On the Third Hand: Mycare

I’ve been looking at various Patient Protection and Affordable Care Act (PPACA) defenses and replacer proposals and noticing a lack of concrete ideas (even bad ideas) for improving the current framework, as opposed to throwing it out and starting over from scratch.

See also: Republicans eye quick partial PPACA repeal if party wins White House

On the one hand, maybe starting from scratch is the only feasible path forward.

On the other hand, America’s Health Insurance Plans (AHIP) and the National Association of Health Underwriters (NAHU) used to seem to like the concept of an exchange-based system. If throwing out the current system and starting over is too hard, but some change is possible, maybe there are ways to revamp the current system.

On the third hand, if people started throwing out even doomed ideas for revamping the system, maybe that would help create the policy “manure” necessary to fertilize the creation of good ideas.

Here are some ideas:

1. Get operation of health insurance exchanges out of the hands of the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS): 

HHS and CMS seem to be doing the job poorly and provide little transparency. If HHS and CMS were simply regulating the exchange system, not running the system, maybe they’d develop and enforce better transparency standards.

2. Acknowledge that the main users of the central exchange system will be live-human advisors and a few consumers who like tinkering with complicated websites, not typical consumers:

Just about every private health insurance sales website has gone down that path. Why not the PPACA public exchange system?