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 Posted: Wed Sep 20th, 2017 02:38 pm
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DaNkinator



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Looks to cut funding and send everything back to states. 

Allows insurance providers to not cover for pregnancy, pre-exisiting conditions, and other things.

Eliminates mandates. 

Thoughts by those here that detest Obamacare?

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 Posted: Wed Sep 20th, 2017 02:46 pm
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broke



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Your country is so fucking backwards its kinda funny from an outsider perspective.



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 Posted: Wed Sep 20th, 2017 03:15 pm
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DaNkinator



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I can see that, but it isn't funny to the millions that will more than likely be priced out of having any kind of healthcare.

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 Posted: Wed Sep 20th, 2017 03:37 pm
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srossi

 

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Until politicians are willing to look at real healthcare reform, that includes reasonable and consistent price lists for common procedures, you can dick around all you want with insurance and we'll all be bled dry.  An appendectomy or C-section should not bankrupt the average person, nor should hospitals be allowed to charge insurance companies (taxpayers) loan shark rates for it.  This is the problem.  Solve this issue, and many people won't even need insurance, and if they choose to buy it, it will be affordable to all. 

Medical care is the only thing that exists where you just accept that there's no way to tell how much it will cost at any given marketplace.  No one would accept that an apple might cost you 20 cents at one supermarket or $20,000 at another, and after you get the mystery bill and don't pay they'll just call you and say, "Well what can you afford to pay?  We'll take that."     

If you're still talking about insurance, there's nothing to talk about.  Insurance isn't the issue.  No one should have insurance because no one without insurance is actually expected to pay "full price" anyway, they pay pennies on the dollar or nothing at all.  It's all part of the game.

This is where we're headed with colleges too.  We're actually already there.  Once it becomes acceptable that no normal person can afford something, the government just starts writing blank checks that we all have to pay for eventually.  Do away with student loans and have every college at 5% occupancy where they have to fire almost their entire staff and sell off their grounds and see how fast tuition prices drop by tens of thousands.  Less than 2 years, guaranteed.  But if we can't even have the balls to do that about something that isn't life and death, we'll never do it with healthcare.  As long as people rely on insurance companies to pay for healthcare, and hospitals know they can bill these massive companies whatever they want and no one will bat an eye, you'll never have affordable healthcare.  Have 95% of the hospitals on the verge of shutting down because they can't keep the lights on, and doctors with massive student loans who wind up on the streets because no one's hiring, then you'll get healthcare reform.  And then an aspirin in a hospital will cost 30 cents instead of $30 again.       

Last edited on Wed Sep 20th, 2017 03:50 pm by srossi



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 Posted: Wed Sep 20th, 2017 05:16 pm
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DaNkinator



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Agreed.

I'm just curious why those who are so adamant that Ocare is bad, can support something like this.

Other than that whole "me and my own" mentality....that is until it happens to them and their own.

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 Posted: Wed Sep 20th, 2017 05:30 pm
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srossi

 

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DaNkinator wrote: Agreed.

I'm just curious why those who are so adamant that Ocare is bad, can support something like this.

Other than that whole "me and my own" mentality....that is until it happens to them and their own.

There's some buzzwords in there that Republicans like, especially states' rights (except when they don't like states' rights when it suits their purposes not to).  And the average person on both sides isn't smart enough to understand the real problem, so the best anyone can hope for is slight modification of the shit we already have.  Obamacare/Romeycare was a miserable compromised failure that both sides would've been fine with if their side came up with it, but that screwed over the average American like every other bill that the Republicans and Democrats pass.  Asking how Republicans can support this new shit is the same as asking how Democrats can defend the old shit.  It's all still shit.  And Graham is only slightly less hated than Obama in Republican circles anyway, so putting his name on this is hardly a step forward for them.      

Last edited on Wed Sep 20th, 2017 05:36 pm by srossi



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 Posted: Wed Sep 20th, 2017 05:40 pm
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KGB

 

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Here's an excerpt from the Conservative Review about how this half-baked repeal can be beneficial in the long run, despite not solving a damn thing today.  I don't like the idea of waiting any longer than necessary to dynamite the entire Government/Insurance cartel because in the meantime people's lives are at stake, but if my daughter doesn't have to spend her adult life dealing with third-party health care then I personally am willing to do what it takes to get there. 
 
To be clear, this bill absolutely does not fulfill the promise of repealing Obamacare. It leaves the core price-hiking regulations in place and only offers states minor flexibility to adjust some of the minor regulations. It leaves most of the tax hikes in place and leaves the Medicaid expansion and exchange subsidy funding to the states. While this sounds more conservative, the reality is that the blue states will use the funding to push even stronger government-run health care, while most Republican-run states will follow the Kasich model of perpetuating the status quo of endless government subsidies and interventions, even if funneled through the venture socialism of “private” insurance.
 
Prices will, therefore, not come down, for those not being subsidized. It’s debatable whether the bill may slow the crushing growth of insurance inflation. The plan certainly won’t create a climate in which new insurers could compete with the incumbent powers, because the existing lobbyists will work with unelected HHS officials and state insurance officials to carve out a statutory and subsidy regime that blocks competition.
 
