Following AHCA defeat, Trump signals new openness to Dems

[Magox]

 

It's a little difficult for me to complain about the ACA when my sister-in-law (as part of the under 24k/over 40 group) has health coverage for the first time in her life. It seems to be the only part of the ACA that came close to working as intended.

 

Of course, she can't get care, because she's covered under Medicaid expansion and it's tough to find a provider (e.g. she needed to see a pulmonologist. There were TWO in the entire DC metro region that took Medicaid. Got an appointment with one, three months in the future...then that doctor moved out of the area. Access to COVERAGE does not equal access to CARE.)

 

 

There is little doubt that there are winners. Many people tend to view these things from their ideological points of views that truly are abstract in nature, but once you begin to see the actual human impact up close, it does provide some perspective to it all, at least it did for me. I recognize the good that expansion of coverage does for many families and society, the problem as you noted with this particular law is that those who don't qualify for subsidies often times have to pay unreasonable prices, and the other problem as you also pointed to is that the networks are tiny. The quality of doctors and access to care is much smaller than it was pre ACA.

[GG]

The fundamentals need to change, which means lobbyists will be kicking and screaming because there will be losers. Hannity keeps talking about a very ineteresting concept in Kansas. I think the gist of it is doctors banded together and will cover most all services except catastrophic . The cost to the consumer forcthis " coverage" is 50$ per month per adult and 10$ pm per child. Then the family buys a " catastophic" policy from an insurance company . This could be the wave of the future. Insurance industry would take a hit, but the country would be better off. The insurance companies are most of what's wrong with health care IMO.

 

Insurance companies just float the money from the participant to the providers. They're not the reason the premiums are sky high.

[Pine Barrens Mafia]

Just shopping for insurance, as my wife lost her job (actually, had a health crisis, and can no longer work), and I'm unemployed for another month.

 

The cheapest plan I could find for our income bracket, based on what we've already made this year (i.e. assuming neither of us has any more income this year) was $900 a month with a $12,000 deductible. The penalty for not having insurance at all was $1300 a year.

 

That makes absolutely no sense whatsoever. Between premium and deductible, that's about 20% of income vs. about 2%? And that was supposed to encourage people to buy insurance? I knew the ACA was bad...I didn't know it was this bad.

 

Mark Cuban was on the tube this weekend talking about putting catastrophic coverage under a government insurance scheme, but requiring cash pay or some other form of insurance for little stuff (doctor visits, checkups, colds, whatever). I could get behind that arrangement.

Edited March 27, 2017 by joesixpack

[Taro T]

Just shopping for insurance, as my wife lost her job (actually, had a health crisis, and can no longer work), and I'm unemployed for another month.

 

The cheapest plan I could find for our income bracket, based on what we've already made this year (i.e. assuming neither of us has any more income this year) was $900 a month with a $12,000 deductible. The penalty for not having insurance at all was $1300 a year.

 

That makes absolutely no sense whatsoever. Between premium and deductible, that's about 20% of income vs. about 2%? And that was supposed to encourage people to buy insurance? I knew the ACA was bad...I didn't know it was this bad.

Saddened to read that your wife's health took a hit.

 

Hope everything works out for you & her.

 

We get insurance through my wife's employer who is self-insured. Obamacare was not kind to self-insured companies.

 

Since the ACA went through, our monthly bill is up significantly & our deductible is also up a lot. We don't drop it though because we have kids playing sports.

[Pine Barrens Mafia]

Saddened to read that your wife's health took a hit.

 

Hope everything works out for you & her.

 

We get insurance through my wife's employer who is self-insured. Obamacare was not kind to self-insured companies.

 

Since the ACA went through, our monthly bill is up significantly & our deductible is also up a lot. We don't drop it though because we have kids playing sports.

 

The plan I'm on costs $500 a month in premiums, and still has a $6000 deductible.

 

And TYTT wonders why I'd rather be on medicare at this point.

[Meathead]

 

 

Bernie Sanders plan would cost $33 Trillion, which is essentially what you were discussing. You know how Bernie wants to tax the hell out of rich people, right? Even if you had it his way, which won't happen any time soon, he'd still be over $18 Trillion short over the next decade.

 

 

thanks for that link. i read a bunch of stuff on his proposals during the election but never saw this article that does a good job laying it out in detail

 

its a tough nut for sure. we gotta fix the ACA if its going to stick around, and i dont trust republicans to do it on their own. so i think all we can hope for is somehow the parties come together and get it done as well as they can, together

[Boatdrinks]

Insurance companies just float the money from the participant to the providers. They're not the reason the premiums are sky high.

