I Hate Dialysis Message Board
Off-Topic => Political Debates - Thick Skin Required for Entry => Topic started by: Bill Peckham on February 27, 2017, 12:44:25 PM
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"Nobody knew that health care could be so complicated," Trump said. "And statutorily and for budget purposes, as you know, we have to do health care before we do the tax cut."
http://www.usatoday.com/story/news/politics/2017/02/27/donald-trump/98470506/
I would guess that there are probably two adults in the United States who did not know that organizing a national health care system is complicated. One, apparently, is the President; I can't even guess who the other person might be ...
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Probably Pence.
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President Obama.
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President Obama.
uh Wut?
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Sorry, I wasn't very clear. I meant to say that President Obama probably didn't know, at first, how complicated PASSING the ACA would be.
My fear is that Rand Paul's bill might get serious consideration. His plan assures coverage for pre-existing conditions in people with "continuous health care coverage". So, if you have CKD that was covered by your employer provided plan, should you lose your job but then get another one, technically you do not have "continuous coverage", so that would me that you'd be without insurance for your pre-existing condition. At least, that's how I read it. If I'm wrong, PLEASE tell me!!
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If you want to keep your doctor... you can keep your doctor.... If you like your insurance you can keep your insurance....
Yeah... Nobody.
At least Trump is honest and transparent. Knowing this he will give it his BEST to do it. Not hide like Obama did.
If you are honest to yourself you KNOW that people who are not sick.... do not know how complicated Health Care is.
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If you want to keep your doctor... you can keep your doctor.... If you like your insurance you can keep your insurance....
Yeah... Nobody.
At least Trump is honest and transparent. Knowing this he will give it his BEST to do it. Not hide like Obama did.
If you are honest to yourself you KNOW that people who are not sick.... do not know how complicated Health Care is.
It's not Trump that worries me (at least, not for the moment), rather, it's Congress. They seem to have absolutely no idea what to do.
You don't have to be sick to know how complicated health care is. Out of the 500-odd Congresspeople, surely enough of them have either been ill themselves or have had family members and/or friends who have had a chronic illness.
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You don't KNOW unless it is YOU or a 1 step away loved one. My inlaws had NO idea about dialysis. Not until his kidneys failed. Then the light bulb went on. Amazing how that works.
Most people know our health system is screwed up, but they don't get the bills and the outrageous EOB's or the long waits in the ER or doctor's office or the weeks waiting for an appt.
MM oh how easily we forget....
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You don't KNOW unless it is YOU or a 1 step away loved one. My inlaws had NO idea about dialysis. Not until his kidneys failed. Then the light bulb went on. Amazing how that works.
Most people know our health system is screwed up, but they don't get the bills and the outrageous EOB's or the long waits in the ER or doctor's office or the weeks waiting for an appt.
MM oh how easily we forget....
I agree, and I haven't forgotten!
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The problem with the ACA is that what Obama asked for is not what the Senate wanted and by the time all the Senators Requests were added the ACA needed surgery. Then the republican hatred began and rather then fix the ACA they tried to kill,it. If three Republican Senators oppose the repeal and replace bill then they need the democrats to pass it. Even if the republicans have enough votes to pass they don't have enough votes to stop a democratic filibuster.
As far as a pivitol moment this one is interesting the democratic senators will demand cosessions from the republicans and any consesions will probably drive conservative. Republican senators to oppose right now with every republican senator voting for it you will need. A democrat to vote cloture.more democrats more consessions more conservative senators probably drop out.
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I hope we are in a stalemate and it goes on as-is. I really worry they might vote for the repeal first and thing things will collapse on the "fix" and that will lead to death panels and the like.
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The only thing that I would think would cover you would be COBRA. The premiums would be outrageous though. If you didn't take COBRA between jobs, that's where I think you would fall out of coverage.
Sorry, I wasn't very clear. I meant to say that President Obama probably didn't know, at first, how complicated PASSING the ACA would be.
My fear is that Rand Paul's bill might get serious consideration. His plan assures coverage for pre-existing conditions in people with "continuous health care coverage". So, if you have CKD that was covered by your employer provided plan, should you lose your job but then get another one, technically you do not have "continuous coverage", so that would me that you'd be without insurance for your pre-existing condition. At least, that's how I read it. If I'm wrong, PLEASE tell me!!
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Avoiding unintended consequences is tricky, but the goal is to prevent people from waiting until they are certain of filing a significant claim to buy health insurance.
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I think health insurance should be mandatory just like car insurance is. From what l got from the new Trump insurance plan, people with pree-existing conditions will have insurance available to them , but they don't say how much it will cost. !! Available is not the same thing as affordable. Example. There are $40,000 new SUVs available for me to buy, but on my income it's not affordable !
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The preexisting trap meant that even if you had cobra your new employer may or may not cover you as a new hire. Over the years I have had several friends trapped in a job because of family members who would loose coverage if he or she changed jobs. Layoffs could be a death sentence under preexisting conditions.
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Have you noticed how @Bill Peckham is quite the rubble rouser, posting political threads and then letting others fight it out?
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Yep but he does pick good ones. He just lights the fuse and runs like well he does start interesting threads.
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heh
To be fair IHD was down for the weekend. I actually feel better that there is no way this Congress and Administration will be able to figure this out and actually pass healthcare legislation. It is turning into farce - no one is allowed to see the proposal, no legislative guidance forthcoming from the administration - it's all bluster about an imaginary plan that will cost less, cover more people and provide better care. I find it hard to imagine what republicans involved think is going to happen.
In the absence of healthcare legislation they can't move forward on the budget which has a deadline coming up next month. The administration isn't even staffed up - they haven't even put forward names for over 500 positions subject to Senate confirmation. If it was January they would be behind where they need to be, as it is they are too busy to putting out fires to catch up.
Everything Trump hopes to do is complicated, it doesn't get easier after healthcare. Trump's idea of governing seems to be signing executive orders but that isn't how it works. Hard to see how this ends up as anything other than abject failure. SAD
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Hard to see how this ends up as anything other than abject failure. SAD
I'm hoping from full scale gridlock!
I'd feel much safer if nothing changes, and I have Medicare plus employee insurance and a working wife who hopefully will retire with access to health insurance. Having had a per-existing condition all my life I really hope to not loose the protections added via the ACH.
And at this point in my life I understand most everyone gets sick and our tax dollars end up covering people who choose to not hold insurance, so for that reason I see no reason to not force them to have insurance or pay extra into the tax system that will bail them out.
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The Medicaid piece of the ACA is where I expect the clearest division in the republican ranks because the republican line on Medicaid doesn't hold up once it leaves the republican worldview bubble. Medicaid may have its problems but it is better than the alternatives, morally and fiscally.
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And at this point in my life I understand most everyone gets sick and our tax dollars end up covering people who choose to not hold insurance, so for that reason I see no reason to not force them to have insurance or pay extra into the tax system that will bail them out.
They should be allowed to opt-out, with "opt out" meaning no provider will be required, under any circumstances whatsoever, to provide care without proof of payment prior to rendering such care. Everyone can live with the consequence of "government will make the ER treat me", but some have a problem with being told to pay something into the system. Fine, let those people sit it out ... completely.
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The ER can't turn away children. That is heartless. But, what to do?
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Strange, but when Mr.Obama was in office, we did not get to see anything in the ACA. Remember Nancy Pelosi's famous statement. We have to pass the bill so we can get to read it??? And no one complained, except of course those dumb Republicans. And NOW, it is just shameful that President Trump appears to be moving in the same way, people are shocked!!! Just amazing.
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Strange, but when Mr.Obama was in office, we did not get to see anything in the ACA ...
LOL the the fourteen month long gauntlet (http://www.reuters.com/article/us-usa-healthcare-timeline-idUSTRE62L0JA20100322) that the ACA went through is just like the process the House is planning to wrap up by April 1 - so long as you convert months into Congressional work days. But to be fair I think that each day of the Trump administration does feel like a month.
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Then it is going to be a LONG 8 years for you.
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I'm hoping it's a long 4 years, and in 2018 there will be mid term elections. The senate will probably stay republican side 23 democratic senators are UP for reelection and Orly 8 republikano, but iFM things continue the House may be UP for grabs. The aca Now has a approval rating OF 60 percent. Finally iFM Trump was picker UP ON a wire tap may guess IT was him talking to a Russian diplomat since the US must have FISA taps on the Russians.
