Obamacare...(new title): GOP DEATH PLAN: Don-Ryan's Express

[Larry]

Yeah, I'd read brief mentions of things in the ACA which, while they're certainly easy to demonize, actually sounded like they might be good ideas.  

 

Like, say, having a panel of doctors and scientists look at medical practices, and analyze their cost/benefit statistics.  

 

What could be more "fiscally conservative" than that?  

[tshile]

Panel of experts reviewing stuff sounds too sciencey

 

[twa]

16 minutes ago, Larry said:

  

 

Like, say, having a panel of doctors and scientists look at medical practices, and analyze their cost/benefit statistics.  

 

What could be more "fiscally conservative" than that?  

 

Like the Texas death panels...

[Bliz]

18 hours ago, tshile said:

Yay free market solution for a problem that isn't free market.

 

For free market principles to work you have to be able to opt out of the service... you can't opt out of Healthcare. You can opt out of health insurance, but only if you think it's worth it to gamble on whether you'll need medical services or not...

 

 

 

Plus the barriers to entry are extremely high.  I can't just start up Bliz Insurance Co to offer what I feel is a superior product.  So you have a ton of demand, with only a few suppliers, and they're generally immune from market forces because there isn't really that much competition.

[PeterMP]

http://cepr.net/publications/op-eds-columns/the-economics-of-the-affordable-care-act

 

" Thus far, the ACA has actually worked better than expected in most respects. The number of uninsured actually dropped somewhat more than had been projected, despite the fact that a number of states controlled by Republican governors and/or legislatures opted not to expand Medicaid as had been required in the measure passed by Congress. The cost of the program has also been less than projected as health care cost growth has slowed sharply in recent years. The ACA likely contributed to slower cost growth, although that slowdown preceded the ACA, so other factors are clearly involved.

Insofar as the ACA has run into problems, those have been attributable to too few healthy people in the health care exchanges, and too little competition among insurers. Many commentators have wrongly blamed the problem in the exchanges on a failure of young healthy people to sign up for insurance. This is not the cause of the problem, since more people are getting insured than had been projected. The reason fewer healthy people are showing up on the exchanges is that fewer employers dropped insurance than had been projected. The problem this for the exchanges is that people who get insurance through an employer mostly work at full-time jobs, and people who are able to work at full-time jobs are healthier than the population as whole. By continuing to provide insurance for their workers despite the ACA, employers are effectively keeping healthy people out of the exchanges.

The other problem with the exchanges has been limited competition, as many insurers have dropped out after the first few years. The loss of competition has meant higher prices. This could have been addressed in part by offering a public plan through Medicare or Medicaid, as President Obama had originally proposed. Obama dropped this part of the plan in the face of opposition from the insurance industry, but reinstating it would increase competition in the exchanges."

 

He leaves out that the first was at least a contributing factor for the 2nd.  Companies dropped out because the people on the exchanges were sicker than expected (because there were fewer healthy people in them).

 

http://money.cnn.com/2017/01/18/news/drug-pricing-mallinckrodt-ftc-fine/index.html

 

Drugmaker fined $100M for hiking price 85,000%

 

"The complaint also alleges that Questcor thwarted attempts by its competitors to introduce a similar drug to the U.S. market by out-bidding their efforts to acquire Synacthem, which is used to treat the same conditions, in 2013.

 

Now, the company must give up its rights to Synacthem and allow another company to produce the product."

 

A company was generating a comparable drug so they bought it and were willing to pay for it than everybody else because it would give them a monopoly on a treatment(s) for a disease and then raised prices.

 

More things like this would help.

Edited January 19, 2017 by PeterMP

[tshile]

17 minutes ago, PeterMP said:

The reason fewer healthy people are showing up on the exchanges is that fewer employers dropped insurance than had been projected.

hard core GOPers aren't going to like this reasoning

 

[PeterMP]

18 minutes ago, tshile said:

hard core GOPers aren't going to like this reasoning

 

 

A key part of the Republican plan is to force people out of employer healthcare:

 

"Ryan also wants to limit the tax breaks for employer-based insurance to nudge companies into buying cheaper, high deductible, policies for their employees too. The idea is similar to the so-called Cadillac tax in Obamacare that levies a tax surcharge for expensive health insurance policies

.

Howard says workers might prefer a high-deductible plan, especially if they were aware of how much of their compensation goes to health insurance. He says companies should ask their employees the following.

"Do you know that $20,000 of your wages are going every year to insurance?" he asks. "Would you rather have $10,000 in your pocket, put $5,000 into a high-deductible plan or something like that, and then put some aside for a rainy day that will accumulate over time?

Conservatives argue that making people buy their own health care — even with money provided by the government or their employer — will get them to shop around for the best quality and price, and lower overall health care costs in the long run. "

At some level it would actually work.  Not because of what they are arguing, but because it would force the healthier people to be in more of a mix with people that are less healthy.

Edited January 19, 2017 by PeterMP

[tshile]

i was thinking more because of the time and effort put into the "if you like your plan, you can keep your plan" stuff the GOP went on about forever.

 

a report saying that part of the problem with aca is fewer people lost their plans than expected, doesn't exactly go well with their rhetoric

 

[The Evil Genius]

[TheGreatBuzz]

I just saw Trump signed an executive order on obamacare.  How do we find out what it said?

[tshile]

We don't yet.

