Fantasy Football - Footballguys Forums
Sign in to follow this  
timschochet

Trumpcare- Passed the House and onto the Senate; will it pass there? And what will it finally look like?

Recommended Posts

18 minutes ago, sn0mm1s said:

I wouldn't say "often" unless you also want to claim the uninsured price is "often" less than the insured price. The point is pricing and costs are neither transparent nor consistent. I don't think you can discuss any sort of cost reform until you can actually quantify what is being charged and to whom and what the net collected amount is by the doctor/hospital.

I guess I don't know what things are like near you. I do know that in my practice I deal with a lot of medical bills, and at least in the last 10 years I have never had a client to my knowledge whose physician charged less to the uninsured than to insurance companies.  Half of what you pay for with insurance companies is the negotiated rate.  

Insurance would definitely be a lot less worthwhile in my area if it were the other way around. 

  • Like 2

Share this post


Link to post
Share on other sites
37 minutes ago, Eephus said:

Well then, what about government employees including the military?  They can't possibly be trusted to vote except in their self-interest so let's take away their vote too. 

So you actually are comparing people getting government handouts to those who serve in the armed forces?  By using that comparison it shows that no discussion can help you understand

Share this post


Link to post
Share on other sites
Just now, Ratbone said:

So you actually are comparing people getting government handouts to those who serve in the armed forces?  By using that comparison it shows that no discussion can help you understand

I believe he's suggesting that voting for someone who can give you a pay raise is a conflict of interests similar to voting for someone who can provide you with free stuff, but maybe I'm wrong.

  • Like 1

Share this post


Link to post
Share on other sites
5 minutes ago, Henry Ford said:

I believe he's suggesting that voting for someone who can give you a pay raise is a conflict of interests similar to voting for someone who can provide you with free stuff, but maybe I'm wrong.

I assumed he was but I know he is smart enough to see that one is a job that you work at and risk your life in.  The other is sitting on your bottom waiting for money to be sent each month. There is really no comparison. 

  • Like 2

Share this post


Link to post
Share on other sites

From what I hear Trump/Republican plans is largely:

- Tax credits for insurance for folks based on age, not income (rich folks get same as poor)
- Block grants to states for medicaid spending that's not tied to inflation
- HIgh risk pools to cover folks with pre-existing conditions (woefully underfunded based on estimated - somewhere around 1/100th or less the total estimated cost of these risk pools)
- HSA's to help with the cost of medical coverage/expenses

There are huge flaws with most aspects of this plan, if you can call it that.  Basically at the current time the republicans don't have a coherent, fleshed out plan that can be subject to analysis, despite years of claims to the contrary and actions to repeal obamacare without a replacement.

The republican focus at this point isn't on coverage, it's about saving money and making the program look less like an entitlement than as allowing folks to pay for their own stuff.  Any program like that is destined to fail to cover anywhere near the numbers covered now, due to the lengths one has to go to to achieve cost savings.  

Share this post


Link to post
Share on other sites
10 minutes ago, Henry Ford said:

I believe he's suggesting that voting for someone who can give you a pay raise is a conflict of interests similar to voting for someone who can provide you with free stuff, but maybe I'm wrong.

This is how I took it too.  Somebody is pretty defensive here. 

Share this post


Link to post
Share on other sites
3 minutes ago, Ratbone said:

I assumed he was but I know he is smart enough to see that one is a job that you work at and risk your life in.  The other is sitting on your bottom waiting for money to be sent each month. There is really no comparison. 

There are a lot of assumptions in this statement about people who need help that is not going to help any healthy debate.  There is a wide spectrum of people who are in these various programs. 

  • Like 2

Share this post


Link to post
Share on other sites
17 minutes ago, Ratbone said:

So you actually are comparing people getting government handouts to those who serve in the armed forces?  By using that comparison it shows that no discussion can help you understand

It was a reductio ad absurdum counter to your ridiculous and undemocratic idea of taking the vote away from people receiving government assistance.  It really has nothing to do with the question of healthcare unless your plan is to make citizens choose between voting rights and medicine.

Share this post


Link to post
Share on other sites
16 minutes ago, Eephus said:

It was a reductio ad absurdum counter to your ridiculous and undemocratic idea of taking the vote away from people receiving government assistance.  It really has nothing to do with the question of healthcare unless your plan is to make citizens choose between voting rights and medicine.

Hey, it's their choice.  They could choose to die but have the right to vote. 

Share this post


Link to post
Share on other sites
13 minutes ago, Henry Ford said:

Hey, it's their choice.  They could choose to die but have the right to vote. 

3 to 5 million dead people made that choice last November

Share this post


Link to post
Share on other sites
Just now, Eephus said:

3 to 5 million dead people made that choice last November

I think we can all agree that changing the rules on who's allowed to vote should probably be off the table, regardless of whether people vote for or against their best interests.

