And ACA dismantlement starts [Archive]

creaker

3-6-17, 9:59pm

Here's a summary from: http://www.usatoday.com/story/news/politics/2017/03/06/house-republicans-unveil-obamacare-replacement-bill/98826894/ and http://www.nbcnews.com/politics/congress/republicans-unveil-obamacare-replacement-bill-scrapping-individual-mandate-n729871 - seems like they all miss important points in their articles. I don't see squat about what happens to the exchanges. And it sounds like requirements for employer provided insurance goes away.

And if you have any need to ever be on Medicaid I'd suggest making it happen before 2020 or you may be waiting in line a long time.

Here are the details of Republicans' proposed health care system.

REPLACING OBAMACARE:

Tax credits: The bill provides tax credits for people to purchase insurance based on age. Twenty-year-olds can receive a tax credit worth $2,000, and the credit grows the older a consumer gets. A 60-year-old can receive a $4,000 tax credit.

The tax credits start to be reduced for a person making more than $75,000 and a couple making more than $150,000 to ensure that high-income patients' insurance isn't being federally subsidized.

Health savings accounts: The bill expands the incentive to use so-called health savings accounts by doubling the allowed-contribution to more than $6,000 per person and $13,000 for a family.

Medicaid: In 2020, Medicaid expansion would be frozen and new people would be barred from enrolling under the income-based system. The new way to provide coverage would allow states to implement eligibility based on population, essentially putting a cap on the number of people who can enroll in the Medicaid.

WHAT STAYS:

The measure isn't a full repeal of Obamacare. It would keep some of the most popular components of the Affordable Care Act, including an assurance that people with pre-existing conditions can keep their insurance. It also allows people under the age of 26 to stay on their parents' insurance.

added:

And the bill would not repeal the popular provision barring insurance companies from denying coverage to people with pre-existing health problems. Instead, to keep people from buying coverage only when they need it, insurers could raise premiums 30% for those jumping back into the market.

added:

Here's a much gloomier assessment: http://www.latimes.com/business/hiltzik/la-fi-hiltzik-obamacare-repeal-20170306-story.html

If anyone can balance any of this out with some positive things, it would be good to hear.

MaryHu

3-7-17, 12:10am

Sorry, there are no positive things coming out of this congress with which to balance this news.

Tax credits don't do any good for folks who owe little if any tax; you know, low income people. UNLESS the credits are made refundable (which the republicans see as "just another entitlement program". These (low income people) are the same folks who would have a hard time scraping together any money to put into a health savings account. This is a great system for the wealthy since it also comes with big tax cuts for them. This is the height of hipocracy from our congress critters who enjoy "really terrific" health insurance at OUR expense. Let's take away their health insurance and see how they like it.

Yppej

3-7-17, 6:33am

I see the small positive as Trump says he will not dismantle Medicare or Social Security, so if you survive the healthcare system until you are 65 you can rest a little easier.

flowerseverywhere

3-7-17, 6:57am

I see the small positive as Trump says he will not dismantle Medicare or Social Security, so if you survive the healthcare system until you are 65 you can rest a little easier.

Yet.

The wealthiest and and insurance company CEO's will make out very well. And the ability to by a cheaper stripped down plan is all well and good untill you have to use it. At any time you can fall and tear a rotator cuff or break a leg, or be the unlucky one who with no family history or risk factors get cancer, or have a heart attack. We will go back to people losing everything over medical bills.

I also read read the bill and the accompanying articles and I saw little that made me happy. many more people will be without good insurance, many will have no insurance and the rich will get richer. As usual, the working middle class loses.

Rogar

3-7-17, 8:15am

If I'm looking for positive things, it's an improvement from whatever was in place before the ACA and more generous than I'd expected from the conservatives.

The incentives probably sound good on paper but are probably not going to be a huge relief for some people. I expect the number of uninsured will go up a lot. It seems to me like what both versions lack is an effort to bring health care costs down. I don't have brilliant answers for that but it seems like other countries have lower costs with better outcomes.

flowerseverywhere

3-7-17, 11:33am

catherine

3-7-17, 11:38am

I see the small positive as Trump says he will not dismantle Medicare or Social Security, so if you survive the healthcare system until you are 65 you can rest a little easier.

Whew! That's me.

I don't understand this plan. So these credits replace the Exchanges?

The incentives probably sound good on paper but are probably not going to be a huge relief for some people. I expect the number of uninsured will go up a lot.

I agree. So you pay for your own healthcare, or at least your own deductibles/copays and premiums as well if you're not attached to an employer. Then you get a tax credit from the government. Don't like it.

The thing that many, not all, Republicans don't realize is that there are lot of people in urgent need who just can't wait around for their tax credit once a year. Or they can't even put food on the table, never mind stash money in their HSA. They need medical services at a moment in time, and it's usually not April 15. I'm sure I'm not getting this.

I really can't wrap my mind around this plan--must investigate when I get a minute.

Alan

3-7-17, 11:56am

Http://thehill.com/homenews/house/322664-chaffetz-americans-may-need-to-choose-between-buying-new-iphone-or-healthcare

Jason Chaffetz has the solution. Don't buy a new iPhone and spend the money on healthcare. Clueless.
I wonder where he got an idea like that? Maybe here: http://www.cbsnews.com/news/obama-to-youth-leaders-health-care-worth-as-much-as-your-iphone/

"Mr. Obama told the youth leaders gathered that he's not sure what the monthly cost of an iPhone is -- "I am not allowed for security reasons to have an iPhone," he said -- but that he expects that the cost of health coverage on the new Obamacare marketplaces is comparable."

ApatheticNoMore

3-7-17, 12:21pm

And it sounds like requirements for employer provided insurance goes away.

this doesn't matter, they were not enforcing it anyway and never looked like they had any intent to. It's more honest not to have a law if you aren't going to enforce it anyway (I mean AT ALL, they weren't just lax in enforcement, they made a decision not to enforce it).

ApatheticNoMore

3-7-17, 12:28pm

It won't help the poor, the Medicaid expansion will hurt them, so yea it's mostly the poor who lose out with this. But even for the middle class 75k is a fairly low cut off to start reducing tax benefits if the whole of your plan is so called tax benefits.

flowerseverywhere

3-7-17, 12:30pm

I wonder where he got an idea like that? Maybe here: http://www.cbsnews.com/news/obama-to-youth-leaders-health-care-worth-as-much-as-your-iphone/

"Mr. Obama told the youth leaders gathered that he's not sure what the monthly cost of an iPhone is -- "I am not allowed for security reasons to have an iPhone," he said -- but that he expects that the cost of health coverage on the new Obamacare marketplaces is comparable."

that referred to the Obamacare marketplace. If you read the new bill and explanations of it you will find that the cost of an iPhone per month will be way way less than what premiums are expected to be for the poor and lower income folks who were covered through subsidies. Trumpcare will punish the poor and lower middle class and reward the rich. After many years of promising repeal and replacement with a better more affordable plan I would have expected more than these proposals. Even the middle class should expect to struggle to pay for coverage.

sweetana3

3-7-17, 12:31pm

Everyone needs to wait to see what the insurance companies do with this crazy mess. First, they have to say whether they will even provide any ACA policies in 2018 by May. Then they need to provide costs and this will be a shock for everyone no matter what plan they have.

jp1

3-7-17, 12:32pm

I wonder where he got an idea like that? Maybe here: http://www.cbsnews.com/news/obama-to-youth-leaders-health-care-worth-as-much-as-your-iphone/

"Mr. Obama told the youth leaders gathered that he's not sure what the monthly cost of an iPhone is -- "I am not allowed for security reasons to have an iPhone," he said -- but that he expects that the cost of health coverage on the new Obamacare marketplaces is comparable."

