Did you follow any of his links? Avik Roy wrote a 102 page document detailing how to get market based coverage to be near universal. He has been talking about this for a very long time and has written hundreds of articles about this in NR, WSJ, NYT, Forbes and more.
https://drive.google.com/file/d/0B4VpAFwBu2fUQjNtaU82djRwM2s/view
https://freopp.org/understanding-freopps-obamacare-replacement-in-10-minutes-or-less-cef35faad51a
I took a read through the exec summery, and I dont see how this conflicts with what I said. Risk pooling and cost pooling are 2 sides of the same coin.
I dont think that everything he says is realistic. He says that he wants to move people from medicaid and medicare to privatized subsidized health insurance. People who are on those programs are generally happy with them, and they have lower administration costs. And both the programs have privatized aspects already. Just toon into daytime TV for 10 minutes and you will see all the advertisements for private insurance companies trying to get you to choose them during medicare open-enrollment. In NYS most medicaid is run by private companies and you need a reason to be on straight medicaid. As
@ExGingi likes to point out medicaid is the gold standard in NY.
His plan isnt that different from the ACA. The ACA provides subsidies for people upto 400% of the poverty line. In order to get past the individual mandate you have to lower cost of insurance to the point that most people will get it anyways.
The bigger issue is cost. Roy has some good ideas on how to reduce costs and they should be given a good hard look at by policy makers.
The US spends 17% of GDP that means on *average* a person making a decent salary of 75k a year has to pay 12.8k towards healthcare. ( this number is distorted by many things including healthcare that paid via taxes and the person might be getting employer health insurance that raises his gross compensation. I only use it as an illustration)
But none of the GOP bills that went to the floor didn't really address costs, and they didn't really make anything better except for the few paying the enhanced medicare tax on investments.
Also a note on the process that they used.
The gave a lot of grief to the Dems for doing it in secret but the Dems had committee hearings and 10 months of an open process. Obama held town halls and went on the road to sell it.
A lot of GOP amendments were adopted in the committee process.
Mcconnoll literally introduced the bill a few hours before the final vote.
Graham saying he was only voting for the bill to get to conference committee is BS. They could have informally worked out a bill with House leadership without risking them passing what Graham called bad policy.
