Response to TrumpCare not so great

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anonymous_coward
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@Matt: "Just have a single

@Matt: "Just have a single payer system with a 1 or 2% income tax"

How do you decide what is covered by the single payer system and what is not?

Does every pregnant mother get a breast pump? How about psychiatric services? Birth control pills? Morning after pill?

Every procedure/operation becomes a political battle. Nothing can ever dropped from coverage, because that would be a political sh*tstorm.

I'm a Democrat but I firmly believe that a free market solution to decide what is covered vs. not is best (assuming there is downward pricing pressure, as per my solution above).

I will admit that the NHS (British single payer) does have a bit of downward pricing pressure, in the sense that anything above a certain price just doesn't get covered (that was my understanding, I don't have a source).

BTW businesses supplying health care started because of wage caps that were applied in WW2 to combat wartime inflation. Since employers couldn't pay employees beyond a certain point, they started offering other "perks", health insurance being one of them.

Jonathan Read
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This is actually worse than

This is actually worse than Obamacare if I might explain why. It doesn't fix anything. I doesn't fix the cost problem, doesn't get rid of many of the bad components of Obamacare. It's a watered down try to please everyone plan, which is always the worst.

The real problem is this though. Right now the democrats OWN Obamacare and all its failures. Enact this and the republicans own the healthcare system.

You either have to do a full revamp and fix or leave it alone, this will just cause the GOP to lose the government.

anonymous_coward
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"You either have to do a full

"You either have to do a full revamp and fix or leave it alone, this will just cause the GOP to lose the government."

Well, what does a "full revamp" look like? It's not like they haven't had 6 years to plan this out.

johnw
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At the the moment the GOP

At the the moment the GOP looks like that dog ,that chases a car and barking wildly ,when the car stops they have no idea what to do with it. I guess I'm not really surprised that they don't have a better plan for the repeal and replacement of obamacare after six years,after all they are politicians and they are full of shit......

Ugenetoo
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This will never be fixed.

This will never be fixed.
There's too much money being hand delivered by the insurance industry to the politician's pockets for the real culprit, Big Insurance to be eliminated from the picture.
No insurance company EVER diagnosed, treated, and cured anyone.
"Share the Wealth".
"Share the Risk".
What's the diff?

Mike G
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I have to question who is

I have to question who is making the money from Obamacare and considering how the health insurance companies are pulling out, I'd say it is the health care industry that is getting the money.

You know that whole industry which is huge, from the infrastructure, the security at the door, the many tiers of that service industry from those that wax the floors to those that do triple bypasses.

When you actually think about what has occurred over the past decades, much of what we have had can be called racketeering. With such racketeering the industry was going to break and thus the medical corporations had to try and force more money into the system through mandatory health insurance.

The GOP probably knew all this and just went along with it, with some self-serving mouthing about bigger government vs smaller government, you know the BS that the GOP and DEMs been feeding us for decades.

Now that Trump gets elected on the promise of dumping Obamacare, he probably had little clue as to how the health care system was hanging by a thread and had to have forced participation by whoever they could muster.

So the uniparty has to come up with another BS plan. THAT will kick the can down the road.

More kicking the can down the road, you will see it across the spectrum of the DC and now Trump.

Reality is not a state of mind in DC nor the media or the average joe in America.

Ugenetoo
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HC costs have risen because

HC costs have risen because the insurance industry has allowed them to.
Insurance companies make a percentage of the money they handle.
The more costs rise, the more they handle, and the more they profit.

Mike G
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HC costs have risen because

HC costs have risen because the insurance industry has allowed them to.

I believe that is right ugene, I've noticed little questioning in the past decade on bills vs one decade or two prior.