So, was chaffetz trying to say that under the new republican plan that the price of insurance isn't going up? Or was he just trying to plagiarize an Obama because the words sounded good? That does seem to be the hip republican thing to do these days. (And yes, I realize that hip republican is kind of an oxymoron.)

iris lilies

3-7-17, 12:34pm

I agree with both Chaffitz and
Obama--make sure your health care is covered before you sign on for the latest and greatest iPhone.

what is wrong with that?

creaker

3-7-17, 12:45pm

So, was chaffetz trying to say that under the new republican plan that the price of insurance isn't going up? Or was he just trying to plagiarize an Obama because the words sounded good? That does seem to be the hip republican thing to do these days. (And yes, I realize that hip republican is kind of an oxymoron.)

Sounded more like saying people who can't afford to pay for their healthcare are just economically irresponsible, and it's their own damn fault. To be sure there are exceptions out there - but most people who can't afford an iPhone don't have one. And many folks have smart phones because they can't also afford a landline/home computer/internet.

jp1

3-7-17, 1:15pm

I agree with both Chaffitz and
Obama--make sure your health care is covered before you sign on for the latest and greatest iPhone.

what is wrong with that?

I suppose there's nothing wrong with saying, essentially, 'dead people can't talk, so buy some damn health insurance.' But I think obama was trying to make a fundamentally different point, that point being that the insurance won't be much more expensive than one's phone bill. By paraphrasin/plagarizing him, chafetz is fundamentally obscuring or ignoring that point.

bae

3-7-17, 1:21pm

Alan

3-7-17, 1:39pm

Sounded more like saying people who can't afford to pay for their healthcare are just economically irresponsible, and it's their own damn fault. I wonder if there's anything to that?

http://i2.cdn.turner.com/money/dam/assets/151029160725-apple-purchases-by-income-780x439.png

Florence

3-7-17, 1:41pm

And it's all so unnecessary. The majority of Canadians seem to be happy with their healthcare system. At least, I don't think any of them are trying to emulate our system. Why can't we just adapt a Canadian type system?

bae

3-7-17, 1:46pm

I wonder if there's anything to that?

"Apple purchases online" may roll in iTunes purchases - movies, music, that sort of thing. It's pretty easy to run up an Apple bill simply renting a movie on iTunes/AppleTV now-and-then.

creaker

3-7-17, 1:47pm

Alan

3-7-17, 1:49pm

If Alan weren't picking up the bill for us, our household's monthly medical insurance payments would be about the same as a lease payment on a Tesla Model S P100D, which goes 0->60 in just a hair over 2 seconds.

Thanks Alan!I'll be out in Northern California and Southern Oregon over the summer. Any chance you can meet me and give me a turn at the wheel? I know it's a bit out of your way, but, fair is fair.

creaker

3-7-17, 1:52pm

I wonder if there's anything to that?

http://i2.cdn.turner.com/money/dam/assets/151029160725-apple-purchases-by-income-780x439.png

I agree there are people who don't spend wisely (doesn't that have something to do with why we are here?). But should we blame everyone for that? I know my cheapo $80 android is not in this graph, although I could afford something better.

bae

3-7-17, 1:55pm

I'll be out in Northern California and Southern Oregon over the summer. Any chance you can meet me and give me a turn at the wheel? I know it's a bit out of your way, but, fair is fair.

No trouble at all, it came with lifetime free recharging. America is great!

iris lily

3-7-17, 2:09pm

I wonder if there's anything to that?

http://i2.cdn.turner.com/money/dam/assets/151029160725-apple-purchases-by-income-780x439.png
I take issue with that measure! It is bogus!!! My household, kinda/sorta in that income class depending on what you count, has all of these in our extra refrigerator in the basement:

1703

Dozens and dozens of apples, and we didnt buy a one of them! They are from our city orchard and DH's family farm. The squirrel-man I live with eats tons of apples.

ApatheticNoMore

3-7-17, 2:12pm

so what does the graph show anyway, that Apple phones can be kind of pricey? Most health insurance plans for most income brackets (except if you are currently very heavily subsidized) are going to run quite a bit more than those Apple costs. Most of those Apple costs break down to about maybe $65 a month. Good luck finding health insurance for that monthly price. You won't. No way, no how. So giving up Apple phones isn't going to pay the insurance bill.

Alan

3-7-17, 2:18pm

so what does the graph show anyway, that Apple phones can be kind of pricey? Well, they are that, but I think it shows that the lowest income demographics pay as much for their Apple products as others with much higher income levels. It's up to the observer to determine whether that is irresponsible or not.

dmc

3-7-17, 2:28pm

This plan works much better for me. I'd rather have the tax break and be able to fund a HSA. And I don't even have a iPhone.

Rogar

3-7-17, 2:59pm

Jason Chaffetz has the solution. Don't buy a new iPhone and spend the money on healthcare. Clueless.

The specifics may be inaccurate, but I think there is a point to be made. There are young and mid-aged healthy people who have never considered health insurance a priority but maybe spend an equal amount on non-necessities. A new iphone might be a start, but throw in monthly phone costs, cable TV, some sort of high speed internet for gaming, maybe a fancy car, motorcycle, or house payment, booze, or whatever. I'm coming from a life of frugal living but I know people who did not have health insurance who could probably afford it. Along comes the ACA where the government foots part of the bill and they can fit a few toys in with insurance. I'm not judging right or wrong, just saying.

When these healthy younger people drop out of the insurance pool, like will surely happen now, it will make things even more expensive for everyone else.

LDAHL

3-7-17, 3:08pm

No trouble at all, it came with lifetime free recharging. America is great!

Whose lifetime? You, the car or Tesla?

jp1

3-7-17, 3:15pm

This plan works much better for me. I'd rather have the tax break and be able to fund a HSA. And I don't even have a iPhone.

No surprise there. It was written with expletive in your demographic in mind.

