about universal healthcare.  Key word is... begin.

greenskeeper carl's picture

All he has to do after repealing obamacare (or before) is STRICTLY enforce existing laws regarding cartels and price fixing, as well as it being illegal to charge different people different prices for the same thing. Viagra in some countries is 1$ a dose, and its like 40 here. Karl Denninger has written extensively about this.

ACP's picture

We obviously need a 90% tax on movie tickets and all Hollywood produced media. And a 90% federal tax on all actors making over $50k a year.

This will make sure the wealthy are paying their "FAIR SHARE" to pay for healthcare for the poor.

CheapBastard's picture

Gates and Zuckerbegrger want to help the poor, so double tax on FB and Bill Gates massive trusts. Same with Buffet Holdings.

 

It's only fair.

DownWithYogaPants's picture

Has Karl Denninger had a 4 hour hard on?

If you have a 4 hour hard on call your doctor.  To thank him.

Never One Roach's picture

I don't care about whether the poor or anyone else is "covered" but I am NOT paying for all these people who can't control themselves eating bad stuff.

It all boils down to "accountability" in many cases. Why should I struggle not to eat that donut or pizza or double whopper to stay healthy and hold my own premiums down, and then be forced to pay for some fatso who eats like a pig?

scsherman's picture
scsherman (not verified) Never One Roach Jan 16, 2017 1:13 PM

You seem overly concerned with what other people are doing. I assume you are against all insurance? Because it's not like you weren't paying for fatsos before Obamacare.

FixItAgainTony's picture

People wouldn't get so fat if govt would stop subsidizing the worst crops: sugar and corn syrup. These are then snuck via ingredient obfuscation into most food products as cheap filler for the manufacturer and health degrading to the hapless, trusting consumer. Trump could do wonders for the US just by stopping that ADM/Flosun corporate welfare.

bobbbny's picture

Stop all subsidies to everything.

It's called a free market.

Saves a lot of money too.

Oracle of Kypseli's picture

I would prefer that the Donald abolishes the penalty for not having insurance and let O'Bummer-care collapse. Then watch premiums go way down expecially if it is mandatory for hospitals, clinics and doctors to publish pricing of medical services.

 

lie_to_me's picture

Pricing for services in a doctor's office is 100% determined by the carrier. So the cost of the service is determined by the contracted price between the carrier and the provider. (It's more like BCBS says "jump" and the doctor says "how high." Patients can already call their carriers to get a range of costs for various levels of office visits. The more doctor time you consume with your laundry list of complaints the more costly the visit. The physician can give ypu the CPT codes for any procedure planned and you can contact your insurance company to determine coverage and cost ( which depends on coverage and whether your deductible has been met.) Don't  blame us. Physicians have zero control over the healthcare system. We don't have time to educate you about your insurance coverage. Time instead to put your big boy pants on and do it yourself. 

 

toady's picture

I tried to call, but the wife handcuffed me to the bed.

BennyBoy's picture

Enforcing some laws on the books is one way to reduce medical expenses by about 80%:

It is for this reason that 15 United States Code exists -- to protect capitalism by making illegal the formation of cartels, price-fixing and similar acts -- in other words, to make cheating and using force to block competing business entrants instead of innovating illegal.

For those ignorant of history 15 United States Code was passed in 1890 because multiple firms, including Standard Oil and Chesapeake & Ohio Fuel, among others, were engaged in the above set of acts and were screwing people who were dependent on their products.  The Clayton Act, passed in 1914, closed several loopholes that certain firms tried to exploit.  Robinson-Patman was passed in 1936 to explicitly outlaw price discrimination against buyers of like kind and quantity of goods.

To those who say that Health Care providers "aren't" engaging in acts that are rank and outrageous violations of 15 United States Code (Sherman, Clayton and Robinson-Patman, respectively) let's take health care and transplant it into the sale of, oh, cars and see if you still agree with your position.

