Repealing the ACA under Trump

[BigRedBuster]

 

 

 

But, still....nobody is attacking the pink elephant in the room.

I understand this to be your ongoing, and well-placed, concern about costs. I just don't see how we can control costs through government intervention and maintain a democracy.

There are a few dozen other countries that are controlling costs through universal healthcare and are still democracies.

How about we reevaluate how the RUC works, and sets prices. Since they seem to determine the cost for procedures, and it's completely out of wack. How about we make pricing transparent and require it to be submitted to the patient before an operation. You wouldn't have work done on your car before you receive an estimate would you?

 

All of those seems reasonable, and wouldn't corrupt our Democracy.

 

The government set up a huge website to provide an insurance market place (which I think is a great idea).

 

What if the government sets up a website where all healthcare providers are required to post prices. So, anyone needing a knee replacement would go on the site, plug in "knee replacement" and what area they want to search....and the cost is listed from all the providers in that area? You could even then develop it farther to have some type of "success score" to go with it.

 

Need a vasectomy? Plug it in and be able to tell within seconds where it's cheapest and your not having any more kids.

[TGHusker]

Thing is, the Republicans are smart enough to hold back implementation on a lot of this stuff until 2020, after the midterms & the next election. That was written into the House's version of this Bill, and I'll just about guarantee it's in the Senate's.

 

That way, the ramifications of this aren't felt until years down the road, and a lot of people will be tired of, and tune out, the uproar over it all.

 

This is a deeply, bitterly cynical law the Republicans are writing, and it's going to hurt people.

 

 

Perhaps the biggest question people should be asking themselves, with the 2018 mid-terms coming up, is why the Republicans are so emboldened to write and pass a law like this in spite of all the opposition. Why do they feel there will be no ramifications for this action?

Both parties play the delay game - as you recall the Dems delayed implementation of some of the requirements until after the 2014 midterms to help at risk dems.

 

I haven't read anything on this as I was at meetings all day until now. I think it is repugnant for either party to schedule implementation of a policy/law after an election just for political reasons. They aren't facing the music of their decisions - popular or not.

[TGHusker]

 

But, still....nobody is attacking the pink elephant in the room.

I understand this to be your ongoing, and well-placed, concern about costs. I just don't see how we can control costs through government intervention and maintain a democracy.

 

Knapp and BRB - don't you think allowing insurance companies to cross state lines would drive competition and therefore drive down costs of insurance. Also tort reform to drive down liability costs - but wt safe guards for gross negligence. I'm thinking out loud here and I always thought these were two ideas, pushed by Repubs in the past, that would have a positive affect on costs. Are these items even in the bill?

[StPaulHusker]

 

 

But, still....nobody is attacking the pink elephant in the room.

I understand this to be your ongoing, and well-placed, concern about costs. I just don't see how we can control costs through government intervention and maintain a democracy.

 

Knapp and BRB - don't you think allowing insurance companies to cross state lines would drive competition and therefore drive down costs of insurance. Also tort reform to drive down liability costs - but wt safe guards for gross negligence. I'm thinking out loud here and I always thought these were two ideas, pushed by Repubs in the past, that would have a positive affect on costs. Are these items even in the bill?

 

In some instances allowing an insurance company to cross state lines would drive competition. But the problem is that not all insurance companies are national.

[TGHusker]

 

 

 

But, still....nobody is attacking the pink elephant in the room.

I understand this to be your ongoing, and well-placed, concern about costs. I just don't see how we can control costs through government intervention and maintain a democracy.

 

Knapp and BRB - don't you think allowing insurance companies to cross state lines would drive competition and therefore drive down costs of insurance. Also tort reform to drive down liability costs - but wt safe guards for gross negligence. I'm thinking out loud here and I always thought these were two ideas, pushed by Repubs in the past, that would have a positive affect on costs. Are these items even in the bill?

 

In some instances allowing an insurance company to cross state lines would drive competition. But the problem is that not all insurance companies are national.

 

So that may drive the smaller guy out of business and thus perhaps in the long run actually reduce competition.

[Danny Bateman]

I'd love to have a long, in-depth conversation with someone that believes a true free-market approach is the solution to our healthcare problems here in this country. Competition, choice, freedom, personal responsibility... all of that jazz.

Because make no mistake about it, this bill isn't a true free-market option. It's a series of extremely cynical, extremely ill-advised half-measures. It's had no input from anyone other than this iteration of the GOP itself and industry lobbyists. This GOP railed for years and years against the ACA, successfully... they made tremendous gains at every level of government. I take issue with a lot of aspects of how they did it, but nonetheless, they used this issue greatly to their advantage...

