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00:00

Finance Allah shmoop What is Obama care Well the technical

00:07

term Yeah it's the Patient Protection and Affordable Care Act

00:12

Obama care is well just the affectionate nickname like Bubba

00:15

or Sparky or monkey buns Anyway the goal of this

00:18

act was to provide all Americans with health care insurance

00:22

and the intent a noble one Lots of people don't

00:25

have health insurance because they have like literally no money

00:29

or nobody will ensure them because they're oh so sick

00:32

or because well they're just daredevil arrogant thrill seekers who

00:36

never think that gravity will fight them So how did

00:40

our then president expect to be able to get this

00:42

done well enormous financial expense with an extremely high degree

00:47

of difficulty to pull off on a national scale Essentially

00:51

the plan was to meaningfully expand Medicaid which is the

00:55

insurance for the poor and the disabled Well instead of

00:57

covering most people for a relatively modest tax to the

01:00

poor it would offer Medicaid which while still not offered

01:04

to all people was expanded in many states well paid

01:08

for by a variety of taxes including higher taxes for

01:11

individuals in some corporations such as medical device manufacturers and

01:16

taxes on insurance plans It originally forced everyone to either

01:19

buy insurance individually have it provided by an employer or

01:23

else pay a penalty Now if you were a normal

01:26

hardworking healthy ish taxpayer it meant that your tax bill

01:30

instead of being eleven thousand two hundred fourteen dollars would

01:34

now be eleven thousand eight hundred fourteen dollars And a

01:37

lot of Americans were upset at having to take the

01:40

six hundred dollars that they had earmarked toe by Johnny

01:43

clothing and a new swing set next year and now

01:46

give it to the sick and or disabled masses Well

01:49

Obama care essentially change the rules for what is expected

01:52

from a health care insurance plan Doctors are not required

01:55

to treat you but your insurance was required to provide

01:58

a broad basket of benefit like any previous illness you

02:01

had or certain procedures you'd had done had to be

02:04

included in your health plan People had to purchase plans

02:08

that offered this package whether or not they needed the

02:10

full amount of insurance Fair not farewell Let's think about

02:14

this concept because a lot of people were and continue

02:16

to be really angry about Obama care and they're not

02:19

all idiots not like these people On the one hand

02:22

it makes sense that you should get care if you're

02:25

sick right This is in India This is in a

02:27

poor African country where the warlords drive Ferraris as their

02:31

population starves This isn't even an article where the rulers

02:35

barely give a fish to the ruled So the idea

02:38

of covering everyone and anyone who is ill is really

02:40

not a terrible thought The truth is that the added

02:43

cost of covering everyone was managed through subsidies by requiring

02:48

everyone have insurance or pay a fee and requiring broader

02:51

forms of insurance The generally healthy and young subsidized the

02:55

old and sick In addition subsidies for care or offered

02:59

for the indigent Obama care also created incentives for people

03:03

to just pay the penalty and avoid insurance altogether and

03:06

or not really care for themselves or worry about their

03:09

own health management because the government now mandated that coverage

03:13

regardless of an individual's health or lifestyle So let's have

03:16

that fourth Dona Who cares If obese people are ten

03:19

times more likely to get very expensive to treat diabetes

03:22

The government will cover the cost O And how do

03:26

you feel about that at Cole who's always riding his

03:28

motorcycle eighty miles an hour between cars on the freeway

03:31

with no helmet Yeah he crashes Doesn't die He costs

03:35

a million dollars of insurance or government money depending on

03:38

the type of coverage as to live in the hospital

03:40

for you know five months Taxpayers will have to spend

03:44

their money on that guy instead of offering computer science

03:47

courses to their entire district under the federal matching funds

03:51

for education that we're supposed to be there Well the

03:53

truth is our budgets are finite and expanding Medicaid wasn't

03:57

free We are a hugely indebted country with most of

04:01

our states in analogous ly bad financial shape So money

04:04

isn't free And when we pay for things they come

04:06

out of other things And Obama care basically made the

04:10

decision that the motorcycle guy can get coverage at similar

04:13

rates to the rest of us regardless of how much

04:16

risk he takes And yes he's the extreme case and

04:19

a lot of other less extreme and way more positive

04:23

cases were covered as well But if it was your

04:25

kid's computer science courses that were canceled to reallocate tax

04:29

dollars to that motorcycle ball Well you'd give pause right

04:33

Did Obama care really encourage people to care less than

04:35

they already did about their health Probably not But it

04:38

did create a kind of adverse selection in that the

