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


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@goskins10  My reply to your post from the election thread

 

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Many of those costs go down over time - along with the loss of some of the income from Billionaires. We can also get money from not being the worlds cops and getting out of regime change wars. Again, a small increase in net cost for middle class is fine. Again, it's worth it to eliminate the risk of medical bankruptcy. This says nothing of the ability to reign in run away medical costs. 

 

Considering the monumental increase in the federal budget being proposed by Sanders, we'll need more than savings here and there.  Even a trillion lost from wealth tax alone is 67% of the Trump Tax cut.  (and I think I saw 1.75 trillion from billionaires alone over a decade) It is a huge hole in the budget.

 

I'm not gonna bother addressing the GOP crap because I'm a life long Dem that has no appetite for GOP policies.  In fact, I'm not even that far away from Sanders/Warren version of progressive policies as a whole, but my position being, if you're gonna sell progressive policies, you gotta sell the whole picture, not just oh these are great things to have in your life and we'll find the money somewhere so let's worry about that later.  

 

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They can do that now and do. The fear of some mass exadus is again proven to be false. Will some leave? Possibly. But some mass exodus? Not hardly. 

 

 

 

Right now, they don't have an annual incentive of 5%-8% to do it.  

 

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No, you should judge him on history of those campaigning on change. We have checks and balances in place for a reason. But sometimes you need to start in an extreme position to get some reasonable movement. Here is a video worth watching about how the fact is Bernie's positions a are not actually as far left as people make it out to be - in fact for many he the compromise to a much more progressive agenda. 

 

Plenty of people make this argument, that people should ignore the more progressive part of Sanders' platform because it will never pass.  If MFA is liberal version of build that wall, we should never hear about it again.  

 

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Most other countries do have a private option - including the countries is referring to. That just gets ignored. 

 

 

But he is fact proposing modeling those - but with improvements. We should be looking at the best of those systems and fixing those things that are not as good. That is all he is saying.  

 

No he is not.  This is precisely my point.  People think that Sanders' plan will be US version of those systems overseas, but it decidedly is not.  Sanders himself said that private insurance will be entirely abolished (then he backtracked a bit by saying it could remain for procedures not covered by MFA like cosmetic procedures and for unions).  But it is not the type of private options that exists in other countries.  If people want that, fine.  But a lot of people don't even know that's what Sanders is pushing for.  

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2 minutes ago, bearrock said:

@goskins10  My reply to your post from the election thread

 

 

Considering the monumental increase in the federal budget being proposed by Sanders, we'll need more than savings here and there.  Even a trillion lost from wealth tax alone is 67% of the Trump Tax cut.  (and I think I saw 1.75 trillion from billionaires alone over a decade) It is a huge hole in the budget.

 

I'm not gonna bother addressing the GOP crap because I'm a life long Dem that has no appetite for GOP policies.  In fact, I'm not even that far away from Sanders/Warren version of progressive policies as a whole, but my position being, if you're gonna sell progressive policies, you gotta sell the whole picture, not just oh these are great things to have in your life and we'll find the money somewhere so let's worry about that later.  

 

 

Right now, they don't have an annual incentive of 5%-8% to do it.  

 

 

Plenty of people make this argument, that people should ignore the more progressive part of Sanders' platform because it will never pass.  If MFA is liberal version of build that wall, we should never hear about it again.  

 

 

No he is not.  This is precisely my point.  People think that Sanders' plan will be US version of those systems overseas, but it decidedly is not.  Sanders himself said that private insurance will be entirely abolished (then he backtracked a bit by saying it could remain for procedures not covered by MFA like cosmetic procedures and for unions).  But it is not the type of private options that exists in other countries.  If people want that, fine.  But a lot of people don't even know that's what Sanders is pushing for.  

 

Here are vthe actual details - https://feelthebern.org/bernie-sanders-on-healthcare/  Debunks much of what you are saying about his plan. 

 

I am not even a Bernie fan. He is about 4th on my list. But I do agree with him on health care. This harping on the cost is a cop-out. It's been explained - people can choose to ignore it and just believe what you want but the money is there - and you can't have this discussion without discussing the GOP budgets becasue part of that money comes from reversing their idiotic tax cuts. 

 

No reason to continue. You have already made up your mind. Fair enough. It's your right. Thanks for the discussion. 