  • Like 1

Share this post


Link to post
Share on other sites
43 minutes ago, adonis said:

From what I hear Trump/Republican plans is largely:

- Tax credits for insurance for folks based on age, not income (rich folks get same as poor)
- Block grants to states for medicaid spending that's not tied to inflation
- HIgh risk pools to cover folks with pre-existing conditions (woefully underfunded based on estimated - somewhere around 1/100th or less the total estimated cost of these risk pools)
- HSA's to help with the cost of medical coverage/expenses

There are huge flaws with most aspects of this plan, if you can call it that.  Basically at the current time the republicans don't have a coherent, fleshed out plan that can be subject to analysis, despite years of claims to the contrary and actions to repeal obamacare without a replacement.

The republican focus at this point isn't on coverage, it's about saving money and making the program look less like an entitlement than as allowing folks to pay for their own stuff.  Any program like that is destined to fail to cover anywhere near the numbers covered now, due to the lengths one has to go to to achieve cost savings.  

I don't think the problem is with Democrats or Republicans.  The problem is that healthcare costs are expanding at an unsustainable rate, so any "plan" is going to implode eventually.  

Share this post


Link to post
Share on other sites
2 minutes ago, shader said:

I don't think the problem is with Democrats or Republicans.  The problem is that healthcare costs are expanding at an unsustainable rate, so any "plan" is going to implode eventually.  

Exactly.  As they were prior to the ACA.  Something absolutely has to be done about this.

Edited by Henry Ford
  • Like 1

Share this post


Link to post
Share on other sites
3 minutes ago, Henry Ford said:

Exactly.  As they were prior to the ACA.  Something absolutely has to be done about this.

It's detonating pension plans and it's going to detonate the budget of the federal gov't as well.  It's unsustainable.  Obamacare could have been the best idea in history, but it won't work when hospitals are fleecing you for simple visits to the ER.

  • Like 4

Share this post


Link to post
Share on other sites

If Obama had to do it all over, I think he would  swing for the fences. He got ObamaCare passed with ZERO GOP support. So he probably could have gotten anything he wanted shoved through, including single payer.

I'm not buying into the repeal noise. Once an "entitlement" is in place, it never goes away. The govt loves spending our money. Wasn't the income tax was supposed to be temporary ? 

  • Like 1

Share this post


Link to post
Share on other sites

It won't  work until the government comes down on the side of the people, not the insurance and health care companies. Obama wasn't willing to do that, and neither is Trump. 

  • Like 5

Share this post


Link to post
Share on other sites
6 minutes ago, MikeIke said:

It won't  work until the government comes down on the side of the people, not the insurance and health care companies. Obama wasn't willing to do that, and neither is Trump. 

Can you be more specific? What in your view does coming down on the side of the people mean, in real terms? 

Share this post


Link to post
Share on other sites
49 minutes ago, BowieMercs said:

If Obama had to do it all over, I think he would  swing for the fences. He got ObamaCare passed with ZERO GOP support. So he probably could have gotten anything he wanted shoved through, including single payer.

Good chance he would have lost a lot of spineless democratic support. Republicans aren't the only ones in the pockets of healthcare

  • Like 7

Share this post


Link to post
Share on other sites
42 minutes ago, timschochet said:

Can you be more specific? What in your view does coming down on the side of the people mean, in real terms? 

It means the insurance companies being willing to take a little less profit in exchange for more more people getting access to health care. 

This is my biggest problem with how our system works nowadays - companies squeezing every nickel and to hell with the customers, employees, and the public.  I feel like a company has a civic duty to help the country by helping individuals. When the average consumer has more money, everyone wins. 

I also realize that this will never happen. The only people that matter are the ones with money. 

ETA : I feel the same way about the company I work for. Record profits for 9 straight quarters, however annual salary increases for non-executives are capped at 3%. That's :bs:

Edited by MikeIke
  • Like 4

Share this post


Link to post
Share on other sites
4 hours ago, Yankee23Fan said:

Figure out a way for the people of this country to live healthier lifestyles, and cushion the economic blow of the baby boomers that are in the process of bankrupting everything.

No more smoking, McDonalds, or Coke.  Good luck with that.

  • Like 1

Share this post


Link to post
Share on other sites

Realistically speaking, pre-existing conditions, chronic illnesses etc need to go into a govt backed high risk pool if we don't move to a single payer system. 

Want to see a large scale single payer system? Look at the Veteran's Administration Hospitals.  Not sure what the answer is, but I guarantee it's not simple.

Share this post


Link to post
Share on other sites
Just now, BowieMercs said:

Realistically speaking, pre-existing conditions, chronic illnesses etc need to go into a govt backed high risk pool if we don't move to a single payer system. 

