As the article notes (a bit floridly), there is a fundamental conflict between GOP ideology (the rich should not have their income taken away to support the poor; the poor should not be given money that might discourage them from trying to be not-poor) and GOP promises about health insurance reform (better, cheaper, more flexible care for more people).
Trying to pass a less affordable, cheaping-out version of the ACA as the AHCA is only going to (continue to) offend conservative ideology and tick off people who thought the Republicans actually had a better idea.
The other inherent conflict holds true not just for the AHCA but the ACA itself — trying to provide health care via providing health insurance. Insurance is a risk-based gamble that more money will come into the system than is paid out of it. That's why and how insurance companies work very hard and very diligently to make a profit.
But sick people use more health care spending than they pay in — that's why they need in insurance. An insurance plan can only work if you get healthy, non-spending people into the system (before they suddenly discover that, hey, a critical illness or injury can happen to anyone, any time).
The ACA tried to do this through mandatory coverage (though, hampered by very weak penalties, it didn't work, leading to increased premiums and companies leaving the system); the AHCA does this by charging a penalty surcharge for people buying insurance for the first time or after a break of more than 63 days (the surcharge, though, is not going to be seen as so high as to really compel people to stay in the system, except for the very poor who simply won't be able to afford it; it, too, will not work).
Which brings me around to this point: making access to health care contingent on for-profit insurance pools simply doesn't work to cover everyone, or even adequately cover most. You must force people to be in the system, or — put a bit more palatably — build the system around everyone being included (via taxes).
That doesn't seem to be something the GOP is interested in doing, which means their attempt to live up to their promises, even as they bend their principles, is going to fail worse than the ACA ever did.
(It's been suggested that this is the long game plan — break the system further, then, at some later date, throw up your hands and declare it all a socialistic mess and let's go back to poor people dying of illness in their slums, because that's the American Way. Would that work? Would that redound on the Republicans? We may get to see.)
Republicans are now paying the price for a years-long campaign of Obamacare lies
They promised better insurance. They can’t deliver. Now the jig is up.
Yep, which is why one of the main problems with the ACA occurred when Obama decided to toss out the single payer option before the proposal was even given to congress.
There are only two versions of healthcare systems that work:
1) The Bismarck Model, where the government gives you cash dollars to buy insurance from a list of NON-Profit insurance companies. This is the system that Germany and many other countries use.
2) The Beveridge Model, which the U.K. uses and what Medicare is.
We as a nation have decided (because of FREEDOM!'1!) that unless people are punished for being hurt, accidents, environment , and/or genetics that they are just free loading grifters and layabouts. But that is what you get from a nation of psychopaths.
It's how both parties have done business for a while, though Democrats to a lesser degree. Immigration and tax reform are other big promise items during campaign season. Democrats have been able to make Healthcare promises a thing of the past, since they finally accomplished a law…They can sit back and let the GOP flail at this. I would like to see immigration reform as well, but doubtful.
You said it more concisely than +Yonatan Zunger, but he covers more ground… and I love this article…
https://healthcareinamerica.us/how-to-ask-good-questions-about-health-reform-725887002c03#.ge7ssp85q
I am (usually) more concise than +Yonatan Zunger, but he's usually more informative and entertaining.
+Simon B And, yes, that was a fine article about the different kinds of risk pools and costs and questions about health insurance. To paraphrase the President, who would have thought it was so complicated (rolls eyes)?