Healthcare!

[kb2012]

Well hopefully some Democrats will get on board. Even all of the ultra-liberal economics professors I had in college were smart enough to realize that the ACA is robbing Peter to pay Paul. And with the crazy results of this election, a growing number of blue states are being contested. The Democrats will have to please their constituency or lose their seats.

 

[Isiah6:8]

Well hopefully some Democrats will get on board. Even all of the ultra-liberal economics professors I had in college were smart enough to realize that the ACA is robbing Peter to pay Paul. And with the crazy results of this election, a growing number of blue states are being contested. The Democrats will have to please their constituency or lose their seats.

You took the words out of my mouth. It will be interesting to see for sure. I think that there are some very good things in the ACA (no lifetime limits on coverage, staying on parents insurance until 26, etc), and just whatever comes forward from all this is more sustainable.

 

[Blizzard]

Interesting observation in the complete repeal vs Republican replacement debate:
https://www.nytimes.com/2017/03/21/...th-gop-plan-than-with-simple-repeal.html?_r=0

The Congressional Budget Office recently said that around 24 million fewer Americans would have health insurance in 2026 under the Republican repeal plan than if the current law stayed in place...

...But one piece of context has gone little noticed: The Republican bill would actually result in more people being uninsured than if Obamacare were simply repealed. Getting rid of the major coverage provisions and regulations of Obamacare would cost 23 million Americans their health insurance, according to another recent C.B.O. report. In other words, one million more Americans would have health insurance with a clean repeal than with the Republican replacement plan, according to C.B.O. estimates.

With that in mind, if you're going to light the match, burn the fucker down.

 

[TLDR20]

Interesting observation in the complete repeal vs Republican replacement debate:
https://www.nytimes.com/2017/03/21/...th-gop-plan-than-with-simple-repeal.html?_r=0


With that in mind, if you're going to light the match, burn the fucker down.

Burning it down would burn the people who signed it down. There are way too many popular provisions in the ACA. Preexisting condotions, coverage on parents plans until 26. People love a lot of that. They(middle class and upper middle class Republican voters) aren't going to be pleased when their 21 year old graduates college and doesn't have health insurance.

 

[kb2012]

Interesting observation in the complete repeal vs Republican replacement debate:
https://www.nytimes.com/2017/03/21/...th-gop-plan-than-with-simple-repeal.html?_r=0


With that in mind, if you're going to light the match, burn the fucker down.

Keep in mind that being insured is just a label. Just because you have insurance, what good is it with a $5,000 deductible, when you're spending $3,000-$4,000 out of pocket in medical expenses anyways? You're still paying that amount out of pocket with a high deductible, but now you're forced to pay these premiums, which are on the rise. Yeah, you "have insurance" but what good does it to you if you never get to use it? It does nothing to actually reduce out of pocket medical expenditures. Sure, it could come in handy if you get in a nasty car wreck or have a freak accident, but it's important to remember that even though these are big headline stories, they're not as common in proportion to the 99% of the healthcare utilization in this country, which is general medical services like a family practice or the occasional referral to a specialist. And even if you go see a specialist, insurance won't kick in unless you meet your deductible, and then you're still on the hook for the first 5 grand.

My point is this: The reason the law was put into place was because healthcare was "unafforable" and "millions of Americans were uninsured", but having insurance doesn't mean shit unless it's good insurance. It's a freakin political tagline; that's it. They want to be able to say "I helped millions of Americans get covered under health insurance!" They're still broke though. Healthcare in general is still unafforable.

Burning it down would burn the people who signed it down. There are way too many popular provisions in the ACA. Preexisting condotions, coverage on parents plans until 26. People love a lot of that. They(middle class and upper middle class Republican voters) aren't going to be pleased when their 21 year old graduates college and doesn't have health insurance.