04:41

worst health managers or least healthy people who were likely

04:44

the most expensive to treat would be encouraged to opt

04:48

in to Obama care and just keep on keeping on

04:51

with Joe Camel and the gang and not worry Be

04:54

happy As Obama care was rolled out it expanded coverage

04:57

dramatically so that it wasn't just for cataclysmic things like

05:00

lung cancer and diabetes And under ten broad categories healthcare

05:04

costs were codified and reapportioned So you had emergency services

05:08

like ambulances And then he had drugs covered basically an

05:11

expansion of Part D of Medicare mapped onto Medicaid Add

05:15

to this coverage maternity leave Then it also added in

05:18

the castle for allowing kids to stay on there parentsplans

05:21

until they were age twenty six Then an added premium

05:24

costs for old people that were essentially rent control That

05:28

is those costs Toe old people could not be more

05:31

than three times the cost for the same service to

05:33

young people and remember that market forces would dictate that

05:37

young people on a relative basis almost never get sick

05:40

when compared tto old people So the real market costs

05:43

were away more than three times like the rent control

05:45

was really inefficient And again these extra costs beyond what

05:49

the market would naturally dictate they should be came out

05:53

of the pockets of the hardworking money earning taxpayers through

05:56

Medicaid expansion or subsidies for providing insurance And plus while

06:00

it raised is the cost of insurance for healthy people

06:03

who have always had coverage because they had to subsidize

06:07

the care of the sick And then there was the

06:09

smoker provisioned Yeah remember Obama smoked So uh this lit

06:14

a fire under his opponent's part of Obamacare also capped

06:17

the cost to smokers who used to pay higher rates

06:20

for their insurance It capped cost two smokers such that

06:23

they couldn't be charged more than one point five times

06:26

the normal rates of non smokers even if they were

06:29

ten times more Likely is a group tohave very expensive

06:32

to treat health care problems And this whole program was

06:35

structured as mandatory meaning that Obama care required that every

06:39

single person in the country have health insurance Not a

06:42

terrible idea but it required employers toe pay for it

06:45

if the company was of a certain size or required

06:48

individuals to purchase it If employers didn't pay and individuals

06:53

didn't purchase Yes they originally faced that penalty that big

06:57

or else thing we were talking about like a motorcycle

06:59

guy Yeah he must pay for insurance Well he's too

07:03

stupid to wear a helmet than you Khun Fairly ask

07:06

Why would he be smart enough to at least Carrie

07:08

basic insurance Well the government then has to essentially force

07:11

him to brush his teeth while he still has a

07:13

few left So Obamacare forced you to carry insurance or

07:16

you pay the fine or penalty if you didn't and

07:19

Trump's tax reform package promptly removed that penalty putting the

07:22

burden back on the individual or set another way If

07:25

that person wants to risk life and limb they should

07:27

be able to just not on the taxpayers nickel Well

07:31

the broader goal financially revolved around the notion that if

07:33

you had a large enough pool of money to cover

07:35

the sick then the healthy who need little to no

07:38

maintenance would essentially foot all the bills So who would

07:41

you guess would then not want this coverage and obese

07:44

diabetic old flower shop worker or a healthy young person

07:48

who could run a sub forty five minutes and K

07:50

Yeah the young people just opted out for better or

07:53

worse Wiser stupid They just didn't sign up for Obama

07:56

care And that was where the beginning of a financial

07:59

wakeup call began Governments or simply bad at predicting consumer

08:03

behavior And if all of this wasn't controversial enough given

08:06

that this country's health issues are regional ahs well a

08:09

cz national meaning that a night stay in the car

08:11

cost way more in Manhattan than it does in Tuscaloosa

08:15

Obama care tried to push down to the state level

08:17

is much admin as it could in the process It

08:20

created state exchanges And that's about geographic states not states

08:25

of consciousness and of course with government workers trying to

08:28

build complex websites while the backend technology and the rollout

08:31

completely failed embarrassingly And for some this was actually surprising

08:36

shocking Even Like when you think of America's best and

08:39

brightest technology people you probably don't think of the D

08:43

m V or the T s A Or the technologies

08:46

that either of those places proffer Anyway the policies gave

08:50

states the right to go it alone and try to

08:51

manage their own Obama care policies are basically just give

08:54

back the money to Medicaid and let the federal government

08:57

deal with things the way they had been So that's

08:59

obamacare In a nutshell Lots of nuts And plenty more 00:09:02.92 --> [endTime] to be Sheldon They passed the donut Yeah

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