Tuesday, February 7, 2017

Dumb Executive Order #1: Repeal Obamacare

Tracking the executive orders and memos of Donald J. Trump, and how you know that no expert actually looked at them before he signed them, Part I:

Executive Order Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal, Signed January 20, 2017.

You know this one has to be good, because the title includes "Minimizing the Economic Burden of the Patient Protection", which if you take out the "the", really gets at the heart of the order - protecting patients imposes an economic burden on somebody, but it's not the patients.

Section 1 - the confusing part here is that it really doesn't do anything.  The President can't just repeal a law that Congress passed.  It's like the Constitution is still a thing.  Instead, we want the healthcare markets to be more competitive!  Yeah!!!!  Free market!!!!  ...except for that pesky ethics problem and known market failure in the health care market.  There's no access to perfect information in setting a price, mostly because in order to do this, doctors and patients need to know how much someone is willing to pay for an operation that will save their life.  Is open heart surgery worth $5,000?  $10,000?  $100,000?  That's unfettered capitalism, and I doubt people really want to be thinking about their doctors as maximizing profits when they decide whether or not to treat their cancer.  So, yeah... rhetoric sounds great to the Austrian Economist, but that's just about it.

Section 2 - this asks the Sec. of Health and Human Services (who isn't confirmed yet) not to impose fiscal burdens on States, individuals, or families (aw...).  Or health insurance companies, or medical device companies, pharmaceutical companies (less aw...).  Except that there is that pesky law out there.

Sections 3-4 - Flexibility!  States Rights!  Except that this is in regards to a Federal tax dollar spending, so really?  It also encourages interstate insurance markets, which might be okay, except that the ACA guidelines for minimum coverage levels will be gone.  So, everyone can purchase the health care quality guaranteed by Mississippi!

Section 5 - Oh yeah.  There is that comment period on regulations.

Section 6 - Laws exist.

So what does this do?  Not a damned thing. Congress is trying to figure out a replacement, but yeah, changing the ACA is going to be a mess, mostly because people like some aspects of the law.  We'll see what the Republicans come up with. Stay tuned!

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