But I'm sticking to my racketeering theme, and it goes beyond anything that I could point out.

johnw
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I said in a an earlier post I

I said in a an earlier post I'm waiting to hear "" Rates and deductibles won't be going down if the ryan bill passes but they won't be increasing at the same rates we've seen under obama care , you know that's a real reduction in costs".....The usual bet Mortimer?A dollar?
"And under the new plan rates will rise 15 TO 20% until 2020 at a much lower rate than obamacare.....and that will be a substantial reduction in cost"......geez whiz.....The the free market will kick in and it will all be honky dory......Does anyone remember that the out of control increase of premiums and reduction of coverage in the free market are what created the conditions that engendered obamacare?
Those 15 to 20% increases may let the insurance companies recoup some of their "loses" from the obamacare years..... Be expecting your letter " Dear Policy holder please assume the position........

anonymous_coward
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@Ugenetoo: "HC costs have

@Ugenetoo: "HC costs have risen because the insurance industry has allowed them to.
Insurance companies make a percentage of the money they handle.
The more costs rise, the more they handle, and the more they profit."

Do you have a source? Because I'm pretty sure this is completely false.

For 1, the operating margin for big insurers has been pretty much the same for the last 30-40 years.

Secondly, Obamacare mandates that insurers pay out 80% of premium money as claims, so if premium costs go up, it's because they are paying out more claims.

Finally, and I've posted this half a dozen times now, the reason health care costs are going up is because of an owner-agency conflict. The patient decides what procedures to get & drugs to consume, but the cost is borne by all premium payers, so a patient will never turn down a procedure because of cost.

As a result, health care providers have no incentive to keep costs down. A drug can extend your life by 30 days but costs $1,000,000? Who cares, premium payers will cover it!

If you look at medical procedures that are not covered by insurance (LASIK for example), the costs have fallen by 40% or so over the last 20 years. As long as cost is not part of the decision process for choosing medical care, costs will never fall.

Jonathan Read
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Exactly!

Exactly!

Health insurance isn't insurance. When your car needs gas, or an oil change, or a wiper replaced does your insurance cover it? OF course not. Day to day maintenance and upkeep is your responsibility, insurance is for catastrophic issues. Rare occurrences.

That is how insurance works, every pays in a low amount to cover the off chance that something bad happens. Our health insurance operates more as a service plan than insurance. Service plans are expensive because they are used often and people knowing they have a plan overuse them.

If insurance was actually insurance we could all afford the premiums. we could have a medicaid type program to cover the poor for every day medical expenses and everyone else could budget in their treatment needs.

johnw
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There's a big difference for

There's a big difference for most folks between a $39.95 oil change and filter four times a year and an occasional set of brakes and a $6000 deductible....for regular health maintenance...

Jonathan Read
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Maybe you misunderstood.

Maybe you misunderstood. There wouldn't be a deductible. Insurance would only be involved for catastrophic treatment, injuries, cancer. Anything above a certain amount.

Everything else is just paid out of pocket. As in the post I responded to medical treatments that are not part of insurance have seen cost reductions while all treatments that are part of insurance has seen increases.

Costs would go down and people could afford their treatments. It would actually be using the market to impact healthcare costs, right now demand is inelastic. Prices go up and demand does not go down because everyone is splitting it. The price is not a factor in peoples medical decisions, so there is no downward pressure on cost.

Tom C
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"HC costs have risen because

"HC costs have risen because the insurance industry has allowed them to.

Insurance companies tried to reign in healthcare costs with the HMOs, which slowed the rise for a short time. Then, at one point, the American College of Surgeons flew in an old lady to testify before congress, breaking down in sobs, because the mean old insurance company wouldn't let her see her own doctor, who she loved so much.

Cowardly congresscritters scampered for the hills.

As a result, the shift has been toward insurance companies now to just paying what the big health care companies demand... and the insurance companies happily pass the costs along. While there is some friction against rising prices there, the forces against it are too great - doctors recommending tests and procedures with minimal benefit, and patients - who don't pay directly for those - happily take those procedures if they are convinced (by the doctor) there is even a small benefit to them.

