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

[TradeTheBeal!]

12 minutes ago, Kilmer17 said:

For you maybe.  But it's there.  Is it possible that for someone else it is onerous?

 

My family insurance has gone up 4000 dollars a year in the last 3 years.  It's not through the ACA, but the ACA has played a part in it's rise by forcing competition out of the market.

 

Get a part-time job.

 

#bootstraps

#papajohns

[Hersh]

20 minutes ago, Kilmer17 said:

Sure it does.  It absolutely forces people to buy insurance or pay a fine.  It absolutely has had a devistating affect on the number of options people have for insurance companies and for doctors that are available and willing to take the insurance they are now forced to carry.

 

I do love the constant jabs from the left at the poor folks in the US.  Keep it up.  It's working for you.

 

And lastly, in true lib form, you took something I said, changed it ever so slightly to make it sound worse, different etc.  Par for the course anymore.

 

Who is jabbing the poor? 

 

Three final points: 

1. No one here thinks the ACA doesn't need to be fixed. It's not the ACA dictating the issue with doctors, it's insurance companies and it's doctors choosing what insurance they accept. For instance, my son's pediatrician accepts all but one specific BCBS plan. It's there choice. It's also the arbitrary choice of insurance companies who is in their networks.

 

2. Having crappy, cheap insurance plans negatively impacts the rest of society. Let me know if you need an explanation. 

 

3. Your point of view is easily summarized by GOP=good, Dems=bad. You literally don't think Obama was trying to help people by you support a guy that wants to fix/improve and keep the ACA. 

 

 

[Kilmer17]

1 minute ago, tshile said:

When they advocate for catastrophic plans with high deductibles yes, that's what I think they are doing.

 

And the statistics show that people with those plans are the ones that wind up hurt the most by the system.
 

Those type of plans already exist under the ACA.  (IE plans that people choose the lowest premium with high deductibles).  Are you advocating a system where people have to prove that they can afford the deductible?

[tshile]

6 minutes ago, Kilmer17 said:

 

I meant through the exchange.  We have an employer provided policy.

Which are the same types of policies offered on the exchange.

 

ACA applies to all policies, it doesn't matter where you purchase them.

 

(except for the congresscritters i think they exempted themselves)

[Kilmer17]

1 minute ago, Hersh said:

 

Who is jabbing the poor? 

 

Three final points: 

1. No one here thinks the ACA doesn't need to be fixed. It's not the ACA dictating the issue with doctors, it's insurance companies and it's doctors choosing what insurance they accept. For instance, my son's pediatrician accepts all but one specific BCBS plan. It's there choice. It's also the arbitrary choice of insurance companies who is in their networks.

 

2. Having crappy, cheap insurance plans negatively impacts the rest of society. Let me know if you need an explanation. 

 

3. Your point of view is easily summarized by GOP=good, Dems=bad. You literally don't think Obama was trying to help people by you support a guy that wants to fix/improve and keep the ACA. 

 

 

Again, it's another strawman fallacy.  Shocking.

 

When the ACA was being "debated" people on the right pointed out that their would be issues with doctors, insurance companies, rising rates etc.  Those points were ignored because Obama and the Dems had the conch and wanted to "win".  So spare me the us vs them statements.  

1 minute ago, tshile said:

Which are the same types of policies offered on the exchange.

 

ACA applies to all policies, it doesn't matter where you purchase them.

 

(except for the congresscritters i think they exempted themselves)

Exactly my point.  The ACA has had a negative affect on the rates, company options and doctor accessibility.

[tshile]

10 minutes ago, Kilmer17 said:

Those type of plans already exist under the ACA.  (IE plans that people choose the lowest premium with high deductibles).  Are you advocating a system where people have to prove that they can afford the deductible?

 

They are not quite the same.

 

The only thing I truly advocate for is that people pay for the services they use.

 

Gambling on your health, and when you lose making it an expense to everyone else, is bull****.

 

I'd be just fine if you had to prove your ability to pay for services before getting them. Most people are not cool with that though.

 

All I ask if that you all pick something that makes sense, and stops having my rights go up because some dip**** refused to get health insurance, had a problem, and didn't pay his bill.