Let's assume that a car dealer decides to sell poor people a Frobozz Max (we'll use a made-up make and model) for $3,000.  He decides to charge rich people $50,000 for the same vehicle.  He posts the $50,000 price as his "chargemaster" price for the car, but some people will get it for a lot less.  To figure out exactly how much you will pay you must tell him what sort of insurance you have and you must also sign a piece of paper allowing him to bill you anything up to and including the $50,000 before you can have the vehicle -- you'll find out how much it is only after you leave the lot.  The "middle class" guy will probably, provided he has the "right" insurance, pay somewhere around $8,000 for that car.  But, if he doesn't, he might get swatted for the entire $50k.

https://market-ticker.org/akcs-www?post=231764

Jim in MN's picture

Sorry everyone but here is an entire 2-page proposal that I think will get the job done.

 

A Deplorable Proposal On Health Care Reform: Joint Open Premium Yield (JOPY) Fund

By Jim in MN special to ZeroHedge.com

The 2016 Presidential election has created a unique moment in American politics.  The ground has shifted and the apple carts of both major parties, as well as the national media, have been upset.  Into breach must now step an unruly and rapidly organized cadre of volunteers—the Deplorables, today’s peaceful Minutemen.

Establishment Republicans, along with the remaining Democratic forces, will attempt to preserve the status quo across a range of key issues.  The storylines will be all the things that cannot be done. 

But the storyline that America needs to succeed is what can be done.

‘Guns and butter’ issues are named for a famous statement from Frederick Von Bismarck, who unified Germany from the martial Prussian state and a collection of German-speaking territories in the 19th century. 

The 2016 election was marked by a failure of the status quo to serve the American public’s interest on guns and butter issues.  The attempt to fool voters by substituting a set of emotionally fraught social issues failed in a complete and devastating fashion.

In order to forge a successful Presidency and a new direction in American politics, it is critical for the incoming Trump Administration to score major wins on guns and butter issues.  The pre-Inauguration work on U.S. manufacturing firms and trade demonstrates both the importance of these issues, and the precious room for change that the electoral earthquake has created.

Health care is directly in the new Administration’s sights.  There is immense appetite for change.  If the next reforms fail, systemic collapse or a national single-payer scheme become by far the most likely outcomes.  Facing this extreme strategic risk, it is clear that the President-elect has an opportunity to bring in the executives of the Nation’s health care insurers, major care providers, and pharmaceutical firms.  He can make, and expect to win, very tough demands and come to very big deals with these executives.

The question is—what does he ask for?

Replacing the Affordable Care Act has been an elusive quest for the establishment Republicans.  On the Democratic side, and mix of timid incremental fixes rests uneasily with an urge to socialize the entire health care sector.  This intellectual bankruptcy is just one more symptom of the failure of the status quo.

Now is the time for a truly Deplorable proposal—one based on the fundamentally American tenets of liberty, free markets, and the quest for innovation.  A proposal that blows by the status quo and the short-sighted strategies of the industry powers that be.  A proposal, most importantly, that can be implemented quickly, offer premium relief to Americans, and create a permanent shift in an industry that makes up 20 percent of the U.S. economy.

The basis of this proposal is twofold: First, that the executives of the industries can and will make major changes under existential threat (indeed, this is the only means to induce such change); and second, that significant cost efficiencies are possible in health care delivery and administration, but have not been incentivized due to the baroque, opaque, and often nonsensical regulatory tangle that both stifles competition and allows profiteering to those who learn to game the system.

What the President-elect should demand is the creation of a $100 billion fund, paid for up front by the industry.  We call this the Joint Open Premium Yield fund or JOPY.  This fund would be used to pay the profits for those elements of the industry that demonstrate significant efficiency gains over the following three years.  For the first time, corporate boardrooms would be seeking lean and efficient cost structures rather than padding and gold plating (to inflate or hide excess profits).  Insurance companies, hospitals, medical partnerships, and patients would all share a common goal, to meet needs at the lowest cost.   Foreign providers and procedures should be allowed to compete in open marketplaces.  At least five competitive sources should be sought, or if necessary created, for as many cost points as possible.  In this manner, one three-year ‘big bang’ would be the genesis of a culture of competition and, one can hope, excellence in service delivery.

