I'm just curious how you know all of this and who leaked it?
We all know that you have to pass a bill before you find out what's actually in it.
OT: AHCA
- Thread starter iceheart08
- Start date
We all know that you have to pass a bill before you find out what's actually in it.
I'll just throw this out there, since waist size is an important topic in TWZ - maybe insurance should be charged by the pound (or fat %, since you can weigh more with muscle).
Obesity is one of the biggest drivers of preventable chronic diseases and healthcare costs in the United States. Currently, estimates for these costs range from $147 billion to nearly $210 billion per year.1 In addition, obesity is associated with job absenteeism, costing approximately $4.3 billion annually2 and with lower productivity while at work, costing employers $506 per obese worker per year.3
Obesity is one of the biggest drivers of preventable chronic diseases and healthcare costs in the United States. Currently, estimates for these costs range from $147 billion to nearly $210 billion per year.1 In addition, obesity is associated with job absenteeism, costing approximately $4.3 billion annually2 and with lower productivity while at work, costing employers $506 per obese worker per year.3
This is a good point. I do think that Republicans are further away on the vote count than Democrats were in 2009/2010.
Bingo - AARP would've come out against it even if it said all seniors will have their entire medical bills paid for by conservatives and conservatives only.
I don't know much about the proposed AHA right now, but I'm not loving what I'm hearing. At the end of the day, less government interference and more competition is the best option.
"Pooling mechanism?" Does he think this is his idea? Does he understand this "mechanism" already exists, and is called an EXCHANGE?
AARP is the biggest lobby. Not the tobacco & guns. AARP. You're gonna pay non baby boomers. And, that includes the terrible gen xers & millenials.
Yeah, but it's more than that.
The ACA is structured so that the old folks in the AARP are fleecing the young, who have lower medical costs.
So the AARP LOVES it !!! Of COURSE !!
FWIW, Obama care is actually Romney Care which we have had in Mass. since 2006. I don't know much about it but I think it has been fairly successful .
http://www.philly.com/philly/blogs/health-cents/Obamacare-vs-Romneycare-Is-there-a-difference.html
http://www.philly.com/philly/blogs/health-cents/Obamacare-vs-Romneycare-Is-there-a-difference.html
The first of the boomers are over 70. Think about this. That's why I don't want to bash millennials, they're gonna learn soon.
He's talking about smaller pools by association. The specific example I heard him talk about was members of a credit union could pool together. The exchange is one big pool, yes. His plan would allow for pools by association smaller than just at the state level. Members of the exchange have no bargaining power as it is currently constructed.
If that's all you could parse out of that I'm doubly sold on his plan.
A competitive, free market system cannot exist in healthcare. Hospitals, by law, are required to provide you service regardless of your ability to pay. Please, describe another "competitive" industry which mandates you provide service to someone with the inability to pay. Before I go any further, I'm not stating hospitals shouldn't be required to treat everyone. I am just tired of the point that a competitive market is the only solution.
As for the AHCA, I am really disappointed in the proposed solution. As OP stated, the subsidies are being replaced with refundable tax credits. The tax credits are tied to age ratings, but not income. The bill repeals the requirement for essential benefits in coverages and widens the rate band gap between younger policy holders and older ones. Hopefully, it will allow younger policy holders into the market and mitigate the higher costs for older adults. However, concern exists that the tax credits, as currently proposed, will not be sufficient to cover enough of the cost of insurance coverage. Thus, the insurance market will react to this by creating lower cost policies which are not robust, and which will have even higher deductibles than currently exist. By the way, uncollective medical expenses have more than tripled at hospitals across the coutry because of patients' inability to pay for the deductibles and coinsurance required by their policies. The results is smaller, rural hospitals closing across the country.
The above is just one example of the complexities of the current situation. AHCA is not the answer, but hopefully dialogue will continue and the AHCA will evolve.
~cc
I think you can come up with insurance plans that cross state lines. Don't give me the ER BS, you're going to get that no matter where you live.
There has to be a way to make it a competitive market.
Or, just put everyone on what is essentially a Medicare plan. Hell, they're the ones placing the rates of reimbursement to the providers.
Yeah, you are going to get the "ER BS" anywhere you live but the markets aren't the same for all hospitals (e.g., rural vs. urban, SES, etc.). Further, complications like the Medicare wage index, DSH payments, Medicaid, etc. create different reimbursement issues for "competitive markets." I support free market but healthcare is not setup for free market to exist.