They aren't doing it out of the kindness of their hearts. They are making a profit and don't deliver care. Why are the doctors in Wichita banding together and doing an end run around them? One of the MDs was on with Hannity and said " why should I charge $45 for a test that costs me $1.85 because some insurance co says I have to"? There has to be a better way, and their concept is interesting. An insurance company's business model doesn't really work with health care. It's not like car insurance where some may never need it, many will seldom put in a claim etc. Everyone will need to use their medical coverage at some point. The vast majority of which will be later in life.

thanks for that link. i read a bunch of stuff on his proposals during the election but never saw this article that does a good job laying it out in detail

 

its a tough nut for sure. we gotta fix the ACA if its going to stick around, and i dont trust republicans to do it on their own. so i think all we can hope for is somehow the parties come together and get it done as well as they can, together

Neither party can " fix" healthcare on their own. The ACA is too expensive for accomplishing very little. Both sides will need to hammer it out . It's just the way getting major legislation is designed, short of a having a bullett proof majority to ram something such as the ACA through.

Edited March 27, 2017 by Boatdrinks

[ALF]

"Rich countries, many of them with universal health coverage, are making progress against deadly diseases such as heart disease and cancer. That clearly isn't true for poor, under-educated whites in America, this study shows.

The findings by Case and Deaton come at a curious time – right as President Trump tried (and failed) to convince Congress to strip health care coverage for millions of poor, under-educated white voters."

https://www.aol.com/article/news/2017/03/27/whites-without-a-college-degree-are-dying-in-america-thats-why/22014297/

Medicaid has surpassed Medicare in the number of Americans it covers. It has grown gradually into a behemoth that provides for the medical needs of one in five Americans — 74 million people

https://www.nytimes.com/2017/03/27/health/medicaid-obamacare.html?_r=0

That is a massive number of poor people that don't earn enough to pay taxes, very sad

Edited March 28, 2017 by ALF

[GG]

 

"Rich countries, many of them with universal health coverage, are making progress against deadly diseases such as heart disease and cancer. That clearly isn't true for poor, under-educated whites in America, this study shows.

The findings by Case and Deaton come at a curious time – right as President Trump tried (and failed) to convince Congress to strip health care coverage for millions of poor, under-educated white voters."

https://www.aol.com/article/news/2017/03/27/whites-without-a-college-degree-are-dying-in-america-thats-why/22014297/

Medicaid has surpassed Medicare in the number of Americans it covers. It has grown gradually into a behemoth that provides for the medical needs of one in five Americans — 74 million people

https://www.nytimes.com/2017/03/27/health/medicaid-obamacare.html?_r=0

That is a massive number of poor people that don't earn enough to pay taxes, very sad

 

 

This is the exact trope that's muddling the debate about healthcare reform.

 

Maybe you can explain the leap of logic in equating battling heart disease and cancer with drug & alcohol related deaths in Appalachia?

[Tiberius]

 

This is the exact trope that's muddling the debate about healthcare reform.

 

Maybe you can explain the leap of logic in equating battling heart disease and cancer with drug & alcohol related deaths in Appalachia?

You don't see a link between tobacco, drug and alcohol abuse and cancer and heart disease?

[Dorkington]

I'd still love to see single payer/universal be the default option here. But, with how we tend to operate on the government level (campaign financing, lobbying, contracts, revolving doors, etc) I doubt it would done in a cost efficient manner, since everyone has their hands in the pot looking for a profit.

[ExiledInIllinois]

I'd still love to see single payer/universal be the default option here. But, with how we tend to operate on the government level (campaign financing, lobbying, contracts, revolving doors, etc) I doubt it would done in a cost efficient manner, since everyone has their hands in the pot looking for a profit.

Americans are too selfish, self-important, and impatient.

[SlimShady'sSpaceForce]

I've always felt the Tea Party was too radical so I'd much rather moderate Republicans work with moderate Democrats to get things done. A bipartisan infrastructure bill would be a good start.

Doesn't the Freedom Caucus = Tea Party

Americans are too selfish, self-important, and impatient.

to use a Queen Song

 

I want it all, I want it all, I want it all, and I want it now

But just give me, huh, what I know is mine

People do you hear me, just gimme the sign

It ain't much I'm asking, if you want the truth

[Azalin]

 

There is little doubt that there are winners. Many people tend to view these things from their ideological points of views that truly are abstract in nature, but once you begin to see the actual human impact up close, it does provide some perspective to it all, at least it did for me. I recognize the good that expansion of coverage does for many families and society, the problem as you noted with this particular law is that those who don't qualify for subsidies often times have to pay unreasonable prices, and the other problem as you also pointed to is that the networks are tiny. The quality of doctors and access to care is much smaller than it was pre ACA.