LDAHL

3-7-17, 3:58pm

It's a step in the right direction, but I doubt it will get through the Senate in it's present form.

flowerseverywhere

3-7-17, 4:32pm

I agree with both Chaffitz and
Obama--make sure your health care is covered before you sign on for the latest and greatest iPhone.

what is wrong with that?

nothing. What is my problem is assuming that health care can be afforded without subsidies just with the cost of an iPhone. And that poor or lower middle class have it so easy. A hard life is about to get much harder

bae

3-7-17, 4:56pm

Teacher Terry

3-7-17, 5:56pm

I really love it when people start blaming the poor!thumbsup!

JaneV2.0

3-7-17, 6:06pm

An iPhone SE retails for $399. I don't see how that price, even including the price of a monthly or pay-as-you-go cell/data plan, is anywhere near the cost of health care/insurance. A pair of Nike Air Jordans is $190... A Starbucks Pumpkin Spice Latte (Venti size) is $5.25.

Is "iPhone" some sort of class dog-whistle now?

I imagine it resonates with the same people who thought "Obamaphones" (generic flip phones) were an outrage. (There was government subsidized phone servce for years, under various administrations.)
See above:
"Let them eat cake."

How about we institute a plan that does an end run around the insurance raptors and forces the Pharma bros to slash their exorbitant costs. Just a thought...

jp1

3-7-17, 6:20pm

How about we institute a plan that does an end run around the insurance raptors and forces the Pharma bros to slash their exorbitant costs. Just a thought...

That's so unamerican of you to suggest something awful like that.

JaneV2.0

3-7-17, 7:53pm

That's so unamerican of you to suggest something awful like that.

Yeah. I suppose investors would take a hit. Maybe they could move all their money to renewable resources. Another thought...

bae

3-7-17, 8:11pm

Yeah. I suppose investors would take a hit. Maybe they could move all their money to renewable resources. Another thought...

Are "big pharma" companies producing above-market yields? I mean, if they are such profiteers, it'd show up in the bottom line, right? Which ones are raking in the dough?

JaneV2.0

3-7-17, 8:37pm

Are "big pharma" companies producing above-market yields? I mean, if they are such profiteers, it'd show up in the bottom line, right? Which ones are raking in the dough?

If they're not, they must be cooking the books. There's that red herring of R&D costs, most of which are covered by our taxes for universities. I will give you that their advertising budgets are YOOJ, much greater than R&D. There's a reason drug costs here are astronomically higher than anywhere else; we've elevated greed to the status of a virtue, and there are few laws in place to protect the patient.

iris lilies

3-7-17, 8:40pm

Are "big pharma" companies producing above-market yields? I mean, if they are such profiteers, it'd show up in the bottom line, right? Which ones are raking in the dough?
Yes, so that I can buy their stock.

iris lilies

3-7-17, 8:41pm

I really love it when people start blaming the poor!thumbsup!
The poor will always be with us. As will their cell phone bills, apparently.

Alan

3-7-17, 8:57pm

If they're not, they must be cooking the books. There's that red herring of R&D costs, most of which are covered by our taxes for universities.
I work in small pharma. We don't produce widgets in sweat shops, we employ the best and brightest who spend years developing a few products that take more years of clinical trials and regulatory submissions to gain approval for sale, which doesn't always pan out. We then have a limited life span on the product before it's eligible for the generic market. We are the most highly regulated manufacturers on the planet. We're expensive, otherwise we couldn't exist.

ToomuchStuff

3-7-17, 9:09pm

Home phones for the poor, is something I looked into, as I wanted that service but found I didn't qualify. It is called Lifeline service, and back then was something like $7 a month (before the taxes, which were 50% of my bill). I personally thing the big thing against the "Obamaphone" is both the fact that tents were set up and they were offering it to everyone (fraud), as well as not enforcing it the same as Lifeline service (I was offered one twice), as well as what you got with it: (think about how the news makes these your spokespeople)

http://www.youtube.com/watch?v=tpAOwJvTOio

MaryHu

3-7-17, 9:53pm

"The poor you have with you always" said Jesus to which I would add "beacuase the rich will see to it" (that there are always poor people)

Remember the rich only want one thing: EVERYTHING!

Miss Cellane

3-7-17, 10:19pm

There are still programs to provide low-cost smartphones to people receiving state aid. At least in my state. If you are getting any kind of state aid, you can get a free, refurbished smartphone (not an iPhone) and get service for about $10 a month.

It's seen as a way to make sure people have a phone. And it gives them access to the internet, which they might otherwise not have.

But the cost of an iPhone, without a service plan, is about the cost of 2 months insurance premiums for a single person. Once you give up your phone, what do you give up to pay for the remaining 10 months of the year?

bae

3-7-17, 10:58pm

We're expensive, otherwise we couldn't exist.

So, you're saying I can't find any big pharma outfits on the DOW/NASDAQ that have higher-than-market returns over time, to pad my retirement portfolio with? Darn. Seemed like an easy score.

Probably the books-cooking theory is correct, after all, nobody ever audits these corporations or looks at the books, especially shareholders or regulators. All that cash, secretly hiding in a vault somewhere...

bae

3-7-17, 11:04pm

jp1

3-7-17, 11:21pm

Huh.

Gilead Sciences, a Pretty Big Pharma Outfit (market cap $89 billion), pays a 3% dividend. P/E ratio of ~7.

Ford has a smaller market cap, more cash in the bank, and pays a considerably higher dividend.

Maybe you should be looking at Pfizer instead. They found a not so secret vault. And just imagine if they cut their marketing budget. But at least they don't need to worry about their biggest customer ever trying to negotiate prices, since congress doesn't believe in capitalism. At least not when taxpayer money is involved.

http://www.reuters.com/article/us-pfizer-tax-insight-idUSKCN0T51ZS20151116

ToomuchStuff

3-8-17, 1:52am

"The poor you have with you always" said Jesus to which I would add "beacuase the rich will see to it" (that there are always poor people)

Remember the rich only want one thing: EVERYTHING!

I didn't realize that Greed, or the love of money were only ones with those feelings?

Alan

3-8-17, 8:17am

Maybe you should be looking at Pfizer instead. They found a not so secret vault. And just imagine if they cut their marketing budget. But at least they don't need to worry about their biggest customer ever trying to negotiate prices, since congress doesn't believe in capitalism. At least not when taxpayer money is involved.

http://www.reuters.com/article/us-pfizer-tax-insight-idUSKCN0T51ZS20151116
So, Pfizer's operations cross international borders and they engage in "aggressive tax planning". That seems prudent.

My company operates in much the same way, including being incorporated in Ireland as a plc. The difference between corporate tax rates has enabled us to grow our US manufacturing operations. By the end of this year we will have doubled our workforce within a two year period, providing a stable, middle to upper middle class income to hundreds of local residents. I'm not sure why that makes us bad guys.