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:rofl;
Both accusations are unsubstantiated.
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No they need to be investigated, when the leaked information about contact with the Russian oligarchs was released Trump screamed that the leakers should be prosecuted, the leaked information must be true cause you can't make a roumor top secret. Finally his last set of inane tweets about being wire tapped, what that seems to be is Trump may have been on a call to a Russian who was legally tapped, and he is worried about the content of that call being released.
It's time for a independent prosecutor to take over this morass and get to the bottom off these allegations.
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The House Energy and Commerce bill (PDF (https://drive.google.com/file/d/0B4rblq-fxqLacTVmTmtWbV9wVjg/view)) and the House Ways and Means bill (PDF (https://drive.google.com/file/d/0Bzgzy2KXyxqtTFFSTWxhRHBMRmc/view)) came out tonight. I skimmed them, did a few ctrl F: (the word "patient" is only used outside of section headings once, a reference to 'uninsured patients'; "research" not mentioned outside a section heading; nothing about "outcomes"), read the early analysis. In general the bills shift risk from the government to the taxpayer and shift costs from younger/healthier to the older/sicker. I don't think either bill will be the core of what goes forward, it will have to come out of the Senate and then they can hammer something out in conference. At some point there will have to be a reckoning - the bill that would pass the House will not pass the Senate/ the bill that would pass the Senate will not pass the House.
I will say there is one surprise in the Commerce bill, it's an issue that apparently until now politicians have been too scared to address. On pages 10 to 15 the proposed legislation goes into granular detail regarding the Medicaid eligibility of lottery winners. No really. 9% of the legislation that is meant to improve the efficiency and effectiveness of the US healthcare system is concerned with how many months lottery winners are barred from receiving Medicaid benefits (it varies based on the amount of the winnings). whew - that was what needed fixing, lottery winners using Medicaid. Lives in the balance, trillions of dollars in play and they're concerning themselves with an issue that can only amount to a rounding error. To budget dust. How many people win the lottery and are on Medicaid? Dozens? At 7 or 8 thousand dollars cost/person, imagine if there were a hundred such bamboozlers, it would amount to almost 80% of million dollars every year.
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Well, Bill, everything should be OK because Trump promised us that there would be so much winning that we would eventually beg him not to let us win so much.
So, with that campaign promise in mind, there will be so much winning regarding Medicare that we needn't worry.
I am grateful for that because we are all going to need a lot of health care soon because this President is exhausting. OMG, the tweets, the heinous accusations based on the foamings of some right-wing radio extremist, the anxiety inducing statements and the just plain weirdness is starting to get to us all.
Not to mention that this man is a perv.
Trump is never going to read any sort of health care legislation. He does not see such a thing as his job. He will spend all of his time spewing nonsense punctuated by the occasional telepromptered speech that somehow makes him look "presidential", like that is something hard for him to do. He gets roundly applauded when he manages to "look presidential".
The people who are going to be hurt by Paul Ryan's health care ego trip are the very people who voted for Trump, many of whom need federal programs like Medicaid. Those people's Senators are going to be busy...and worried.
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Here are a couple of links to articles that outline a bit of the big picture.
http://www.foxnews.com/politics/2017/03/06/highlights-house-gops-obamacare-replacement-bill.html
https://www.theguardian.com/us-news/2017/mar/07/obamacare-lite-republicans-bill-to-replace-affordable-care-act-explained
http://www.politico.com/story/2017/03/obamacare-repeal-concession-gop-leadership-235723
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Not to mention that this man is a perv.
"Perv" implied abnormal sexual desires (of course, in today's political climate there is no such thing except when it comes to pedophilia). I think "boor" or "cad" would be more appropriately descriptive.
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What is exhausting is the links to Trump with Russia. Ok, where is the evidence? I think Trump just threw out the wiretapping because it was just as ridiculous. LOL Love Him
Here is your crazy Nancy Peloci. She didn't even read the ACA and obviously didn't read the Trump Care Act.
What an Idiot: http://www.cbsnews.com/news/nancy-pelosi-blasts-house-gop-health-plan-discusses-wiretapping-claim/
Why was it NO BIG DEAL when Obama told the Russians "When the election is over I can be more flexible" ?? No investigation No allegations No News time.
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Here is your crazy Nancy Peloci. She didn't even read the ACA and obviously didn't read the Trump Care Act.
What an Idiot: http://www.cbsnews.com/news/nancy-pelosi-blasts-house-gop-health-plan-discusses-wiretapping-claim/ (http://www.cbsnews.com/news/nancy-pelosi-blasts-house-gop-health-plan-discusses-wiretapping-claim/)
Please tell me what she said that is incorrect.
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What is exhausting is the links to Trump with Russia. Ok, where is the evidence? I think Trump just threw out the wiretapping because it was just as ridiculous. LOL Love Him
If the evidence is there, it will be found. The difficulty will be in releasing "the evidence" because it may compromise National Security. But we already know that the Trump family has extensive financial ties to Russia, and we know that because one of his sons has already said so. The "evidence" of the extent of Trump's ties may well lie in his tax returns, so we should look there. Oh, wait a minute...
Why was it NO BIG DEAL when Obama told the Russians "When the election is over I can be more flexible" ?? No investigation No allegations No News time.
Well, if you remember, the GOP made quite a big deal over it.
Why would there be an investigation? What was illegal about what he said? The difference between this statement and possible Trump administration links to Russia are:
1. Obama was already President. Donald Trump was not.
2. Obama did not have any financial ties to Russia. We know this because we've all seen his tax returns.
3. We knew exactly what Obama said. He didn't go around denying it or lying to Congress. He also didn't try to divert anyone's attention by yelling that a meteor was headed toward Earth and that it would be a disaster because our military had been decimated and that our generals were crap.
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http://www.cnbc.com/2017/03/07/health-insurers-billion-dollar-windfall-gop-obamacare-replacement.html
Speaking of insurers, I was listening to a talk radio station this morning, and of course the topic was the new replacement bill. A woman called in who, when she was 64, had BCBS of Michigan. She was diabetic, and she had just been diagnosed with liver disease and needed a transplant. BCBS declared they wouldn't pay for it because she was diabetic (I am not sure exactly what this had to do with BCBS's denial). The day she turned 65 and was eligible for Medicare, she contacted UW-Madison and was told that yes, she could get a transplant now that she had Medicare.
There's a death panel for ya, yet still the insurance industry will make out like bandits.
It will be interesting/terrifying to see what the final form of this bill will be.
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I watched the Press availability that Price and Spicer gave this morning. Both Spicer and Price said that Obamacare may have given people insurance cards but that is not the same as getting healthcare. They both said that one of the problems with the Medicaid expansion is that people have a Medicaid card but if no one accepts Medicaid you don't really have insurance.
Here is my thinking as I listened to them: Really ?! That's the problem? we need to replace the ACA because people on Medicaid can't get into see a health provider. umm Ok I'll bite ... then what is the solution? Take away the Medicaid card. hahaha you almost had me, I thought you were being serious for a minute.
The Trump plan increases healthcare costs for those who are: poor, elderly, and/or rural. It increases financial risk to those who are: poor, elderly, and/or rural. It won't get through the House let alone the Senate
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Not to mention that this man is a perv.
"Perv" implied abnormal sexual desires (of course, in today's political climate there is no such thing except when it comes to pedophilia). I think "boor" or "cad" would be more appropriately descriptive.
OK. How about just "gross old orange guy"? I can't see anyone in 2017 America using "boor" or "cad'.
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As of right now trump is three votes shy of the votes needed to pass Trump care. Four republican senators have said they will vote against. The four are from states with enhanced Medicaid under the ACA.
Republican Sens. Rob Portman (Ohio), Shelley Moore Capito (West Virginia), Cory Gardner (Colorado), and Lisa Murkowski (Alaska) sent a letter to Senate Majority Leader Mitch McConnell on Monday voicing their concerns. "While we support efforts to repeal and replace the Affordable Care Act and make structural reforms to the Medicaid program," the letter says, "we are concerned that the February 10th draft proposal from the House of Representatives does not provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states."
