Magox

I'm not so sure about that, but thanks.

Absolutely! I've been advocating this for years. We as consumers should have the ability to purchase our medical services in a la carte manner. Price transparency. Menu of options. We should be able to go online to a web service provider where you can plug in a zip code and if you need to get a colonoscopy or an MRI, all the participating providers list the price that they offer that medical service for. For anyone who wants to learn more about what is truly driving up healthcare prices, you should read this. I remember reading this back in 2013, Steve Brill - Bitter Pill It's sort of a long read, but it profoundly changed the way I viewed what was at the heart of rising medical prices. Here is a hint, it's not the insurers. I'm into these kind of things, I try to understand the fundamental problems rather than the talking points that I see all over social media and even here. Which is a part of the reason why I take these little breaks from this site. Watching the retard slap fights on this board can be boring. I try to encourage substantive debate but to little avail

Another interesting proposal from Avik Roy would be to: I like that idea. The cost sharing provision in the ACA lowered deductibles and copays for medical services and really made some basic plans into these gold plated policies. What was unfair about it is that it only rewarded very low income earners of below $20,000 a year to get essentially (depending on zip code) with these near $0 plans with $0 deductibles with $0 PC copays. Whereas people with incomes of just over $40,000 plans would need to get the same silver plans without the cost sharing *(because they didn't qualify for it) with $3800 deductibles high doctor and medical service copays for over $500. Our MGA has signed up people in Oklahoma and if your 55 years old, with an income of $45,000, you'd have to pay $1200 a month for crappy $5k deductible policy, often times HMO's. What this provision would do is flatten out the assistance and more importantly allow customers to manage their own healthcare. I think once people are included in the process of trying to shop around for providers that in turn promotes competition among the medical providers which would lower medical prices. The way the system is now, you only go to the contracted network and since they know that the carrier ie government will pay for it, they can charge what they like because the options are limited. Rather than the cost sharing going directly the carrier, let it go to the consumer via an HSA. Customer will have X amount of funds in it, and they'll be more motivated to shop around medicl services. I think that would be a very positive development.

Avik Roy, who initially came out pretty harsh on the initial bill who I believe is one of the best minds for healthcare reform has some views in how to improve it, which partially are some of the proposed reforms that I suggested they make in post #3655. He also has an opinion that I share on Rand Paul on this matter, that I happen to share.

It does matter, and it does need to be addressed. I generally support free market reforms, however when it comes to healthcare I do believe that Government has a role to play. My guess is that they will increase the tax credits for lower income and older folks. This is not a finished product, I explained this in previous posts. Not just in the reconciliation bill, but there are other changes that will be made to the bill, regulatory relief and added legislation to make this a better bill.

You aren't the only one who seems to be pretty ignorant on what Ryan's/Price's plan includes. This bill only scored the Reconciliation aspect of the bill. You do realize that only certain things can be passed through normal reconciliation budgets, right? This is a 3 step process. A) The reconciliation which repeals and replaces a portion of the intended bill (which will be revised some) B) The regulatory repeals that Tom Price will look to do away with possibly Minimum essential benefits, community ratings etc. C) Legislation, such as Tort Reform, competition across state lines, pharmaceutical reform The score is based off of the first draft of part A). Nothing to do with B and C. I assure you that Spur will not challenge the assumptions of Mulvaney but will come at this from a partisan vapid angle.

Out of all the posts you've contributed to the board, there hasn't been a single one that has had a whiff of substance.

I think there will be some horse trading. My guess is that rather than eliminate the expansion of Medicaid in 2020 as the bill proposes they'll push it forward to 2018 or 2019 and that they'll means test some of the advanced tax credits from some of the higher earning individuals that qualify for them. That way some of the Freedom caucus members can point to some concessions in order to support it. Then once it goes to the Senate, my guess is that they'll increase the advanced tax credits for the lower income earners to make it more affordable for them and that would increase the total amount of people covered. Add that and the legislative and regulations that they are wanting to undo, you'll see a better law than what we are seeing right now. Remember. There are 3 main things that people are looking at: A) Amount of people covered - which as it stands it is lacking B) premiums - according to CBO - as it stands the premiums will drop by 10% C) Deficit concerns- according to CBO- as it stands it will drop by $337 Billion dollars. With the reforms they want to add, premiums will drop even more. So in actuality the report is nowhere near as bad as the media portrays it to be, because as we know liberals and the media judge the success of health care reform based on the total number of people covered. I'm not saying that isn't important, I happen to believe it is. So there is work to be done on that front, but lets not forget that the mandate helped drive those numbers. And lets not forget that there are many more reforms they want to add to the bill that will help in that aspect. NOt to mention that my deep suspicion is that there will be more tax credits provided to the poor to help on that front.