As for insurance plans, I agree with you on crossing statelines. The insurance industry is a mess right now. We can make the claim more people have insurance than ever before, but very few of the new enrollees have the ability to afford their insurance. The law required insurance so everyone bought the lowest premiums with extremely high deductibles. The result was insurance which the individual could not afford the deductible resulting in money be spent to insurance companies and hospitals still taking on bad debt.
~cc
i've long advocated that obama care should have been something states could choose to adopt or not. it could have been a template / infrastructure that stats could decide if they wanted to give it a try. liberal states like Mass, NY, and California would have signed up for the experiment... over time they might have made mistakes and fixed them, over long periods of time if it truly worked well even conservative states would have decided to adopt it because it would have been neccessary to retain major employers / talent.
one reason it works so well in mass is because mass is a high income liberal state already.
You understand that the staggering majority of the best healthcare systems in the world are either single payer or universal healthcare through highly regulated private insurance, right?
Below are the countries ranked ahead of the United States according to the WHO. The bolded ones have universal healthcare.
France
Italy
San Marino
Andorra
Malta
Singapore
Spain
Oman
Austria
Japan
Norway
Portugal
Monaco
Greece
Iceland
Luxembourg
Netherlands
United Kingdom
Ireland
Switzerland
Belgium
Colombia
Sweden
Cyprus
Germany
Saudi Arabia
United Arab Emirates
Israel
Morocco
Canada
Finland
Australia
Chile
Denmark
Dominica
Costa Rica
USA
EDIT: The UHC part of this is difficult. Info on some of the smaller countries is hard to come by.
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It's still a Medicare driven reimbursement system. And the insurance industry is a farce. The private ones will fight over a minor surgery and then tell you you should have waited for secondary approval, which was after you already had the procedure.
I'm in the thought that it's going to go to a Medicare system for all anyways. The doctors are going to freak out but it is what it is.
And, don't get me started on the SC politicians in bed with this industry. I like Tim Scott but he was a former AllState agent who I'm not so sure has totally cut that chord. But, that opens up a whole can of worms if you happen to live below Hwy-17 and make one claim in 20 years.
It's already legal in a few states and insurers haven't jumped on it. It spits in the face of state's rights (which is allegedly important). I don't want South Dakota telling me what should be in a healthcare plan but that's what's going to happen when a state is "business friendly" and the insurance companies all race to the bottom to see who can have the cheapest and worst plans.
Sort of true, except that was the GOP's original aim as well. They just got the added benefit of saddling the Dems with it for 8 years. But make no mistake the Chamber of Commerce types want to rid themselves of healthcare (and honestly they should be rid of it...stupid relic of post WWII salary controls). If that means socialized medicine or pure market based I don't think it matters to them. A pox on both their houses. But pick one dammit!
If you fundamently agree that in our society, people have a right to Healthcare...that we have moved beyond letting people die from preventable disease and fighting to stop others like cancer, then the gov't or other people have to pay for it.
If you don't agree that people deserve healthcare, then I don't know what to tell ya.
But not necessarily the only reason it works well. And for as great as TrumpCare is according to Paul Ryan, how many Republicans in Washington are going to be signing themselves and their families into the plan???
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I had friends of mine that had that exact plan and lost it. I should say that Obamacare is what it was BLAMED on, not necessarily what caused it.
I'm not 100% sure the insurance industry isn't playing people by blaming Obamacare for things that aren't it's fault. Kinda like the oil industry raising prices after they wrecked the Valdez, and the first gulf war.
It is very easy to sit back and say "no coverage for pre-existing conditions" until you or someone you love (could be your child) has one. My wife currently has two pre-existing conditions - type 1 diabetes (not the kind you get for being fat) and she is pregnant. We run a business and purchase private insurance which is very costly. The only reason we were able to do this is b/c of the pre-existing conditions mandate in Obamacare.
In a typical year, her medical expenses alone (including insurance) run us about $21K. This year with baby it will be about $26K. I fortunately earn enough that we can afford that while still living normal lives. Without Obamacare, I would not have been able to start a business that pays other people. I would still be working for someone else.
There are plenty of families out there with children with Type 1 diabetes that would not be able to afford that and still get by. Their kids are suffering. Just saying, it could happen to you, so be careful what you wish for.
i'm not a trump care advocate... i'm a believer that obamacare / romney care is a mostly good system that needs some fixes. i just think that a liberal president and a left leaning congress imposing a law on a country with 30 conservative to moderate states was always going to end badly. if they had let states chose wether they wanted to follow the obamacare blueprint then it could have proven itself over time instead of being politicized with misinformation and sabotage.
I had a private catostrophic plan for years and lost it after Obama. Not much difference but it's the same stuff, different provider. It's BCBS vs Humana.
