| Speaker | Time | Text |
|---|---|---|
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unidentified
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Tuned into C-SPAN. | |
| Thank you! | ||
| That was a make-for-C-SPAN moment. | ||
| If you watch on C-SPAN, you're going to see me physically across the aisle every day, just trying to build relationships and try to understand their perspective and find common ground. | ||
| And welcome forward to everybody watching at home. | ||
| We know C-SPAN covers this live as well. | ||
| We appreciate that. | ||
| And one can only hope that he's able to watch C-SPAN on a black and white television set in his prison cell. | ||
|
unidentified
|
This is being carried live by C-SPAN. | |
| It's being watched not only in this country, but it's being watched around the world right now. | ||
| Mike said before, I happened to listen to him, he was on C-SPAN one. | ||
| That's a big upgrade, right? | ||
| Brian Blaze is the president of the Paragon Health Institute, and he's also the former White House National Economic Policy Advisor for the Trump administration. | ||
| Brian Blaise, welcome to the Washington Journal this morning. | ||
| Thank you for being here. | ||
| Let's begin with that vote in the House yesterday: 17 Republicans joining Democrats to extend for three years these enhanced ACA subsidies. | ||
| Your reaction? | ||
| Yeah, I think that the expansion of those subsidies, the extension for another three years, is a mistake. | ||
| And the Senate has already voted on that exact same piece of legislation, and it only got 51 votes, not the 60 votes that are necessary. | ||
| I think the expanded subsidies have led to lots of problems. | ||
| They've increased prices and premiums. | ||
| They've led to a lot of wasteful spending, increased fraud within the program. | ||
| And I think fundamentally the ACA needs reform, not more taxpayer money going directly to health insurance companies. | ||
| Tell our viewers what you've found. | ||
| You are saying that these enhanced ACA subsidies have led to increasing costs and fraud. | ||
| So let's dig into both of those. | ||
| Start with the costs. | ||
| How have these enhanced subsidies increased costs? | ||
| So Obamacare has underlying subsidies. | ||
| The underlying subsidies were very generous. | ||
| In 2021, Democrats used budget reconciliation to increase those subsidies. | ||
| And when they increased those subsidies, they made the plans fully taxpayer subsidized, work free to the enrollee for individuals who claimed income within a narrow income band. | ||
| What we found is that there were far more Americans claiming income within that band to get fully subsidized plans than were eligible. | ||
| So nationally in 2025, 6.4 million people were enrolled in these fully subsidized plans who weren't eligible for them. | ||
| When the government made that coverage free, what it did was create a landscape that led to fraud opportunities. | ||
| So in many parts of the country, you had these enrollment conglomerates, think lead-generating companies and agents and brokers that advertised cash or gift cards. | ||
| If people would call a phone number, people called the phone number. | ||
| They wanted cash. | ||
| They wanted a gift card. | ||
| And they were told that they needed to sign up for health insurance first. | ||
| So you had a lot of individuals enrolled this way. | ||
| You had brokers who could make up to $6,000 a day in commissions from signing people up for Obamacare plans. | ||
| You also had a lot of these outfits go into big cities, homeless encampments, and sign individuals up. | ||
| So you have a lot of people signed up for Obamacare plans who didn't really know they were signing up. | ||
| In August of last year, the Trump administration released information on the number of Obamacare enrollees that don't use their health care plan at all, and the numbers were staggeringly high. | ||
| In 2024, 12 million people were enrolled in Obamacare plan at some point during the year. | ||
| It didn't use their plan a single time. | ||
| So no doctor visit, no prescription, no lab test. | ||
| That amounted to 35% of all Obamacare enrollees and 40% of these enrollees in fully subsidized plans. | ||
| And just to go through what happens in this case, the individual is enrolled. | ||
| The Treasury is sending a check every month to the health insurance company that's enrolled the individual. | ||
| Again, the individual is not using any health care services. | ||
| The agent or broker responsible for that enrollment is getting a share of that. | ||
| That's their commission payment. | ||
| So you've got windfall profits for health insurance companies for these agent and brokers and these enrollment intermediaries. | ||
| And the individuals aren't using any health care services. | ||