But there will be another use of the $100 billion JOPY fund.  Immediate and significant premium relief for Americans can provide the Trump Administration with its critically needed big win.   It is also fair, and well deserved.  A $100 billion fund would be sufficient to bring $1,000 of premium relief to every American household.  But not all households use private insurance.  So even more would be available to those that do, at least $100 per month, perhaps double that. 

What if the industry succeeds in bringing competitive efficiency to play, but the JOPY fund has been used already for premium relief?  In that event, further sources of funds would be considered, such as a bond securitization.  But if this plan succeeds, so much productive investment and cost-cutting would be unleashed that industry profitability should be greatly enhanced.  Perhaps the JOPY fund is an investment that pays for itself.  The scale and inefficiency of the U.S. health care system today certainly suggests the possibility.

This proposal is not put forward in order to take credit, and not for personal profit.  The specific Deplorables responsible for it have a combined half century of public policy experience, and understand the details of regulated industries including health care as well as anyone in the country.  We are as fed up as the majorities that voted for Donald Trump in state after state in November.  We can do better and we must.

Other reforms are also called for.  Catastrophic care should be paid for directly via a Federal cost reimbursement model, with long term lifestyle and wellness approaches prioritized.  The ‘long tail’ of catastrophic risk needs to be cut off so the vast majority of Americans can have more choices, including the choice of no insurance coverage, in a normally functioning free market.  Incentives can be provided to make self-insuring against catastrophic risk an attractive deal, without forcing its purchase.

Pharmaceutical companies have been parasites on all of us for long enough.  The proposal outlined here is not for them.  The Trump Administration should simply demand an immediate discount sufficient to wipe out the past five years of excess revenue (not ‘profit’ since the drug firms tend to hide excess revenues in their research and development programs, among other games).  The new small-p politics of the big deal make this another immediate win that can, along with significant premium relief from the JOPY fund, turn a true guns and butter issue into a turning point in American political economy.

lie_to_me's picture

No it won't.  You'll just get rationing of care. CMS already has a "pay for performance" system. Disaster. Result.  More physicians dropping Medicare assignment. Fewer doctors for an increasing Medicare population. Also when CMS drops the reimbursement for a procedure below the cost to perform the procedure physicians may refuse to offer that procedure to patients. Many physicians are dumping "fee for service" for alternative models for reimbursement   which don't involve the carriers e.g. direct patient care . I doubt that most physicians would agree to participate in a nationalized healthcare system. ( I don't want  to work for the government. Do you?) Nor can they be conscripted. We are licensed by the states not the federal government. HHS could do something with Medicare  i.e. you can't participate unless you take our national heath service patients. I suspect that most physicians would tell HHS to shove their Medicare patients  (Worst payer. Nightmare to deal with. I don't see Medicare patients.) Why not let physicians fix healthcare. We're the ones who actually provide care and no one asked us for our opinions on the ACA. That's for sure.

 

JohnG's picture

".. and they must treat you."

No.  They are required by law to STABILIZE you, then you are trandferred to a hospital that accepts Medicaid to be TREATED on the taxpayers dime.

 

 

(I don't give a damn about insurance, I just don't want to pay for anybody's medical needs but mine.....everybody carries thier own damn ball.)

American Psycho's picture

"Insurance for everybody..."  Unless that is followed with "provided by the free market" I'm not impressed.

Ignatius's picture

What kills free enterprise these days are largely privatized rackets which raise the fixed costs and barriers to market entry.  The role of government is to keep those fixed infrastructure costs as low as possible (opposite of what we currently have).