Regulation has forced almost all the private docs into the regionals where sophisticated administrators, who know which procedures generate the most profit, can base compensation and bonuses on docs' production and in-system referrals which help squeeze the most bucks from those with the most insurance. The $35 visit to your local GP is gone, replaced by a $200 visit to your local regional family practice office - plus the few hundred dollars worth of "standard tests" they can pile onto that.

The advantage of single-payer type systems is they break down this corrupt system, but unfortunately, since they would be run by the government, it will not result in efficiencies, but instead, pointless inefficientcies which benefit no one.

Eventually with a central system you end up with a system with rising costs and diminishing output. It's what governments do. The idea that by putting government in charge of healthcare would result in more and better healthcare with less cost was absurd on its face, and only believed by fools.

The ideas brought up on this thread to try to get more market forces - from the consumer side - involved in getting healthcare on the right track are good, and it's actually not that hard from a system perspective to have good ideas there.

The problem is the politics involved, and gutless politicans. As soon as the AMA carts granny up in front of the congressional committee to complain that the $35 co-pay suddenly thrust upon her now means she can't pay her electric bill any more, it will all over. And the media eats just that nonsense up and will put those stories into the echo chamber every time, especially when its couched in a compelling (but absurd) narrative.

Oddly, the young struggling family of 4 who is now paying $24,000 a year for health care, and is skipping doctors' visits because of the $6000 deductible, doesn't seem to interest them. Health care reporters used to be from the business side, now they are from the brain-dead social-justice mindless-zombie crew that just regurgitates whatever the sharp PR crew feeds them, as long as it is couched in the "narrative". As a result, those who claim to fight hardest for the poor, instead end up as instruments wielded deftly by the richest and greediest. .

It's a political problem. Ryan, Schumer the MSM and those crooks are in it up to the tops of their pockets, make no mistake about it. Breaking that cabal is going to take guts.

anonymous_coward
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@Jonathan Reed: "Everything

@Jonathan Reed: "Everything else is just paid out of pocket. As in the post I responded to medical treatments that are not part of insurance have seen cost reductions while all treatments that are part of insurance has seen increases."

One big difference is that a car insurance policy can only pay out the total value of the vehicle.

What's the value of a human life? Right now there's no cap, you can spend an infinite amount of money trying to keep someone alive.

Tom C
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What's the value of a human

What's the value of a human life? Right now there's no cap, you can spend an infinite amount of money trying to keep someone alive.

I think you mean "cost." You can spend as much as you want. Well, you can spend as much as you have.

As far as the monetary "value" of a human life, liability lawyers calculate it all the time.

johnw
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This whole health care mess

This whole health care mess has to be very stressful for politicians , I mean think about trying to protect your bribe money , campaign contributions and nepotism deals safe from scrutiny and intact while trying to convince the taxpayers and premium payers you are looking out for them......Give 'em a little reach around ,like shopping across state lines or an increase in HSA accounts....... here doggy have a nice bone......
.Take someone like spicer how does he manage to talk out of both sides of his mouth at the same time without his head exploding? Classic crap ...premiums rise in the short term but you'll be saving big in the future........ wow...... just wow....ryan and company never fail to disappoint.....ever.

Tom C
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Ryan is the poster boy for

Ryan is the poster boy for the corrupt establishment - he lives to scr#w the populous to keep the gravy train flowing to his rich pals. It's the uniparty Americans voted against. He knows he's headed for trouble, but as long as the gravy train keeps going, he has his raison d'etre.

Like the Democraps, for the GOP-E, serving the people just isn't in the plan. Heck, it's counter-productive.

anonymous_coward
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@Tom C: "I think you mean

@Tom C: "I think you mean "cost." You can spend as much as you want. Well, you can spend as much as you have."

No, I meant the value that is insured. For car insurance, collision is the value of replacing the car; liability is usually capped at some largish amount.

