>> REPEALING OBAMA CARE HAS BEEN THE GOAL OF REPUBLICANS IN
CONGRESS, AND WITH THE REPUBLICAN PRESIDENT COMING INTO
OFFICE IT LOOKS LIKE THEY ARE GETTING THEIR WISH.
BUT WHAT HAPPENS TO MILLIONS WHO HAVE ONLY HAD HEALTH CARE UNDER
THIS CONTROVERSIAL LAW?
WHAT WILL REPLACE OBAMA CARE?
AMERICAN INTERNATIONAL COLLEGE PROFESSOR OF ECONOMICS JOHN
ROGERS SPOKE WITH CONNECTING POINT CORRESPONDENT CAROLEE
MCGRATH TO DISCUSS JUST THAT.
>> WELL THE REPUBLICANS HAVE TALKED A LOT ABOUT IT, BUT I
THINK IT WAS SENATOR McCASKILL SAID FOR SIX YEARS WE'VE BEEN
LOOKING FOR THE REPUBLICAN PLAN UP AND DOWN, AND WE HAVE NOT
SEEN IT, SO I THINK THAT WHAT THEY NEED TO DO IS ARTICULATE
THE REPLACEMENT OR THE ALTERNATIVE OR HOW IT'S GOING TO
WORK GOING FORWARD, AND THERE ARE A LOT OF PROPOSALS ON THE
TABLE, BUT IT'S STILL A LOT OF UNCERTAINTY AS TO WHAT'S GOING
TO HAPPEN IN JANUARY AFTER THE INAUGURATION WHEN THEY GET
STARTED WORKING ON THIS.
>> I THINK THAT PART OF THE PLAN HAD BEEN TO PUT IN THE REPEAL,
BUT HAVE IT PHASE IN, IN A FEW YEARS, IS THAT SOMETHING THAT
WOULD GIVE THEM ENOUGH TIME TO REPLACE PROVISIONS?
>> WELL, IT WOULD, BUT YOU ARE DEALING WITH COMPLEX INSURANCE
MARKETS, AND THAT COULD BE DESTABILIZING SO I THINK THAT
THERE IS A DEBATE GOING ON AMONGST THE POLICY-MAKERS,
WHETHER IT'S BETTER TO JUST TRY TO DO EVERYTHING RIGHT AWAY, AND
THEN MOVE FORWARD, WITH THE NEW PLAN, OR GIVE IT SEVERAL YEARS,
I THINK THAT THEY ARE TENDING TOWARDS GIVING IT MORE TIME, BUT
I THINK THAT ALSO HAS A DOWN SIDE IN TERMS OF THE CONFUSION
THAT COULD RESULT.
>> SO IN 2017 ACCORDING TO THE REPORT IN FISCAL TIMES, PREMIUMS
WILL GO UP BY DOUBLE DIGITS IN 31 STATES, AND ALSO THE
DEPARTMENT OF HEALTH AND HUMAN SERVICES HAD A REPORT THAT SAYS
THAT AVERAGE PREMIUMS WILL INCREASE BY 25%.
>> I THINK THE REALLY CRITICAL ISSUE IS THE EXCHANGES, WHICH
WE'RE SUPPOSED TO BE THE MAINSTAY OF THE PROGRAM, SO
PEOPLE WHO DID NOT HAVE INSURANCE WITH THEIR EMPLOYER,
OR WHO DID NOT FALL UNDER MEDICAID OR MEDICARE AND
MEDICAID REMEMBER WAS EXPANDED IN ALL BUT 20 STATES SO A LOT OF
PEOPLE WERE PICKED UP UNDER MEDICAID.
BUT THE PEOPLE IN THE MIDDLE ARE DIRECTED TO THE EXCHANGES, AND
FOR A NUMBER OF REASONS THOSE MARKETS ARE NOT WORKING WELL.
AND A LOT OF THE INSURANCE COMPANIES HAVE ACTUALLY BACKED
OUT OF THE EXCHANGE, THE EXCHANGE MARKETPLACES.
SO THAT'S WHERE THE REAL CRISIS IS.