GGuy's picture
GGuy (not verified) Ignatius Jan 16, 2017 12:00 PM

My Plan....YOU WANT IT, PAY FOR IT YOUR FUCKING SELF

Ignatius's picture

Oh, I agree.  And be sure to let us know how your home nuclear weapon ICBM program is going.  Could be a model for the rest of us.  As for me, all I can tell ya is everytime I test fire an ICBM outa the back yard the neighbors get a little pissed; apparently it's frightening the pets.

scsherman's picture
scsherman (not verified) Ignatius Jan 16, 2017 1:14 PM

Elon Musk is that you?

American Psycho's picture

Large privatized rackets brought to you by .gov 

The role of government is to enforce contracts through our legal system and protect the ccountry from foreign / domestic threats.  That's about it.  The Gobermint needs to be out of health care and education for that matter.

Ignatius's picture

Government that gets corrupted and privatized is not a government at all (which should represent ALL its citizens).  And we agree that "government" intervention in education and medicine has increased the cost and killed the proper function.

dark pools of soros's picture

Free market doesn't exist when there are millions of billionaires and mega corps.  Why don't you start a game of monopoly with two people owning 80% of the board & money and the other two starting with debt and no assets.  Without some structure you get shit out of wack fast

 

American Psycho's picture

and how do those mega corps maintain their control over competition?  Want to open a business to braid hair?  Get a license after completeing 10s if not 100s of .gov imposed education hours.  Who requires this barrier to entry?  .Gov  Want to start an electric car company?  Go get 100s of millions from .gov like Tesla.  Your bank is too levereged and made the wrong investments?  It's ok, .gov will bail you out.  This is not a free market in the slightest.  When the government imposes high barriers into a certain market and prohibits competition you are left with the mulit-nationals being the only entities to afford the costs. 

WTFRLY's picture

But people have to pull themselves up by their own bootstraps and other shit like that

thatthingcanfly's picture

I agree with Phantom.

Please find the subsection in the Constitution that authorizes the Federal Government to see to the medical needs of ONE citizen of any of the several States.

We need a change of paradigm here. I thought that's what Trump campaigned on.

Twee Surgeon's picture

You know that Opiates ,Coke, etc, were off the shelf products in 1910 @.

I think an alternative Medical community would rise up if the Pharmaceuticals not regulated as they are, unconstitutionally. They must protect the Medical racket.

TuPhat's picture

Trump is being way more socialist than what I wanted for President.  How can I wait another four years for better government?

No OB Wan Kenobe's picture

Actually, not only is there not a right to insurance, there is not a right to medical care. There is, however, a right to pursue medical care. Just like there is only a right to pursue happiness, not a right to happiness.

A right to medical care implies that the physician (provider) does not have the right to refuse to provide medical care for whatever reason. Consequently his rights are violated. True basic human rights apply to everybody.

The question of emergency care involves ethics and morality. A physician and emergency facility has an ethical obligation to provide care in an emergency; thus the staff of an ER should (but do not have to) treat true emergencies. It would be unethical to not provide true emergency care.

 

 

 

slightlyskeptical's picture

It may not be a right but it is the right thing to do.

Disregard for other people is not a commendable state. 

lie_to_me's picture

Agree with all of above (unless George Soros needs emergency care.)

Zero_Ledge's picture

Don't worry, Trump will not follow through. It's just like the plans for the wall that have already changed - i.e. Mexico will pay for it ... LATER.

Trump will later claim that "insurance for everybody" means that people can still walk into emergency rooms and never pay the bills - just like now.

Rabbi Chaim Cohen's picture

And one more thing, if .Gov controls it, it is a heartbeat away from single payer. You won't be in office forever Donnie.

Read our lips: "we need a real free market solution, with just enough regulation to keep the fat cats honest" Get the government OUT of healthcare!

rejected's picture

Careful! You might get what your wishing for.

Lynx Dogood's picture

What the hell? Trump, go look at Singapore!

canisdirus's picture

He never was conservative. That's what everyone has missed this whole time. He's a populist and socialist. He's been a socialist his whole life if you go back to his statements and associations in prior decades.

I still firmly believe that the country voted as close to "Bernie" as they could with the options available.

