The wasted overhead of the old system (15-30%) has been tamed by the ACA to 10-15%. Given the 1 trillion that the private system controls, the overhead is about 130 billion. Medicare, with 50 million clients, has an overhead less than 2%, or about 3 billion. The difference is enough to insure 80% of the 30 million uninsured, and if we add the $170 billion spent on emergency treatment for those lacking insurance (according to the American Association of Emergency Physicians), where the average visit is $2000, or 90% higher, than regular doctor visits, there is enough saved to fund the 30 million uninsured and to add ffull dental and vision (50 billion, according to the Insurance Institute).
With this background, let's go to stage 2: the Republican flip.
When the Democrats found they did not have the votes for single payer (which is now supported by the majority of Americans. A May/2016 Gallup poll found:
"PRINCETON, N.J. -- Presented with three separate scenarios for the future of the Affordable Care Act (ACA), 58% of U.S. adults favor the idea of replacing the law with a federally funded healthcare system that provides insurance for all Americans. At the same time, Americans are split on the idea of maintaining the ACA as it is, with 48% in favor and 49% opposed. The slight majority, 51%, favor repealing the act."
That is, nearly 6 in 10 Americans now support a single payer system.
This is the preference to replace the ACA. Have the Republicans proposed such a single payer system? This not socialized medicine such as the UK has or the VA (whose original plan was adopted by the Founding Fathers in Congress without one dissenting vote, setting up government hospitals and doctors for maritime workers who were mandated to pay for it).
Once the Republicans saw that the Democrats had stolen THEIR plan, they unanimously opposed it. They have tried to repeal it over 50 times, and now they have begun to do so. So what is their alternative plan?
They do not have one because the Democrats stole it!
Trump, who once long ago supported single payer, has said that he wants everyone covered, which implies a guarantee of healthcare, proposed in the original Republican plan but missing in the ACA. The one specific plan Trump has, in the campaign, proposed is allowing people to buy "across state lines."
This is an empty promise because there is no law which today prevents an insurance company from selling in any state, nor any law which forces them to.
The private insurers are in control, withdrawing from regions to allow monopoly pricing, raising rates, canceling plans, at their will, all the while shifting blame to the government plan which was, in essence, a form of corporate welfare, giving them tens of millions of subsidized customers.
So the Republicans have no plan because they have opposed the plan they created and now are repealing it, with no alternative in sight.
How then have the private insurers fared under the ACA? It was designed to transfer trillions in public funds to their private pockets, with CEO salaries, 98% higher than top Medicare management, and reaching, in 1 year when 4 million Americans lost their jobs and 10 million went on SNAP, the obscene level of the United CEO making $106 million, taking home 85 million after taxes.
Here is the data on healthcare insurers: publicintegrity.org reports..............
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