You're not being fair. The Hatch/Upton/Burr plan keeps all of those provisions in.

https://energycommerce.house.gov/si...files/114/20150205-PCARE-Act-Side-by-Side.pdf

 

[Devildoc]

Keep in mind that being insured is just a label. Just because you have insurance, what good is it with a $5,000 deductible, when you're spending $3,000-$4,000 out of pocket in medical expenses anyways? You're still paying that amount out of pocket with a high deductible, but now you're forced to pay these premiums, which are on the rise. Yeah, you "have insurance" but what good does it to you if you never get to use it? It does nothing to actually reduce out of pocket medical expenditures. Sure, it could come in handy if you get in a nasty car wreck or have a freak accident, but it's important to remember that even though these are big headline stories, they're not as common in proportion to the 99% of the healthcare utilization in this country, which is general medical services like a family practice or the occasional referral to a specialist. And even if you go see a specialist, insurance won't kick in unless you meet your deductible, and then you're still on the hook for the first 5 grand.

My point is this: The reason the law was put into place was because healthcare was "unafforable" and "millions of Americans were uninsured", but having insurance doesn't mean shit unless it's good insurance. It's a freakin political tagline; that's it. They want to be able to say "I helped millions of Americans get covered under health insurance!" They're still broke though. Healthcare in general is still unafforable.

Most of this is catastrophic insurance, period.

Until they deal with the insurance industry, tort/malpractice industry, regulatory/accreditation industry, pharmaceutical industry, and lobbying industry, it will remain unaffordable.

I am not always keen about my employer, and my insurance does increase every couple years, but it is not bad insurance, and still affordable, so I am better off than a lot of people.

 

[Blizzard]

Burning it down would burn the people who signed it down. There are way too many popular provisions in the ACA. Preexisting condotions, coverage on parents plans until 26. People love a lot of that. They(middle class and upper middle class Republican voters) aren't going to be pleased when their 21 year old graduates college and doesn't have health insurance.

I'm admittedly not a fan of any of these proposals for the reasons mentioned in my initial post in this thread; primarily that they do nothing to actually address the fundamental cost issues associated with health care. That said, there is no reason it couldn't be burnt down and rebuilt from scratch, with a little thought this time. If there are provisions that are "popular", they could be written back into a new plan.

 

[Isiah6:8]

I am not always keen about my employer, and my insurance does increase every couple years, but it is not bad insurance, and still affordable, so I am better off than a lot of people.

Quick opportunity to save some money if you can negotiate it:

It is very expensive for a company to insure their employees. If you have a spouse who is working, use this as leverage. Rough hand estimate the cost to a company to insure an employee as $5,179 for a single employee and $12,591 to cover a family per year (83% of the premium on the avg premium for single coverage; 72% for family). Talk to your company or have spouse talk to theirs, and give them a win-win opportunity. Your family will save the company money by not going on the company insurance, and in turn, they will write a check for the full amount of the insurance that your family pays. Your family is covered, and the company is saving more money by not having you on their insurance.

My wife and I looked at the coverage options and hers was much better than what mine was offering. I brought this to my company, and they are more than happy to write a check every three months which pays for us to be insured on the best plan if we did not come on my firm's insurance plan and stayed on hers.

Roughly 90% of employers are seeing rate increases, they want to save where they can whenever they can.

 

[Devildoc]

Quick opportunity to save some money if you can negotiate it:

It is very expensive for a company to insure their employees. If you have a spouse who is working, use this as leverage. Rough hand estimate the cost to a company to insure an employee as $5,179 for a single employee and $12,591 to cover a family per year (83% of the premium on the avg premium for single coverage; 72% for family). Talk to your company or have spouse talk to theirs, and give them a win-win opportunity. Your family will save the company money by not going on the company insurance, and in turn, they will write a check for the full amount of the insurance that your family pays. Your family is covered, and the company is saving more money by not having you on their insurance.

My wife and I looked at the coverage options and hers was much better than what mine was offering. I brought this to my company, and they are more than happy to write a check every three months which pays for us to be insured on the best plan if we did not come on my firm's insurance plan and stayed on hers.

Roughly 90% of employers are seeing rate increases, they want to save where they can whenever they can.

If I was single, it's at almost no-cost. My wife is at home (we homeschool), so there's that. Still, it's 'only' $461/month. I know others have it far worse.