Surging Chaos's picture

Well... yeah. People didn't go for Trump because he was allegedy conservative. (Otherwise Cruz would have gotten the nomination.) The people wanted Trump because he's a political strongman.

"We must here return for a moment to the position which precedes the suppression of democratic institutions and the creation of a totalitarian regime. In this stage it is the general demand for quick and determined government action that is the dominating element in the situation, dissatisfaction with the slow and cumbersome course of democratic procedure which makes action for action's sake the goal. It is then the man or the party who seems strong and resolute enough 'to get things done' who exercises the greatest appeal. 'Strong' in this sense means not merely a numerical majority – it is the ineffectiveness of parliamentary majorities with which people are dissatisfied. What they will seek is somebody with such solid support as to inspire confidence that he can carry out whatever he wants."

-- Friedrich Hayek, The Road to Serfdom

If you want to know why and how Trump got elected, that quote explains it all.

Sanity Bear's picture

That quote doesn't apply at all, since there's nothing even remotely democratic about establishment institutions and procedures. What actually exists is radically different from any sort of genuine representative system.

Trump simply represents the refusal of the people to continue to go along with an oligarchic system that is determined to eliminate the independence of the individual, and isn't shy about using genocidal tactics to that end.

Or to put it more simply, "we're not going to just roll over and die".

FreezeThese's picture
FreezeThese (not verified) Surging Chaos Jan 16, 2017 12:07 PM

From your prophet's book in 2000 ... which we can deduce few read prior to voting:

"We must have universal healthcare. ... I'm a conservative on most issues but a liberal on this one. We should not hear so many stories of families ruined by healthcare expenses. .... Doctors might be paid less than they are now, as is the case in Canada, but they would be able to treat more patients because of the reduction in their paperwork...The Canadian plan also helps Canadians live longer and healthier than Americans. There are fewer medical lawsuits, less loss of labor to sickness, and lower costs to companies paying for the medical care of their employees. If the program were in place in Massachusetts in 1999 it would have reduced administrative costs by $2.5 million. We need, as a nation, to reexamine the single-payer plan, as many individual states are doing."

Raging Debate's picture

Freeze- But understanding of observing Trump on the thread. He is a nationalist, some sound economic polices. For Healthcare he is for universal Healthcare. It is privaledge, not a right and doesnt work to spend money on it if empire building. I argued with liberals what there problem with him and some deeper thinkers talked healthcare. But one that one major issue he agrees.

A.society cannot have universal health care and empire. It can't afford it. Obamacare was a tax. It helped filled his campaign coffers and tax revenue shortfall in the short term. A crappy .gov solution to a crappy previous .gov solution will be offered next but Obamacare as a tax was the worst. Universal health care can work, kind of. It will be a medium term solution but it won't be 'terrific' as Trump claims. And to work medium term lobbying has to be restricted. I'll take the butter over guns (for now). Unit aggregate revenue is increased, nothing is going to be 'terrific'. No way to increase revenue until lobbying shrinks be it money, energy or medical lobbying. 

lie_to_me's picture

Because the government does everything so well? Doctors fled MA with the onset of Romneycare which does ration care. Patient's wait to see a doctor increased by six weeks. You will get a two-tiered system. VA type system for  the peons and better care for those who can afford it and are willing  to pay for it. No free lunch. That is btw other people paying for your healthcare.

scsherman's picture
scsherman (not verified) Surging Chaos Jan 16, 2017 1:17 PM

Cruz isn't conservative either. He is also a theoist, which is actually worse than a socialist or communist.

ejmoosa's picture

The word coservative does not mean anything.

It's freedom of choice or nothing.

Rabbi Chaim Cohen's picture

I had been hammering this point for the past year and a half to little avail. At best, Trump is a Reagan Democrat. At worst he's a Socialist strongman, ala Hugo Chavez. ZHers need to face this reality and set their expectations and their baloney alarms accordingly. He has yet to prove his positions and responses, but we MUST hold his feet to the firejust as diligently as we would with Hillary Clinton. Politicians are predators, don't ever turn your back on the best of them.