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Hey, did any of you notice that should this bill pass, one of the "winners" would be the tanning industry (not as in the tanning of animal skins, rather, as in the self-tanning of Trump skin)? See? What did I tell you???? :rofl;
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Rand Paul ain't gonna go for it, either.
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Outside of the White House and Congressional leadership - is there anyone who is in favor of the Republican bills? Serious question ... any group or healthcare policy advocate?
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There is enough evidence to initiate a formal investigation with a independent prosecutor. The trump campaign, Flynn, and Trump all denied that there was contact between his campaign and the Russians. During the campaign the Russian hacked the DNC, another and turned over the emails to wiki leaks. Then we hear that despite vehement denials almost every senior member had contacted the Russians. We have a right to know if the Trump campaign influenced the Russians to hack and release information about Clinton. There is enough evidence to begin a formal investigation with subpoena power and a grand jury to compel testimony with the threat of perjury if someone lies. Wake up and smell the possible traitors what was the contact with the Russians about, what was promised and if the trump organization asked the Russians for help. Failing to do this would be as bad as writing watergate off as a college initiation prank.
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Failing to do this would be as bad as writing watergate off as a college initiation prank.
Or ignoring the "pay to play" aspect of the Clinton Foundation as something not worth a criminal investigation, particularly with respect to access granted to big donors as well as the Uranium One deal.
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For 8 years during the Obama years I had to listen to every right wing nut claim Obama was a Moslem, or he was born in Kenya. Now a republican wins and we are all suppose to ignore the real contacts his entire campaign staff had with a foreign power that was messing with a American election and contacting the opposition party and we should ignore this. Like hell , it's watergate all over with the nixion appoligists all denying the entire sordid mess. Now the trupets defend the undefendable. Yes there is no prof but there is enough probable cause to start a investigation of trump and his trumpets during the election.
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CIA is watching through Televisions with the audio on and making it look like someone else is doing it. I think all roads are futile. Not sure you can catch anyone doing it because it will actually be someone else. If they are watching ME they will be bored out of their skull.
My Aunt said "What black likes Trump" I said Ben Carson.... she said "well, He is a republican"..... :rofl; Yet I'm a racist.... LOL
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https://www.congress.gov/bill/115th-congress/house-bill/1275/text (https://www.congress.gov/bill/115th-congress/house-bill/1275/text)
The bill was introduced today as :
H.R.1275 - World's Greatest Healthcare Plan of 2017
At what point does embarrassment overcome rank partisanship?
Sorry it was too good to check out - this is a different bill
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H.R.1275 - World's Greatest Healthcare Plan of 2017[/size]
LOL!!!! So I guess this means that it won't be the "World's Greatest Healthcare Plan" in 2018 and beyond?
One of the many problems with Trump is that no one has a sense of what he believes in (except for making money) or what he really cares about (except for making money).
But he did make this promise to us:
http://www.cbsnews.com/news/donald-trump-promises-health-insurance-for-everybody/
This is different from what the GOP is saying. They are saying that we will all get "access" to care. "Access" is different from "insurance". "Insurance" is the mechanism by which everyone can PAY for their health care. I have "access" to a Ferrari; all I have to do is walk into a showroom, but that doesn't mean I can pay for it.
So we much be careful when we go to interpret what Congress votes on. We need to make sure that they give the President what he promised us, which is legislation that ensures that EVERYONE will have HEALTH INSURANCE.
I really do hope that Mr. Trump will fulfill this promise.
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What they got right: Don't bury the subsidy for people who will be allowed to buy at below market rates on a few people, take it from general revenue. The big problem with Obama care is the "youth surcharge" resulting in people not wanting to buy something that is, by design, a "bad deal" for them and putting this de-facto surcharge only on pool patients.
What is scary is block granting Medicaid to the states. This is just lobbing the grenade out of the federal bunker and into the state one before it explodes.
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How is this affordable to a 30 year old with student loans and working in a new business who doesn't provide benefits.
$300 a month premium with a $10,000 deductible ?? My friend's son has this. Good thing he is healthy. He wouldn't go skiing the other day because he didn't want to get hurt. Couldn't afford to get hurt.
I will let you know how this will change for him when he gets Trump Care.
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How is this affordable to a 30 year old with student loans and working in a new business who doesn't provide benefits.
$300 a month premium with a $10,000 deductible ?? My friend's son has this. Good thing he is healthy. He wouldn't go skiing the other day because he didn't want to get hurt. Couldn't afford to get hurt.
I will let you know how this will change for him when he gets Trump Care.
Would you prefer there to be an out of pocket maximum? Say $7,150/year? That is what it would be under Trump Care ... the reason being that is what it is now (https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/) and the proposed legislation does not change it. Your 'friend's son' should get some help with his insurance, he more than likely qualifies for subsidies that would allow him to choose a plan with lower copays. And with the money he saves he would be able to go skiing every weekend. Tell him to Google "Health Insurance Broker" for information instead of trusting Facebook posts.
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Now that TrumpKare has been voted in overnight while most of America was asleep, what I want to know is, what's the point of me saving $$ for retirement? If healthcare is going to become my complete and total responsibility, and I have a prohibitively expensive medical condition, then what's the point of saving for retirement when I'm not going to be able to afford to keep myself alive long enough to use it? I'm 43, working FT at a telecom co in a union-protected position. However, from what I understand, TrumpKare is going to take away tax incentives for employers to provide insurance. We all know that big corporations only really care about the bottom line, and not about the welfare of their employees. So tell me, what's the point???
Thank you, Republican Congress and Senate for helping to lower the life expectancy in these United States of America. An even bigger thank you to the people who voted these vile people to office.
KarenInWA
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Now that TrumpKare has been voted in overnight while most of America was asleep, what I want to know is, what's the point of me saving $$ for retirement? If healthcare is going to become my complete and total responsibility, and I have a prohibitively expensive medical condition, then what's the point of saving for retirement when I'm not going to be able to afford to keep myself alive long enough to use it? I'm 43, working FT at a telecom co in a union-protected position. However, from what I understand, TrumpKare is going to take away tax incentives for employers to provide insurance. We all know that big corporations only really care about the bottom line, and not about the welfare of their employees. So tell me, what's the point???
Thank you, Republican Congress and Senate for helping to lower the life expectancy in these United States of America. An even bigger thank you to the people who voted these vile people to office.
KarenInWA
I hope that long term those of us with ok jobs will come out ok, but we better start planning on spending about $20,000/year ($12k premiums and $8k copay) for healthcare as we age, and much more if you don't have access to a retirement insurance scheme (thankfully my wife works for the federal government and should have access to insurance in retirement) - the market rate has to keep sky rocking on public insurance pools if only non healthy people sign up.
I worry mostly for lower income folks and children in those families. If people can no afford Obama Care with subsidies and the like how can they afford insurance without subsidies. Medical savings accounts will not help the lower income folks. The half of our population with less than $1,000 in savings will not all the sudden start saving money in a Medical savings account.
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So you guys were FINE with Obamacare? Really? How do you know. Most if not all of us are covered by Medicare. I don't even see a bill. I see the EOB which makes me crazy.
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No one likes this bill, so I am hopeful that it won't even pass and get to Trump's desk.
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So you guys were FINE with Obamacare? Really? How do you know. Most if not all of us are covered by Medicare. I don't even see a bill. I see the EOB which makes me crazy.
See Karen's post.
Have you read the new bill? What do you like about it?
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This new bill if passed will cut the solvency date of medicare substantially. It will also get rid of the reforms that are closing the donut hole in medicare D. Additionally it will increase the age band rating from 3:1 to 5:1 for those of advanced age 50 - 64 that are in the individual market for insurance. At the same time it will give the wealthiest Americans and certain special interest groups a significant tax break. The reduced solvency of medicare plays into Ryan's hand of having to do reforms on medicare like his voucher program which ultimately shifts more financial responsibility to the elderly and disabled on medicare. The ACA certainly has flaws that can be made better. This bill is horrible for everyone who is not young, healthy or wealthy.