 

I had great health insurance before and I could afford it. I have great health insurance now and I can afford it. So if we're all going to play the game selfishly, I can play that way too. Just make everyone eat the consequences themselves when they gamble and lose.

 

6 minutes ago, Kilmer17 said:

 

Exactly my point.  The ACA has had a negative affect on the rates, company options and doctor accessibility.

 

This is not true (the rates part.) It has decreased the rate of change of premiums on the whole. That's not a negative affect (though technically it is, lol math)

 

The options and doctor accessibility is complicated and there have definitely been ramifications from ACA, but it's not nearly as cut and dry as the people on the right make it out to be. Especially when you consider that many of things they **** about going away, went away because they were inadequate in terms of coverage (that thing we keep getting back to that study after study after study shows was a big driver in the increasing costs of health insurance)

 

Edited July 14, 2017 by tshile

[Kilmer17]

1 minute ago, tshile said:

 

They are not quite the same.

 

The only thing I truly advocate for is that people pay for the services they use.

 

Gambling on your health, and when you lose making it an expense to everyone else, is bull****.

 

I'd be just fine if you had to prove your ability to pay for services before getting them. Most people are not cool with that though.

 

All I ask if that you all pick something that makes sense, and stops having my rights go up because some dip**** refused to get health insurance, had a problem, and didn't pay his bill.

 

I had great health insurance before and I could afford it. I have great health insurance now and I can afford it. So if we're all going to play the game selfishly, I can play that way too. Just make everyone eat the consequences themselves when they gamble and lose.

 

See, I'm pretty sure I agree with your broad policy position.  Just differ in the way we get there.

[PleaseBlitz]

4 minutes ago, Kilmer17 said:

 

Exactly my point.  The ACA has had a negative affect on the rates, company options and doctor accessibility.

 

This is highly dependent on your exact situation, so it is problematic to make a blanket statement like this.  It has had a negative impact on some people, it has had a very positive impact on others (people who never had access to coverage before, people with preexisting conditions, old people, etc.).  

[tshile]

1 minute ago, Kilmer17 said:

See, I'm pretty sure I agree with your broad policy position.  Just differ in the way we get there.

 

If you're going to force medical professionals to care for someone regardless of whether they can afford it (or chooses not to afford it when they could), then the previous system only serves to hurt those of us that can afford it and get it.

 

People who don't pay their bills... that money is made up in tax deductions by the company (lost of tax revenue to fund our government hurts you and me just as much as any other 'cost'), in rate hikes for procedures/premiums/devices/etc.

 

The cost magnifies when you have doctors, techs, hospitals, and insurance companies all in the process adding on fees; collection services, interest, etc. The $$'s lost when it's all said and done, that are actually passed on to us, are much higher than it would have been to just pay for the damned service ourselves up front.

 

I want to lose less money to the healthcare system. ACA isn't perfect, it's not close, but the previous system was a disaster that regard.

 

[Hersh]

5 minutes ago, Kilmer17 said:

Again, it's another strawman fallacy.  Shocking.

 

When the ACA was being "debated" people on the right pointed out that their would be issues with doctors, insurance companies, rising rates etc.  Those points were ignored because Obama and the Dems had the conch and wanted to "win".  So spare me the us vs them statements.  

Exactly my point.  The ACA has had a negative affect on the rates, company options and doctor accessibility.

 

For you it's 100% an us vs them issue. You put the word debated in quotes as if to claim the ACA was not debated. That is a completely false assertion. Your position on the issue is so blantanly biased that there really is no point in continuing the discussion. You may proceed in rooting for the ACA/Obama to fail...unless Kasich gets in there and improves it. Then it will be a good thing.

[Kilmer17]

3 minutes ago, PleaseBlitz said:

 

This is highly dependent on your exact situation, so it is problematic to make a blanket statement like this.  It has had a negative impact on some people, it has had a very positive impact on others (people who never had access to coverage before, people with preexisting conditions, old people, etc.).  

That's a very fair and accurate description.   