| And the fact that happened on such a massive scale directly because of the expanded subsidies with the program, I think necessitates a change of direction, not just continuing public policy that led to so much fraud. | ||
| We estimate in 2024, the Treasury sent insurers $35 billion for people that didn't use their health plan a single time. | ||
| Is there a way to address the issue of that $35 billion price tag? | ||
| And if so, what is it? | ||
| I mean, I think everyone should have to pay for the plan. | ||
| If you have fully subsidized plans, you've created this recipe for fraud. | ||
| And a lot of these enrollees, like they don't know that they're enrolled. | ||
| And why should they have any incentive to care because they're not paying any of the premium? | ||
| If you go back to underlying Obamacare subsidies and you get rid of the enhanced COVID-era bonuses, individuals would have to pay about $25 a month for a health insurance plan. | ||
| That's reasonable from my perspective. | ||
| They would still receive a subsidy that covers the vast majority of the cost of the premium, like 95% of the cost of the premium. | ||
| I think having a minimum premium payment that is high enough to deter the improper enrollment is really important. | ||
| And then insurance companies, if they are receiving so much money from individuals that don't use any health care services and have been improperly enrolled, I think they should face penalties because really they're the ones that have benefited from these massive fraud and improper enrollment schemes. | ||
| Do you know if the Senate deal that is being brokered by a bipartisan group of senators addresses the fraud that you're talking about and the issue of folks being on the ACA and paying zero and some of them don't even know they're on it? | ||
| It takes a small step in that direction, but I think it doesn't go nearly as far as it needs to go in order to meaningfully reduce the fraud. | ||
| So again, if the credit, if the bonus, the COVID era bonuses expire, individuals would go back to having to pay a premium for these benchmark plans. | ||
| The Senate would put in place the deal that has the outline that I've read about would put in place a $5 minimum premium payment a month. | ||
| I think $5 is way too low. | ||
| It would also allow that to be prepaid in advance, which I think leads to opportunities for manipulation and abuse. | ||
| I think it's got to be a monthly premium payment to make sure that people are actually enrolled. | ||
| So I think they're very cognizant of the fraud in the Senate, but I think what they have so far is wholly inadequate to really address the problem. | ||
| Okay, Brian Blaze is our guest here this morning. | ||
| Join the conversation. | ||
| And to do so, Democrats dial in at 202-748-8000. | ||
| Republicans, 202-748-8001. | ||
| Independents, 202-748-8002. | ||
| If you are on the ACA, dial in this morning at 202-748-8003. | ||
| Renee is up first in Florida, Democratic caller. | ||
| Good morning, Renee. | ||
|
unidentified
|
Good morning, Greta. | |
| Thanks for your service. | ||
| I really appreciate it. | ||
| I depend on you now more than ever. | ||
| But as far as Brian goes, and we're talking about fraud, I remember Senator Rick Scott being found guilty for fraud. | ||
| And now he's a senator. | ||
| And I have two brothers. | ||
| One works in tree service, so he doesn't have insurance and takes advantage of that affordable health care. | ||
| And a brother that is an electrician that's not in a union that has been able to take advantage of that. | ||
| And they have got the best health care. | ||
| And Trump says he's going to give people $2,000. | ||
| That's going to go nowhere. | ||
| Renee, let's take that. | ||
| Yeah, let's take that last point. | ||
| President saying, let's give the money right to the consumer. | ||
| And Renee giving you examples of relatives where that's not going to go far enough. | ||
| And right now, they like what they have with the ACA. | ||
| Renee, I also live in Florida. | ||
| Florida is actually the epicenter of the Obamacare fraud. | ||
| There are five times as many enrollees in the state of Florida in these fully subsidized plans that are eligible. | ||
| And a lot of the sophisticated and some not sophisticated enrollment schemes, they really start in South Florida. | ||
| It's a massive problem. | ||
| And if you, I would encourage the viewers to look at a Bloomberg piece called Chasing the Healthcare Hustlers of South Florida. | ||
| It really is an expose on how the fraud schemes developed and the opportunities for all the fraud. | ||
| So to the second part of your question, President Trump, I think, is correct when he says we are sending too much money directly to health insurance companies. | ||