Rogar

3-8-17, 8:22am

There are a few interesting things I ran across while trying to study up on the new bill. One surprise is that 70 million Americans are on Medicaid. Basically one in five people qualify as being in a poverty level that makes them eligible for medical services. A lot of them are children and elderly. So they really don't buy insurance in the traditional way and insurance rate increase would not affect them. If the new bill rolls back the ACA medicaid expansion some of these people would lose medicaid eligibility. My big surprise was how many people are in this program and qualify as being at some sort of poverty level.

Another item of interest was the proposal to change the "age tax". It basically would allow insurance companies to charge the elderly not yet on Medicare more. AARP says maybe $3000 more per year for a person over 60. So that would basically wipe out the $4000 a year tax incentive for people over 60 that is in the new bill. Nice work congress.

As an off-shoot I looked up compensation for the CEO of Gilead. $18 Million a year in wages and benefits. I can only guess that if there were price controls on drugs, like other countries have, they might have to slim down some of their compensation packages. http://www.fiercepharma.com/pharma/gilead-keeps-martin-s-pay-at-18-8m-last-year-as-ceo

LDAHL

3-8-17, 8:45am

I see the new law would abolish the tanning tax. Clearly the work of the Dark Lord.

Lainey

3-8-17, 9:52am

There are a few interesting things I ran across while trying to study up on the new bill. One surprise is that 70 million Americans are on Medicaid. . . .

Another item of interest was the proposal to change the "age tax". It basically would allow insurance companies to charge the elderly not yet on Medicare more. AARP says maybe $3000 more per year for a person over 60. So that would basically wipe out the $4000 a year tax incentive for people over 60 that is in the new bill. Nice work congress.

As an off-shoot I looked up compensation for the CEO of Gilead. $18 Million a year in wages and benefits. I can only guess that if there were price controls on drugs, like other countries have, they might have to slim down some of their compensation packages. http://www.fiercepharma.com/pharma/gilead-keeps-martin-s-pay-at-18-8m-last-year-as-ceo

Agreed. As a 62 year old who is retiring in 2 months, it looks like I picked the worse time to enter Obamacare thanks to the idiot Trumpsters. I'll be praying for good health until Medicare kicks in, or maybe I can pay any surprise medical bills with my paper tax credit...

ToomuchStuff

3-8-17, 10:24am

If one of the owners of my company retired, (62) his social security, would give him $50 more then his insurance cost per month, this year.

Tybee

3-8-17, 10:38am

See, ToomuchStuff, that is EXACTLY the problem. At 61, this is really hitting close to home. But I would not have had money to pay for ACA, either. And I already can't afford my medications.

Teacher Terry

3-8-17, 12:48pm

I have a good friend that had to take an early disability retirement from the state due to her severe MS. She received a pension of 900/month and 500 went to her health insurance cost. She rented a room in a home and had some savings to tide her over until she was eligible for SS. Yes I got her a flip phone through lifeline so here is an example of some undeserving person sucking up our "freebies." Honestly I think some of the people on here have never had something really bad happen over which they have no control that negatively impacted their finances.

ApatheticNoMore

3-8-17, 1:04pm

If one of the owners of my company retired, (62) his social security, would give him $50 more then his insurance cost per month, this year.

the cost of healthcare is a problem, but SS is set up for you really really being penalized for collecting at 62 regardless. I find it inevitable I may have to anyway some day, not many people hiring 60 somethings afterall.

creaker

3-8-17, 1:05pm

Agreed. As a 62 year old who is retiring in 2 months, it looks like I picked the worse time to enter Obamacare thanks to the idiot Trumpsters. I'll be praying for good health until Medicare kicks in, or maybe I can pay any surprise medical bills with my paper tax credit...

That's a good question - is the tax credit for medical expenses including insurance? Or just for health insurance premiums?

Yppej

3-8-17, 5:47pm

the cost of healthcare is a problem, but SS is set up for you really really being penalized for collecting at 62 regardless. I find it inevitable I may have to anyway some day, not many people hiring 60 somethings afterall.

My mother found it made sense to claim benefits at 62. She was ill and unable to work and said due to COLA's her benefit would rise but if she had 3 to 7 more years with no contributions, on top of the years she missed paying in when she was a stay at home mom, her projected future benefits at 65 or 70 would have gone down not up. So claiming at 62 may not be a bad idea depending on your circumstances.

Lainey

3-11-17, 6:27am

That's a good question - is the tax credit for medical expenses including insurance? Or just for health insurance premiums?
I'm not sure, it's one of the proposed changes still in flux that's floating around for the Obamacare "repeal."

flowerseverywhere

3-14-17, 6:03pm

I hope Trumpcare passes. Sometimes things have to hit rock bottom before people wake up. I know so many people who think that Obamacare is awful and the Republican bill will change everything. After seven years of a vow of repeal and replace let them do it. They were elected according to the rules in place across the board. So let them pass their bill. See if the CBO is partisan and Trump will fulfill his promise of better insurance with more people covered for a cheaper price.

I know more people who are ecstatic with the recent comments about we don't want non white babies. I know people who don't care who is in the Oval Office as long as his skin is white. And people who go to church every Sunday and read the Bible who want every illegal person booted out and all refugees back where they belong. So let it happen.

Instead of all this effort protesting work to elect people who care about the poor, refugees, and the hard working law abiding immigrants. Work for real immigration reform. And for people who understand how complicated health care is and will work to make it better.

People wanted Trump and a republican house and senate. Give them what they ask for. In the meantime live as simply as possible to take care of yourself and save for your future because a future without social security and Medicare as we know it is bleak for most old people. And a present with more uninsured clogging the ER's will have a bad effect on all of us.

ApatheticNoMore

3-14-17, 6:55pm

People wanted Trump and a republican house and senate. Give them what they ask for.

only I think the actual facts show this is not so based on popular vote totals (for the Presidency OR things like the Senate). While we don't necessarily know what totals would be in a system that WAS based on the popular vote, we do know the system as it is doesn't work that way.

It doesn't give people the party the majority votes for (much less the policies anyone actually wants which we can only speculate on most of the time, as there is no way that ever gets tabulated by voting - sometimes polls of such exist for what polls are worth).

In the meantime live as simply as possible to take care of yourself and save for your future because a future without social security and Medicare as we know it is bleak for most old people.

it would be one thing and perhaps a blessing and perhaps in some cases even possible if one only had to save for one's own future. But the old people with a bleak future may very well be one's own parents etc. and so one must first worry about that (concretely things like the Medicaid program for nursing home care). So really much wiser by far to take the old AA saying on changing the things one can, and accepting the things one can not change and KNOWING very much may be in reality things they can not change, than pretending one can somehow change one's own circumstances enough to effect miracles. The future may be a blessed near miss, the future may be very bad, much depends on things that can not be fully planned for or foreseen (whether and when people get sick, how health care costs go up by the decade etc. - yea restricting this conversation to health care here).

