Trumpcare Unveiled

[Eurodriver]

Man, I'm hurt. See posts 68, 78, and 90 in this thread. Also see Chris Wallace's interview of Jim Jordan on today's episode of Fox News Sunday.

I'm sorry man! Busy af over here.

ETA: Watched Jordan's interview. Sure wish he was speaker. 05:10 is where pre-existing conditions begins.

http://www.foxnews.com/politics/2017...t-to-work.html

[RetroRevolver77]

-Repeal/Reform EMTALA.
-Treat people who can pay. Don't treat those who can't. (Beyond the ER, and MEDICALLY NECESSARY treatment to avoid death or loss of limb in the immediate sense).
-Stop treating non-compliance for free.
-Allow healthcare insurance plan shopping anywhere in the US.

I currently pay $277/mo. I am 31, M, Never smoker, No disorders or diseases (not even glasses). I have a nearly $4K deductible.
I COULD pay $49.99/mo, and have a $500 deductible. But that plan "doesn't qualify" with Obamacare.

The goal with all of this healthcare BS is to give as much shit away as possible to people who won't pay for it. ****. That. Aside from life/limb-saving intervention, it's a consumable. Like food. Etc.

So currently, we are all billed for the 20 aspirin that are NOT billed because charity...and we are also billed for the massive insurance costs incurred by insuring noone gets rich of suing, and we must include the profit loss from those who DO successfully sue, and we must pay for...all that shit, that makes your $0.20 ASA 325mg pill cost you $20.

Want to get rid of that? Manage liability. Remove charity cases, stop forcing insurance companies to take shitty clients with preventable diseases at "fit and healthy" rates. Etc. etc. etc.

America is gutless and won't do it though, so nothing is going to fix it. It's all just different ways of drawing the same conclusion, these different "reforms".

Obamacare was designed to destroy the Middle-Class's ability to save for retirement and pay for education for their children.

[6933]

Yes, mandated coverage of pre-existing conditions is a no-go if any bill ever hopes to provide affordable care.

Agree. We also need Tort Reform. Wife is an OB/GYN in Mormon country. She does approx. 35-40 deliveries/month. Also many surgical procedures. NEVER been sued. Her malpractice is close to 80K/yr. Several deliveries/month are from indigent patients or ones that refuse to pay. All that time, energy, lost sleep, and time away from family without compensation. !0's of thousands $$/yr. lost. Can't be written off. Straight loss.

We also need insurance across state lines.

I'm out. This topic can make my blood boil. No easy answers. Can I get some individual responsibility spread across the USA?

[TommyG]

Why have I yet to hear absolutely anything on repealing the pre-existing condition regulation?

How can insurance companies function if someone with cancer can simply sign up at $500/mo (hell, even $1000/mo) and then immediately receive treatment?

This. You can't force enough people into the system to make up for it. You can prolong the agony but eventually it will crash the system. A true market solution looks like it would result in a lot of financial pain in both the health care and insurance industries which makes it unlikely either side of will take a real shot at fixing it.

[26 Inf]

Obamacare was designed to destroy the Middle-Class's ability to save for retirement and pay for education for their children.

Seriously, weren't most middle class folks already working for employers that provided health coverage? My premiums had been going up each year well before Obamacare was passed.

I agree, the ACA (Obamacare) is far from ideal, but to lay the increase in medical costs at the feet of some nefarious plot to destroy the middle class flies in the face of what has actually happened.

Between 1970 and 2008, the share of the economy going to health care rose from 7.2% to an estimated 16.6%, or from about $356 per person in 1970 to an estimated $7,868 per person in 2008.

Employer-sponsored health coverage premiums for family coverage have increased by 97% since 2000, from $6,438 to $12,680 in 2008.

http://kff.org/health-costs/issue-br...election-2008/

The rate of rise in family insurance premiums actually slowed a little between 2011 - 2016, premiums rose 20% during that period; they rose 31% between 2006 - 2011; and they rose 63% between 2001 - 2006.

The rise in Rx drug spending: 2015 - $457 billion (rose 19.7% in the three years from 2012 and 22.5% in the six years from 2009); 2012 - $367 billion (rose 3.6% in the three years from 2009); 2009 - $354 billion.