| Again, all of these subsidies, they go directly from the U.S. Treasury to the health insurance company, regardless of whether the individual uses the plan or even aware that they are enrolled in the plan. | ||
| I think we need to have a health care system that serves the individual patient. | ||
| And the way that the health care system is going to serve the patient is if the patient is in control of the financing. | ||
| So President Trump has talked about health savings accounts and expanding health savings accounts. | ||
| And I think it is very reasonable and good public policy if we can take some of these subsidies that we are sending directly to the health insurance companies and reorient them to the individual so that the individual has the control and can purchase the coverage and health care that works best for them. | ||
| We will go to Steve in Tampa, Florida, Republican. | ||
| Hi, Steve. | ||
|
unidentified
|
Good morning. | |
| I saw Brian when he was on during the shutdown, and he really educated us on what was going on. | ||
| He was the first one to tell us about the 35% of the people that were on the plan didn't even know they were on the plan and didn't use it. | ||
| That was confirmed with CMS Administrator Oz when he was attacked by Hakeem Jeffries as being a clown. | ||
| He explained that 35% of the people did not know that they were on the plan. | ||
| Brian also explained that the biggest lobbyists for the plan were the insurance companies because that's the only way they could raise their profit because their profit was set based upon what the premium was. | ||
| So if the premium goes up, the subsidy goes up, they gain more profit. | ||
| So he is well educated. | ||
| He's telling the truth. | ||
| I think what should be done is a six-month subsidy because health care is expensive. | ||
| And after six months, or within six months, Congress must come up with a revised plan to perpetuate the Affordable Care Act. | ||
| Okay, Steve, let's take that point and that suggestion. | ||
| Mr. Blaise. | ||
| Yeah, so Steve, I appreciate that. | ||
| And the way that underlying Obamacare subsidy works, just so all of the listeners are aware, it caps the amount of the premium that an individual has to pay for this benchmark plan. | ||
| So over time, as Obamacare premiums have significantly increased, the enrollee share of the premium has remained constant. | ||
| So on autopilot, because of the underlying subsidies, and this has nothing to do with the bonuses, the COVID era bonuses that go away, the subsidies get more generous. | ||
| So in 2014, the subsidy covered about 68% of the premium for the average enrollee. | ||
| By 2020, before these COVID-era bonuses, it covered 80% of the premium. | ||
| And this year, it will also cover 80% of the premium. | ||
| So the underlying Obamacare subsidies are already very generous. | ||
| They cover 80% of the premium for the typical enrollee. | ||
| One of the things that I am very concerned about is a lot of people get coverage through their employer. | ||
| They get much less benefit from the government in terms of a tax advantage when they get coverage through their employer than if they get coverage on the Obamacare exchange. | ||
| That's very distortionary and it harms people that have employer-based insurance. | ||
| And what it also leads to is small employers dropping coverage. | ||
| So there's significantly fewer small employers that offer coverage now than did when Obamacare started. | ||
| And, you know, employer coverage tends to be better. | ||
| It covers more doctors and hospitals than Obamacare coverage. | ||
| And it's also very expensive when employers drop coverage and move workers into the heavily subsidized exchanges. | ||
| So I think extending the enhanced subsidies worsens these underlying distortions and leads more, one, it punishes people that get insurance through the workplace, but it also encourages small employers to drop coverage. | ||
| All right, Edna's next. | ||
| In Illinois, Democratic caller. | ||
|
unidentified
|
Good morning. | |
| Morning. | ||
|
unidentified
|
Good morning. | |
| I cannot understand why there is so much talk about the Affordable Care Act. | ||
| If President Obama's name was not in front of it, you wouldn't have all of this talk about it. | ||
| My brother went to school in Stockholm, Sweden. | ||
| He got a PhD from the University of Stockholm in economics. | ||
| What he told us the way those people take care of their citizens is just amazing. | ||
| But all of the politicians here are still in the money. | ||
| They are the ones who are still in the money. | ||
| It's not the people. | ||
| We can live much better. | ||
| We got a guy, supposedly FBI, using a plane to go visit his girlfriend. | ||
| What is this? | ||
| This is fraud. | ||
| All right. | ||
| Edna, Illinois Democratic Color. | ||