Here is the AARP's take on it for what it is worth.
http://www.aarp.org/politics-society/advocacy/info-2017/aarp-opposes-healthcare-bill.html?intcmp=AE-HP-FLXSLDR-SLIDE2
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Don't panic yet this bill has to clear the house and senate, Ryan ha enough power to push this through the house but the senate is another manner. The republican majority in the senate is 2, ties would be broke by pence, 4 republican senators have announced opposition to this bill at this point this bill looses. Even if the republicans try to make this a budget reconciliation bill to avoid filibuster the courts would step in since that would push the bill out of compliance.
Finally if this bill by some miracle passes in less tha 2 years the midterm elections arrive and the people will get to judge the morons who pushed this bill.
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President Trump is at least OPEN to negotiations. He is willing to get it right. Let's come together and get it right this time. They still are not looking ath truth in billing. As long as hospitals and DaVita lie about their costs then we will get nowhere.
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President Trump is at least OPEN to negotiations. He is willing to get it right. Let's come together and get it right this time. They still are not looking ath truth in billing. As long as hospitals and DaVita lie about their costs then we will get nowhere.
I agree with this. But there are two problems.
1. Trump promised to repeal and replace Obamacare just as the Paul Ryan acolytes have been promising for years. That means that they have to work from scratch, and THAT means that whatever they come up with, they own. I don't understand why there is such a rush to do this. It's spooking everyone.
2. I can't be sure that Trump has fully read and digested this new plan. He is selling it without seemingly having given it a great amount of thought. He has the attention span of a gnat with ADD, and I don't think he cares enough to make sure that we all have affordable insurance, which is NOT what Ryancare looks to provide. I'll just have to wait and see what actually lands on his desk.
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Well, in defense of Trump, Day one the media was asking When the new repeal replace plan was coming. Every damn day it was harp harp and NOW that they threw something out there they (you) are mad that it is not perfect. It is not Trump's fault that the Republicans weren't working on it for six years.
You can't replace it because you are using tools such as health care, insurance, prices, doctors.... That is like trying to replace the Mississippi River. They can make it better. If you worry about who is "taking credit" you will get nowhere. Something needed to be done. Obama gave it a try but he should have been open to negations. He should have been working on it for the last six years. The 2 good things were no pre-existing conditions and keeping you kid on your insurance until they are 56 or 26... And Trump is keeping that. I've heard people screaming about that.... OMG he can't win.
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Trump campaigned on the promise that he would have the ACA repealed from Day One and would get big cheers from his supporters, so naturally the media would ask him about it.
But you're right in that it is not Trump's fault that the GOP has not been working on this for six years. That's Ryan's fault, although today he claimed that this bill has been pretty much ready since June of 2016.
Obama WAS open to negotiations. Fourteen months worth of negotiations, and not only that, but changes were made even AFTER the ACA was put in place (ie changes to the Cadillac tax and the medical devices tax). Obama's problem was that he was trying to be accommodating to too many groups, and that's how the ACA got so messy.
I personally don't care that much about Obama's "legacy" or anyone's "legacy". I don't care who gets "credit".
The people who are screaming about pre-existing conditions and keeping your 25 year old kid on your insurance are conservatives who are concerned about how to pay for that.
This is not Trump's bill. It is Paul Ryan's bill. I hope that if we get a REAL "TrumpCare" bill, it will have all of the things he promised, like affordable insurance for everyone, which is what universal health care is. The conflict will come from all of those entities that make a profit off of sick people. And Trump is, if nothing else, a "businessman", a man who holds profit as the most laudable goal.
The enduring question is how to provide affordable (and how is that defined? Who gets to decide what is "affordable"?) health insurance to everyone while at the same time ensure that insurance companies, hospitals, doctors, et al earn an "adequate" profit?
There is no country on earth that has been able to provide health insurance based ONLY on free market principles because people do not get sick by choice.
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Once you agree people should be covered even if they have preexisting conditions then you have to have the rest.
The problem is that the public positions the Republicans took for the last 8 years do not match their policy ideas. If you want to lower deductibles or the monthly cost of insurance it is an easy matter of increasing the subsidies and/or motivating more (healthy) people to buy insurance. The republicans have zero interest in doing either so there was never a chance they would actually lower costs or deductibles. At some point Trump supporters will have to accept the fact that they have been bamboozled. Trump supporters you have been used.
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Yes Trump is a great negotiator just ask the Russians.
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They are already trashing the CBO before the bill has even been scored. Its like they know the results will be bad so they got to throw out doubts about the CBO.
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http://talkingpointsmemo.com/dc/gop-health-care-bill-repeal-medicare-tax-funding-crisis (http://talkingpointsmemo.com/dc/gop-health-care-bill-repeal-medicare-tax-funding-crisis)
Do not think being on Medicare is going to provide you with a safe harbor - the bill in the House will:
"By repealing a payroll tax on high earners that provided a critical additional revenue stream for the Medicare trust fund, the GOP's proposed American Health Care Act would speed up the fund’s exhaustion by as many as three to four years, according to estimates from health care policy experts."
Before the ACA passed the Medicare trust fund was expected to go into the red in 2016. The ACA pushed that date out to 2028. Trumpcare reverses those gains.
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That fits in perfectly into Ryan's narrative that reforms to medicare need to be considered along with his repeal and replace of ACA. This was part of his Better Way agenda to convert medicare into a voucher program that shifts costs to beneficiaries. Create a crisis then claim I told you so. He even went as far as to claim that the ACA caused solvency problems for medicare when in fact the opposite is the truth. If they pass this bill a lot of people will be royally screwed. The scary thing is the right wing of the party wants to take the screwing to the next level. I hope the gap between the far right and the centrists in the GOP causes this bill to fail. For those that support Trump, I urge you to google up some videos of what he promised on healthcare and compare it to what you see in this plan that he is now advocating for. Its night and day difference. This bill totally shafts the poor, the elderly and those with bad health issues while giving a big tax cut to the wealthy and certain special interest groups. The really crazy thing is this bill screws many that voted for him and rewards many that did not.
Bill you seem to feel it will never pass. Is that because of the split between the right and the center of the party?
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Am I the only one who thinks that part of the premise of the whole "Make America Great Again" is to lower overall life-expectancy of Americans? We already trail behind our Western peers in this category. Do we want to be #1 in Lowest Life Expectancy of Western Nations and celebrate that?
And yes, I do believe that the ACA needs a lot of work to make costs more fair across the board. What we really need is to take profit and the middle man out of our healthcare. Insane profit at least. Profit for innovation and bettering health is always good, but profit for more sick care is not.
KarenInWA
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Good summary of what this plan does compared to what was promised.
http://www.vox.com/policy-and-politics/2017/3/10/14881200/trump-health-care-promises
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Well, should we just keep people alive forever on machines no matter the cost? Originally, you had to qualify for a dialysis machine. Not a bad idea. Is this country going to go broke keeping everyone alive? Sucking our young people dry? All the healthy immigrants and Refugees who have immune systems of steel can all come in and work and pay taxes to keep us FAT, SICK Americans Alive? Maybe that is the Left's plan.
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Well, should we just keep people alive forever on machines no matter the cost? Originally, you had to qualify for a dialysis machine. Not a bad idea. Is this country going to go broke keeping everyone alive? Sucking our young people dry? All the healthy immigrants and Refugees who have immune systems of steel can all come in and work and pay taxes to keep us FAT, SICK Americans Alive? Maybe that is the Left's plan.
Wow, Rerun, that is a very cold and hateful post you just wrote. Me personally, i have never been overweight. When I was diagnosed with stupid kidneys, I was 23, 5'8" and weighed no more than 130 lbs. I personally don't advocate keeping those who are barely living life in a bed and not able to get out of bed on their own, but then again, I'm not the one who is making those decisions. I certainly don't advocate for death for those who are sick, but still able to have a quality of life, like many dialysis patients are, as well as chronic cancer patients and a whole list of other maladies that humans experience but I don't have the time to list. So are you saying we should do a total "Survival of the Fittest" and if you can't survive with out the help of medication/treatment and/or medical professionals, then lets put you on an island until you die a natural death? Seriously???