 

But now they're in control. The rubber is meeting the road, and they want to have their cake and eat it too. It's well established that the party thinks they will lose major ground in 2018 if they fail on this because they think not repealing would kill the enthusiasm of their base. So they want to give the illusion of a complete repeal and replace that they can campaign on. But at the same time, they realize that the contents of the bill are political polonium. If we as a people can shine a light on what this bill actually is, it's going to be a poison pill for the electoral fortunes of all who vote for in at least pseudo-competitive areas. So they were forced to keep a few things they don't like and add some symbolic pieces to the bill that they can prop up as protections for the people squarely on the chopping block as losers of this legislation...

 

And then of course, the real reason they're doing it. Obama did it, and we can't have that. And of course the rich need to be unburdened so they can get back to becoming job creators or trickling down or whatever the GOP believes about them...

 

But this isn't a free-market healthcare bill. It's a crappier, watered down version of Obamacare that they can tout as the healthcare solution that saved Americans from the tyranny of socialized medicine (and covertly unburdened the wealthy, so they can further unburden them in their tax plans in the near future).

Oh, and I also believe treating healthcare like any other commodity you'd buy off a shelf is wildly misguided and a very poor idea.

[StPaulHusker]

 

 

 

 

But, still....nobody is attacking the pink elephant in the room.

I understand this to be your ongoing, and well-placed, concern about costs. I just don't see how we can control costs through government intervention and maintain a democracy.

 

Knapp and BRB - don't you think allowing insurance companies to cross state lines would drive competition and therefore drive down costs of insurance. Also tort reform to drive down liability costs - but wt safe guards for gross negligence. I'm thinking out loud here and I always thought these were two ideas, pushed by Repubs in the past, that would have a positive affect on costs. Are these items even in the bill?

 

In some instances allowing an insurance company to cross state lines would drive competition. But the problem is that not all insurance companies are national.

 

So that may drive the smaller guy out of business and thus perhaps in the long run actually reduce competition.

 

It could. I just don't know that there is enough national focused companies to really make it a competition in the first place.

[JJ Husker]

 

 

But, still....nobody is attacking the pink elephant in the room.

I understand this to be your ongoing, and well-placed, concern about costs. I just don't see how we can control costs through government intervention and maintain a democracy.

 

Knapp and BRB - don't you think allowing insurance companies to cross state lines would drive competition and therefore drive down costs of insurance. Also tort reform to drive down liability costs - but wt safe guards for gross negligence. I'm thinking out loud here and I always thought these were two ideas, pushed by Repubs in the past, that would have a positive affect on costs. Are these items even in the bill?

 

Personally, I've never understood this crossing state lines argument. Currently it is tough enough finding providers who are in your insurers network. What good would say an insurer from Missouri do me in Colorado? Who have they negotiated pricing with? What choices of providers am I going to get from an insurer multiple states away from me? I just don't see the benefit at all of this crossing state lines deal. The guys already operating in my state can't seem to get a handle on costs or expand provider network. I think it's smoke and mirrors.

[Danny Bateman]

Oh for the love of...

 

[TGHusker]

 

 

 

But, still....nobody is attacking the pink elephant in the room.

I understand this to be your ongoing, and well-placed, concern about costs. I just don't see how we can control costs through government intervention and maintain a democracy.

 

Knapp and BRB - don't you think allowing insurance companies to cross state lines would drive competition and therefore drive down costs of insurance. Also tort reform to drive down liability costs - but wt safe guards for gross negligence. I'm thinking out loud here and I always thought these were two ideas, pushed by Repubs in the past, that would have a positive affect on costs. Are these items even in the bill?

 

Personally, I've never understood this crossing state lines argument. Currently it is tough enough finding providers who are in your insurers network. What good would say an insurer from Missouri do me in Colorado? Who have they negotiated pricing with? What choices of providers am I going to get from an insurer multiple states away from me? I just don't see the benefit at all of this crossing state lines deal. The guys already operating in my state can't seem to get a handle on costs or expand provider network. I think it's smoke and mirrors.

 

I think the idea is that companies will have a larger pool to sell to and also with more companies competing for that same pool, the consumer therefore has more options - choosing better cost providers or better service providers.

[Danny Bateman]

Obama weighs in...