| I'm going to go to Sue next, who's in Florida, Independent. | ||
| Hi, Sue. | ||
|
unidentified
|
Hi. | |
| Good morning. | ||
| I have a few comments and a few questions. | ||
| Okay. | ||
| This health savings account that Trump wants to put a few dollars in, how much is enough? | ||
| Let's say if you're a young person and you didn't expect to have any big health problems, and then all of a sudden you have a blood clot, a heart attack, is there going to be enough money in that account? | ||
| And if you have like any kind of emergency, you're not going to go and price hospitals and doctors. | ||
| So I'm not sure how that's going to work. | ||
| Sue, I'm going to leave it there. | ||
| Brian Blaze, two comments from you from callers. | ||
| First, address Edna's concern that people are critical of the ACA because they hate President Obama, former President Obama. | ||
| Yeah, I mean, I think that may be true for a small number of individuals, but I think the ACA continues to be in the policy debate because it was such a big change to government health care policy. | ||
| It's significantly, its regulations significantly changed and increased the price of coverage in the individual market, necessitating these extraordinarily large subsidies, which were then enhanced during the pandemic and set to expire after 2025. | ||
| So they were set to expire because they are very costly. | ||
| They were not made permanent because the Democrats, when they were in control, like they're too costly to make permanent. | ||
| We're just going to set them in place for a few years. | ||
| They're set to expire. | ||
| They're very expensive to continue. | ||
| They've led to massive amounts of fraud and improper enrollment, as we have found. | ||
| And it's a policy debate right now about the best direction going forward. | ||
| I think what we need to have is a very, I wish we had a more robust, realistic debate about the underlying flaws within Obamacare and a rational conversation about how to move forward and address the flaws in a bipartisan way. | ||
| I think that just dumping more money directly to health insurance companies is just patently irresponsible public policy, given what we know about the problems in the program, particularly over the last couple of years. | ||
| I think on the caller about HSAs, you know, to have an HSA, you need to have a high-deductible health plan. | ||
| So you do have insurance that protects you if you have catastrophic medical expenses. | ||
| What I like as a financing model is that insurance is used to cover expensive but low probability events. | ||
| That is what we use insurance for in every other aspect where we have insurance in our economy. | ||
| But for routine, for shoppable services, people don't have to, shouldn't have to use their insurance. | ||
| Insurance raises a whole bunch of administrative costs. | ||
| We now know that insurance tends to be more expensive, that providers charge more if individuals have insurance than if they don't use their insurance. | ||
| And for routine shoppable services, it makes a lot of great deal of sense for individuals to pay directly. | ||
| And expanding HSAs is one way to get more direct payment from consumers where they're more cost-conscious, discerning shoppers of care than if we run everything through a comprehensive insurance plan. | ||
| Brian Blaise is the president of the Paragon Health Institute, also a former White House National Security Council policy advisor in the Trump administration. | ||
| Brian Blaise, so then when you talk about routine health care not being part of the insurance model, what does going to your doctor look like? | ||
| Yeah, I mean, that's a great question. | ||
| So there's a lot of models where people can get upfront pricing. | ||
| And if they don't use their insurance, if you say that you're going to pay in cash, you can find out what the cash prices are. | ||
| And the cash prices tend to be a lot lower than if you use your health insurance. | ||
| So many plans now have high deductibles. | ||
| Most people actually don't hit their annual deductibles. | ||
| So you have incentives to shop when you're below your annual deductible. | ||
| And that really is where HSAs have the most value or these routine shoppable services. | ||
| There are some ideas in some states that if you find healthcare that is out of your insurance network, it is cheaper than going within your insurance network, that you can take that amount and have it applied to your in-network deductible. | ||
| I think there's some reasons to like that type of model. | ||
| But I think there are different ways that people can finance and pay for health care other than this very complicated process where you get the explanation of benefits, you get bills from the insurance company like months later. | ||