Every man for himself assumes not just that we take care of ourselves (which has come easy enough) but that we ONLY take care of ourselves. But one can't necessarily do the latter, because in reality people take care of aged relatives but there are limits (that's why Medicaid eventually kicks in for old folks care), people take care of kids but there are limits (in some cases that's when Medicaid kicks in), people may take care of others as well (siblings, in-laws etc.). I'm not saying one *should* take every single one of them on mind you! :) But at any rate, one person can't take care of all those who may need it, even blood, it's much better if there are programs that help such people.

Teacher Terry

3-14-17, 7:38pm

iris lilies

3-14-17, 9:03pm

Part of me says that Flowers is right and people get what they deserve. The problem is that so will other people that don't deserve it. ANM is also right. I am the guardian for my friend with dementia and when we put her in a home last year we put her in one that we could afford on her ss and pension. Now her needs are much more so the cost is double. The $ is gone and I had to apply for Medicaid which she got. she has no family left so no other options but the home. It just boggles my mind how the Repubs like Ryan are smiling ear to ear when they are avoiding their voters and know that they are going to deeply hurt old people, poor people, etc. It's as if they are saying "Let them eat cake."
I am not clear how your example illustrates loss of ACA for your friend.

what I was always amazed by was and is the number of people who deliberately chose not to take the ACA health insurance their President assured them they could afford. They said they couldnt afford it. I guess they were lying. ..?

catherine

3-14-17, 9:50pm

I am not clear how your example illustrates loss of ACA for your friend.

what I was always amazed by was and is the number of people who deliberately chose not to take the ACA health insurance their President assured them they could afford. They said they couldnt afford it. I guess they were lying. ..?

The subsidies do make health insurance MORE affordable but some choose not to take advantage. I think of my son, who makes about $40k as a server and he just recently chose to sign on. He's young and didn't sign up earlier because he would rather go out to eat once a week than pay for Obamacare. I finally talked him into it.

Then I think of my BIL. I learned that the White House was soliciting Obamacare disaster stories, so I figured I'd troll the site and write this:

I have been self-employed since before the ACA. My insurance premium for myself and my husband has only gone up $200 ($1359-1554)--a reasonable increase given the exponential cost of healthcare overall, as well as the increase in my age.

Now, my BIL never could afford health insurance. He didn't work for an employer that offered it, and because he was relatively healthy, he didn't worry about it. But his family was concerned, and so we pressured him to sign up for Obamacare when it was available, which he did. He was able to get generous subsidies, based on his income.

Just last month he wasn't feeling well, and so he went to the ER, where he was diagnosed with severe hypertension--223/120!! They kept him in for observation, and the EKG showed that he has an enlarged heart because of undetected hypertension. The fact that he had had no health insurance for years kept him from getting the preventative care that could have provided early intervention.

If it weren't for Obamacare, he would now be facing extraordinary medical bills in addition to other financial struggles. Thanks to Obamacare, he can afford the medication he needs to keep him from a high risk of stroke or heart attack.

That's my story.

As we all have said repeatedly, Obamacare is far from perfect. But if Obamacare is a 4 on a 10-pt scale, the GOP alternative is -1. I read a thing on FB today: "Offering a poor person a tax credit is like offering a starving person a cookbook." The GOP plan is useless.

jp1

3-14-17, 11:25pm

ToomuchStuff

3-15-17, 1:34am

...repeal the ACA instead of passing this asinine bill that they are trying to rush through before people have a chance to read it.

Wonder where I have heard that before:
http://www.youtube.com/watch?v=hV-05TLiiLU

ApatheticNoMore

3-15-17, 1:56am

The thing I find remarkable is that the CBO's assessment is that Trumpcare will cause the loss of insurance to more people than the ACA added to the insurance rolls. In other words it would truly be better overall if they really did just completely repeal the ACA instead of passing this asinine bill that they are trying to rush through before people have a chance to read it.

in part probably because the bill affects medicaid (and not just expanded medicaid either) and so it goes beyond just repealing the ENTIRE of the ACA. It cuts medicaid programs that existed before the ACA. I doubt it was medicaid expanded or not that people couldn't afford, but it has some downsides - in most cases you have to be really poor although sometimes if you are elderly it will pay for a nursing home and let you keep some assets, if collected at the wrong time (in your 50s for the most part) the government could claw back money from your estate if you have any.

JaneV2.0

3-15-17, 12:09pm

Alan

3-15-17, 12:55pm

Blame endlessly greedy insurers, Pharma, hospitals, etc. that keep pushing prices ever higher. You're right! Health care was a bargain when it consisted of leeches and poultices.

jp1

3-15-17, 12:58pm

JaneV2.0

3-15-17, 1:12pm

You're right! Health care was a bargain when it consisted of leeches and poultices.

Health care was affordable in my lifetime--which admittedly is a long one--before insurance got involved. And you had choices back then. Ancient history.

But most civilized countries provide affordable health services now. Just not this one.

ApatheticNoMore

3-15-17, 1:28pm

Peter Schiff recently posted a column where he came to the conclusion that the AHCA will actually kill the health insurance industry. Basically he believes that without the mandate many healthy people will simply go without insurance until they become sick, at which point it will make sense to pay the 30% penalty.

I'm not sure that it was that hard to avoid the mandate now, if basically one played games with their taxes and under-withheld. It did require some game playing (it's kind of why anyone can be made to hate D.C., when the advantages go not to honest normal time-crunched people who mostly play very directly by the rules, but instead those best at gaming the system).

Taking that a step further he predicted that without the employer mandate some employers, possibly many, will choose to self insure low levels of healthcare but then if an employee develops a more serious illness simply buy them insurance at the 30% penalty rate, thus keeping all the 'healthy' employees out of the health insurance system.

well the employer mandate has NEVER been enforced. So is there really that significant a difference from a law they seem never to plan to enforce and not having one at all? I guess one could always fear they might decide to enforce the former someday ...

The result being only the sickest people buying insurance and Trumpcare being responsible for the 'death spiral' that the republicans have been expecting since the ACA started.

speculation about a death spiral are not purely a Republican thing (I didn't say it's true, I honestly have no idea, but it is not just Republican):
http://www.politico.com/story/2017/02/obamacare-market-death-spiral-aetna-mark-bertolini-235041

Teacher Terry

3-15-17, 1:42pm

IL: how it affects my friend is that he wants to cut Medicaid and where would that leave people like her?

ApatheticNoMore

3-15-17, 5:04pm

Yea cuts MediCAID and MediCARE. I hope no one was planning or knows anyone who is planning to use MediCARE for anything serious in the next decade. (These trust funds are often complicated and I don't know how they work, the truth is in reality the government could just pay for this stuff out of deficits the same way it funds anything it really WANTS to fund (like a new war), but there may be laws that tie their hands for actually doing so. Or with general taxes also but there may political issues doing so).

http://thehill.com/policy/healthcare/324102-experts-worry-obamacare-repeal-plan-puts-medicare-trust-fund-at-risk

People not loving the plans offered on the exchanges, ok I get it, for many better than what came before, and for some worse. But Medicaid and Medicare are really the only safety nets we have in this country as far as healthcare.