Overall, prescription spending amounted to 16.7% of all health care service expenditures in 2015.

http://time.com/money/4503325/obama-...sts-obamacare/

Here is an interesting article about rising healthcare costs which explains the rise from the 60's to today:

https://www.thebalance.com/causes-of...-costs-4064878

I don't know what the answer is, but it has been going on long enough that it is ridiculous to declare it a plot by Obama to destroy the middle class.

I hate it when basic fairness makes it seem as if I'm defending a guy I never voted for, but damn.

[26 Inf]

Seems to be a pretty level headed article regarding basic cause and affect. What do you think?

https://www.thebalance.com/causes-of...-costs-4064878

Thanks,

Dan

[Caeser25]

Agree. We also need Tort Reform. Wife is an OB/GYN in Mormon country. She does approx. 35-40 deliveries/month. Also many surgical procedures. NEVER been sued. Her malpractice is close to 80K/yr. Several deliveries/month are from indigent patients or ones that refuse to pay. All that time, energy, lost sleep, and time away from family without compensation. !0's of thousands $$/yr. lost. Can't be written off. Straight loss.

We also need insurance across state lines.

I'm out. This topic can make my blood boil. No easy answers. Can I get some individual responsibility spread across the USA?

She doesn't charge other people higher costs to cover her losses for those that don't pay?

Edit: or send/sell those nonpayers to a collection agency? I had a hospital screen up and send me to a collection agency for a bill I did pay.

[Hmac]

She doesn't charge other people higher costs to cover her losses for those that don't pay?

Edit: or send/sell those nonpayers to a collection agency? I had a hospital screen up and send me to a collection agency for a bill I did pay.

No, can't do that on a per-patient basis, but when setting prices for services, the rate of non-payment is taken into account...those that can pay do pay more to make up for the $35 billion annually incurred for those that can't (or won't). Of course, "setting prices" is a pretty meaningless concept because private insurers pay a negotiated contract price, and reimbursement for Medicare/Medicaid patient is set by law and is remarkable mostly for its underpayment relative to actual cost of care.

Sure. They can send patients to a collection agency. That's a loser, recovering literally pennies on the dollar.

[6933]

Of course, "setting prices" is a pretty meaningless concept because private insurers pay a negotiated contract price, and reimbursement for Medicare/Medicaid patient is set by law and is remarkable mostly for its underpayment relative to actual cost of care.

Sure. They can send patients to a collection agency. That's a loser, recovering literally pennies on the dollar.

She also takes a larger percentage of Tricare than any other provider in the practice. We both come from long .mil families so she has a sense of obligation. Tricare reimburses LESS than Medicaid. It's not all about the money, but at some point it has to become a factor. Thanks to the lousy reimbursement rates from Tricare and Medicaid, she will be reducing her number of patients she accepts from either. When the difference between a private insure and Tricare and Medicaid is(averaging) $500-$1200; what do you expect? That adds up to 10's of thousands of $$/yr. Being a Good Samaritan doesn't pay the bills.

[Sensei]

Seems to be a pretty level headed article regarding basic cause and affect. What do you think?

https://www.thebalance.com/causes-of...-costs-4064878

Thanks,

Dan

Overall, it is an excellent historical account of how we got to the period when the ACA was passed. It focuses on a couple of themes that Hmac and I have been harping on: 1) the interplay of increased consumption of high tech resources and 2) government induced market distortions from unintended consequences.

Where I think the article falls short is in chronicling what has happened since the ACA was passed. The author seems to believe that the ACA has changed the trajectory of rising costs for the better, but I'm not convinced. Yes, there was a brief dip in the rate of cost increase 6 years ago, but that had a lot to do with our prolonged economic downturn. Healthcare costs are now back up to increasing at around 5% which is triple inflation and about what we saw prior to the ACA.

I suspect that the ACA's failure to control costs has a lot to do with the fact that it did little to address consumption and regulation/market distortion; it in fact probably exacerbated the later. What the ACA did was mainly to SHIFT costs. It reduced Medicare reimbursements to afford expanded Medicaid, thus taking resources from the sicker elderly population and giving it to a younger poor population. It also massively increased the burden on the middle class to cover those with pre-existing conditions. Small businesses, large corporations, and their employees saw a massive increases in premiums, deductibles, and out of pocket expenses as insurers were required to accept those with pre-existing conditions and cover services previously left to their clients. Its hard to find anyone making between 75-250K who didn't see at least a 30% increase in out of pocket expenses between 2011-2016.