| I mean, the way that we pay for so much of health care in the U.S. is complex, frustrating for both patients and providers. | ||
| And it's because insurance companies have too much power within allocating healthcare resources in the U.S. Connie in Colorado, following up on something you said earlier. | ||
| She wants to know, she says, if you know that these administrators are defrauding the ACA, why aren't they being arrested? | ||
| So some of them are. | ||
| It's actually a couple of major lawsuits that were brought by the Department of Justice. | ||
| One that resulted in a conviction a month or two ago. | ||
| There were two individuals. | ||
| They were, again, based in South Florida. | ||
| They were manipulating people to get their information, sometimes paying people a nominal amount in order to get their information and enroll them, basically massage or just outright fabricate information on the application to qualify for them for a fully subsidized plan. | ||
| And then what happens is the individual gets enrolled. | ||
| The US government starts cutting checks to the insurance company. | ||
| And then these brokers who have enrolled the individuals, they get a cut from the insurance company for every month that one of these individuals is enrolled. | ||
| Those two individuals, the amount of improper and fraudulent subsidies that they were responsible for was over $200 million. | ||
| And there's other schemes like that throughout the country. | ||
| That's really just a tip of the iceberg. | ||
| It is very hard. | ||
| It takes a lot of resources on the back end if you're going to pay out all this money and then try to deal with it through the criminal justice system. | ||
| What we need, if you're going to really meaningfully reduce the fraud and the improper enrollment and spending, is better incentives from the government policies. | ||
| And I think those better incentives start from Congress not extending the COVID era subsidy bonuses. | ||
| We'll go to Teresa next in Tennessee, Republican caller. | ||
|
unidentified
|
Good morning. | |
| You're the best I've ever heard on explaining Obamacare subsidies. | ||
| Please give me a minute. | ||
| There's only 22 million people on Obamacare. | ||
| So with all this money, what does that equal out for recipient of Obamacare? | ||
| And Democrats say that all they want to do is protect health care for the people. | ||
| I have private health care. | ||
| They never want to help me with my prices or give me any kind of a subsidy. | ||
| I've never reached my deductible amount, never in the whole time I've had it. | ||
| And the fraud, remember when this first started, Republicans kept saying, oh, illegals are getting free health care. | ||
| And of course, abortions are being government funded, but yet they turn around last night and vote for it. | ||
| This is as big a fraud as the Minnesota fraud. | ||
| Can you imagine the fraud that's going on in Obamacare? | ||
| You know, that the Democrats are ignoring and probably getting kickbacks from. | ||
| I mean, it's just a scheme. | ||
| It's just a scam. | ||
| And, you know, it's got to be stopped. | ||
| Trump says that he's not for it. | ||
| So I would hope that he could get a veto-proof majority to go against it. | ||
| I hope it never comes out of the Senate. | ||
| Okay, Teresa. | ||
| Well, let's take a look at what House Republicans would like to do on health care. | ||
| This passed the House on December 17th, 216 to 211. | ||
| Their proposal expands association health plans, funds a cost-sharing reduction program, meant to lower premiums, imposes requirements on pharmacy benefit managers, does not extend the expired enhanced ACA subsidies, and does not include Senate GOP plan to provide health savings accounts. | ||
| Brian Blaze, what did you think about what House Republicans proposed? | ||
| So I thought what House Republicans proposed was a reasonable set of policies to address some of the underlying problems within Obamacare and expand affordable coverage options. | ||
| So Association Health Plans, what they do is allow small businesses to join together and increase their purchasing power. | ||
| And large group plans are able to get some regulatory advantages and economies of scale that small employers don't get. | ||
| So it doesn't make any sense for government policy to discriminate against small employers in favor of big business. | ||
| And this equalizes the playing field. | ||
| So I think association health plans make a lot of sense. | ||
| The CSR appropriation, it's a little bit complicated to get into. | ||
| To try to make it a little simpler, there were two underlying subsidies within Obamacare. | ||
| We've talked about the premium subsidy, which goes to insurers to lower premium amounts. | ||