I'm not disagreeing with what you are saying and I happen to believe in a higher power. I don't believe there can be such organized beauty that would be created through complete randomness. I feel that there is an order that exists. Having said that, I was simply taking TYTT's take on the matter and applying it to BF's.

The mandate usually pushes younger people to buy it rather than those that need it. But your point isn't lost, this is something that Trump will have to be cognizant of. His sort of core supporters aren't as hard line ideologically market base driven than other parts of the base. I mean the guy basically said he wanted to give Universal coverage on the campaign trail, my hunch is he'll move more towards that direction than where the proposed bill is today.

Most people tend to view budget deficits and debt in an abstract manner. They know it's not good to have them but they really can't see how it personally affects them. Whereas people see people losing coverage and premium increases/decreases not as an abstract concept but in real life consequential terms. The coverage aspect and premiums is where this will be judged most in the public arena. That's where it needs to be addressed, hopefully the GOP will be able to come to a compromise that does deal with these issues.

More on the Budget considerations Essentially the majority of the decreases are due to less coverage provided, primarily Medicaid. This scoring from the CBO emboldens the centrists case more so than the Freedom Caucus. The report was generally positive for budgetary reasons and reaffirmed that the market stability wouldn't be an issue. The main problem is that too many people would lose their coverage. I outlined above the compromises to be had. Hopefully some of these things will be taken up.

I'd normally agree with this, but I don't believe there is an appetite among Democrats to work with Republicans much less Trump. I think the best way to get bipartisanship at this point is to force the Democrats hand by passing something close to what the Repubs are doing, which then the sinking reality that this would then be indeed the law of the land would hopefully encourage some Democrats to then work with Repubs on legislation to add to the law. Reconciliation can only do so much. Yes, the don't have a great rack record with this, however the CBO director is Republican appointed. Just wanted to throw that out there.

I'd imagine if they expanded the risk pools with additional funding via federal subsidies administered by the states or directly from the carriers, along with tort reform, competing across state lines, getting rid of community rating and minimum essential benefits with an added menu of even higher deductible policies, my educated guess would be that premiums would go down much more than 10%.

That's the problem, which if the bill was written and approved by the Freedom Caucus or Rand Paul, rather than 24 million people, you would be talking about a number considerably higher. THAT IS WHY, that there has to be compromise. The advanced tax credits for the poor will have to be higher to attract more people than as currently written to offset some of those Medicaid losses, while phasing them out for people with incomes above $55k or $60k rather than the $75k that is currently proposed. Which would help offset some of the cost.

Keep in mind, that this does not include with doing away with the minimum essential benefits, community rating nor does it factor in tort reform or competing across state lines. Also, this is something else that I'd think that the Freedom Caucus members should be pleased with.

Couldn't you make the same argument for "arachnid unicorns"?

From the perspective of those that use the term "cuck" A) traitor to his white race B) someone who is a supposed conservative who allows Liberal orthodoxy to dictate norms of society C) Someone who gets "triggered" easy Cuck

My guess is that he'll be somewhere in the $7.5-$8.5 M a year range.