Want to see a large scale single payer system? Look at the Veteran's Administration Hospitals.  Not sure what the answer is, but I guarantee it's not simple.

Medicare.  Medicare.  Medicare. 

  • Like 1

Share this post


Link to post
Share on other sites
1 minute ago, Henry Ford said:

Medicare.  Medicare.  Medicare. 

Yeah, I hear it's great for a motorized wheel chair ;) 

  • Like 1

Share this post


Link to post
Share on other sites
4 hours ago, Ratbone said:

It should just be repealed and go back to the free market. Some people will not be able to afford health insurance. That is unfortunate, but there is no way to pay for it for everyone. Do I wish there was a better way, for sure. But there isn't. The middle class has had costs go up so far that they can't hardly go to the doctor either. When government benefits are such that people are turning down jobs because they get more money and benefits if they don't work, then that is a major problem. 

How so?  We are the richest country in the world, yet the only major industrialized nation that doesn't.  Why are our costs so much higher than other countries.  Even drugs that are developed here cost us more than other countries.  

We can afford to purchase a bigger military than the rest of the world combined, but we can't afford basic healthcare.  I don't buy it.

  • Like 5

Share this post


Link to post
Share on other sites
3 hours ago, Ratbone said:

How does this all work with a shortage of doctors. If people aren't going to make a lot of money then taking the time and money to become a Dr won't be the direction they go. A single payer system would make it so that you could almost never get into the Dr in a populated area. Practically it just doesn't work in a capitalist society with the population of the US. 

I disagree with your shortage of doctors assessment, and this isn't something I have given a great amount of thought to, but what if we paid qualified candidates a salary to go to medical school?  

IMHO healthcare should be like the school system.  Provide basic service to the public free of charge (obviously paid for via taxes) and allow private health insurance for people who wish to see a private doctor or have some procedure/service that is not provided under the public system.  

  • Like 2

Share this post


Link to post
Share on other sites
2 hours ago, Henry Ford said:

I guess I don't know what things are like near you. I do know that in my practice I deal with a lot of medical bills, and at least in the last 10 years I have never had a client to my knowledge whose physician charged less to the uninsured than to insurance companies.  Half of what you pay for with insurance companies is the negotiated rate.  

Insurance would definitely be a lot less worthwhile in my area if it were the other way around. 

But are they really negotiating the rate?  The whole thing comes across as totally corrupt in my opinion.  I posted in the ACA thread that when I took my 1-month old twins in for their checkup they each saw the doctor for 10 minutes and each got their first vaccines.  There was a mix-up with COBRA and the doctor thought I was uninsured.  I got a bill for $500 per kid for the office visit and $2,500 per vaccine for a total of $6,000.  Obviously the insurance didn't pay this amount, but I felt like the healthcare provider just pulled a number out of thin air.  If a vaccine cost them $2,500 you can bet your ### they wouldn't be blowing me up on my phone every year to get my shot.

The insurance companies just pass whatever the costs are onto us, but it adds a veil of secrecy to the whole process.  I don't think they have the greatest incentive to lower the costs

  • Like 1

Share this post


Link to post
Share on other sites
27 minutes ago, Dickies said:

But are they really negotiating the rate?  The whole thing comes across as totally corrupt in my opinion.  I posted in the ACA thread that when I took my 1-month old twins in for their checkup they each saw the doctor for 10 minutes and each got their first vaccines.  There was a mix-up with COBRA and the doctor thought I was uninsured.  I got a bill for $500 per kid for the office visit and $2,500 per vaccine for a total of $6,000.  Obviously the insurance didn't pay this amount, but I felt like the healthcare provider just pulled a number out of thin air.  If a vaccine cost them $2,500 you can bet your ### they wouldn't be blowing me up on my phone every year to get my shot.

The insurance companies just pass whatever the costs are onto us, but it adds a veil of secrecy to the whole process.  I don't think they have the greatest incentive to lower the costs

They absolutely have incentive to lower the cost - the lower the cost the more different things you have to pay for out of your deductible before they pay a penny and the less they spend on care.  

But exactly - you got a bill for $6,000 from the provider, no doubt your insurer actually paid $2,000-3,000, and even if you had to pay that out of pocket for deductible, you'd be getting a $3,000-4,000 benefit out of having insurance. Which is huge. 

Share this post


Link to post
Share on other sites
3 hours ago, adonis said:

From what I hear Trump/Republican plans is largely:

- Tax credits for insurance for folks based on age, not income (rich folks get same as poor)
- Block grants to states for medicaid spending that's not tied to inflation
- HIgh risk pools to cover folks with pre-existing conditions (woefully underfunded based on estimated - somewhere around 1/100th or less the total estimated cost of these risk pools)
- HSA's to help with the cost of medical coverage/expenses

There are huge flaws with most aspects of this plan, if you can call it that.  Basically at the current time the republicans don't have a coherent, fleshed out plan that can be subject to analysis, despite years of claims to the contrary and actions to repeal obamacare without a replacement.