| There was a second subsidy that also goes to insurers and would lower the deductibles and co-payment amounts of individuals that buy Obamacare plans. | ||
| The underlying Obamacare didn't contain a ballot appropriation for that second subsidy program. | ||
| So the Obama administration was making illegal payments to insurers. | ||
| That was what the court said. | ||
| So the Trump administration complied with the court ruling. | ||
| What insurers did in response was significantly increase premiums. | ||
| And because the subsidy, the premium subsidy, is a function of the benchmark plan premium, overall subsidies in Obamacare increased. | ||
| So a CSR appropriation would lower premiums and it would lower subsidies. | ||
| But one of the few of the points that the previous column made, Teresa, she said that there were 22 million people in the Obamacare market. | ||
| That's right. | ||
| So we're just talking about the individual health insurance market. | ||
| There are seven times more people that get coverage through their employer than get coverage through the exchanges. | ||
| And on a per enrollee basis, the government is spending more than three times as much to cover individuals in Obamacare than in employer plans. | ||
| This is one of my major concerns with small employers dropping coverage and sending their workers to the heavily subsidized exchanges is that it grows the cost to the taxpayers so significantly. | ||
| Jay is next in North Carolina, Independent. | ||
|
unidentified
|
Good morning. | |
| And thank you so much, sir, for the clarity that you're providing to this conversation on details that I didn't even know about, especially on the crazier end of the fraud part that you were talking about. | ||
| But my question really is, this really just, I think, takes us back to the initial conversation, which those of us who are a little bit younger and maybe were excited about the Obamacare possibilities with possibility for universality of care and really the quality of care that's needed. | ||
| Now I've got young children. | ||
| I'm caring for an elderly parent, right? | ||
| And all of that, and even having private insurance myself, it's just a nightmare of the entire process, every aspect of it. | ||
| It's all, you know, just, you know, it's just really, really tough to navigate for the average person. | ||
| And so just what do you think is really the solution where everybody can get the coverage that they need, can get preventative care, can get an appointment for just a physical, and it's not like eight months out. | ||
| You know what I mean? | ||
| And what would that price point be? | ||
| And is it something that, you know, somebody who might be a little bit further on the other end of the spectrum politically can just see that everybody everywhere is really having this issue with the entire insurance process and really wants the conversation to be about health care and not health insurance. | ||
| And what is that number? | ||
| Is it $100 a person every single month? | ||
| And then we can just get this out of the way and get back to the healthcare part or wouldn't just guide us with that process, sir. | ||
| Thank you. | ||
| Yeah, well, thank you for that, Jay. | ||
| You raise a lot of important issues. | ||
| Touch on a few of them. | ||
| I think Americans are overwhelmed with the complexity of the U.S. healthcare system and also the cost. | ||
| And actually, one of the problems with the cost is that a lot of Americans don't actually know how expensive it is. | ||
| Like if you get coverage from your employer and half of all Americans get coverage from their employer or an employer of a family member, the employer, there's an employer share. | ||
| And there's this commonly held view that the employers are paying for that share. | ||
| That is not what happens in reality. | ||
| In reality, employers are offering compensation and they are directing a portion of that compensation to the individual. | ||
| So we're paying for that health insurance cost in the form of lower wages. | ||
| So a lot of the wage growth has slowed in the U.S. over the last few decades because so much of the compensation increase has happened through healthcare. | ||
| Government policy distorts both the demand side of the market and the supply side of the market. | ||
| The way we're going to get more affordable, accountable health care is to address government policies that both limit supply and policies like that are government rules that restrict health care providers from practicing to the top of their license or that restrict new competition to come into markets. | ||
| And then on the demand side of the market, we so heavily subsidize comprehensive health insurance, which is the most administratively complex way to finance so much of our health care expenses. | ||
| And we discourage ways that people can pay without having to go through health insurance. | ||