Rogar

3-15-17, 5:30pm

Health care was affordable in my lifetime--which admittedly is a long one--before insurance got involved. And you had choices back then. Ancient history.

But most civilized countries provide affordable health services now. Just not this one.

I don't think a person can blame insurance for the total rise in health care. Alan is sort of right. Now we have expensive equipment to do things like CAT scans and MRI's, cancer treatments that can cost 10's of thousands a year, all sorts of joint replacements, and other things that we didn't have a few years ago.

I don't know about the second part. We probably pay less than other countries and maybe have less positive outcomes but other countries have affordable health care for individuals because it is heavily subsidized by governments through taxes and government regulation of the industry.

As far as Medicaid goes, the figures that have come out have been an eye opener. One out of five Americans are on Medicaid and half of all pregnancies! I really don't know enough of the details to say that is bad or good, it's just an amazing number to me. It will be interesting to see how the bill gets modified to be more or less generous, among all the criticisms. If the fiscal conservatives get their way it could well pave the way for Medicare reform. It would be a sad day if we can no longer provide for the poor elderly and disabled but can afford to boost military spending by large amounts.

The news has not given much about how states would be expected to pick up the Medicaid slack created by the reductions. I think that is the expectation that goes along with the reductions, though Im not seeing yet how that could work.

JaneV2.0

3-15-17, 5:46pm

I don't think a person can blame insurance for the total rise in health care. Alan is sort of right. Now we have expensive equipment to do things like CAT scans and MRI's, cancer treatments that can cost 10's of thousands a year, all sorts of joint replacements, and other things that we didn't have a few years ago. ... .

Insurance, Pharma and their incessant pushing of overpriced drugs, employer-based "wellness programs" that are just a marketing ploy for Pharma and a way to push up insurance costs, and health professionals on the take are much of it, but I'd add the willingness of people to overuse doctors, and participate in the ordering of endless scans and tests and antibiotics and other, more useless and dangerous drugs--designed to be taken indefinitely--are certainly part of the problem.

herbgeek

3-15-17, 6:26pm

and other things that we didn't have a few years ago.

We are also much more litigious than other nations. I'm sure that is a factor in there too: cost of malpractice premiums, the lawsuits, and the extra tests run to try and avoid that.

catherine

3-15-17, 6:31pm

Insurance, Pharma and their incessant pushing of overpriced drugs, employer-based "wellness programs" that are just a marketing ploy for Pharma and a way to push up insurance costs, and health professionals on the take are much of it, but I'd add the willingness of people to overuse doctors, and participate in the ordering of endless scans and tests and antibiotics and other, more useless and dangerous drugs--designed to be taken indefinitely--are certainly part of the problem.

I never agree with Jane more than when she talks about healthcare. Yes, Pharma has to recoup their R&D investment costs, but the nature of capitalism and being accountable to shareholders is that you drive up prices as high as you possibly can. And when no one person is pulling the money out of their own pocket, "what the market will bear" is horrifically inflated prices.

Do we have great medical advances to avail ourselves of? Yes. But if we didn't have other market forces pushing processed foods, cigarettes, alcohol, environmental toxins and a "grab and go" culture, we probably wouldn't need half the drugs and medical interventions too many of us depend on.

sweetana3

3-15-17, 6:46pm

I thought this info would be an eye opener for some.

http://kff.org/other/state-indicator/total-population/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22 :%22asc%22%7D

ApatheticNoMore

3-15-17, 7:04pm

pinkytoe

3-15-17, 8:02pm

Since I'm in the early 60s group that is supposed to be hard hit, I guess I will have to practice benign neglect health practices. I have never prescribed to the medical paradigm as it exists anyway - all of the conventional treatments and procedures scare me more than the illnesses they supposedly cure. It just pees me off how we have to make everything so difficult and ugly when it doesn't need to be.

iris lilies

3-15-17, 9:28pm

So which ones do people on ACA exchange plans fit into? The "non-group" or the "other public", I'm thinking non-group but that is pretty much everywhere less than 10%, and "non group" is not strictly ACA, but includes non-ACA individual plans AND I strongly suspect a few although not many employer plans (some employers use non-group plans that is, I had an employer like that, it sucks not to get group type benefits, although it still was employer subsidized).

I have heard it said those affected by exchange plans are actually small in number and those who get subsidies a subset of even that as self-employed sometimes earn too much (the cut off for subsidies is low cutting out much of the middle class IMO - but luckily most middle class people don't have to rely on exchange plans - they are employees or their spouses are).

Meanwhile 1/3 of the population or so is on Medicaid and Medicare (including ACA expanded Medicaid). That's why using some existing dissatisfaction with exchange plans to go after Medicaid and to a lesser extent Medicare will be so painful. It's one of those nuclear bombs to kill a flea things (if one considered the exchange plans a flea that is).

People on ACA exchange policies are in "non-group" in the Kaiser chart posted by sweetana. Thanks for that!

Yes, it is shocking how tiny is the number of people that actually uses insurance on the exchanges. The overriding statistic that illustrates the general ineffectiveness of The ACA is that after all of the strum und drung of it that EVERYONE in the United States, all 300 million of us, got to experience, about 6% more of the population had health insurance in 2015 when compared to earlier (2009?) figures. That is off the top of my head, but it is pretty close. Talk about nuclear bomb to kill fleas, that is it, The ACA.

jp1

3-15-17, 9:46pm

If I recall correctly something like 82 or 83% had some sort of insurance before the ACA took effect, so yeah, adding 6% to that number isn't great. It's only 33% or so of the previously uninsured. But for some of those people it is undoubtedly life saving. And probably cost reducing, assuming it reduced the number of ER visits through earlier treatment. Personally I'd have preferred some sort of single payer system, but that just wasn't in the cards.

More importantly, though, are the protections for pre-existing conditions and denials of coverage after people got sick and the end of lifetime caps. SO has good quality employer provided health insurance but last year he had over $500,000 in medical treatment due to an issue that is better but still not fully resolved. It's quite conceivable that, without the ACA, he would have hit the lifetime cap in a year or two. He still takes a prescription that costs nearly $10,000/month. It's expected that he won't need it for forever, but if they don't resolve the underlying problem he may very well end up on it for the long term.

Teacher Terry

3-16-17, 1:23pm

iris lilies

3-16-17, 4:17pm

The ACA allowed my best friend's 19 yo daughter to get a liver transplant. She had insurance through her Mom's policy. She developed a rare liver disease and was too sick to go to college. So without the ACA requirements she would have been off her Mom's insurance. Also many people only had catastrophic insurance and then were able to buy decent insurance.

I have read parts of the bill and skimmed others. Have you?

The provision for 26year old child coverage has not changed.

why, exactly, do,you think your friend in the nursing home loses
Medicaid coverage?

To the average AMerican that $7,000 deductible IS catastrophic. While I think that is silly and people need to budget mpre for their health care snce everyone seems to want it all for free, that is the feedback I get.

