Jump to content

The Affordable Care Act II - Because Mr. Obama Loves You All


Recommended Posts

Another interesting proposal from Avik Roy would be to:

 

 

The AHCA, unlike the older leaked draft, also repeals Obamacare’s cost-sharing subsidies, whereas FREOPP’s plan, Transcending Obamacare, proposes converting them into fiscally equivalent Health Savings Account deposits. Those HSA deposits, or something like them, are essential for helping people near the poverty afford their co-pays and deductibles, and should be part of the GOP bill.

 

 

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.

Link to comment
Share on other sites

Another interesting proposal from Avik Roy would be to:

 

 

 

 

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.

That's a big part of what we should do and people should be permitted to buy higher deductible policies as their HSA account balances grow.

 

We also need to solve the pricing mystery in health care services. As consumers it's nearly impossible to get a medical practitioner to tell you the cost of the service you are buying and depending upon the insurance you have (or don't have) the disparity of price for the same service is huge. Pricing needs to be more transparent and flattened out somehow.

Link to comment
Share on other sites

That's a big part of what we should do and people should be permitted to buy higher deductible policies as their HSA account balances grow.

 

We also need to solve the pricing mystery in health care services. As consumers it's nearly impossible to get a medical practitioner to tell you the cost of the service you are buying and depending upon the insurance you have (or don't have) the disparity of price for the same service is huge. Pricing needs to be more transparent and flattened out somehow.

This is very true. But the pricing is tied to insurance - NOT healthcare insurance, but the more litigious kind - Workmen's Comp and Automobile and Liability insurances. That's why you're always asked if your condition you present with at your Dr.'s office is a worker's comp or the result of an accident. If so, they bill bust out retail for their services. If not, there's a pas de deux that the insurance company and the Dr.'s office workers do. A lower bill is submitted to the carrier, they "negotiate" a "discount" for the services, and a lower fee results - with the patient being left to pick up what the insurance carrier doesn't.

Link to comment
Share on other sites

That's a big part of what we should do and people should be permitted to buy higher deductible policies as their HSA account balances grow.

 

We also need to solve the pricing mystery in health care services. As consumers it's nearly impossible to get a medical practitioner to tell you the cost of the service you are buying and depending upon the insurance you have (or don't have) the disparity of price for the same service is huge. Pricing needs to be more transparent and flattened out somehow.

 

 

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 :bag:

Link to comment
Share on other sites

 

 

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 :bag:

 

This is a fantastic post.

Link to comment
Share on other sites

 

Your work in this thread over the years is appreciated by many, I'm sure. :beer:

 

I agree. He's certainly offered information worth considering, especially with all the political BS tied to the issue.

Link to comment
Share on other sites

This is an area where the Moderate/centrists will have to compromise with the Freedom Caucus.

 

 

President Donald Trump's White House is increasingly likely to support some conservative-backed changes to the House Obamacare alternative, two administration officials said Monday — a move that comes after a nonpartisan budgetary analysis showed 24 million people could lose insurance under the bill.

One senior administration official, speaking on the condition of anonymity to describe internal discussions, said the White House is weighing ideas for a "significant" manager's amendment to the bill before it hits the House floor next week. Officials would like the changes — which would likely be offered in the House Rules Committee — to appease some conservatives.

Possible modifications being considered include phasing out the Medicaid expansion quicker, from the current Dec. 31, 2019 date to the beginning of 2018, and moving changes supposed to occur in the insurance market from 2020 to 2018.

"I think the changes that the conservatives want are more and more likely,” said a second White House official.

 

 

 

which is something that I thought we'd see - Post #3655

 

Concessions from the centrists:

A) The bill right now ends the expansion of Medicaid in 2020, Move it to the end of 2018.

 

 

 

 

 

 

 

But if they are to do this, then there will have to be additional tax credits for those that would lose their coverage to get Moderate/Centrist support. It's a two way street. Not everyone will be able to get what they want, there will have to be some give and take or we'll end up keeping what we currently have.

Edited by Magox
Link to comment
Share on other sites

Well..............I don't know if we will have to wait too long before changes will be coming.

 

The much-maligned Obamacare replacement bill will face its biggest test so far on Thursday, as a House of Representatives committee filled with conservatives could derail the legislation backed by Speaker Paul Ryan before it gets to the House floor.

 

At least seven Republican members of the Budget Committee have made public statements in the past week indicating they want a full repeal of Obamacare, but it’s unclear whether four of them will decide to go out on a limb and vote no.

 

One of them, Mark Sanford of South Carolina, joined Kentucky Sen. Rand Paul at a news conference last week to slam the legislation as a dereliction of the Republican Party’s campaign promises.

 

(Excerpt) Read more at mcclatchydc.com ...

 

 

Maybe after that we could get a phase two, where some of the needed changes that Magox has (so well) documented will be discussed more.

 

 

.

Edited by B-Man
Link to comment
Share on other sites

Well..............I don't know if we will have to wait too long before changes will be coming.

 

The much-maligned Obamacare replacement bill will face its biggest test so far on Thursday, as a House of Representatives committee filled with conservatives could derail the legislation backed by Speaker Paul Ryan before it gets to the House floor.

 

At least seven Republican members of the Budget Committee have made public statements in the past week indicating they want a full repeal of Obamacare, but it’s unclear whether four of them will decide to go out on a limb and vote no.

 

One of them, Mark Sanford of South Carolina, joined Kentucky Sen. Rand Paul at a news conference last week to slam the legislation as a dereliction of the Republican Party’s campaign promises.

 

(Excerpt) Read more at mcclatchydc.com ...