 

Last thought, ultimately, if we can find enough money to kill people we should be able to find enough money to keep people alive. Maybe stop one to do more of the other. 

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So honest question (and maybe this has been tried and I just didn’t know).  I’m a firm believer in the cost of medical care itself needs to be addressed before we worry about how to pay for it.  That said, has the government tried some form of anti-corruption/colluding/whatever it is called against the healthcare field?  Probably going after the drug manufacturers first?

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36 minutes ago, TheGreatBuzz said:

So honest question (and maybe this has been tried and I just didn’t know).  I’m a firm believer in the cost of medical care itself needs to be addressed before we worry about how to pay for it.  That said, has the government tried some form of anti-corruption/colluding/whatever it is called against the healthcare field?  Probably going after the drug manufacturers first?

 

You can obviously write a treatise on the subject, but antitrust enforcement in healthcare presents particular difficulties in that application of the traditional antitrust test is not a perfect fit.  For example, what one might consider collusion among providers or hospitals can be justified as promoting not only economic benefit, but patient outcomes too (the government lost a lot of these antitrust cases against hospital mergers in the 90's).

 

Anticompetitve behavior in pharma is definitely a problem and is something the government has gone after.  For example, government has ramped up prosecution of pay to delay settlements (where two pharmas contractually agree to delay introducing generics under the guise of settling a dispute over the underlying patent) under both Obama and Trump admin and won some important cases in the last 10 years.  But when you get one court victory, corporations will try another way the next time, requiring further litigation.  And if the company ever wins one of these litigations, now there's a blueprint.

 

All these stem from the fact that DOJ has to rely on a set of laws passed in the first half of the 1900's to address anticompetitve behavior in the healthcare field.  Sometimes the principle fits, sometimes it doesn't.  Of course the best solution would be for Congress to get off their ass and pass a new law addressing antitrust in healthcare.

 

But at the end of the day, healthcare is expensive in the US because hospitals and doctors hold more cards in setting prices than patients (who also seem rather uninterested in shopping for prices all that much).  And insurers are in somewhat of an odd situation where their profit is capped at a percentage of premium (giving natural incentive to not rein in the premiums or reimbursement rate too much).  Add to that the fact that many areas are served by a few insurers, you get the idea.

 

Even public option plans talk about universal reimbursement rates.  Buttigieg proposes a single rate, negotiated across the country, with variance for cost of living.  Unless we require doctors, hospitals, and pharmaceuticals to simply charge less, I doubt we'll see a whole lot of savings.

 

Edited by bearrock
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57 minutes ago, bearrock said:

And insurers are in somewhat of an odd situation where their profit is capped at a percentage of premium (giving natural incentive to not rein in the premiums or reimbursement rate too much).

 

Insurance company profits aren't capped at a percentage of premiums.  The profits are capped as a percentage of medical expenses, which more technically is called the Medical Loss Ratio (MLR).  Not premiums.

 

In some cases, this has resulted in rebates to consumers (which in reality is decline in premiums).

 

https://www.healthinsurance.org/obamacare/billions-in-aca-rebates-show-80-20-rules-impact/

 

The other thing that has happened is an increase in medical claims-meaning fewer rejected claims and/or out of pocket expenses (superficially this might seem like a positive, but if it is coupled with an increase in fraud then that's not really true).  If the insurance company was rejecting claims because they were fraud or just unnecessary health care use, then it isn't really good.

 

There certainly is no less of an incentive to lower premiums than before the law was passed.

Edited by PeterMP
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24 minutes ago, PeterMP said:

 

Insurance company profits aren't capped at a percentage of premiums.  The profits are capped as a percentage of medical expenses, which more technically is called the Medical Loss Ratio (MLR).  Not premiums.

 

https://www.healthcare.gov/health-care-law-protections/rate-review/

 

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The 80/20 Rule generally requires insurance companies to spend at least 80% of the money they take in from premiums on health care costs and quality improvement activities. The other 20% can go to administrative, overhead, and marketing costs.

 

The 80/20 rule is sometimes known as Medical Loss Ratio, or MLR. If an insurance company uses 80 cents out of every premium dollar to pay for your medical claims and activities that improve the quality of care, the company has a Medical Loss Ratio of 80%.

 

Insurance companies selling to large groups (usually more than 50 employees) must spend at least 85% of premiums on care and quality improvement.

If your insurance company doesn’t meet these requirements, you’ll get a rebate on part of the premium that you paid.