Anyway, it doesnt matter, the Senate wont be signing off on this version, anyway.

catherine

3-16-17, 4:48pm

To the average AMerican that $7,000 deductible IS catastrophic. While I think that is silly and people need to budget mpre for their health care snce everyone seems to want it all for free, that is the feedback I get.

I think it's more that people want it affordable--not necessarily free. A heart attack shouldn't bankrupt anyone, but it happens--especially to people who just haven't been able to get their earning up to a point where they could afford decent healthcare.

BTW, my deductible isn't $7,000; it's significantly lower, and I get good coverage for that. I agree with you that having skin in the game is a good way to keep healthcare costs down--but that would be skin, not an arm and a leg.

Teacher Terry

3-16-17, 7:37pm

IL: when my friend's daughter got sick the ACA had just been implemented. So she could have not stayed on her Mom's insurance if she had gotten sick the year before. They are talking about huge cuts for Medicare and Medicaid. My friend in the nursing home had lots of $ and insurance. Battling stage 4 ovarian cancer for 20 years and her DH cancer took everything they owned.

creaker

3-23-17, 4:24pm

Anyway, it doesnt matter, the Senate wont be signing off on this version, anyway.

Or the House, it looks like - at least not today.

bae

3-23-17, 8:26pm

Healthcare rant of the day:

I'm on a boring medication. Once every 7-10 days, I need a single dose.

Before ACA, my doctor gave me a prescription, the pharmacy filled it, and a 3 months' supply of medication, list price, was $65.00. It was an injectable, and I dosed myself, so there's another $.25/dose for a syringe and needle and band-aid. (If the nurse/doc did the injection, the charge to the insurance was $90/dose with the office visit, which seemed wasteful, so I just did it myself, as the Doc was fine with that.).

After I was unable to keep my insurance once the ACA kicked in, because my sort of catastrophic policy was viewed as horrible, and the insurer simply left the state, my new insurance providers, in order to prevent fraud, only allowed one month's worth of medications to be issued by the pharmacy at once. So, instead of one large bottle of meds, lasting 3 months for $65, I each month would be issued 4 little teeny tiny single-dose bottles. Which cost $40/bottle.... $40.25 a dose, with syringe, compared to the previous $5.76/dose. Plus of course whatever it costs everyone each month to call in a prescription, verify, fill it, and do all the paperwork. Great cost savings there.

Now, every year since the I've had to change insurers, because insurers are fleeing this state, or at least this zip code, as fast as they can.

I called in a refill order this week. The new insurer denied it, because "it requires pre-authorization, and we want you to talk to your doctor about these other possible alternative medications instead...". Now, I'm sorry, but the paper-pusher on the other end of the phone has never examined me, or looked at my medical records, how *dare* they offer a medical opinion. I'm pretty sure they aren't licensed to practice medicine either... The problem was resolved in about 15 minutes, with a conference call with the insurer, my doctor, and my attorney, but dang.... Normally, they take 72 hours to "pre-authorize" a prescription.... (And really, "pre-authorization" for a medication I've been taking for 5 years, for which we have charts and graphs and bloodwork...?!?!?)

Imagine, if you will, some 85 year old person, taking 7-10 medications, as I don't find uncommon when I visit their homes on emergency medical calls. Imagine the hell they must go through if they are treated this way by their insurers... The stuff I'm taking isn't for any life-threatening condition, I can exist for many months without it, but what happens for more time-sensitive stuff, when the patient isn't as able to just bring down the wrath of Khan on the insurer?

The insurance system needs taken out behind the barn...

(Oh, there's another completely minor medication I take. It costs, well, next to nothing. It went off-patent many decades ago. A year's supply costs perhaps $20. They still insist on issuing me this stuff 30 days at a time... I can't imagine how much money they save doing this...)

flowerseverywhere

3-23-17, 8:32pm

To the average AMerican that $7,000 deductible IS catastrophic. While I think that is silly and people need to budget mpre for their health care snce everyone seems to want it all for free, that is the feedback I get.

.

well, I think that many of us who are able prepared to cover a lot of our medical expenses as we aged. The problem is those many people who were forced to leave good paying jobs as factories closed, got caught in the housing downturn, lost pensions when they lost their jobs. Sometimes crazy stuff happens beyond your control.

I live in a big retirement community. I have neighbors who had several big companies in their town close suddenly as jobs went to Mexico. They lost a lot of value in their house, the man was virtually unemployable with all the other fifty year olds looking for work and she had only part time work which she tried to increase but could not. They were lucky that their son helped them buy a small house, and they live a very frugal life. A major medical problem will put them under and they did nothing wrong.

iris lilies

3-23-17, 9:12pm

well, I think that many of us who are able prepared to cover a lot of our medical expenses as we aged. The problem is those many people who were forced to leave good paying jobs as factories closed, got caught in the housing downturn, lost pensions when they lost their jobs. Sometimes crazy stuff happens beyond your control.

I live in a big retirement community. I have neighbors who had several big companies in their town close suddenly as jobs went to Mexico. They lost a lot of value in their house, the man was virtually unemployable with all the other fifty year olds looking for work and she had only part time work which she tried to increase but could not. They were lucky that their son helped them buy a small house, and they live a very frugal life. A major medical problem will put them under and they did nothing wrong.
I have tons of sympathy for people who have no job in a place where jobs bs are no t forthcomingl and especially for older people.

I have far less sympathy for people, and I know many, who think they shouldn't be paying anything for health care and wh have means. One such couple is flying to Paris next month. They will be spending a year's worth of ACA premiums on that trip.

People just dont prioritize needs over wants. Anther set of friends we have are still working at age 70, well, the man of the house is. Actually, I know a several people still working at ages 70-80. But I digress. This one couple has to sell their house because they can no longer afford it and its not a huge house. He is working at Home Depot. I saw her come out of the nail salon last week, glad she hasnt had to give up that necessity.

iris lilies

3-23-17, 9:14pm

I weeded for two hours on this glorious, cool, sunny afternoon and listened to NPR. The reporters barelly kept the glee from their voices in talkng about the Republican stalemate in the House re the ACA.

ToomuchStuff

3-24-17, 3:33am

Bae's prescription thing makes me think of my own. Before the ACA, I would pay for my own prescription, as it was one that a large corporation sells for $4 to an individual. To an insurance company it was more and according to a relative who went elsewhere, his cost the insurance company $11 for the same thing he could have paid $4 for, and guess whose pocket that money comes out, in the end, when your rates go up (with everyone elses).
After the ACA and "mandated insurance", they started charging customers the insurance rate, unless they were a next level member.
Now, because of a level of bureaucracy, I am awaiting a refill after not being on the medicine for a couple days, awaiting.