But it was the only option. It's really been the same for over 25 years. If you're a small business, independent contractor, or solo insured, you get minimal options. It's really the same cost as shopping the market as an insured in South Carolina.
Would not surprise me the insurance industry is pushing the blame game, been doing for yearsto mask the fact that they're the real ********.
That point can be argued. People may have the right to the access to healthcare without actually having a right to healthcare. They still have to obtain it, through purchasing a plan one way or the other, or through having the means to pay for their own issues as they come up. Kinda like - I have the RIGHT to own a gun, but I don't have the right TO a gun. I still have to buy the thing. The government just can't tell me I cannot have it, but they aren't just gonna give it to me either.
I acknowledge that this comes with more than a few stickey wickets though. For one - if someone comes into a hospital with their leg nearly severed and bleeding to death, do you take the time to make sure they can pay before working on them? Of course not.
Children that don't have healthcare - what about them? Another stickey wicket. Nobody is gonna sign up to let kids die because their parents suck - including me.
Born with a condition that requires constant treatment? Another problem, though I think that solution is more in the cost of pharmacuticals than the insurance side.
So we will probably wind up with some sort of a compromise. I don't know enough about health care to tell you what that should look like. Ideally if someone has a life-threatening disease they will be treated and either their insurance will pay or they will write a check. Kids and those who, through no fault of their own cannot get insurance, we figure something out.
I don't think the model used in the scandanavian countries (Norway I think is the one that everyone quites) of total government-supplied healthcare and high taxes would work here. That depends on a specific ratio of people paying in to people using it. Simple math equation. Those countries are just different in culture and I don't think their concepts would work here. It is actually starting to have problems there too.
two interesting things come up in this...
pre-existing conditions should never be an issue for children if they are covered their entire life... there should be some way to ensure continuity of coverage for things always covered under previous insurance plans. much of the problem with the old way of doing things was people were trapped in their company provided insurance and therefore had no career mobility.
two... i wonder if the way to transition to universal health care is to make it universal for children up to a certain level of coverage and then let adults make their own decisions (and live or die with them) by age 26. i had a 1 month time period between jobs in my 20s and i bought a 1 month policy as a result. if people don't want to take responsibility for their own livlihood i'm ready to let them so long as it doesn't cause children to suffer. (its much more complicated i know because if your parent dies you are going to suffer)
I agree. I think all people have the right TO Healthcare. It shouldn't be free, but it seems to me the ACA tried really hard to make everyone pay a share unless they couldn't afford it.
Yes the ACA has had problems, but why not fix the problems rather than introducing a ton of new ones.
The single biggest issue with the ACA was the way it was introduced. "We have to pass it to see what is in it" was the stupidest thing anyone ever said on a political stage. That soured a lot of people on the whole concept.
Plus you know Trump and the Republicans will want to put their own stamp on it. Even if what they come up with is 85% the same as Obamacare.
its a bad quote, but but what was really meant was you were never going to know if it worked until after it was tried / implemented... as i said above... should have been voluntary for states to opt in and opt out... would have solved 90% of its problems.
In all fairness, pre existing conditions can show up in adults and will not be diagnosed until so. Thing is, the effects don't show up or cause problems until adulthood. It's not just children.
And, for the kids with existing conditions, how do they change plans? Forced to work for the same employer because to change would mean you're now a pre-existing? How about an adult who gets the oh **** dx from something no one figured out until they're over 26? It's not just the kids here
That's one issue.
Healthcare is really a local issue in regards to delivery. Expanding on what you've said, out of state carriers will struggle in it's negotiation and implementation of forming a delivery network because they need traction with local hospitals and providers. You don't just walk in and start negotiating rates that are better than what's currently in place. They could buy into an existing network I guess. But that's not going to help much.
The Heritage Foundation is pretty open market/pro-competition on it's views and they even think it's not helpful.
Not sure how to fix it, honestly. We have some to brightest people in this country and they can't figure it out, left and right.
Insurance is the biggest fraud in the country. I pay someone money incase something happens to me and when something happens, I still pay. Just not as much. That's a joke.
Insurance is the biggest fraud in the country. I pay someone money incase something happens to me and when something happens, I still pay. Just not as much. That's a joke.
Yeah. I mean I want a single payer healthcare system, so I'm certainly biased. I do not, however, see how anything proposed in the AHCA does anything to actually improve the situation (unless we think rich people aren't getting taxed enough, it definitely alters that). The best I can say for it is that it keeps some of the good things about the ACA. I sincerely doubt it passes anyways, so this is likely much ado about nothing.