The republican focus at this point isn't on coverage, it's about saving money and making the program look less like an entitlement than as allowing folks to pay for their own stuff.  Any program like that is destined to fail to cover anywhere near the numbers covered now, due to the lengths one has to go to to achieve cost savings.  

Interesting that you've seen the plan already.

  • Like 2

Share this post


Link to post
Share on other sites
1 hour ago, Dickies said:

How so?  We are the richest country in the world, yet the only major industrialized nation that doesn't.  Why are our costs so much higher than other countries.  Even drugs that are developed here cost us more than other countries.  

We can afford to purchase a bigger military than the rest of the world combined, but we can't afford basic healthcare.  I don't buy it.

Blinders dude, take them off. We've definitely been doing it wrong. It's not like the world wants our quality healthcare nor use of our military. Everyone else is better....

Share this post


Link to post
Share on other sites
2 hours ago, Dickies said:

I disagree with your shortage of doctors assessment, and this isn't something I have given a great amount of thought to, but what if we paid qualified candidates a salary to go to medical school?  

IMHO healthcare should be like the school system.  Provide basic service to the public free of charge (obviously paid for via taxes) and allow private health insurance for people who wish to see a private doctor or have some procedure/service that is not provided under the public system.  

Here is an article about it- http://www.foxbusiness.com/features/2016/04/20/why-u-s-doctor-shortage-is-getting-worse.html   Granted it is Fox so that will mean it isn't true.  SO here is a 2nd article that can be interpreted a few ways.- http://www.pbs.org/newshour/rundown/u-s-really-facing-serious-doctor-shortage/

I do like your idea though of paid medical school or some incentive. 

  • Like 1

Share this post


Link to post
Share on other sites
6 hours ago, sn0mm1s said:

Competition, in the form of more insurance companies options, isn't the answer. IMO, making costs transparent is the answer. I have no idea how it is considered acceptable for a doctor/hospital to charge an insurance company (who passes the costs down to you anyway) 5-10 times as much for the same treatment than they would charge you paying in cash.

Completely agree. Part of the problem is that government involvement in health care (e.g. subsidies, credits, Medicare/Medicaid reimbursements and price-fixing) has resulted in lack of cost transparency.

Share this post


Link to post
Share on other sites
6 hours ago, shader said:

I think Obamacare accomplished some great things.  We probably all know someone who benefited from it at some point.  I know a number of people that have it.

But Trump is right that Obamacare is collapsing.  

Where he's wrong is in the why.  There is a really, really big problem right now and it's the healthcare system and the out-of-control cost of healthcare.

There's one blogger that I've followed for many years.  He's a little wacky (I think he has Asperger's) and at times rants and raves.  But he's also incredibly smart.  When it comes to healthcare, that's the only drum he's beating right now.  I agree with him.

His thoughts on the speech:  https://market-ticker.org/akcs-www?post=231873

 

 

That's Denninger. I mentioned him earlier.

Share this post


Link to post
Share on other sites
6 hours ago, Henry Ford said:

It would have been if Bernie had won.  As it is, it would have to be very long term. 

How so with a Republican Congress?

Share this post


Link to post
Share on other sites
Just now, dickey moe said:

How so with a Republican Congress?

If Bernie had won, I don't believe we would have a Republican Congress. 

Share this post


Link to post
Share on other sites
8 minutes ago, Henry Ford said:

If Bernie had won, I don't believe we would have a Republican Congress. 

We'll have to agree to disagree on that.

Share this post


Link to post
Share on other sites
1 hour ago, dickey moe said:

Completely agree. Part of the problem is that government involvement in health care (e.g. subsidies, credits, Medicare/Medicaid reimbursements and price-fixing) has resulted in lack of cost transparency.

Lack of transparency in medical expenses would be a problem with or without government involvement.  Regulation, insurance and litigation don't explain the cost differences for common medications and procedures in this country vs. others.  Everybody has an anecdote about price gouging.  I don't believe it's gotten progressively worse since the ACA; it's been ridiculous much longer than that.

Candidate Trump talked about tackling costs but President Trump has made no moves toward action.  Just about my best case scenario for his presidency is for Trump to take a populist turn on this issue, tweet about the drug companies and make very very good deals with the industry.

  • Like 1

Share this post


Link to post
Share on other sites
16 hours ago, dickey moe said:

What are the viable options for reducing health care costs, that do not require govt.-mandated price-fixing? Would more competition necessarily lead to reduced costs?

Price transparency would be huge. 