22 minutes ago, Hersh said:

 

For you it's 100% an us vs them issue. You put the word debated in quotes as if to claim the ACA was not debated. That is a completely false assertion. Your position on the issue is so blantanly biased that there really is no point in continuing the discussion. You may proceed in rooting for the ACA/Obama to fail...unless Kasich gets in there and improves it. Then it will be a good thing.

It is?  Thanks for telling me.  Makes your argument alot easier to defend I suppose.

[Hersh]

37 minutes ago, Kilmer17 said:

That's a very fair and accurate description.   

It is?  Thanks for telling me.  Makes your argument alot easier to defend I suppose.

 

It's your words based on your feelings instead of based on facts. If you want to come at it from the perspective of you being in a segment of the population that is caught in a bad spot with regard to the ACA, I'd bet you'd have a lot more support in that pretty much every evil liberal wants to fix the ACA. If you want to call out the BS from insurance companies leaving markets (because they are taking losses in that segment, despite overall profits being strong) I'd bet you'd have a lot of support. We had a segment of the population go without adequate health care for a long time and it should be to no ones surprise that the first few years the costs to insurance companies would be greater as people finally get the treatment they've needed for years. More people would be on your side if things like this were acknowledged rather than Obamacare is just all bad. 

[Kilmer17]

4 minutes ago, Hersh said:

 

It's your words based on your feelings instead of based on facts. If you want to come at it from the perspective of you being in a segment of the population that is caught in a bad spot with regard to the ACA, I'd bet you'd have a lot more support in that pretty much every evil liberal wants to fix the ACA. If you want to call out the BS from insurance companies leaving markets (because they are taking losses in that segment, despite overall profits being strong) I'd bet you'd have a lot of support. We had a segment of the population go without adequate health care for a long time and it should be to no ones surprise that the first few years the costs to insurance companies would be greater as people finally get the treatment they've needed for years. More people would be on your side if things like this were acknowledged rather than Obamacare is just all bad. 

At least you are acknowledging the faults and failures of the ACA.  It's too bad people werent listening or acknowledging them when they were pointed out before it was passed.

 

OF COURSE Insurance Companies are acting like they are.  They are for profit entities.  OF COURSE people like me are paying more in premiums so others can have more coverage.  That's the only way to pay for it.  OF COURSE doctors are limiting the insurance plans they accept or are going to "conceirge" service, They are businessmen as well.  

 

These are all inherent problems with the ACA.  They cannot be fixed.  Or at least, I havent seen any proposal that would fix them.  

 

 

[tshile]

5 minutes ago, Kilmer17 said:

These are all inherent problems with the ACA.  They cannot be fixed.  Or at least, I havent seen any proposal that would fix them.  

 

 

 

The biggest way to 'fix' that is to bring down the cost of the care itself.

 

ACA failed to implement any cost controls outside of the HCHAPs system which is imposed only on doctors and hospitals.  Basically they're cutting medicare reimbursements if certain things aren't met (and I honestly think their criteria is shortsighted and dumb, the hospital suffers if a person doesn't do the exercises at home they were instructed to post-surgery and that's not fair)

 

Expanding medicaid is one option because it gives the government more power to set the prices for things, and insurance companies can use that as a standard for their own policies. It would be an unofficial form of price fixing. That has obvious issues, and when you factor in that we're talking about health care for people those issues should not be taken lightly. Yes - the tax payer pays more money for these people, but the hope is the cost is offset by getting people care and treatment before something becomes more expensive to care for or treat (which we would still pay for at that point) and the hope that they can help set prices.

 

Imposing price-fixing measures on pharmaceuticals and medical devices is another avenue to curb cost, but there's a very valid argument about R&D and how to keep prices low without stifling innovation.

 

It would also be nice if we could get the national as a whole to realize the value to society if people used primary care physicians more often, instead of using the ER instead, and took better care of themselves. I don't know how you do that.

 

But... we can't get to those conversations because we're stuck in this "obamacare is socialism/evil/etc" argument and that's why there's such frustration from people who are not strictly in the repeal/replace group.

 

Add to it that after all these years, the GOP doesn't even have a plan to replace it... all this time... what the hell man...

 

And add to it that, in places like where I am, the local GOP people are proposing a roll back on regulations for things like requiring sufficient need for new operations to open up in the area, which is basically nothing more than a way to make sure poeple with money have the best doctors and facilities while people without have the worst.
 