AS YOU SAY PEOPLE ARE JUST BEING HIT WITH BIG INCREASES IN
PREMIUMS IN MANY LOCATIONS.
>> IS ONE OF THE REASONS BECAUSE SOME OF THE YOUNGER PEOPLE ARE
SAYING LISTEN I WOULD RATHER PAY THE PENALTY FOR 700 THAN THE
PREMIUM, IF I AM A 27-YEAR-OLD HEALTHY KID?
>> WELL WHEN THE PROGRAM STARTED, THERE WERE GOVERNMENT
ENCOURAGED THE INSURANCE COMPANIES TO GET INVOLVED, AND
THE INSURANCE COMPANIES WERE HOPEFUL THAT THEY WOULD PICK UP
A LOT OF NEW CUSTOMERS, BUT EXACTLY THAT HAPPENED THAT THE
PEOPLE WHO DON'T THINK THAT THEY NEED THE INSURANCE DON'T GET IT.
THE PEOPLE WHO DO NEED THE INSURANCE BUY IT, AND THAT IS
CONTRARY TO THE WAY THAT THE INSURANCE WORKS, AND THE, IN
ONLY WORKS WHEN YOU HAVE A LOT OF HEALTHY PEOPLE SUBSIDIZING A
FEW ILL PEOPLE.
IF YOU HAVE A LOT OF ILL PEOPLE, IT GOES INTO RAN ADVERSE
SELECTION PROCESS.
>> HOW ABOUT LETTING CONSUMERS SHOP FOR THE BEST PRICES FOR
PROCEDURES?
>> THAT WOULD BE THE BEAUTY OF THE HEALTH SAVINGS ACCOUNT.
YOU WOULD HAVE MORE INCENTIVE TO SHOP AROUND.
>> IF YOU GO IN FOR A KNEE REPLACEMENT, ON YOUR MIND IS I
WANT TO REPLACE THIS KNEE, NOT HOW MUCH IS IT GOING TO COST ME.
I AM NOT LOOKING AT THAT PRICE TAG, OR IF YOU ARE GOING IN TO
HAVE A BABY, YOU WANT TO HAVE THAT BABY, YOU ARE NOT LOOKING
AT HOW MUCH IT WILL COST ON THE OTHER SIDE.
>> THAT'S THE BASIC PROBLEM WITH THE HEALTH CARE MARKET.
IF YOU GO OUT AND BUY A NEW CAR YOU MIGHT WANT A MERCEDES BUT
YOU REALIZE YOU CANNOT AFFORD IT SO YOU BUY A LOWER PRICED CAR.
YOU DON'T DO THAT WITH HEALTH CARE.
THERE IS NOT A COMPETITION BETWEEN SUPPLY AND DEMAND THAT
REGULATES A FAIR PRICE.
AND SO THAT WOULD BE ONE WAY TO INTRODUCE THAT COMPETITION.
AND THAT CONSUMER AWARENESS AND CHANGE CONSUMER BEHAVIOR, BUT
LET'S FACE IT, IT'S MUCH MORE DIFFICULT TO DO THAT AS YOU SAY
WHEN YOU ARE TALKING ABOUT YOUR KNEE OR YOUR BABY, THAN IT IS IF
YOU ARE BUYING A NEW CAR.
>> THIS GOES A COMPLICATED ISSUE.
THEY ARE GOING TO BE LOOKING AT, AND JUST IN A FEW SHORT WEEKS.
>> THEY HAD THEIR WORK CUT OUT FOR THEM BECAUSE THERE ARE
20 MILLION PEOPLE WHO HAVE PICKED UP INSURANCE AS A RESULT
OF THIS, SO WHATEVER YOU MIGHT SAY ABOUT THE PROGRAM, THOSE
PEOPLE DO HAVE INSURANCE, AND THEY NEED TO MAKE SURE THAT THEY
ARE REVISING AND REBUILDING AND RE-ENGINEERING THE SYSTEM.
THEY DON'T DO SOMETHING THAT'S GOING TO DEPRIVE THOSE PEOPLE OF
ACCESS.
>> OK, PROFESSOR JOHN ROGERS THANK YOU VERY MUCH FOR JOINING
US TODAY.