Little story to explain what I mean - I became a father a little over a year and a half ago.  I've also been a life/health insurance broker for over a decade (so both pre-ACA and currently, but that doesn't matter for this story).  When my wife first went to the hospital to deliver, they got her all comfortable and such - and I went downstairs to the billing office to give them all of her insurance information and such.  I handed the billing lady a copy of her health ID card (it was with Blue Cross and Blue Shield).  She took the info on the card and looked it up in her system to verify that the coverage was still in force, which it was.  I then asked her a direct question, full well knowing she wouldn't give me an answer - "assuming no complications, what will the cost of this delivery be here?"  She looked at me like I had three heads - "I have no idea."  I said, "well, you will charge that carrier something for your services, can you tell me what that's going to be?"  Nothing. 

For big procedures, it won't matter as you'll just hit the max OOP on your policy so you wouldn't care between a $100k surgery and a $500k surgery - it will be the same $6k max OOP to you regardless - but for many services, maybe you'd want to do a little price shopping, but you can't see any of the prices.

  • Like 6

Share this post


Link to post
Share on other sites
15 hours ago, Henry Ford said:

Half of what you pay for with insurance companies is the negotiated rate. 

Very, very true (with participating providers, of course).  This is so often overlooked and not understood by my clients.

  • Like 1

Share this post


Link to post
Share on other sites
44 minutes ago, matttyl said:

Price transparency would be huge. 

Little story to explain what I mean - I became a father a little over a year and a half ago.  I've also been a life/health insurance broker for over a decade (so both pre-ACA and currently, but that doesn't matter for this story).  When my wife first went to the hospital to deliver, they got her all comfortable and such - and I went downstairs to the billing office to give them all of her insurance information and such.  I handed the billing lady a copy of her health ID card (it was with Blue Cross and Blue Shield).  She took the info on the card and looked it up in her system to verify that the coverage was still in force, which it was.  I then asked her a direct question, full well knowing she wouldn't give me an answer - "assuming no complications, what will the cost of this delivery be here?"  She looked at me like I had three heads - "I have no idea."  I said, "well, you will charge that carrier something for your services, can you tell me what that's going to be?"  Nothing. 

For big procedures, it won't matter as you'll just hit the max OOP on your policy so you wouldn't care between a $100k surgery and a $500k surgery - it will be the same $6k max OOP to you regardless - but for many services, maybe you'd want to do a little price shopping, but you can't see any of the prices.

Great example, and especially the bolded mindset. There isn't even one consideration being given by the human beings involved in this transaction as to the cost. This is a basic child birth. Something that happens millions of times per year, literally. Mind boggling, really.

  • Like 4

Share this post


Link to post
Share on other sites
47 minutes ago, matttyl said:

Price transparency would be huge. 

Little story to explain what I mean - I became a father a little over a year and a half ago.  I've also been a life/health insurance broker for over a decade (so both pre-ACA and currently, but that doesn't matter for this story).  When my wife first went to the hospital to deliver, they got her all comfortable and such - and I went downstairs to the billing office to give them all of her insurance information and such.  I handed the billing lady a copy of her health ID card (it was with Blue Cross and Blue Shield).  She took the info on the card and looked it up in her system to verify that the coverage was still in force, which it was.  I then asked her a direct question, full well knowing she wouldn't give me an answer - "assuming no complications, what will the cost of this delivery be here?"  She looked at me like I had three heads - "I have no idea."  I said, "well, you will charge that carrier something for your services, can you tell me what that's going to be?"  Nothing. 

For big procedures, it won't matter as you'll just hit the max OOP on your policy so you wouldn't care between a $100k surgery and a $500k surgery - it will be the same $6k max OOP to you regardless - but for many services, maybe you'd want to do a little price shopping, but you can't see any of the prices.

This is the big problem with healthcare.  It's illegal in other industries.  

Can you imagine going to get your brakes done and they say "eh well we're not really sure until we get in there", and then they charge you $899.00? But the next time it's $1,899? You'd have a fit and threaten to sue.  But when the medical industry does it, we just accept it and move on.

Edited by shader
  • Like 2

Share this post


Link to post
Share on other sites

The question in terms of healthcare is simple.  When does it all go belly-up and why?

There's no way that healthcare costs can continue to go up like they are.  First of all, people cant' afford the health insurance as it's skyrocketing.  They also can't afford the actual healthcare, as I'd bet most people have ridiculously high deductibles.

It will hit a point where people throw their hands up and quit.  Either they quit on health insurance, or they quit on their doctors bills.

Hospitals have ever-expanding budgets, ridiculously expensive IT infrastructure and equipment, high-paid doctors (3rd highest paid in the world I think?)...They work like corporations.  In fact, most of them are.  Most hospitals are run by big corporations who are 100% about profits.  So what happens when their budgets get strained (as they do)?