 

They are required to spend 80-85% of the collected premiums on healthcare and quality improvements.  Meaning that their profit cannot be any higher than 15-20% of collected premiums (obviously it will be less due to overhead and etc).  On one hand, improvement on overhead and efficiency can ensure more of that 15-20% turns into profit.  On the other hand allowing the dollar figure of 80-85% to grow (by higher reimbursement rates and more approval of procedures) will result in higher dollar figure of ins. co.'s 15-20%.

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  • 2 months later...
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Missouri passed Medicaid expansion, largely from votes that came from middle-upper class suburbs. Rural counties, which stand to benefit the most, voting overwhelmingly against it. 
 

The level of brainwashing that has happened to poor rural whites is unfathomable. Dying sick and poor to own the libs is a lifestyle choice now.

Edited by No Excuses
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6 minutes ago, No Excuses said:

Missouri passed Medicaid expansion, largely from votes that came from middle-upper class suburbs. Rural counties, which stand to benefit the most, voting overwhelmingly against it. 
 

The level of brainwashing that has happened to poor rural whites is unfathomable.

 

It's a damn shame that all Repubs have left to keep them in power is fear and hate, yet those are the two biggest motivators that appeal directly to our most primitive instincts

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46 minutes ago, Mr. Sinister said:

 

It's a damn shame that all Repubs have left to keep them in power is fear and hate, yet those are the two biggest motivators that appeal directly to our most primitive instincts

I would never refer to poor, rural, white folk as primitive... but they’re probably the closest we’ve got to matching the description.  Perfect target for the GOP (and snake oil salesmen like Trump, Alex Jones and the money grubbing evangelicals).  Sad to see.  

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1 hour ago, Mr. Sinister said:

 

It's a damn shame that all Repubs have left to keep them in power is fear and hate, yet those are the two biggest motivators that appeal directly to our most primitive instincts

 

Almost every time there is a big ticket ballot initiative these days, the conservative policy agenda loses no matter what part of the country we're talking about. Obamacare medicaid expansion has now passed this year in ruby red Oklahoma and Missouri.

 

A sizeable chunk of the GOP only votes for the white grievance agenda. If racism wasn't such a strong driving force in the country, the GOP would have very little to offer to most of the electorate.

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  • 4 weeks later...

With Canada and Mexico borders closed, Americans are trapped in their own health-care system

 

"Want to hear the joke about insulin?" goes the bleak gag about America's drug prices. "You have to go to Canada to get it."

 

But even that's not an option anymore.

 

Pandemic travel restrictions have made Americans prisoners of their country. Even within North America, Mexico and Canada have closed thousands of kilometres of border to all but essential travel, roiling plans for vacation, work, and school. For cash-strapped Americans, it has also cut off access to medicines and health-care services that they can't afford at home -- at a time when money is tighter than ever.

 

Click on the link for the full article

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35 minutes ago, TryTheBeal! said:

I’m starting to think we’re never gonna see Trump’s big, beautiful healthcare plan.

 

We already saw the GOPs.  (And, curiously, Trump never actually mentioned his.)  

 

(Why every Dem candidate wasn't hanging that albatross around the neck of every Republican who voted for it, is another one of those things I just don't get about Dem political decisions.)  

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  • 4 months later...

Biggest health insurer plans to deny ER bills if it doubts you had an emergency

 

Doctors and hospitals are condemning plans by UnitedHealthcare—the country’s largest health insurance company—to retroactively deny emergency medical care coverage to members if UHC decides the reason for the emergency medical care wasn’t actually an emergency.

 

In the future, if one of UHC's 70 million members submits a claim for an emergency department visit, UHC will carefully review what health problems led to the visit, the “intensity of diagnostic services performed” at the emergency department (ED), and some context for the visit, like the member’s underlying health conditions and outside circumstances. If UHC decides the medical situation didn’t constitute an emergency, it will provide “no coverage or limited coverage,” depending on the member’s specific insurance plan.

 

Emergency medical doctors and hospitals were quick to rebuke the plan. They say it sets a dangerous precedent of requiring patients to assess their own medical problems before seeking emergency care, which could end up delaying or preventing critical and even lifesaving treatment.

 

The policy was initially set to take effect July 1. But in an email to Ars Thursday, UHC now says it is delaying the rollout amid the criticism—at least until the end of the pandemic.

 

Click on the link for the full article

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