 

Not stopping CNN from going ape ****. They quickly pivoted from "all we know is this one sentence" to "that's all the EO says, how irresponsible"

 

 

[twa]

it is a procedural step.

[LadySkinsFan]

So this.

 

 

[Kilmer17]

Moving this line of thought here. 

 

Not enforcing the the individual mandate=brilliant.  

 

The ACA will die on the vine without it.   And allow Congress and Trump to pass a legitimate, realistic solution without having to debate the minutiae of the existing disaster. 

 

Without enforcement, Ins Cos will simply pull out.  

[Elessar78]

Let's be honest, they have no plan. Never wanted one. Never will. They are in the pockets of the insurance companies. As by definition of "conservative"-they want the status quo

[Kilmer17]

13 minutes ago, Elessar78 said:

Let's be honest, they have no plan. Never wanted one. Never will. They are in the pockets of the insurance companies. As by definition of "conservative"-they want the status quo

Lol.  THEY are in the pockets of insurance companies????!   Who was the biggest winners with the ACA?   The insurance companies.  

[PeterMP]

22 minutes ago, Kilmer17 said:

Lol.  THEY are in the pockets of insurance companies????!   Who was the biggest winners with the ACA?   The insurance companies.  

 

Not, really.  The ACA capped profits as a function of health care spending in a way that wasn't and increased some taxes and fees.  Clearly, Pharma and providers came out better than the insurance companies from the ACA initially (i.e. no caps on profits as a function of anything).  Though if you waive the health insurance company fees, that certainly starts to balance out, which (the Republican) Congress did last year over the objections of Obama:

 

https://www.bloomberg.com/news/articles/2015-12-16/congress-moves-to-pause-obamacare-taxes-causing-barely-a-ripple

 

"  The insurer tax applies to business lines including private Medicare, Medicaid and individual plans. The one-year pause in the tax will boost earnings at UnitedHealth Group Inc. by about 3 percent in 2017, while Humana Inc.could see an 8 percent earnings increase., according to Ana Gupte, an analyst at Leerink Partners. "

Edited January 23, 2017 by PeterMP

[LadySkinsFan]

Insurance companies didn't like being forced to insure those with their defined pre-existing conditions (although they could charge excessive premiums), having to pay 80% of proceeds to healthcare, and capping lifetime payouts.

 

Now they will be free to go back to their price gouging, excessive profits business model.

 

Yay for insurance companies.  /sarcasm

 

[Elessar78]

32 minutes ago, Kilmer17 said:

Lol.  THEY are in the pockets of insurance companies????!   Who was the biggest winners with the ACA?   The insurance companies.  

People who previously couldn't get any insurance. Just a thought. 

[visionary]

 

 

Edited January 23, 2017 by visionary

[Elessar78]

Not sure if irony is the correct word, and not even directly Obamacare. But my coworkers just had a fit of Trump mania outside my office (fake news about the inauguration headcount, Madonna!, underestimated the number of conservatives). But then one of them starts talking about her father's really expensive hospice care—"... it's really expensive, like $4000 more per month, but medicare picks up all of that"

 

So no one should be on the govt's dole. Unless it's you. 

[Kilmer17]

Nobody is willing to even discuss the insane costs related to extension of life in those horrible situations.   But it's necessary.  

[tshile]

1 hour ago, Kilmer17 said:

Moving this line of thought here. 

 

Not enforcing the the individual mandate=brilliant.  

 

The ACA will die on the vine without it.   And allow Congress and Trump to pass a legitimate, realistic solution without having to debate the minutiae of the existing disaster. 

 

Without enforcement, Ins Cos will simply pull out.  

Without getting into specifics of aca or the proposed replacement, you think it's smart to kill the mandate which (by your post, you agree) will kill the ACA by forcing insurance companies out without having a replacement ready?

 

If so, how long can we go, in your estimate, between killing the mandate and implementing (not passing, implementing) a new system?

[Elessar78]

11 minutes ago, Kilmer17 said:

Nobody is willing to even discuss the insane costs related to extension of life in those horrible situations.   But it's necessary.  

It's hospice care, in this case—not life extension. Just making them comfortable.

8 minutes ago, tshile said:

Without getting into specifics of aca or the proposed replacement, you think it's smart to kill the mandate which (by your post, you agree) will kill the ACA by forcing insurance companies out without having a replacement ready?

 

If so, how long can we go, in your estimate, between killing the mandate and implementing (not passing, implementing) a new system?

**** it, man. It's their short-lived ascendency that they're are playing with it if they toss out 18 million people off their insurance without a replacement. 18 million isn't a radically big number—until you remember you only won the presidency by about 150K votes in 2 key states. 

[TheGoodBits]

1 minute ago, tshile said:

Without getting into specifics of aca or the proposed replacement, you think it's smart to kill the mandate which (by your post, you agree) will kill the ACA by forcing insurance companies out without having a replacement ready?

 

If so, how long can we go, in your estimate, between killing the mandate and implementing (not passing, implementing) a new system?

 

I think he meant *politically* smart to make ACA actually as bad as GOP has been claiming for years. But it's cynical as hell. Cause turmoil in the markets, prices spike, people can't afford insurance, no longer enforce the mandate, then come riding in with a repeal and pretend you aren't the ones that caused this to happen.

 

Then if you are Paul Ryan, you can easily sell the high risk pool death panels to America, because 95% of the country will see their insurance costs drop significantly. Just stick the cancer patients in underfunded high risk pools and let them die.