[Kilmer17]

4 minutes ago, tshile said:

 

The biggest way to 'fix' that is to bring down the cost of the care itself.

 

ACA failed to implement any cost controls outside of the HCHAPs system which is imposed only on doctors and hospitals.  Basically they're cutting medicare reimbursements if certain things aren't met (and I honestly think their criteria is shortsighted and dumb, the hospital suffers if a person doesn't do the exercises at home they were instructed to post-surgery and that's not fair)

 

Expanding medicaid is one option because it gives the government more power to set the prices for things, and insurance companies can use that as a standard for their own policies. It would be an unofficial form of price fixing. That has obvious issues, and when you factor in that we're talking about health care for people those issues should not be taken lightly. Yes - the tax payer pays more money for these people, but the hope is the cost is offset by getting people care and treatment before something becomes more expensive to care for or treat (which we would still pay for at that point) and the hope that they can help set prices.

 

Imposing price-fixing measures on pharmaceuticals and medical devices is another avenue to curb cost, but there's a very valid argument about R&D and how to keep prices low without stifling innovation.

 

It would also be nice if we could get the national as a whole to realize the value to society if people used primary care physicians more often, instead of using the ER instead, and took better care of themselves. I don't know how you do that.

 

But... we can't get to those conversations because we're stuck in this "obamacare is socialism/evil/etc" argument and that's why there's such frustration from people who are not strictly in the repeal/replace group.

 

Add to it that after all these years, the GOP doesn't even have a plan to replace it... all this time... what the hell man...

 

And add to it that, in places like where I am, the local GOP people are proposing a roll back on regulations for things like requiring sufficient need for new operations to open up in the area, which is basically nothing more than a way to make sure poeple with money have the best doctors and facilities while people without have the worst.
 

Again, we agree.  The issue is the cost of healthcare.  Not the cost of insurance or the regulations imposed or relaxed on insurance companies.  One side is claiming Obamacare is evil.  The other is claiming every single thing the GOP is proposing is evil.  I think they both suck.

 

Your last point was also pointed out in the ACA debates.  When doctors stop taking insurance because it becomes too much of a hassle and no longer profitable for them, who do you think still goes to those doctors (or facilities)?  It's those that can afford it.  So yes, one of the issues with Obamacare is exactly that.  Poor people are getting worse doctors and facilities.

[Hersh]

Not all health insurance companies are for profit. Also, we have to remember that there were big increases every year in the cost of insurance before the ACA. You were also already paying more for people that didn't have coverage and ended up going to the ER or not being able to pay their bills. 

 

The number one reason there are still problems with the ACA waiting to be addressed is the GOP was 100% obstructionist from day one and has done nothing but promised a repeal. The number two problem is that our POTUS kept promising the impossible: comprehensive health insurance with low premiums and low deductibles and didn't have an actual plan. These two problems have created an atmosphere of not being able to fix anything. 

[tshile]

1 minute ago, Kilmer17 said:

 

 

Your last point was also pointed out in the ACA debates.  When doctors stop taking insurance because it becomes too much of a hassle and no longer profitable for them, who do you think still goes to those doctors (or facilities)?  It's those that can afford it.  So yes, one of the issues with Obamacare is exactly that.  Poor people are getting worse doctors and facilities.

 

Yeah... but that sort of has a problem. Medicare is a huge portion of the population doctors see. Especially doctors that spend time in hospitals, as opposed to the ones that have their own family practice in town. If they just decide to stop taking insurance, they've decided to cut majority of their patients out.

 

The problem I have with insurance is that, given all the problems and the fact that we treat healthcare as a right and not like everything else, insurance becomes an unnecssary middleman sucking money out of the system.

 

on the flip side, the only other option is single payer, and everything the government touches gets screwed up.

 

the problem with the GOP's ideas is that they think they can fix the old system, and I just haven't seen where what they plan on doing will actually do that. I'm honestly open to any idea - like I said, I'm fine, so I'm just for reducing what it costs for me to continue to be fine.
 

also, @Kilmer17, one thing that is significantly under-reported on, that was about through the ACA change (though not by ACA, just by changes in the way the market place is owrking) is that hospitals are becoming their own insurance providers.