 

 

I'm addressing this to you because you've been the most informative person here on the subject, and I'd be interested in your opinion on something that I have trouble understanding with the ACA, the AHCA, and government involvement in medicine and insurance in general.

 

I do not view healthcare, either the insurance aspect or the medical aspect, as "a system". I realize this may be a somewhat naive point of view given what we have now, but when I look at this so-called system, I see an industry - doctors, nurses, and health care professionals working in conjunction with insurance providers. I remember well when obtaining care was significantly less difficult and much more affordable.

 

I can't begin to identify or enumerate all of the factors that have caused the cost of coverage to skyrocket or make access so much more difficult, but it appears to me that nearly all of it can be laid at the feet of legislators and regulators. I did a search yesterday on current costs, on average across the country, of starting a private practice as an MD. It was ridiculous. Aside from all the normal costs for getting a degree, starting and staffing a business, and maintaining it, there was the cost of equipment ( I was shocked at the cost of things like x-ray machines and examination tables, and I knew they'd be expensive ), and malpractice insurance. I can only imagine what it costs to operate and maintain a fully staffed hospital.

 

These things were already expensive several decades ago when we had less regulatory and legislative involvement, and costs seem to have increased proportional to the increase in government intrusion into the industry. Government has always been there to find an area in the business, or identify a class of under-served people, that requires regulation, and every time they do, coverage becomes more expensive. We now have layers upon layers of regulation and outright control, and the ACA seems to have become a tipping point with ever-increasing premiums and unaffordable deductibles.

 

I realize that I'm only stating my case in extremely simple terms, but for the life of me, I don't understand why we as a nation would turn to the very same entities for help in fixing these problems that cause most of the trouble in the first place.

Edited March 28, 2017 by Azalin

[Magox]

 

I'm addressing this to you because you've been the most informative person here on the subject, and I'd be interested in your opinion on something that I have trouble understanding with the ACA, the AHCA, and government involvement in medicine and insurance in general.

 

I do not view healthcare, either the insurance aspect or the medical aspect, as "a system". I realize this may be a somewhat naive point of view given what we have now, but when I look at this so-called system, I see an industry - doctors, nurses, and health care professionals working in conjunction with insurance providers. I remember well when obtaining care was significantly less difficult and much more affordable.

 

I can't begin to identify or enumerate all of the factors that have caused the cost of coverage to skyrocket or make access so much more difficult, but it appears to me that nearly all of it can be laid at the feet of legislators and regulators. I did a search yesterday on current costs, on average across the country, of starting a private practice as an MD. It was ridiculous. Aside from all the normal costs for getting a degree, starting and staffing a business, and maintaining it, there was the cost of equipment ( I was shocked at the cost of things like x-ray machines and examination tables, and I knew they'd be expensive ), and malpractice insurance. I can only imagine what it costs to operate and maintain a fully staffed hospital.

 

These things were already expensive several decades ago when we had less regulatory and legislative involvement, and costs seem to have increased proportional to the increase in government intrusion into the industry. Government has always been there to find an area in the business, or identify a class of under-served people, that requires regulation, and every time they do, coverage becomes more expensive. We now have layers upon layers of regulation and outright control, and the ACA seems to have become a tipping point with ever-increasing premiums and unaffordable deductibles.

 

I realize that I'm only stating my case in extremely simple terms, but for the life of me, I don't understand why we as a nation would turn to the very same entities for help in fixing these problems that cause most of the trouble in the first place.

 

 

If you want to spend a good couple hours reading this, which I highly suggest anyone who has an interest in learning what is driving healthcare costs, then I recommend you read

 

Steven Brill's Bitter Pill

 

There is no one answer, its for a wide variety of reasons, such as the cost of the underlying product going up, lack of price transparency, doctors recommending unnecessary tests (which is a cash cow for medical providers) , end-of-life-care demand is higher than in other countries, cost shift clawback policies and how hospitals charge patients (see chargemaster in the article, super interesting).

 

Of course none of this talks about all the other things that we can do to bring down premiums which has more to do with insurance reform, but the real driver of higher prices has to do with the underlying product, which is that the cost of providing care has been skyrocketing.

 

One of the solutions that has been suggested is to incorporate compensating Medical providers with more of a medical outcome model as opposed to strictly volume and per service fee.

[Azalin]

 

 

If you want to spend a good couple hours reading this, which I highly suggest anyone who has an interest in learning what is driving healthcare costs, then I recommend you read

 

Steven Brill's Bitter Pill

 

There is no one answer, its for a wide variety of reasons, such as the cost of the underlying product going up, lack of price transparency, doctors recommending unnecessary tests (which is a cash cow for medical providers) , end-of-life-care demand is higher than in other countries, cost shift clawback policies and how hospitals charge patients (see chargemaster in the article, super interesting).