I worked at one of these big corporations once in the IT dept.  I watched the IT dept make a 100 million dollar mistake because they didn't do any testing.  When that happens, who pays?  When a hospital system gets hacked and decides to spend an enormous amount of money to bolster their security, who pays?  When doctors and nurses and staff want pay raises, who pays?  In a hospital system, the source of income is clear.  It's sick and dying people.  

When a massive business is built around taking care of sick and dying people, the only way to increase the costs (unless you want to get really nefarious and imagine that they are trying to keep people sick, which I don't believe) is by raising the costs. 

So it's a cycle that feeds on itself and eventually the whole thing will implode and the detonation will be truly awful.  The bad part?  What happens if these major companies go bust?  I suppose the federal government will have to step in again.  

 

 

  • Like 2

Share this post


Link to post
Share on other sites

And even if the costs were transparent (which they aren't), how are they justified?  To end my little example story above - my son was 5 weeks early (it apparently runs in my family) so he was pretty underweight (5 pounds, 5 ounces).  He wasn't as bad off as I was when I was born 4 weeks early, though, thank God.  The hospital wanted to keep him a few days to be sure he was going to be ok and to try to put some weight on him.  Completely understandable - and he had wonderful care for 6 days in the nursery (not accredited to be called a NICU at the time, but same idea).  24 hour nurses, state of the art equipment....blah blah.  The all in bill for this (which includes the actual delivery and wife's 2 nights afterwards), roughly $40k (the vast majority paid by insurance).

That may sound ridiculous - but just over 2 years ago a family member of mine had an accident.  They fell off a horse when the horse spooked, and the horse reared back and stepped on their head, crushing part of their skull over their left eye.  An emergency helicopter ride to get them to the hospital ~40 miles away - roughly $35k.  17 nights in the ICU, I believe was roughly $25-30k per day.  A few surgeries (numerous plates implanted into face, forehead, skull) and follow ups....all in hit 7 figures.  Yup, over a mill.  Crazy costs.

Share this post


Link to post
Share on other sites
6 minutes ago, shader said:

It will hit a point where people throw their hands up and quit.  Either they quit on health insurance, or they quit on their doctors bills.

We've hit that point - at least in the Obamacare/ACA individual markets.  There are fewer people enrolled this year than there were last year.  That's what happens when the average prices there went up by 25.6% last year.  So the unhealthy stay in because it's still a good deal for them, but the healthy leave not seeing any value in it. 

As for folks quitting on doctor bills - that's been happening for years, and still is.  Medical expenses has been the top reason for personal bankruptcy for a long time I believe. 

Share this post


Link to post
Share on other sites
15 hours ago, BowieMercs said:

If Obama had to do it all over, I think he would  swing for the fences. He got ObamaCare passed with ZERO GOP support. So he probably could have gotten anything he wanted shoved through, including single payer.

I'm not buying into the repeal noise. Once an "entitlement" is in place, it never goes away. The govt loves spending our money. Wasn't the income tax was supposed to be temporary ? 

And his party would have rejected him.  They rejected the notion of a public option (which is a significant compromise to single payer) and he didn't seem to fight all that much for the public option.  We think he'd have had more success with something even more liberal?  I doubt it.

  • Like 2

Share this post


Link to post
Share on other sites
46 minutes ago, The Commish said:

And his party would have rejected him.  They rejected the notion of a public option (which is a significant compromise to single payer) and he didn't seem to fight all that much for the public option.  We think he'd have had more success with something even more liberal?  I doubt it.

I think the thought at the time was to make it a moderate compromise to get Republican support, so more elements of some things he thought conservatives/republicans would support were put in there.  Had he known that despite it being largely a rehash of many republican ideas, the republicans would be 100% opposed to whatever he put out there that would accomplish the same goals, he might have started off more liberal in terms of a solution.

One of the biggest critiques he had starting out, in terms of negotiating with the Republicans, was that he started at a position of compromise rather than taking an initial hard-line on his side and fighting to get to the middle.  No need to argue whether this was accurate or not, but it was a pretty common complaint about the early years of his presidency...ACA included.

Share this post


Link to post
Share on other sites
Just now, adonis said:
49 minutes ago, The Commish said:

And his party would have rejected him.  They rejected the notion of a public option (which is a significant compromise to single payer) and he didn't seem to fight all that much for the public option.  We think he'd have had more success with something even more liberal?  I doubt it.

I think the thought at the time was to make it a moderate compromise to get Republican support, so more elements of some things he thought conservatives/republicans would support were put in there.  Had he known that despite it being largely a rehash of many republican ideas, the republicans would be 100% opposed to whatever he put out there that would accomplish the same goals, he might have started off more liberal in terms of a solution.

One of the biggest critiques he had starting out, in terms of negotiating with the Republicans, was that he started at a position of compromise rather than taking an initial hard-line on his side and fighting to get to the middle.  No need to argue whether this was accurate or not, but it was a pretty common complaint about the early years of his presidency...ACA included.