So why should conservatives support this plan?

The one element of Obamacare that would be repealed under this plan are the requirements that individuals purchase and employers offer cartel insurance.
You might be pondering the obvious problem: By maintaining the regulations but getting rid of the mandates, less money will be pumped into the system, forcing unsubsidized rates to climb even more, a point we made in opposition to previous half-baked repeal schemes?

True, and that is the point! If we can’t repeal Obamacare, let’s allow the malignancy of Obamacare to destroy the existing model of insurance, which was never a free market to begin with. When we allow individuals and employers to exit the system, the cartel will no longer have us by the neck. You see, the more they raise their prices, the more people will just give up on insurance. Employers will drop coverage like a hot potato as well. In fact, the coverage regulations forcing insurers to cover people after they get sick for the same price works to our advantage under this scenario, because people will readily leave the system and then stick the system with the tab when they need the coverage.

In the meantime, as we have explored in previous posts (here and here), health-sharing ministries have shown an alternative model to the existing insurance paradigm. Graham and Cassidy are wrong about prices coming down under their bill. The continued higher prices, in conjunction with allowing people to opt out, will create a market for health-sharing association plans in which groups of individuals and associations get together and pool their resources to cover catastrophic needs. The basic needs would be paid for directly by the consumer to the doctor.

This is how any market should work. This will make the consumer, not the government/insurance cartel, the actual consumer. This will spawn a revolution in price transparency and actually bring down costs by circumventing the entire insurance system.

 
https://www.conservativereview.com/articles/how-to-save-free-market-health-care-out-of-the-ruins-of-obamacare

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 Posted: Wed Sep 20th, 2017 09:22 pm
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Big Garea Fan

 

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srossi wrote: Until politicians are willing to look at real healthcare reform, that includes reasonable and consistent price lists for common procedures, you can dick around all you want with insurance and we'll all be bled dry.  An appendectomy or C-section should not bankrupt the average person, nor should hospitals be allowed to charge insurance companies (taxpayers) loan shark rates for it.  This is the problem.  Solve this issue, and many people won't even need insurance, and if they choose to buy it, it will be affordable to all. 

Medical care is the only thing that exists where you just accept that there's no way to tell how much it will cost at any given marketplace.  No one would accept that an apple might cost you 20 cents at one supermarket or $20,000 at another, and after you get the mystery bill and don't pay they'll just call you and say, "Well what can you afford to pay?  We'll take that."     

If you're still talking about insurance, there's nothing to talk about.  Insurance isn't the issue.  No one should have insurance because no one without insurance is actually expected to pay "full price" anyway, they pay pennies on the dollar or nothing at all.  It's all part of the game.

This is where we're headed with colleges too.  We're actually already there.  Once it becomes acceptable that no normal person can afford something, the government just starts writing blank checks that we all have to pay for eventually.  Do away with student loans and have every college at 5% occupancy where they have to fire almost their entire staff and sell off their grounds and see how fast tuition prices drop by tens of thousands.  Less than 2 years, guaranteed.  But if we can't even have the balls to do that about something that isn't life and death, we'll never do it with healthcare.  As long as people rely on insurance companies to pay for healthcare, and hospitals know they can bill these massive companies whatever they want and no one will bat an eye, you'll never have affordable healthcare.  Have 95% of the hospitals on the verge of shutting down because they can't keep the lights on, and doctors with massive student loans who wind up on the streets because no one's hiring, then you'll get healthcare reform.  And then an aspirin in a hospital will cost 30 cents instead of $30 again.      

I agree with srossi. Maryland has a Health Services Cost Review Commission that sets the rates that Maryland hospitals can charge and basically limits the amount of profit that a Maryland hospital can make. Even with the Commission in place, hospital charges still seem wildly inflated to me. I can't imagine what the hospitals in other states charge.

My biggest gripes with healthcare spending are:

1) There is no price transparency in healthcare - in most cases, the person getting the care has no idea how much his portion of the bill will be until the bill arrives in the mail and it details what the insurance did / didn't cover. Estimates aren't readily available.

2) Medication formularies can change throughout the year but patients can only change insurance during open enrollment - patients can be hit with co-pay costs much higher than they are used to when a pharmacy benefits manager changes its formulary tiers or worse yet, removes medications from its formulary. And the pharmacy benefits manager can do this any time that it wants. Meanwhile, the patient is stuck with whatever the pharmacy benefits manager decides and can't change insurance until open enrollment time - assuming that a competitor is even available. Patients can always ask their doctor to prescribe a different medication that will be covered but that can cause a lapse in medication therapy and the new drug may not work as well.

3) 90% of healthcare spending is spent on 10% of patients - I am estimating the numbers because I can't remember them exactly (learned in a college course that I took about 5 years ago). People with expensive chronic conditions and emergency room "frequent fliers" consume most of the healthcare dollars. Previously, most of these people were unable to get insurance due to pre-existing conditions but now they have coverage and insurers have no idea how to handle them besides jacking up everyone else's rates to cover them. I am totally in support of providing coverage to people with pre-existing conditions, I just have no idea how to cover the cost without hurting everyone.