| So I think we need to do a set of reforms that both address the supply side of the market and expand the capacity of the healthcare providers to provide services for Americans. | ||
| We need to make sure that artificial intelligence, because I think there's a real role for artificial intelligence to improve diagnoses, that that's allowed to play out. | ||
| And then we need to address the supply side of the market where government needs to stop directing so much of the subsidies and favoritism to big health insurance companies. | ||
| Tony in Charlotte, North Carolina, on our line for Democrats here talking to Brian Blaise. | ||
| Good morning. | ||
|
unidentified
|
Good morning. | |
| I want to just address one or two issues with Brian. | ||
| Number one, Brian, people don't shop for health insurance like they shop for car insurance. | ||
| Okay, if you've got a child that has a 102 fever, you're not going to get on your phone and start shopping for insurance. | ||
| Number one, that's stupid. | ||
| Number two, the way in which if people have a very short memory in America, when the ACA was passed, the Republicans ran to the Supreme Court to get rid of the individual mandate. | ||
| If we want to lower this cost in this program, we need to bring back the individual mandate. | ||
| So I want you to address the individual mandate, and then you can go back to that Luffy point about shopping for insurance. | ||
| People are not going to shop for insurance in emergencies. | ||
| That's ridiculous. | ||
| All right, Tony. | ||
| Well, I think the point you intended to make is that people can't shop for health care when they're in emergencies. | ||
| And clearly, that's true. | ||
| So if you're in a medical emergency, you're not going to be calling various providers and finding out what the prices are. | ||
| But people can't shop for health insurance. | ||
| The problem is most people don't shop for health insurance. | ||
| Most people just get the insurance product that their employer chooses for them on their behalf. | ||
| And I think there's significant problems when we outsource the purchase of a major financial product to our employers. | ||
| They don't choose other financial products and narrow our choices of those. | ||
| It's just health insurance on the individual mandate. | ||
| So the individual mandate was a key component of Obamacare. | ||
| The individual mandate was a tax penalty on individuals that didn't buy the government-approved insurance. | ||
| It was subject to the first major Supreme Court case on Obamacare. | ||
| The Supreme Court upheld the constitutionality of the individual mandate as a tax in a very controversial five to four decision. | ||
| The individual mandate in Obamacare did not work. | ||
| The reason that we know it didn't work is because Congress, and I'm glad they did, I don't think that the government should be penalizing people who don't purchase its approved health insurance. | ||
| But the Congress in 2017 repealed the tax penalty, and President Trump signed that. | ||
| And the elimination of the individual mandate tax penalty took effect in 2019. | ||
| And it had no effects in the market. | ||
| The individual mandate did not lead people to buy coverage who it was against their economic interests to buy that coverage. | ||
| The story of Obamacare is the story of subsidies. | ||
| The only way that the market works is because the government is paying almost the entire amount of the premium. | ||
| If people have to pay the premium themselves, they don't find the coverage valuable. | ||
| And I think that is an indictment on the law that subsidies have to be so large in order to induce people to purchase the product. | ||
| If you're only going to purchase the product, if the government pays 90% of the cost, that provides us some really good measure that people don't value this program. | ||
| Who values it are the big health insurance companies whose stock prices have soared because the federal government is pouring so much subsidies directly into their copper. | ||
| Frank, in San Francisco, Independent, our last call here this morning. | ||
| Go ahead, Frank. | ||
|
unidentified
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Okay, yeah, I call in on Independent Line because Democrats are not left-wing enough for me. | |
| If you had a left center and right, that would make more sense to me. | ||
| I don't have representation in Congress or Senate. | ||
| All right, Frank, your comment or question about healthcare. | ||
|
unidentified
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Okay, the guy stole my fire. | |
| I have chest pains. | ||
| Oh, let's shop. | ||
| Let's shop for health care. | ||
| Wonder if I should go see a doctor or not. | ||