This makes zero sense given what happened.  The GOP was exactly NONE of the equation.  His own party didn't have the appetite for a public option, which again, was a significant compromise to single payer.  This has nothing to do with the cooperation he might/might not get from the GOP.  It's about the cooperation he'd get from his own party.  And it was crystal clear that the GOP was going to be 100% in opposition to him...they said that...blatantly.

Share this post


Link to post
Share on other sites
1 hour ago, matttyl said:

We've hit that point - at least in the Obamacare/ACA individual markets.  There are fewer people enrolled this year than there were last year.  That's what happens when the average prices there went up by 25.6% last year.  So the unhealthy stay in because it's still a good deal for them, but the healthy leave not seeing any value in it. 

As for folks quitting on doctor bills - that's been happening for years, and still is.  Medical expenses has been the top reason for personal bankruptcy for a long time I believe. 

There's considerable uncertainty about the future of the ACA.  It has received few modifications/improvements.  The republicans ran on a platform of repealing it entirely, right in the middle of the season for renewals.  The health plans aren't sure what's going to happen...there's just a ton of uncertainty out there right now.

But the number of uninsured folks who now have insurance is still significantly higher than before the law was passed.  There are definitely problems with it...but either you try to fix the problems with the system, and improve things, or you end up dropping a lot of folks off of insurance plans and likely not doing much about costs either.

The Republicans have had 8 years, or more, to come up with a good solution.  Year after year, we hear that they have it...it's ready, they're ready to repeal obamacare and put in their solution.  It'll save money, it's responsible...but year after year, promise after promise they fail to materialize.

I'm not here to play partisan politics, but to me that shows me that coming up with a conservative solution to this issue is incredibly challenging and republicans have known this all along.  It's easier to just oppose someone doing something than it is to put up your own idea that you say is better and receive pushback for that.  If you think about it, with the 50+ votes to repeal obamacare on the books, and no republican plan that we can point to and analyze, it's a pretty sad state of affairs imo for those who simply criticize without putting up a plan that improves things.

We'll see though...they're gonna have to put something up and the details I posted earlier are leaks from the plans floating around washington...and while they don't comprise an entire solution, they do represent the leading thoughts as far as I've heard.

Share this post


Link to post
Share on other sites
3 minutes ago, The Commish said:

This makes zero sense given what happened.  The GOP was exactly NONE of the equation.  His own party didn't have the appetite for a public option, which again, was a significant compromise to single payer.  This has nothing to do with the cooperation he might/might not get from the GOP.  It's about the cooperation he'd get from his own party.  And it was crystal clear that the GOP was going to be 100% in opposition to him...they said that...blatantly.

https://www.theatlantic.com/politics/archive/2015/07/the-real-story-of-obamacares-birth/397742/

Quote

There was a fourth lesson: Try in the Senate to find Republican support at an early stage, instead of waiting until the political dynamic shifts toward implacable opposition. The failure to engage John Chafee, Chuck Grassley, Orrin Hatch, and their colleagues at an early point in 1993, when they crafted their own plan and were willing to negotiate and cut a deal, proved deeply damaging, if not deadly in 1994. As the midterms loomed and Democrats were on the defensive, Chafee and his colleagues were told by then-Republican Leader Bob Dole that there would be no deal, period.

In the House, that lesson was not applicable this time; Eric Cantor and House Republicans had already made it crystal clear that they were not cooperating under any circumstances. There, Democrats debated the issue for several months, but mostly amongst themselves, before introducing a detailed bill that emerged from committees in July 2009 and passing it through the House later in the year with just one Republican vote.

But with Obama’s blessing, the Senate, through its Finance Committee, took a different tack, and became the fulcrum for a potential grand bargain on health reform. Chairman Max Baucus, in the spring of 2009, signaled his desire to find a bipartisan compromise, working especially closely with Grassley, his dear friend and Republican counterpart, who had been deeply involved in crafting the Republican alternative to Clintoncare. Baucus and Grassley convened an informal group of three Democrats and three Republicans on the committee, which became known as the “Gang of Six.” They covered the parties’ ideological bases; the other GOPers were conservative Mike Enzi of Wyoming and moderate Olympia Snowe of Maine, and the Democrats were liberal Jeff Bingaman of New Mexico and moderate Kent Conrad of North Dakota.

Baucus very deliberately started the talks with a template that was the core of the 1993-4 Republican plan, built around an individual mandate and exchanges with private insurers—much to the chagrin of many Democrats and liberals who wanted, if not a single-payer system, at least one with a public insurance option. Through the summer, the Gang of Six engaged in detailed discussions and negotiations to turn a template into a plan. But as the summer wore along, it became clear that something had changed; both Grassley and Enzi began to signal that participation in the talks—and their demands for changes in the evolving plan—would not translate into a bipartisan agreement.