 

https://www.facebook.com/barackobama/posts/10154996557026749

 

The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America. It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else. Those with private insurance will experience higher premiums and higher deductibles, with lower tax credits to help working families cover the costs, even as their plans might no longer cover pregnancy, mental health care, or expensive prescriptions. Discrimination based on pre-existing conditions could become the norm again. Millions of families will lose coverage entirely.

 

Simply put, if there’s a chance you might get sick, get old, or start a family – this bill will do you harm. And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation.

[BigRedBuster]

 

 

 

But, still....nobody is attacking the pink elephant in the room.

I understand this to be your ongoing, and well-placed, concern about costs. I just don't see how we can control costs through government intervention and maintain a democracy.

Knapp and BRB - don't you think allowing insurance companies to cross state lines would drive competition and therefore drive down costs of insurance. Also tort reform to drive down liability costs - but wt safe guards for gross negligence. I'm thinking out loud here and I always thought these were two ideas, pushed by Repubs in the past, that would have a positive affect on costs. Are these items even in the bill?

Some...but I think it would have a minimal affect.

 

That competition is at the wrong level. Right now, insurance doesn't care what something costs as long as its with what they expect. They don't care if it's 15,000 or 150,000.

 

That wouldn't change.

[JJ Husker]

 

 

 

 

But, still....nobody is attacking the pink elephant in the room.

I understand this to be your ongoing, and well-placed, concern about costs. I just don't see how we can control costs through government intervention and maintain a democracy.

 

Knapp and BRB - don't you think allowing insurance companies to cross state lines would drive competition and therefore drive down costs of insurance. Also tort reform to drive down liability costs - but wt safe guards for gross negligence. I'm thinking out loud here and I always thought these were two ideas, pushed by Repubs in the past, that would have a positive affect on costs. Are these items even in the bill?

 

Personally, I've never understood this crossing state lines argument. Currently it is tough enough finding providers who are in your insurers network. What good would say an insurer from Missouri do me in Colorado? Who have they negotiated pricing with? What choices of providers am I going to get from an insurer multiple states away from me? I just don't see the benefit at all of this crossing state lines deal. The guys already operating in my state can't seem to get a handle on costs or expand provider network. I think it's smoke and mirrors.

 

I think the idea is that companies will have a larger pool to sell to and also with more companies competing for that same pool, the consumer therefore has more options - choosing better cost providers or better service providers.

 

I understand that's the idea. I just can't picture it doing any good in the real world. Many of these insurers have very large pools to work with now and it doesn't seem to be doing any good. BCBS Anthem as an example....their prices and options in Colorado (in the marketplace anyway) are not very good. I was going to say they suck but they aren't the worst options. And even the best options are bad.

 

Personally I think this whole talking point of more competition and crossing state lines is just what the GOP clings to because they are philosophically opposed to anything resembling single payer, socialism, universal care, etc. Free market solution just happens to be something tolerable for them even though it has been proven time and again to not work when it comes to healthcare. There has to be some cost constraints imposed and the free market system and competition just haven't managed to get the job done.

[funhusker]

 

 

 

But, still....nobody is attacking the pink elephant in the room.

I understand this to be your ongoing, and well-placed, concern about costs. I just don't see how we can control costs through government intervention and maintain a democracy.

Knapp and BRB - don't you think allowing insurance companies to cross state lines would drive competition and therefore drive down costs of insurance. Also tort reform to drive down liability costs - but wt safe guards for gross negligence. I'm thinking out loud here and I always thought these were two ideas, pushed by Repubs in the past, that would have a positive affect on costs. Are these items even in the bill?

Some...but I think it would have a minimal affect.

 

That competition is at the wrong level. Right now, insurance doesn't care what something costs as long as its with what they expect. They don't care if it's 15,000 or 150,000.

 

That wouldn't change.

 

What do you mean by this? As I read it, it is completely false. BlueCross and CHI just had a huge fiasco not too long ago in Omaha.

 

edit: As I reread it, I would assume you mean that insurance is okay to pay whatever as long as all health providers charge within that ballpark, a.k.a.: "what they expect." But that also wouldn't be true. HCP's want insurance companies to provide payments to help make up for the defaulted debts they take on via ER visits and uninsured patients and will do what is necessary to increase the amount of insured patients. Insurance companies also look to partner with HCP's that offer the lowest costs and best results to keep customers in their network. Lower costs equals ability to charge less for premiums. I'm just not sure where you want to see the competition.

[Moiraine]

Why are they calling it mean instead of cruel? Is it because it's the word Trump used?

 

It sounds so childish.