For health insurance, there is no cap, as long as the procedure is covered.

johnw
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The simple fact that

The simple fact that insurance companies "invest " money should allow people to buy a clue..... invest in what , for profit hospitals , pharmaceutical companies, medical device companies........? Nothing possibly incestuous there .....
There is a plethora of information on the internet regarding this.....
Anyone who thinks that allowing companies to sell across state lines is going to significantly increase competition.....is nuts these guys are holding all the cards.......Have you read about all of the proposed consolidations and mergers in the insurance business? Why would they let prices go down.....?

First, they pool the money to pay claims. Second, insurance companies pay for expenses involved in selling and providing insurance protection. Third, insurance companies invest money. Earnings from investments help keep down the cost of insurance to policyholders.

How Insurance Works - Insurance Institute of Michigan

www.iiminfo.org/CONSUMERS/HowInsuranceWorks

Tom C
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For health insurance, there

For health insurance, there is no cap, as long as the procedure is covered.

Many health insurances do have a cap, typically 1 or 2 million dollars.

But that's different than the point I objected to - mainly that cost is different than value.

anonymous_coward
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"But that's different than

"But that's different than the point I objected to - mainly that cost is different than value."

That's a semantic difference, I didn't mean "value" in the generic sense, I meant value specifically as it applies to what is insured by a policy (cost is what you would normally apply to the price you pay for something on an open market.)

Bruce Libby
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I agree the response to

I agree the response to proposal has not been to good.
I wonder if part of the problem is the fact that there is just to many opinions and guesses as to what it will be or cause.
I have heard or read since the budget projection (that is what it is) numbers of uninsured by 2026 of 14,000,000
to 24 ,000,000 !

Given I do not know many there are today and the probably don't kind of makes responding kind of difficult.

Tom C
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That's a semantic difference,

That's a semantic difference,

Not merely semantic at all, with respect to the healthcare debate. It's critical.

johnw
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Hey great news with the

Hey great news with the savings of a 15% increase for the next three years my premium will go down from $83 per to $126 per week....damn that common core math really really works.....that's a savings increase of $2236 ...hope it actually increases 20% think of the saving I get then!!!!

Mainelion
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Just remember that the

Just remember that the crapweasels who are voting on it get free Cadillac Healthcare for life. I'm sure they have your best interest at heart.

Cheech
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http://www.huffingtonpost.com

http://www.huffingtonpost.com/2012/08/14/janna-ryan-paul-ryan-wife_n_177...

I think it is interesting that Janna Ryan is a democrat lobbyist who has worked for big pharma, and that the speaker refuses to say who the lobbyists who had a hand in writing the bill were. I am not a believer in or of "political coincidence", especially from the likes of Ryan who has every intention of undermining the administration's agenda

http://www.breitbart.com/big-government/2017/03/13/exclusive-audio-emerg...

Roger Ek
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TomC observes:

TomC observes:
"Eventually with a central system you end up with a system with rising costs and diminishing output. It's what governments do. The idea that by putting government in charge of healthcare would result in more and better healthcare with less cost was absurd on its face, and only believed by fools."

The more a Doc makes, the higher his malpractice insurance cost. A cardiologist pays a lot more than a family practitioner. Now the system is so broken that a family practitioner cannot afford to have a private office. The Docs either become a "hospitalist" or they hire out to a "network" run by a large chain of corporate hospitals. When I was a kid, the family Doc made house calls. He was prosperous. I doubt that he paid $125,000 a year for malpractice insurance.

Tom C
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Tort reform is another place

Tort reform is another place the 'rats want to avoid at all costs. For that reason, they want this bloated system to suck even more oxygen out of the room for their fat-cat lawyers.

JackStrawFromWichita
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"Many health insurances do

"Many health insurances do have a cap, typically 1 or 2 million dollars. "

Ahhh, that article is from 2008. I believe that under the ACA there are no longer caps.

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