Taken to the extreme, consider the following scenario...

Genetic testing is now available which can detect if a person has a genetic predisposition for certain cancers and other chronic conditions and/or is likely to pass these genetic predispositions to his/her offspring. Insurers are pushing to make this information available to them and/or force their policyholders to take these genetic tests. Should an insurer be allowed to not insure people with these genetic predispositions? Should people with these genetic dispositions not be allowed to have children to prevent these genetic predispositions from propagating?

4) 90% of a person's total lifetime healthcare spending occurs during the last 5 years of a person's life - Again, I am estimating the numbers since I can't remember them exactly. This is where the "death panels" discussion comes in. There is no incentive for an insured person to curtail his/her healthcare spending since the bulk of the bill will be covered by the patient's insurer. This basically gives the patient unlimited spending power to get as many procedures done as possible in the hopes of extending his life. Is it worth it to spend $100,000 on a procedure that might add 2-3 years to your life? While this is a very personal decision, I surmise that if the $100,000 was coming out of the patient's pocket (instead of being paid by the insurer), the patient might be more likely to decide to forego the procedure. Instead, patients are willing to "fight to the end" and "stand up to cancer" by undergoing many expensive procedures in the hope of adding more years to their lives. Again, the insurer pays the costs and then passes the costs onto all of us through higher insurance premiums.

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 Posted: Thu Sep 21st, 2017 12:01 pm
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wittman2

 

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I'm a Republican, I really don't like Obama care, but this plan is actually shittier than the ACA.

I recently had hernia surgery, outpatient, and the total bill was over 100k. My surgeon's part of the bill was only $850. Absolutely ridiculous



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 Posted: Thu Sep 21st, 2017 12:12 pm
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Big Garea Fan wrote: Is it worth it to spend $100,000 on a procedure that might add 2-3 years to your life?

I only live once so fuck yeah it's worth it..



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 Posted: Thu Sep 21st, 2017 01:08 pm
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wittman2 wrote: I'm a Republican, I really don't like Obama care, but this plan is actually shittier than the ACA.

I recently had hernia surgery, outpatient, and the total bill was over 100k. My surgeon's part of the bill was only $850. Absolutely ridiculous

Jesus fucking Christ. 
There is no world where a price tag like that for an outpatient hernia operation makes any sense. None.
Is shouldering that much debt for medical issues just something people do with no hope of ever paying it off? Do they send guys to put your hernia back in if you can't pay by a certain time? 
I know/knew how bad it was down there but seeing that kind of number attached to a Hernia operation is truly WTF. Stunning.



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 Posted: Thu Sep 21st, 2017 01:46 pm
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srossi

 

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Married Jo wrote: Big Garea Fan wrote: Is it worth it to spend $100,000 on a procedure that might add 2-3 years to your life?

I only live once so fuck yeah it's worth it..

You don't have to actually pay it.  Especially if you only have another 2-3 years left.  How are they going to collect that?  Toss them $100 and they'll take it.  Their strategy if you don't have insurance is literally to ask for the highest amount they can think of to put you into shock, and then get you to agree to pay the highest amount that a normal person could afford. 



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 Posted: Thu Sep 21st, 2017 01:49 pm
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DaNkinator



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Big Garea Fan wrote:

My biggest gripes with healthcare spending are:


2) Medication formularies can change throughout the year but patients can only change insurance during open enrollment - patients can be hit with co-pay costs much higher than they are used to when a pharmacy benefits manager changes its formulary tiers or worse yet, removes medications from its formulary. And the pharmacy benefits manager can do this any time that it wants. Meanwhile, the patient is stuck with whatever the pharmacy benefits manager decides and can't change insurance until open enrollment time - assuming that a competitor is even available. Patients can always ask their doctor to prescribe a different medication that will be covered but that can cause a lapse in medication therapy and the new drug may not work as well.



Just sort of dealt with this a few weeks ago.  My son's meds went from a $65 copay last year to $15 this year.  I was stoked. 

So for August, I drop off his prescription and inform them that I want the generic brand. I then get a call a few hours later that my insurance denied the claim for the generic and that they will only cover the brand name.  To which the copay was $160.

WTeverlovingF?  I assume it's some sort of agreement that they have with the pharmaceutical company.  However, after jumping through hoops, it was determined that the copay should have been $15. 

Lucky break.  But that doesn't happen to everyone.

Last edited on Thu Sep 21st, 2017 01:49 pm by DaNkinator

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 Posted: Thu Sep 21st, 2017 01:53 pm
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DaNkinator



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All of these GOP reps along with Trump keep lying that there is protection from insurance providers denying anyone based upon a pre-existing condition.

They're so desperate to push this through that they again want to bypass bipartisan input and even a CBO score.

I'm waiting for those that hate ACA to defend this. Where are you BlueThunder? You seem to disappear in these times.

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 Posted: Thu Sep 21st, 2017 04:27 pm
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wittman2

 

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I hate the ACA but this I won't defend in it's current form. It's a shit plan, and not allowing for pre-existing conditions is horrible.



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