 

[TLDR20]

You're not being fair. The Hatch/Upton/Burr plan keeps all of those provisions in.

https://energycommerce.house.gov/si...files/114/20150205-PCARE-Act-Side-by-Side.pdf

He said burn it down from scratch and start over. How can I be more fair?

 

[Isiah6:8]

If I was single, it's at almost no-cost. My wife is at home (we homeschool), so there's that. Still, it's 'only' $461/month. I know others have it far worse.

Awesome! Ours is a little over $660/mo which isn't terrible comparatively but nice enough to not have to pay.

 

[kb2012]

He said burn it down from scratch and start over. How can I be more fair?

Because all of the serious replacement plans I've seen that they want to implement after Obamacare is dismantled includes those provisions. You're saying it's a bad idea to scrap the current plan because the new plans lack vital regulations, when in fact they preserve a lot of them.

 

[Blizzard]

And just because is a plan provision is "popular", that doesn't mean it's affordable or the best approach.

 

[TLDR20]

Because all of the serious replacement plans I've seen that they want to implement after Obamacare is dismantled includes those provisions. You're saying it's a bad idea to scrap the current plan because the new plans lack vital regulations, when in fact they preserve a lot of them.

You are missing the point trying to argue. He said completely repeal, that means completely.

 

[Devildoc]

Why is healthcare expensive?

Here is the story I got when I came to work this morning:

Overnight a 450 lb woman was laying on her couch, watching TV. She rolled off, called EMS, who brought her to the ED with back pain and head pain. They called a "trauma alert," so the trauma team evaluated. She got: plain films (of everything), pan scan (CT of head, chest, abdomen). By dawn's early light they found...0 injury. She is being discharged with follow up with neurology (for the headache) and ortho (for the various aches and pains).

I can't make this stuff up.

 

[ThunderHorse]

Why is healthcare expensive?

Here is the story I got when I came to work this morning:

Overnight a 450 lb woman was laying on her couch, watching TV. She rolled off, called EMS, who brought her to the ED with back pain and head pain. They called a "trauma alert," so the trauma team evaluated. She got: plain films (of everything), pan scan (CT of head, chest, abdomen). By dawn's early light they found...0 injury. She is being discharged with follow up with neurology (for the headache) and ortho (for the various aches and pains).

I can't make this stuff up.

Natural selection used to make those choices for us...

 

[Il Duce]

I thought this was a pretty readable explanation on how healthcare costs are much different than how we commonly discuss them: What the G.O.P. Doesn’t Get About Who Pays for Health Care

 

[Devildoc]

I thought this was a pretty readable explanation on how healthcare costs are much different than how we commonly discuss them: What the G.O.P. Doesn’t Get About Who Pays for Health Care

Quick and interesting read, but only tells part of the story. Sure, for some, it's an investment (if you want to continue that analogy). But for others, it's the expectation. People show up to the ED or community clinic, they will say "It's free, I have Medicaid/Medicare." So because it's free, they DO consume...over, and over, and over. And they don't get their preventive maintenance (which is why in most cases they are at the ER or clinic).

I don't have the answers, for sure.

 

[Il Duce]

Quick and interesting read, but only tells part of the story. Sure, for some, it's an investment (if you want to continue that analogy). But for others, it's the expectation. People show up to the ED or community clinic, they will say "It's free, I have Medicaid/Medicare." So because it's free, they DO consume...over, and over, and over. And they don't get their preventive maintenance (which is why in most cases they are at the ER or clinic).

I don't have the answers, for sure.

I was more struck by the initial explanation of GDP. The implication to me was we really don't have the right ways of including healthcare into our economic assessments - because when the foundational ones were developed (like GDP) the role and impacts of healthcare weren't oriented to our modern economy.

I thought the authors efforts to put healthcare into different bins of GDP was meant to be an imperfect method - and really helped demonstrate how the lack of effective descriptors impacts policy.

 

[Blizzard]

Disagree on the premise and title of the New Yorker article, II Duce. Also, having the title call out the GOP as not getting it, as though the Dems have any better insight, is laughable. I will be out of pocket for awhile but will try to get a response later tonight.