Yppej

3-24-17, 7:26am

My parents' post-retiree medical plan changed this year and my mom who is on numerous medications is now going through the preauthorization prescription rigamarole Bae is, and costs have skyrocketed. To try to keep them down she went to mail order meds but the letter carrier was on vacation and the post office delivered them to the wrong address so they sat outdoors in someone else's mailbox in the cold overnight. Supposedly they are still effective - if not it would be $400 of her money down the drain. She is trying to get everything switched to a PO box.

She probably spends the equivalent of one 8 hour work day every week on hold and talking to insurance and medical providers. Each time she calls insurers she gets a different person and a different story. It is now to the point she is about to give up on conventional medicine and take quack remedies that her sister advocates.

Tybee

3-24-17, 9:02am

I hear you! Before ACA, my rescue inhaler cost 11. After, it is 75. My other inhales had maybe a 30 dollar copay. Now the copay is 250 dollars, and I cannot afford the medicine anymore. I need another medicine and it is a 200 dollar copay.
So I am definitely going the non-allopathic medical route, and struggle along as best I can, and I do everything in my power to stay away from doctors.

IL, I don't know anybody who spends a year's worth of premiums on a trip to Paris! Everyone I know is like the couple Flowers mentions, including ourselves.

LDAHL

3-24-17, 9:12am

Step 1: Dictate the terms of what every health policy must include.

Step 2: Create penalties and subsidies related to who can charge how much for what to who.

Step 3: Declare that "the free market has failed".

Step 4: Move from an informal to a formal nationalization of health care.

Step 5: Begin discussing euthanasia.

Tybee

3-24-17, 9:33am

"Step 5: Begin discussing euthanasia."

And yet when I mentioned this in another thread, I was called paranoid.
LDAHL, your list is pretty unkind and insensitive to those of us who are living without medications. I don't think you care that you hurt my feelings, but you did.

jp1

3-24-17, 9:52am

Actually step one was: acknowledge that the free market has failed.

Tammy

3-24-17, 10:18am

A year ago I called for refill on a cheap diabetic med for my husband. They said he was no an longer active patient so they couldn't refill it. I said we never left and he was seen within the last year. They said Dr so and so left our practice. I said yes the resident left when his residency was done - but we didn't leave. They said he is no longer an active patient.

I got an appointment with a different practice ASAP and we finally got the script refilled. He missed a week of meds.

I'm a nurse. I know how to make the system work for us. I still couldn't prevent him from missing a week of meds.

I guess we could have sat in an urgent care and begged for a script - but there was no guarantee that would have worked either.

Then I see patients all the time with notes in their charts about medication noncompliance. I wonder who exactly was noncompliant. It's a blame the patient culture ...

Argh!!!

JaneV2.0

3-24-17, 10:51am

Don't get me started on "non-compliant!" I am a grown-ass adult. I make my own decisions about my body. You're not the boss of me, stupid American medical-industrial complex! Ahem.

The system may be more broken than it was before, in some ways. I don't know; I don't participate. I hope I never have to. Several members of my family have just keeled over and died. I hope I'm one of them.

We need to go to something much simpler, but that would likely cut too many greedy participants out of the system. It's like a feeding frenzy now.

I would prefer fee-for-service and a catastrophic coverage of some kind. No bleeping insurance companies and no paperwork designed to confuse a few more dollars out of you. I'm pretty sure it won't happen in my lifetime.

I had the experience of having to stand in line at the pharmacy every month to get thyroid medication (gotta wring that co--pay outta you). My solution? I stopped taking it. That was twenty years ago. So far, so good. Relatives who are on it seem no better off, so I think that was a sound decision.

sweetana3

3-24-17, 12:33pm

Health care should not be run on the capitalistic free market system. It is too critical to everyone. It should not be based only on employment or total poverty. It should not require an emergency room visit for basic care.

If you want capitalism, then give the public transparency. Tell the public what the costs are and keep them consistent. For one CT scan at a local hospital, I found out there was a brochure price, then a price for self pay, then different prices for different insurance companies, then write offs for "poor' patients. It was like trying to buy a cruise or a used car. And I only found out this much due to billing problems and studying the information sent to me.
I feel such sorrow for the elderly, the poor, the mentally challenged, the illiterate for having to deal with such a mess. Then add to it dealing with gate keepers that are given their own agenda and required to work from scripts.

Personally, I just get really mad. Last error I got from a local medical supplier was turned into Facebook negative reviews, email contacts, numerous telephone contacts and a threatened personal visit to the hospital administrator. Not good for my mental health and should never have been necessary. Mom got numerous erroneous bills and had a panic attack over the weekend. Took one phone call and a computer check and determined between the billing and receipt of the bad notices, it had been resolved. Even the customer service person said he wished they did not send these bills out so fast. Numerous errors.

LDAHL

3-24-17, 3:26pm

Health care should not be run on the capitalistic free market system. It is too critical to everyone.

Would that same logic apply to food, housing and energy?

Teacher Terry

3-24-17, 3:29pm

Many European countries have universal healthcare and they spend less then we do and have better outcomes. There is no reason we can't follow their model.

Lainey

3-24-17, 3:50pm

Many European countries have universal healthcare and they spend less then we do and have better outcomes. There is no reason we can't follow their model.
+1
Needs to continue to be repeated.

sweetana3

3-24-17, 4:06pm

There are many options and competition in food and housing. Energy is a special case. We have transparency in prices. You don't like the price of apples at X store, go to Y store. Or change to oranges or fruit juice. If you dont like the gas prices at station X, try station Y. However, they generally track the cost of oil. There are choices of vehicle, sharing/car pooling, using public transport if available, etc. Prices are generally very transparent. Even taxis are regulated as far as price is concerned.

Housing comes in all forms. Rent is pretty transparent. If it is too much, get a roommate or become a roommate. Buy or rent. Yes, we are struggling with homelessness and those issues in cities. Some homelessness due to choice and some due to disaster. It is being worked on but the prices are transparent.

Our energy (electric, gas, propane, etc.)is a controlled system with much governmental regulation. In Europe, there is much more competition and consumers can often change from one provider to another. Prices here are very transparent.

What choice do you have when cancer, ALS, stroke, heart attack presents itself? What competition is available in the marketplace? Do you have the time or health to search out what other choices are available? Do you have the money to pay or deposit up front? Do you do what people did in the past and just not seek out what you cannot afford? In other words, die of treatable conditions? What choices have consumers been given in the drug marketplace in the last few years when very necessary drugs are marked up for profit hundreds of percent? Dont take the drug, try and find an alternative (often none or different medically), suck it up and pay whatever they charge? Natural gas is controlled more than drugs.

I have an issue with many people who say "I dont want to ..........." because I dont like............" I dont want to live with a roommate because I like my own place. I dont want to share a ride because I like my privacy, I dont want to eat what I can afford because I want to eat out or eat all organic......................... I dont want to pay for health insurance because I know I wont need it and I have other things to spend my money on.

But then they will argue that government programs should provide all available options to them for free because "I dont want..........".