 

they'll provide insurance to people, and then if those people use their facilities they'll provide the same care to them at a reduced rate (it's like another level of the in/out of network: out of network -> in network -> at the hospital owned by the insurance company)

 

and the rates are significantly less. So for example something might be 60% covered with a $20 copay at an in network facility but if I use the facility owned by my insurance provider it's 80% covered with no copay. Just a basic example

 

these are popping up everywhere. they're cutting the insurance middle man out of the loop on their own. they make more money, and their customers pay less money, if the hospital just does all its own paperwork.

 

 

i don't know how much credit to give the ACA for that. on the one hand there's nothing in the ACA about it, on the other it didn't start happening at this rate until the ACA was passed. Further complicating it - it's essentially teh same thing Keiser has been doing but at a much greater scale, so it's not exactly something unique that was never tried before the ACA.

 

But it is a big change going on right now that's not being reported very well on.

 

 

[LD0506]

Even heated intelligent debate beats all the other options, well done gentlemen.

[visionary]

 

 

 

[twa]

4 hours ago, LadySkinsFan said:

You know, I didn't qualify for the subsidy, but there were policies available. My problem was that as a self employed consultant I didn't have consistent monthly income to pay the premiums. 

 

You had too much income for subsidy but couldn't afford the magic health plans?

I know about that self employed income thing,

 

I paid for a policy and still got fined

[twa]

 

[skinsmarydu]

OK, y'all know I give some live updates as to where my household is, and what's going on. 

Hubby's company (the plan I'm included in) went from Humana to Cigna.  Every single prescription increased by at least 2X.  They keep billing me for stuff that is currently covered.  (I had my physical in May, paid my $25 deductible, and got a bill for $997.98 for said physical.)...after I had to call TWICE to get my November checkup bill erased, also covered by ACA, and make sure they had the new coverage on file (they have me as "self-pay"...as if...) and I was told they had my new info on file, and everything I said I needed (yearly physical and 6-month checkup, yearly GYN) was covered. 

And I still get a bill for every service and have to make a ****in' phone call to clear it all up...then it rears its ugly head again...rinse, repeat.  Again, Cigna sucks. 

This never happened with Humana.  I never got a bill.  Our scripts were less than half what they are now.

Just my update/rant.

If it gets worse than this, I may just start eating aspirin for my HBP and never give another crap about how I really am.  I'm gonna die anyway, right?

 

edit, add: deductibles did not change.  We never even come close to 'em.

Edited July 15, 2017 by skinsmarydu

[LadySkinsFan]

The HMO bill Nixon signed screwed up us people and was a huge boon to the insurance industrial complex that it's going to take decades to clean up this mess. 

 

Mary, I am so sorry you have to go through this crap with the insurance company. We are all ****ed.

[skinsmarydu]

54 minutes ago, LadySkinsFan said:

The HMO bill Nixon signed screwed up us people and was a huge boon to the insurance industrial complex that it's going to take decades to clean up this mess. 

 

Mary, I am so sorry you have to go through this crap with the insurance company. We are all ****ed.

I feel bad that you had to make the decision you did, to suffer until you got to Medicare age...and your stroke and all, I just don't know how you did it, but I know you're smart and you probably saved a little.  My mom, the nurse, said "Try to save $50 a month if you can't afford insurance...at least you can cover the initial 'sprain your ankle' exam".  Keeping the change in your pocket can get that done...change is savings.  Use it when you have to.  Easy peasy.  (And no one knows, not in any account, etc...yeah, I'm a schemer on such things.)

[LadySkinsFan]

I was able to afford my medication at Wal-Mart, much as I hate shopping there they do have cheap generics. I now buy my medications through my plan d insurance online pharmacy, 90 days of meds, which is good.

 

I bought a Plan F Supplement Insurance, no copays or deductible, lots of coverage all over the world if need be plus none of that in network crap. Helpful when I travel. Plus the Medicare Advantage plans are tied to the ACA, and I don't trust Congress, just look at the **** legislation they are trying to pass. Plus they have restrictions I didn't want.