KarenInWA
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Well, should we just keep people alive forever on machines no matter the cost? Originally, you had to qualify for a dialysis machine. Not a bad idea. Is this country going to go broke keeping everyone alive? Sucking our young people dry? All the healthy immigrants and Refugees who have immune systems of steel can all come in and work and pay taxes to keep us FAT, SICK Americans Alive? Maybe that is the Left's plan.
No, we shouldn't keep people alive forever on machines, not just on dialysis machines but on all of the other machines that keep alive those people who are in a vegetative state. No one is forcing you to stay on dialysis. But there ARE legislators who are forcing to keep alive those people who are so ill and whose quality of life is so poor that they are seeking euthanasia.
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Bill you seem to feel it will never pass. Is that because of the split between the right and the center of the party?
I've been wrong more than I've been right about these sorts of things but in general I think that the only voters who can push back on Trump are the people who voted for him. This is going to create push back from his voters. This plan is so profoundly against the interests of the people who voted for him I think Trump will be quick to fold and blame the failure on everyone but himself. So long as his voters were willing to close their minds to the corrosive effect of his lying (what happens now when there is an actual crises? How much worse will it be because the administration has no credibility?) and not hold him to account for his promises (how many times was this healthcare plan going to be released in a week? or next month?) Trump could claim success because the right people were upset. Now it is real. It will make your life much harder if you are poor, rural and/or 40 to 67, it's not going to be enough that Nancy Pelosi is against it.
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I've been wrong more than I've been right about these sorts of things but in general I think that the only voters who can push back on Trump are the people who voted for him.
VP Pence is to travel to Kentucky this weekend to speak more about the new health care bill. I was thinking that the voters there would be given the chance to listen and to show their support for it or their disagreement with it. But no. He is scheduled to speak only to business leaders.
http://www.courier-journal.com/story/news/local/2017/03/10/details-released-vp-mike-pences-louisville-visit/99002942/
Why do you think these are invite-only events?????????
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Well, should we just keep people alive forever on machines no matter the cost? Originally, you had to qualify for a dialysis machine. Not a bad idea. Is this country going to go broke keeping everyone alive? Sucking our young people dry?
Wow! Rerun. Such coldness. Perhaps YOU would like to volunteer to get off YOUR dialysis machine-- for starters. Maybe they should just line up dialysis people before a shooting squad. Easy money!
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Well, should we just keep people alive forever on machines no matter the cost? Originally, you had to qualify for a dialysis machine. Not a bad idea. Is this country going to go broke keeping everyone alive? Sucking our young people dry? All the healthy immigrants and Refugees who have immune systems of steel can all come in and work and pay taxes to keep us FAT, SICK Americans Alive? Maybe that is the Left's plan.
We should give people a choice, including self-termination in the face of horrendous terminal symptoms (think late stage ALS). Part of the cost problem is religious leaders (for example, Papists in MA) fighting laws that would allow the terminally ill an easy out.
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As I have said before , the rich will get richer ,the middle class will become the lower class and the lower class poor and sick people will be dead ! It is showing up in all King Trumps policies , especially the health care ! Just wait until the new tax reform comes out !
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Well, should we just keep people alive forever on machines no matter the cost? Originally, you had to qualify for a dialysis machine. Not a bad idea. Is this country going to go broke keeping everyone alive? Sucking our young people dry?
Wow! Rerun. Such coldness. Perhaps YOU would like to volunteer to get off YOUR dialysis machine-- for starters. Maybe they should just line up dialysis people before a shooting squad. Easy money!
I will quit someday. I pray every night for the Lord to take me. I feel guilty for sucking the system dry. Believe me.
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I recently faced this question. After my recent heart attack I was in the hospital and was unable to walk the 8 feet to the toilet. This was a depressing moment and I was terrorized thinking that this was going to be my life. As depression settled in it suddenly occurred to me that I was a dialysis patient and I could stop going to dialysis if this situation became unbearable. Well one more stent and a 7.5 hour operation later I am slowly getting my life back. My ejection fraction has more then doubled from the dark days and I have started Cardiac Rehab. But the point is that strangely enough when things looked the worst what pulled me through I'd that I had a get out of jail free card. I could stop dialysis. My life was mine to choose. I am glad that it worked out but even happier that I had a doorway out of a impossible situation. The inability to walk was caused by ventricular tachycardia a potentially fatal problem but one it seems I could be treated for.
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Yup, the freedom to stop is indeed great peace. It makes every day a choice.
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It gives me great peace. :bow;
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If anyone is wondering, as I was, what is the deal with 6 pages of the Trumpcare bill dealing with lottery winnings, here is a very detailed explanation (http://www.cbpp.org/research/health/house-medicaid-bill-would-result-in-more-uninsured-low-income-individuals-and) of a bill from the last Congress that seems to be the basis for the lottery winner language in Trumpcare. The language does not just cover lottery winnings, it covers all lump sum payments - legal settlements, inheritance - the lottery piece is a small part of what it would impact. I think the primary reason the lottery piece is in the Trumpcare bill is to pad the length of the legislation they were submitting.
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This also does NOT promote getting a JOB because holly hell you may get kicked off Medicaid if you make money.
How do these people spend their windfall of $10,000. Beer and cigarettes... casino here I come. We can't control that but if they know the gravy train ends for a year or two, maybe they could save it or hey novel idea pay a health care premium.
I worked on the Pigford Vs. Glickman lawsuit https://en.wikipedia.org/wiki/Pigford_v._Glickman where farmers who won got $50,000 cash (tax free) and car sales went thru the roof.
Teach men to fish don't give them fish.
When I sold my house in CA I got a windfall and then uncle sam took a fourth of it. It was sad but I saved for it. Grow up!
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When I sold my house in CA I got a windfall and then uncle sam took a fourth of it. It was sad but I saved for it. Grow up!
I assume this is only because you did not re-invest in another primary residence, or this was a non-primary residence.
It is dismaying to see how people think the govt and banks should recast underwater mortgages, but not give the govt the windfall (privatize profits and socialize losses).
The language does not just cover lottery winnings, it covers all lump sum payments - legal settlements, inheritance - the lottery piece is a small part of what it would impact. I think the primary reason the lottery piece is in the Trumpcare bill is to pad the length of the legislation they were submitting.
Everyone wants bills that hammer the "elses". If you keep the focus in inheritances, many people will think "If I get an inheritance I don't think it should mean the govt stops paying my bills", but if you talk "lottery" most people figure "I will never win, good idea taxing those other people and leaving me alone".
The best form of inheritance is telling junior "Clean the gold out of my safe once I'm dead and don't tell anyone about it". No paperwork; no medicaid spend down issue; no estate taxes; unattachable by creditors; etc.
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The law was changed you can exempt the first 250 thousand and that exemption is good again in two years.
Edited to make goog good.
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The Congressional Budget Office has released their report on the American Health Care Act
https://www.cbo.gov/publication/52486 (https://www.cbo.gov/publication/52486)
"CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under the legislation than under current law. Most of that increase would stem from repealing the penalties associated with the individual mandate. Some of those people would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums.
Later, following additional changes to subsidies for insurance purchased in the nongroup market and to the Medicaid program, the increase in the number of uninsured people relative to the number under current law would rise to 21 million in 2020 and then to 24 million in 2026."
On average premiums are expected to go down overall, but averages are made of extremes:
"Under the legislation, insurers would be allowed to generally charge five times more for older enrollees than younger ones rather than three times more as under current law, substantially reducing premiums for young adults and substantially raising premiums for older people."
"Because of the magnitude of its budgetary effects, this legislation is “major legislation,” as defined in the rules of the House of Representatives. Hence, it triggers the requirement that the cost estimate, to the greatest extent practicable, include the budgetary impact of its macroeconomic effects. However, because of the very short time available to prepare this cost estimate, quantifying and incorporating those macroeconomic effects have not been practicable."
So we still don't have an official expectation of what this will do to health spending overall. Controlling total health spending is a one of the Affordable Care Act's goal, something it has achieved to an extent beyond expectations. Trumpcare reduces Federal healthcare spending but that is certainly at the expense of overall spending, but because of the speed with which this is being pushed through we won't have an idea of what the expectation should be.
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I'm impressed that the CBO has not been politicized to the point that it always produces an opinion favorable to the current administration.
The current re-write is DOA if the administration cannot even pretend it does not create a huge pool of loosers.