Any rigid ideological stance from the GOP will be destined to fail with the healthcare bill. Here is another centrist Senator who is threatening to withhold support from the bill as currently written, and he believes that there should be more assistance provided. If you go on a purely market driven bill then you'll lose the centrists, if you go too heavy with assistance for the lower income folks you'll lose the hard right. Quite the conundrum. There is going to have to be compromise within the GOP to pass the bill or else we'll end up keeping Obamacare. So I've been reading and hearing the concerns from both sides and here is where I believe a compromise can be found. Concessions from the centrists: A) The bill right now ends the expansion of Medicaid in 2020, Move it to the end of 2018. B) Means test the advanced tax credits. As of right now individuals earning $75,000 get the same advanced tax credit as someone earning $12,000 (which is the Medicaid income threshold) They could lower that amount to $55,000 and gradually phase it out as the way it is written. Concessions from the right: A) As of right now the average assistance provided for Medicaid users is approximately about $6000. Under the current GOP plan, if you don't qualify for Medicaid by just a hair, the average assistance is about $3000. Which means there is a huge drop off. And with the ideological market based driven guys there would be an even larger drop off. No matter what your ideological beliefs are, I'm discussing possible solutions that can at least garner 50 votes, never mind the 60 votes for now. So the solution could be to increase the advance tax credits for lower incomes to a max of $5000 gradually going down as income goes higher. In other words right now as written it is solely age based. Make it aged along with income. Other things that need to be done that cannot go through Reconciliation: A) Tort Reform B) Allowing carriers to compete across state lines C) Eliminate Community based rating D) Eliminate Minimum essential benefits E) Eliminate the employer mandate These provisions would allow carriers to create plans that could fit the needs of the patients. High deductibles, low deductibles, pretty much any design that the customer would want. For young people I would think that high $10k deductible plans with ER, doctor, prescription copays would be very popular and probably could get with their tax credit at a next to nothing cost. This would go along way in helping drive down premiums In order to get these things you have to get 60 votes. Right now the Democrats will resist 100% of the way, there is virtually no incentive for them to go along with the GOP. The question is once the repeal goes through, if it goes through. That's it, this is the law. So what will they do? Can you get a handful of them once they realize this is now the law of the land and actually be constructive to work along to make it a law that more closely mirrors what they'd like? Or do they allow Republicans to fall flat on their faces and potentially politically die with this law? We know that will be leaderships view. But you could probably convince a few Democrats to go along with it. So what are the concessions that can be given to Democrats to get their votes? A) Keep the taxes on earners making over $250,000 in the ACA. This will be a good carrot stick, plus it will lower the cost of the entire bill and add a lot less to the deficit. B) Trump has been talking and meeting up with the Democrats about reducing pharmaceutical costs, my guess is that they want price controls. Deep down that's what Trump wants too even though Price, Ryan and most Republicans don't want this. C) Keep the FFM exchange where the purchase of plans are taking place. Repubs should be in favor of exchanges anyway D) Increase the subsidies provided to people with pre existings which are delivered to the states so that they can administer it. To be honest, it would be better to have carriers create their own Pre ex risk pools regulated by the states. In any case, even the Freedom caucus is ok with assistance provided to the states for pre Ex. The plan should be that if Democrats don't want to be a part of compromising and going along with the bill, there should be an explicit threat made that in the following years reconciliation (because you can only do one a year), that the rest of the things that Republicans want that usually take 60 votes will be pushed through the arcane provision that I recently learned where you could have Pence override the Parliamentarian, which still you'd have to get to at least 50 votes. Of course, wobbly Senate Repubs would be wise to go along with it because without these added market based provisions the US individual healthcare system would take a huge crap and Repubs would get politically wiped. Just trying to think this through in what would be politically viable to get through the house, then the senate under the so-called phase 1 and the phase 3.

I don't believe that will be the case.

I pretty much am right where I was years ago, which is for the most part a classic liberal. I'm generally for less regulations, personal freedom, inclusive, pro business/small business, equality for all and moderate when it comes to healthcare. I believe populism to be extremely shallow and narrow minded and I find the new right wing and the talk radio hucksters to be almost as bad as the progressives. So I really don't support either party but rather support bills or politicians that share my values.

Anthem is a big get and if you look at AHIP who is a major player, they don't seem to have major grievances with the GOP bill and really aren't that far off. I believe that if this goes through you'll see smaller tax credits for higher income folks and larger tax credits for lesser income earners. My guess is that there will be assurances that tort reform and competition across state lines and some sort of lessening of Medicaid to appease the Freedom Caucus and larger tax credits for lower income earners to assuage the concerns of the centrists.

It won't be a scalpel, but not a sledgehammer either. You know Portman, right? Not someone that the anti globalist right wing crowd would love but you know, one of the more sensible intelligent and realistic guys in the Senate, other wise know as a grown up. It's his path that it appears they will be following.

Deregulation is where the optimism from small and large businesses in the country is coming from along with the alleged legislative priorities. I think it's pretty clear to me at least that companies now believe they finally have a partner that is on their side. This is by far the best thing that he brings to the table, from my perspective.