 

 

Enough will fall in line as long as they get a concession or two to point to their base flank. The article that I posted up above mentions Sanford's sentiments:

 

 

"I think we are having very meaningful conversations that will lead to action," said Rep. Mark Sanford, a South Carolina Republican and member of the House Freedom Caucus, who is seeking changes. "My sense is there is a willingness to incorporate."

 

Link to comment
Share on other sites

Here's what the public is being told...........

 

 

CBS Hosts Worry Not Enough People ‘Forced’ to Buy Health Insurance

http://www.newsbusters.org/blogs/nb/kyle-drennen/2017/03/14/cbs-hosts-worry-not-enough-people-forced-buy-health-insurance

 

During a discussion with New-York Presbyterian Hospital CEO Dr. Steven Corwin on Tuesday’s CBS This Morning, co-hosts Charlie Rose, Norah O’Donnell, and Gayle King all accepted his call for more government involvement in the health care industry and fretted that not enough Americans were being forced to purchase medical insurance.

Corwin declared: “I think that we have to, as a country, decide: is health care a right or is it a privilege? If it’s a right, then we’ve got to insure everybody.” Rose invited him to bash the Republican replacement of ObamaCare: “So therefore, what is the fundamental mis-assumption on the part of this bill?” Corwin replied: “The fundamental mis-assumption is that you need to subsidize people more and you need to keep the individual mandate. Otherwise you cannot have a functioning insurance market...”

 

Rose interjected: “You’ve got to have a mandate that forces people to have insurance?” Corwin agreed: “Absolutely.” O’Donnell chimed in: “Just like car insurance.” Corwin seized on her analogy: “Car insurance, property insurance. You need young healthy people who are paying premiums in to offset the costs of other people who are sick.”

 

Later in the discussion, O’Donnell pointed to problems with ObamaCare: “The AMA, the AHA, doctors, hospitals all backed the Affordable Care Act, ObamaCare. And under the promise that premiums would start to slow down. Premiums have sky-rocketed....What happened?” Corwin noted a “lack of competition in certain markets” as being one factor, but then complained: “Secondly, you didn’t have enough young healthy people sign up.”

 

Rose concluded: “That’s the point too, isn’t it?...Young people have to be buying insurance. If they’re not, there’s not going to be a system to take care of older people.”

Near the end of the segment, Corwin acknowledged that ObamaCare did not cover as many uninsured as initially predicted: “And then what do you do in the individual insurance market?...

 

Right now, it’s less than the CBO projected.” However, he laid the blame not on flaws in the policy, but on Americans not following government orders: “...

 

part of that is because people didn’t really insist on the individual mandate, there was a Supreme Court challenge on it, etcetera.”

Link to comment
Share on other sites

 

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

 

welcome to my world

Link to comment
Share on other sites

 

Your work in this thread over the years is appreciated by many, I'm sure.

 

agreed. though i am extremely skeptical that market driven forces will reliably work when they never have in the past. but the wealth of information provided has been very valuable to review imo

Link to comment
Share on other sites

 

Corwin declared: “I think that we have to, as a country, decide: is health care a right or is it a privilege? If it’s a right, then we’ve got to insure everybody.” Rose invited him to bash the Republican replacement of ObamaCare: “So therefore, what is the fundamental mis-assumption on the part of this bill?” Corwin replied: “The fundamental mis-assumption is that you need to subsidize people more and you need to keep the individual mandate. Otherwise you cannot have a functioning insurance market...”

 

Rose interjected: “You’ve got to have a mandate that forces people to have insurance?” Corwin agreed: “Absolutely.” O’Donnell chimed in: “Just like car insurance.” Corwin seized on her analogy: “Car insurance, property insurance. You need young healthy people who are paying premiums in to offset the costs of other people who are sick.”

 

Later in the discussion, O’Donnell pointed to problems with ObamaCare: “The AMA, the AHA, doctors, hospitals all backed the Affordable Care Act, ObamaCare. And under the promise that premiums would start to slow down. Premiums have sky-rocketed....What happened?” Corwin noted a “lack of competition in certain markets” as being one factor, but then complained: “Secondly, you didn’t have enough young healthy people sign up.”

 

Rose concluded: “That’s the point too, isn’t it?...Young people have to be buying insurance. If they’re not, there’s not going to be a system to take care of older people.”

Near the end of the segment, Corwin acknowledged that ObamaCare did not cover as many uninsured as initially predicted: “And then what do you do in the individual insurance market?...

 

Right now, it’s less than the CBO projected.” However, he laid the blame not on flaws in the policy, but on Americans not following government orders: “...

 

part of that is because people didn’t really insist on the individual mandate, there was a Supreme Court challenge on it, etcetera.”

 

 

There is a philosophical debate to be had, whether it is a right to have health insurance or a privilege? Admittedly, my views has slightly moderated over the years, I suppose that is because I've seen the good that expanded coverage has done in an up close personal manner and rather than debating philosophies there are many real life instances that it has helped. That in no way shape or form implies that I'm for the ACA or the structure of it or the inequities it has caused for many middle class families who have been priced out of the market, but that doesn't negate the benefits of expanded coverage. I'm not in the "it is a right" to have health insurance but I'm also not on completely market based philosophy either. Too many people who don't earn enough cannot afford health insurance and I do believe that our government can help bridge the divide in that aspect.

 

In regards to the car insurance being analogous to health insurance is absurd.

 

Car insurance is there primarily for reasons pertaining to liability. If you have a car and it is being financed, you have an obligation to have it insured to protect the guarantor of your loan. Also, you have an obligation to those that you could do bodily harm to behind the vehicle that you are driving. These are protections not for you but for them.

 

Whereas health insurance is for you, not for the well-being of others.

 

In regards to coercing people to buy a product from a private company, that just seems crazy to me. If I don't want to buy a product, I shouldn't have to. Period

Link to comment
Share on other sites

×
×
  • Create New...