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From TPM (http://talkingpointsmemo.com/edblog/--100932):
Donald Trump: "We’re going to have insurance for everybody. There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” Washington Post (https://www.washingtonpost.com/politics/trump-vows-insurance-for-everybody-in-obamacare-replacement-plan/2017/01/15/5f2b1e18-db5d-11e6-ad42-f3375f271c9c_story.html?utm_term=.b0bbd20f5417&wpisrc=al_alert-COMBO-politics%252Bnation) 1/15/17
Donald Trump: "Obamacare has to go. We can't afford it. It's no good. You're going to end up with great healthcare for a fraction of the price. And that's going to take place immediately after we go in. Okay? Immediately. Fast Quick." (CSPAN, Timestamp 34:23 (https://www.c-span.org/video/?405003-1/donald-trump-campaign-rally-las-vegas)) 2/19/16
Donald Trump: "Everybody's got to be covered. This is an un-Republican thing for me to say because a lot of times they say, "No, no, the lower 25 percent that can't afford private. But-- ... I am going to take care of everybody. I don't care if it costs me votes or not. Everybody's going to be taken care of much better than they're taken care of now." - 60 Minutes (http://www.cbsnews.com/news/donald-trump-60-minutes-scott-pelley/), 9/27/15
Donald Trump: "We're gonna come up with a new plan that's going to be better health care for more people at a lesser cost." ABC News (http://abcnews.go.com/Politics/transcript-abc-news-anchor-david-muir-interviews-president/story?id=45047602), 1/25/17
Donald Trump: "There are people who say everybody should have a great, wonderful, private plan, and if you can't afford that, and there is a percentage, a fairly large percentage that can't afford it, then those people don't get taken care of. That's wrong. We're going to take care of that through the Medicaid system. We’re going to take care of those people. We have no choice." Dr. Oz (https://www.washingtonpost.com/news/the-fix/wp/2016/09/15/donald-trumps-visit-with-dr-oz-was-just-as-amazing-as-you-though-it-would-be/?utm_term=.4732892cc795), 9/15/16
Donald Trump: "The new plan is good. It's going to be inexpensive. It's going to be much better for the people at the bottom, people that don't have any money. We're going to take care of them through maybe concepts of Medicare. Now, some people would say, "that's not a very Republican thing to say." That's not single payer, by the way. That's called heart. We gotta take care of people that can't take care of themselves." CNN GOP Townhall (http://www.ontheissues.org/Archive/2016_CNN_GOP_Town_Hall_Health_Care.htm), 2/17-18/16
Donald Trump: "I’m not going to cut Medicare or Medicaid." 5/21/15 (http://dailysignal.com/2015/05/21/why-donald-trump-wont-touch-your-entitlements/). The Daily Signal.
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Looks like Paul Ryan is thrilled with pushing 24 million off of health insurance to save some 330 billion over 10 years in spending. Trump and his staff are bad mouthing the CBO estimates yet their own OMB projections predicted 26 million would become uninsured. Its funny how they accept the CBO projections they like though. I have no idea if this bill can pass but I sure hope it does not as it is written. The example CBO gives of what would happen to premiums of those aged 50 - 64 is down right scary. Thank you dear Lord for Medicare.
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They are just not forcing people to have health care insurance anymore... No mandates and no fines. FREEDOM.
Why would you be pro FORCE anything. What if you were FORCED to get cable TV. So you get it for a few years because otherwise you would get fined. THen Trump gets into office and you are no longer FORCED to get Cable TV. You can buy it if you want to and we will help you but you are no longer will be FORCED to buy Cable TV.
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There is a 30% premium penalty mandate if you have a 63 day or more lapse in coverage so to say no fines is not true. Here is some of Trumps publicly made promises and the CBO response to them:
TRUMP: "We're going to have insurance for everybody. There was a
philosophy in some circles that if you can't pay for it, you don't get
it. That's not going to happen with us." — to The Washington Post, Jan.
15.
CBO: It estimates the bill would leave 14 million fewer people insured in the first year, 24 million fewer by 2026.
TRUMP: People covered under the law "can expect to have great health
care. It will be in a much simplified form. Much less expensive and much
better... lower numbers, much lower deductibles."
CBO: It says
cost-sharing payments in the individual market, including deductibles,
"would tend to be higher than those anticipated under current law."
Cost-sharing subsidies would be repealed in 2020, "significantly
increasing out-of-pocket costs for nongroup (private) insurance for many
lower-income enrollees."
TRUMP, at a Cabinet meeting Monday: "Obamacare, all of a sudden, the
last couple of weeks, is getting a false rep that maybe it's OK. It's
not OK, it's a disaster and people understand that it's failed and it's
imploding. And if we let it go for another year, it'll totally implode."
CBO:
Not in the view of the budget experts. They described the market for
individual policies under Barack Obama's health care law as "stable."
They said it is likely to remain stable under the proposed GOP
replacement legislation, too.
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Well, if you have insurance but have to pay the first $5,000 before you can use it... do you have health coverage?
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Rerun- you are SO brainwashed! It's SAD.
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Well, if you have insurance but have to pay the first $5,000 before you can use it... do you have health coverage?
Yes.
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Rerun- you are SO brainwashed! It's SAD.
Answer my question: If you have health care but have to pay the first $5,000 ...?? Do you really have health care coverage?
I feel sad for/about you too. That is why I keep coming back to get your nasty, demeaning, rude, remarks about me. :guitar:
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Well, if you have insurance but have to pay the first $5,000 before you can use it... do you have health coverage?
Yes.
OK, but you won't use it because maybe you don't have the $5,000. Because you lost it at the Casino. This is all pushing for 1 payer system like Medicare where the Middle Class pays for the poor who mismanage their money.
I think everyone needs basic care. Especially kids up to 18 (IMO) . How come we don't have Trump Dental and Trump Vision?? I just heard that 50% of Americans are "missing" Teeth.
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Why would you be pro FORCE anything.
Are you in favor of FORCING hospitals to provide emergency care to people who cannot prove ability to pay prior to treatment?
What about FORCING an MD not to refuse follow-up care for a patient who is not paying his bills? (ie, patient dismissal)
If the answer is yes, you are in favor of force and the only question is when, and to whom, that force is applied.
It's like the guy at a fancy party who offered a woman to sleep with him. Sure, she said. He said "well, I don't have $1M, how about $50?" and she replied "what kind of woman do you think I am?" to which he responded "we've already established that, we're just negotiating price".
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:rofl; LOL You are correct but I just could not turn away a baby or a puppy who can't pay. Should we have a volunteer hospital where only the really nice people who really Care (Doctors without borders) so people could go there who could not pay?
I know the Union Gospel Mission here has a few doctors who volunteer a couple of times a month to see the homeless.
It makes me mad the people who could have health care but squander their money and expect help. It is the babies and the puppies.
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The answer is if a 5000 dollar deductible makes sense is is the insurance with that deductible 400 a month cheaper than the insurance with no deductible.
The problem is the basic cost structure and payment levels with decreased subsidies drive most people on the ininsured rolls. Last year if I wasn't on Medicare with a great advantage package I would have generated over 900000 in bills. Now since I am on Medicare every thing must be billed under Medicare rates. The other thing they are pushing is to allow patients to be billed for additional money that doctors and hospitals want the patient to pay.
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Should we have a volunteer hospital where only the really nice people who really Care (Doctors without borders) so people could go there who could not pay?
If the docs worked for free, who would pay for the MRI machines, CAT scanners, supplies, drugs (cancer drugs commonly cost thousands per dose), auxillary staff (down to the janitor that cleans the OR), parts (hips, etc.)? My hip job ran something like $40K (insurance negotiated), of which less than $2000 was the surgeon's fee.
The other thing they are pushing is to allow patients to be billed for additional money that doctors and hospitals want the patient to pay.
That would turn it into college style pricing. Examine the finances of every patient and charge the absolute maximum that patient has available for payment.
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The argument using cable tv is bogus because if you won't or can't pay for cable you don't get cable if you don't have health insurance you get crappy care paid for by the taxpayer. You want to force them off the rolls and then pay more money to still pay for their treatment. The only difference is more money ends up in the hospital or doctors pocket.