 

Of course none of this talks about all the other things that we can do to bring down premiums which has more to do with insurance reform, but the real driver of higher prices has to do with the underlying product, which is that the cost of providing care has been skyrocketing.

 

One of the solutions that has been suggested is to incorporate compensating Medical providers with more of a medical outcome model as opposed to strictly volume and per service fee.

 

Thanks

[boyst]

 

 

I hope your wife is alright. Sorry to hear she hasn't got better

Is there really? Again, somebody will always squeal when they pay.

no, they don't. Someone needs to let this incapable of caring for themselves realize the hard way that life isn't a handout.

I'd still love to see single payer/universal be the default option here. But, with how we tend to operate on the government level (campaign financing, lobbying, contracts, revolving doors, etc) I doubt it would done in a cost efficient manner, since everyone has their hands in the pot looking for a profit.

which is why a large number of people were upset when Obama got the government more involved with our health.

 

The government doesn't need to be involved with health care. Even for the poor. Let them figure it out. Let private entities work on it. Let the medical industry figure it out. And if we don't. We can thin the herd out a little.

[Magox]

Trump talking about Bipartisanship again.

 

 

 

President Donald Trump still sees a deal on health care. In fact, he told senators he has “no doubt that that’s going to happen very quickly.”

Speaking in brief remarks at a White House reception for senators and their spouses, Trump brushed off the recent collapse of a House-led bill to repeal and replace Obamacare.

Instead, Trump said, based on the bipartisan crowd gathered he expects to do a deal on health care sooner rather than later.

“A lot of people showed up,” Trump said of the crowd, which included more than half the Senate and their spouses. “People we weren’t expecting. I know that we are all going to make a deal on health care. That’s such an easy one.”

He added, “I have no doubt that’s going to happen very quickly.”

Trump told the senators the public expected action: “We have all been promising it — Democrat, Republican — to the public.”

Trump noted he had "some very special friends in the room” and noted a “shockingly … bipartisan," crowd.

The president said he hoped the event was the start of something new.

"We are going to be doing a great job. Hopefully it will start being bipartisan because everybody really wants the same thing. We want greatness for this country that we love.”

 

 

 

Is he bluffing and sending a message to the Freedom Caucus or is he being serious? I think one thing is clear, if a bill does get through whether it's Republican only or with some moderate Democrats, what the Freedom Caucus had originally wanted will never come about. My hopes is that they try to go the bipartisan route, you'll have much more of the country behind it, it would incorporate the goals of expanded coverage and market based reforms. Not to mention when you do things on a bipartisan basis, the odds of the legislation enduring the test of time go up dramatically. I know I've said this a few times, but the key is that they need to identify those that are willing to negotiate in good faith, the rest they have little use for.

[Meathead]

 

My hopes is that they try to go the bipartisan route, you'll have much more of the country behind it, it would incorporate the goals of expanded coverage and market based reforms. Not to mention when you do things on a bipartisan basis, the odds of the legislation enduring the test of time go up dramatically. I know I've said this a few times, but the key is that they need to identify those that are willing to negotiate in good faith, the rest they have little use for.

 

with the democrats digging in their heels on the SC nomination and now on healthcare, my similar hopes are plummeting

 

why are the dems filibustering gorsuch? i realize the republicans blocking obamas last nominee by running out the clock was disgusting politics, but i still do not support a partisan payback here. gorsuch appears to be a highly qualified candidate, a pretty good choice by don actually, and the dems are absolutely not going to win here. the only thing they are doing is satisfying their base, but thats a poor reason to choose this fight at this time. very disappointing imo

 

and now on hc we have democrat leaders saying don has to 'fully embrace their ideas.' sounds like they are digging in their heels when they should be more conciliatory and ready to negotiate. i expect this may just be early posturing that will recede some if they got going but my confidence is waning right now

 

it feels like the democrats are banking on dons popularity problem getting worse, or perhaps the russian connection gaining credibility, either of which could sink his presidency early. but a pence administration probably wouldnt be much better. even worse for them, if the public decides the dems are blocking progress it all could backfire. seems like a dangerous game to me

 

in any event, it certainly feels like we will have no breakthrough on the crippling gridlock. i had my hopes but they are fading fast

[SlimShady'sSpaceForce]

The Donald says he needs and wants to work with the Dems, then the following days axes more of Obama's actions.

 

Dear Donald. Lesson 1 in How to make friends ... Don't give them any (more) reasons to dislike you.