| We need single-payer health care or, I mean, the Heritage Foundation plan, which was RomneyCare and then became Obamacare. | ||
| They argued for an individual mandate, and then they argued that it was unconstitutional. | ||
| All right, Frank, I'm going to jump in because we're running out of time. | ||
| Brian Blaze, take the universal care and Romney care part of his comments. | ||
| Yeah, so I mean, I think there's something to be said for universal health care. | ||
| I want health care to be much more affordable and accessible. | ||
| The way that I think that happens is by reducing the role of government, both, like I said, on the supply side of the market and the demand side of the market. | ||
| Right now, we have a healthcare system where so many of the resources are not allocated based on which providers, which insurers deliver the best value to patients, but by who has the best lobbyists in Washington, D.C. | ||
| And single-payer health care would expand government control over the sector and even lead to more allocation of resources based on who has political power. | ||
| I don't think that we should be allocating resources based on who has the best lobbyists and the most political power. | ||
| We should be allocating resources based on which providers, which insurers are offering the best value. | ||
| And in order to know which insurers and what providers are offering the best value, people need to be able to spend their own money on the health care that works best for them. | ||
| Brian Blaise is the president of the Paragon Health Institute. | ||
| You can learn more if you go to paragoninstitute.org, also former White House National Economic Policy. | ||
| Certain onalia rights, and among these are life, liberty, and the pursuit of happiness. | ||
| But the line that immediately follows what struck me as a seasoned law enforcement professional, and it says that to secure these rights, governments are instituted among men, deriving their just powers from the consent of the governed. | ||
| And that is really a passion of mine of the Portland Police Bureau, that we understand that we derive our powers from the consent of the governed, that Portlanders have expressed to us how they desire to be policed and how they desire to interact with their local law enforcement. | ||
| That will always continue to be a priority of mine. | ||
| And we have done that remarkably over the last year, particularly in the area of public order. | ||
| I'm so tremendously proud of the way that we have all showed up, both our community, sometimes in the tens of thousands, or maybe minor protests, and even this week with the events in Minneapolis that certainly concerns us and raised the tension and the fear and the angst. | ||
| And we had a demonstration that evening. | ||
| And then the demonstrations last night and the public order events that are happening today and throughout the weekend, I have high expectations that we will continue to be able to express our dissent in a way that demonstrates our commitment to showing how we want to be governed. | ||
| And that means doing so in a way that is calm or is peaceful or is nonviolent, whatever the terminology that you choose to use, but an expectation that these public order events can be held and participated in by all and that they are a place of safety for all, including our public officials and our first responders. | ||
| Last night, we had a couple of events that occurred, one that was across the street here at City Hall, several hundred participants, and then we also had several hundred down at the facility in South Waterfront. | ||
| We, along with our partners from the Oregon State Police, were present down at Southwaterfront last night. | ||
| We did see an increased amount of energy and intensity, which we anticipated given the events of yesterday and on the heels of Minneapolis, and appropriately so. | ||
| I understand Portlanders' concern. | ||
| I understand Portlanders' fear and frustration. | ||
| I believe there is legitimacy to that, and we anticipated that there would be an increased amount of energy. | ||
| Historically, this past year in our public order events, through dialogue officers, through announcements, and through cooperation, we've been able to achieve results and minimize arrests and minimize conflict. | ||
| Last night, there were some who chose not to follow the direction of the officers, and we were required to make a couple of arrests, six actual arrests for disorderly conduct. | ||
| We had a couple of officers that were slightly injured. | ||
| There was one force event not involving munitions, just a force event that will be thoroughly investigated and reviewed through our after-action process. | ||
| But overall, considering the heightened amount of energy and concern last night, I'm still very grateful for the overall vet and the participation. |