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I still say the problem is "TRUTH in BILLING" The hospitals and Doctors and Surgeons all LIE about what things cost. They need a Come To Jesus monent and settle the billing gaps so people know what something will cost. Start there.
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Tomorrow is a big vote ... or not. It is still not clear if there are the votes to pass Trumpcare, if the votes aren't there I'd expect Ryan to pull the vote, but there is a lot of horse trading going on. The proposed changes to the bill means if Trumpcare becomes law people in the first 33 months of using dialysis will be paying a lot more for insurance.
The latest reporting (http://www.washingtonexaminer.com/article/2618178) is that in order to get the Freedom Caucus on board the legislation will strip the essential benefits provision from current insurance rules. This would mean, for instance, that one could choose an insurance policy that does not cover maternity care. Obviously men will be safe saving a few bucks by opting for the plan without maternity care. It'll mean women will pay more if they choose coverage that includes pregnancy, maternity and newborn care but that is the point they are free to choose. I am not convinced that is an actual conservative position but that is the logic - everyone can choose inexpensive coverage if they are willing to forgo some essential benefits.
What are the other essential benefits? There is some variation state to state but they all must include (https://www.healthcare.gov/coverage/what-marketplace-plans-cover/):
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (like surgery and overnight stays)
- Pregnancy, maternity, and newborn care (both before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
- Prescription drugs
- Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)
Plans must also include the following benefits:
- Birth control coverage
- Breastfeeding coverage
So if you can imagine yourself being twentysomething and healthy which essential benefits would you do without if it could mean saving $100s of dollars a month? Everyone will make different choices but the point is that #1: Ambulatory patient services, would be a prime option to cut. If you are young and healthy why would you need that? You could just self pay if you sprain an ankle or if needed use #2: Emergency Services. The problem is that leaves people who have to get policies that include outpatient coverage, for instance people who need dialysis, in insurance pools with other people who have to use outpatient medical care and few people who are young and healthy. That will be a much more expensive policy. Even if you get insurance through your employer it could smack you, because your employer will be free to offer options with low or high deductibles / more or less copays with the difference being the insurance policies will cover different things. Again this will cluster people who need certain coverage - whether mental health or dialysis, or god forbid, someone who needs both (but I am sure that never happens) - into insurance with much higher costs.
At least if it gets too bad you could qualify for Medicaid ... oh, wait :( never mind, you'll be screwed if Trumpcare becomes law.
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We in the USA already have a lower life expectancy for those on dialysis, and for the general population overall. Looks like with this new "healthcare" proposal, we as a nation can look forward to even lower life expectancy - and I suspect lower quality of life as well. MAGA baby, MAGA!!!!! :bow;
What I really love is MAGA is against abortion, but also is against maternity/pre-natal care. Because THAT makes sense,!!! ??? :Kit n Stik; :Kit n Stik; :Kit n Stik;
I'm seriously beginning to think that saving for retirement is nothing but a big waste of $$ for me, and I should just spend freely and enjoy my $$ and life while I still can. It's all going down the toilet soon anyway, with this band of clowns in charge.
KarenInWA
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Bill, have you seen any proposed legislation that would address the question of how one would/could add an "essential benefit" to one's plan?
Yes, a man might choose to save some bucks by not buying coverage for pregnancy/maternity, but that same man might get married one day and choose to start a family. So, at what point can he add this coverage, and will there be a big penalty for adding coverage only when you come to find you need it? (This assumes the mother stays home to look after the baby and thus has no income of her own.)
Or maybe he opts out of paying for mental health coverage but is later diagnosed with a mental illness. What chances would he have for then purchasing coverage for that?
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Oh my God. The Freedom Caucus won't vote for TryanCare because it still includes the pre-existing condition provision in it. The Freedom Caucus wants that cut.
Who ARE these people????
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Bill, have you seen any proposed legislation that would address the question of how one would/could add an "essential benefit" to one's plan?
No they'll need to pass the bill for us (and the CBO) to know the details of how it is suppose to work. Their idea for motivating people to keep coverage (as the bill was first written) is to allow insurers to charge a 30% premium on coverage for a year if sign back up after a coverage gap. I think we can all see the problem with this ... to come out ahead financially you'd just need to go four months without coverage, there are so many other problems with Trumpcare that this fundamental flaw does get a lot of attention but anyway, who knows. At this point everything is in play. It's madness.
Oh and one of the tactics I've seen discussed is to give the Senate instructions to fix the bill. I assume the idea is to get something to a House/Senate committee that would hammer out a final bill. Madness.
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To be fair the preexisting condition provision is the reason it is impossible for the Republicans to devise a plan (that could even theoretically work) that can get 216 republican votes in the house. But for that path to make sense you'd have to also eliminate the requirement that hospitals must treat people who show up needing medical care.
The Freedom Caucus knows that they have the White House by the short hairs so they have every incentive to get all they can out of the legislation.
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The billing problem of wacky 3 tier pricing is caused by people's lack of insurance. Medicare generally reflects the actual cost of the procedure. The private bill reflects greater profits for the provider and partially pays for the uninsured. The uninsured rate is set generally 3 times the insured rate. Why so high the providers don't expect to see a dime of the money from the uninsured patient but with the tax code the provider gets a lovely tax deduction so generally they make as much money as they do from private insurers. The problem is uninsured people the hospital can not turn away a emergency and needs to make up the money somehow.
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Bad debt results in losses for for-profit hospitals (https://www.bloomberg.com/news/articles/2016-02-23/bad-debt-is-the-pain-hospitals-can-t-heal-as-patients-don-t-pay), you can't just claim a procedure is worth a million dollars and wipe out your tax liability, not to mention nonprofits use the same three tier pricing. Avoiding taxes can't be their motivation. In dialysis you can see the dynamic clearly - the rate you pay is based on your size in the market.
Medicare is the largest payor (they pay for the dialysis of about 75% of everyone using dialysis), they get the best price and they get to set the terms of care. There is more compulsion than negotiation to get to that price and those terms, but that's saving Medicare a lot of money. If every dialysis treatment had to be billed and paid the same amount, what do you think that price would need to be (what price would keep the same total amount of money funding the provision of dialysis)?
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To be fair the preexisting condition provision is the reason it is impossible for the Republicans to devise a plan (that could even theoretically work) that can get 216 republican votes in the house. But for that path to make sense you'd have to also eliminate the requirement that hospitals must treat people who show up needing medical care.
Exactly. My point is that what the Freedom Caucus wants is even worse than what the current bill would provide, and it boggles the mind that there are people in our government more ruthless than Paul Ryan.
The Freedom Caucus knows that they have the White House by the short hairs so they have every incentive to get all they can out of the legislation.
Again, exactly. The Freedom Caucus having them by the short and curlies is the price Ryan and Trump are paying to get this passed specifically on the 7th anniversary of the ACA.
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http://www.cnbc.com/2017/03/23/americans-strongly-oppose-republican-plan-to-replace-obamacare.html
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I would rather we spend $ on health care for all , than billions on "the wall " . They are coming in on planes ✈️ now anyway. I saw a cartoon where a doctor with Trump head, was pulling a sheet up over a patients head in a hospital bed , he said " Coverage for all !" And he was laughing 😂
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If Trump/RyanCare fails to pass, it's because it isn't cruel enough to satisfy the Republican blood lust.
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Praying that this horrible bill fails in the house today.
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Obama 2009: Vote for the bill because it’s worth losing your seat.
Trump 2017: Vote for the bill or you’ll lose your seat.
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Never mind.
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Never mind.
Buh bye, Paul Ryan. Trump will find you a place under the bus.
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Scary to think that what kept this junk bill from passing the house was extremists that wanted to take it further to the right. I sure hope Dems vote in mass during the 2018 midterms.
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Nope, I was wrong. All seems to be good between Trump and Ryan.
Now maybe we can get some bi-partisan effort to craft improvements to the ACA where needed.
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Thats the only way to get something good done that will be sustainable. In the mean time the ACA lives!
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I personally think we need to totally do away with Obamacare and turn it back to the private sector. Once that's done, install a rule or regulation that insurances have to accept someone with pre-existing condition.