What became clear before September, when the talks fell apart, is that Senate Republican Leader Mitch McConnell had warned both Grassley and Enzi that their futures in the Senate would be much dimmer if they moved toward a deal with the Democrats that would produce legislation to be signed by Barack Obama. They both listened to their leader. An early embrace by both of the framework turned to shrill anti-reform rhetoric by Grassley—talking, for example, about death panels that would kill grandma—and statements by Enzi that he was not going to sign on to a deal. The talks, nonetheless, continued into September, and the emerging plan was at least accepted in its first major test by the third Republican Gang member, Olympia Snowe (even if she later joined every one of her colleagues to vote against the plan on the floor of the Senate.)

Obama could have moved earlier to blow the whistle on the faux negotiations; he did not, as he held out hope that a plan that was fundamentally built on Republican ideas would still, in the end, garner at least some Republican support. He and Senate Democratic leaders held their fire even as Grassley and Enzi, in the negotiations, fought for some serious changes in a plan that neither would ever consider supporting in the end. If Obama had, as conventional wisdom holds, jammed health reform through at the earliest opportunity, there would have been votes in the Senate Finance Committee in June or July of 2009, as there were in the House. Instead, the votes came significantly later.

To be sure, the extended negotiations via the Gang of Six made a big difference in the ultimate success of the reform, but for other reasons. When Republicans like Hatch and Grassley began to write op-eds and trash the individual mandate, which they had earlier championed, as unconstitutional and abominable, it convinced conservative Democrats in the Senate that every honest effort to engage Republicans in the reform effort had been tried and cynically rebuffed. So when the crucial votes came in the Senate, in late December 2009, Harry Reid succeeded in the near-impossible feat of getting all 60 Democrats, from Socialist Bernie Sanders and liberal Barbara Boxer to conservatives Joe Lieberman, Ben Nelson, Mark Pryor, and Blanche Lincoln, to vote for cloture, to end the Republican filibuster, and to pass their version of the bill. All sixty were needed because every single Republican in the Senate voted against cloture and against the bill. Was this simply a matter of principle? The answer to that question was provided at a later point by Mitch McConnell, who made clear that the unified opposition was a ruthlessly pragmatic political tactic. He said, “It was absolutely critical that everybody be together because if the proponents of the bill were able to say it was bipartisan, it tended to convey to the public that this is O.K., they must have figured it out.”

I mean, it's not worth re-litigating how the ACA came about.  I'm not even trying to argue with whether it was a good law or not.  But most of this stuff is pretty public knowledge and most folks are told a different story about the origins of the ACA than what actually happened.

It does seem likely, more likely at least, that if the Obama administration was negotiating for this healthcare option in a way that did not rely on working with Republicans, that at the very least there would have been included a public insurance option...but instead, they stuck with what's mostly a market solution of healthcare insurances, along with medicaid expansion.  This was done to try at the very least to elicit some cooperation from republicans.  It didn't work.  But it's hard to convince me that if they had realized how opposed the republicans would've been very early on, that the wouldn't have started out with a more liberal baseline.

  • Like 1

Share this post


Link to post
Share on other sites
11 minutes ago, adonis said:

But the number of uninsured folks who now have insurance is still significantly higher than before the law was passed. 

 

I'm not sure you can say that, concerning the individual market that is.  The vast majority of the "newly insured" are covered via Medicaid.  Go look up the numbers - Medicaid enrollment has grown by nearly 20m people since 4th quarter 2013.  The individual market is only slightly larger that it was pre-ACA.....and getting smaller. 

Share this post


Link to post
Share on other sites
6 minutes ago, matttyl said:

I'm not sure you can say that, concerning the individual market that is.  The vast majority of the "newly insured" are covered via Medicaid.  Go look up the numbers - Medicaid enrollment has grown by nearly 20m people since 4th quarter 2013.  The individual market is only slightly larger that it was pre-ACA.....and getting smaller. 

I think that's an interesting point.  

Why do you think it is that commercial markets seem like they've had a saturation of policies while the non-commercial market growth has been huge?

I'll float one idea in that I think a big portion of folks who can afford insurance were already paying for insurance before the ACA.  There may have been a smaller segment of folks who couldn't get it due to pre-existing conditions who might be eligible now, and also a lot of folks under 26 would ride under their parent's plan and not have to get their own for quite some time.

However, a ton of the folks who couldn't otherwise afford insurance have been taken on in the form of Medicaid/Medicare, and given subsidies for commercial insurance.  It would be interesting to get a breakdown of this data by experts...

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Restore formatting

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Sign in to follow this  

  • Recently Browsing   0 members

    No registered users viewing this page.