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The fun part to watch this is as the republican leadership gives in to t Freedom Fanatics to gain a vote they loose a moderate. Trump blames the Democrats, I think he should blame his grammar school teachers since he cant seem to count votes. Even if the republican leadership could get past the house a even beggar hurdle lies ahead in the Senate. Watching this is more fun then I could imagine. It like "The Keystone Kops Run the Government ".
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I personally think we need to totally do away with Obamacare and turn it back to the private sector. Once that's done, install a rule or regulation that insurances have to accept someone with pre-existing condition.
Obamacare is private sector. One has to be careful when using guns to make person A to pay for person B, since it is easy to have unintended consequences if not fully thought through. (All taxes and govt mandated payments are ultimately collected at the point of a gun)
If you allow pre-existing conditions, without other regulations, people will "self select" and only buy insurance once they get a condition or perceive themselves at risk. A big problem with the current system is the cost of selling people like us policies at below the free market rate was spread over a small subset of the population (persons buying policies on the exchange) rather than the population at large
But then, taxes get passed by convincing 51% of the people someone else will pay.
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The real problem is the idea you don't need insurance till you are sick. The people who don't get insurance because they ain't sick are not taking too much of a risk, they know that the hospitals have to take them anyway. In some places fire service is a self funding private affair. If you want the local fire service to cover you if your house catches fire you have to be a paid member. When people are reluctant to pay the fee these departments show up at fires of the uncovered make sure every one is safe then watch the house burn to the ground. Unfair no the owner chose to save money and expected the same service as the members who pay every year. If you don't have health insurance when you need it what should be done is since you could have afforded insurance but choose to put the risk on other citizens is the hospital bill you can't pay should not be removable by bankruptcy. But your wages should be garnished till you pay back with interest the cost you have placed on society. Let that happen a few times then see how many try to game the system.
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In some places fire service is a self funding private affair.
I am not aware of any "private fee based FDs", but there was an interesting story about a public sector FD that was in a town near an area that had no coverage, and the town had no taxing authority to collect revenue from those in this area. The solution was a voluntary subscription fee, to the public fire department, for coverage under the terms you described.
is the hospital bill you can't pay should not be removable by bankruptcy.
Just like student loans.
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Actually you can clear student loans by bankruptcy difficult but in the right circumstances doable. If you have a disabity that there is no expectation of a cure you can get the student loans cleared. A family member went to court to clear them, when it looked like the judge was going to discharge the loans sallie Mae offered to settle all tloans for a ridiculous low fee. The reason is they wanted to keep the no bankruptcy roumor going. My guess is any one with ESRD on dialysis could clear the student loans through bankruptcy since it's a permanent disability.
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Nope, I was wrong. All seems to be good between Trump and Ryan.
Nope, I was wrong again.
Ryan just got bus-squished.
http://www.zerohedge.com/news/2017-03-26/trump-endorses-fox-news-host-call-paul-ryan-resign
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He is very motivated by revenge. I wonder what he has in store for the Freedom Caucus? There is a lot of legislation he could pass if he installed a speaker that would bring to a vote in the House legislation that would get 150 D votes 100 R votes ; legislation that would get 40 D and 20 R votes in the Senate.
He has to be infuriated with the Freedom Caucus, they revealed what a crappy negotiator he is - Trump caved on the 10 essential bennefits and didn't get anything in return. Sad.
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Somewhere former speaker boehner must be laughing like hell.
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He is very motivated by revenge. I wonder what he has in store for the Freedom Caucus? There is a lot of legislation he could pass if he installed a speaker that would bring to a vote in the House legislation that would get 150 D votes 100 R votes ; legislation that would get 40 D and 20 R votes in the Senate.
He has to be infuriated with the Freedom Caucus, they revealed what a crappy negotiator he is - Trump caved on the 10 essential bennefits and didn't get anything in return. Sad.
Taking a deep breath here. OK. Maybe the Freedom Caucus is a blessing in disguise. They are so far right that I have a hard time believing that most Americans would be behind any legislation that would meet their exacting standards. So, perhaps this will force Trump to work with Democrats to help him succeed bigly. Before you know it, maybe we will have bipartisanship once again in Congress. Oh, the irony.
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He is very motivated by revenge. I wonder what he has in store for the Freedom Caucus? There is a lot of legislation he could pass if he installed a speaker that would bring to a vote in the House legislation that would get 150 D votes 100 R votes ; legislation that would get 40 D and 20 R votes in the Senate.
He has to be infuriated with the Freedom Caucus, they revealed what a crappy negotiator he is - Trump caved on the 10 essential bennefits and didn't get anything in return. Sad.
Problem is he maybe can influence who the speaker is but it is up to the members of the house to elect the speaker or take down a speaker. Right now it seems no one else would want the job. Can you blame them? I can't believe Trump supported such a lousy bill. It was the exact opposite of what he promised. The fact that he tried to force it through shows what a Con artist he is. Now on to tax reform I guess. Lets see what type of goodies get offered to the rich. I hope Trump supporters are paying attention. Look at his budget proposal too.
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They're just itching to give more tax breaks to the already obscenely rich. Talk about class warfare! Reverse Robin Hoodism.
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Yeah, I agree that Trump's revenge will have to wait, he pulled himself from the game and without the White House involved it will all be theater. The Democrat and Republican positions are so far apart that I'm not sure what a compromise position could be. Right now they are hanging their hopes on the idea that the exchange insurance markets will collapse, and then democrats will negotiate a deal. There is a lot wrong with the strategy but it does indicate the assumption that democrats won't deal, until something happens. Meaning not any time soon.
Next up is the need to raise the debt ceiling in about a month ... where are those votes going to come from?
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The recent lack of response to a house fire in Obion, Tennessee, has created a national fire storm (no pun intended) in the rural area surrounding the city of South Fulton. As cited in numerous newspapers, editorial columns, Web pages, blogs, Tweets, and other sources, we have come to discover that homeowners in the region outside the town limits of South Fulton, Tennessee, have to pay $75 a year to have fire protection from the town's fire department. Recently, the house of Gene Cranick, who had not paid his $75 fee, caught fire. When the fire department arrived, they announced that since he had not paid his fees, his house would be allowed to burn to the ground. The homeowner offered to pay the $75 on the spot, but the firefighters refused. as the neighbor’s house was an endangered exposure and was covered under this subscription program, it was protected by the firefighters as the Cranick fire was spreading to the neighboring home.
To compound this smack down of the Cranicks and their fire, the mayor of South Fulton ineloquently stated, "If homeowners don't pay, they're out of luck." Well, that does not resonate well with me and my fire service brothers and sisters.
GOGLE subscription fire departments
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LOL. Today Ryan and the GOP say they are not done with the Repeal and Replace. I guess that big tax cut for the rich is just too hard to walk away from. Who knows what Trump will do? You can't trust anything he says.
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If you think the moderate republican split with the freedom caucus was fun to watch over medical issues it will be down right hilarious over taxes. One side wants to virtually eliminate taxes for the one percent the other side wants to take care of the middle class. Ant attempt to draw in democratic votes will require changes that will further divide the republicans. We finally have a government that is fundamentally unable to govern. Mean while it's the keystone cops investigating Russian connection to Comrade Trump. We have a government that looks like it's in a Monty python movie.
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it's in a Monty python movie
You nailled it---except for the part where it isn't funny.
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Actually while I pains me to say I never enjoyed Monty python movies.
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So, any predictions as to where this healthcare debate goes? We have a 2 week recess where I'm sure members are hearing from the voters. They added an amendment to fund high cost patients to the tune of 15 billion dollars over 10 years which even conservatives say is woefully inadequate. I guess this was intended to indicate momentum on the bill. Never the less the GOP seems stuck in a tug of war between the Freedom Caucus and Moderate Reps. Are they going to move on to something else or bring a healthcare bill to the floor? If they add the changes the Freedom Caucus wants they would kill pre existing conditions, community rating and kids on parents policy until 26. Insurance would be the wild wild west again in the individual market. I'm pretty sure this would push even more moderates to a no vote.
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What is beginning to occur to me is we need three new parties, conservative, moderate, and liberal. Split the republicans between the Conservative and moderates, split the democrats between the moderate and liberals.
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I would go for that. :thumbup;