Trump/GOP still trying to kill us through "healthcare"

[kickingandscreaming]

They're at it again. Trying to force another version of trupm/ryan"Care"  on the population.  This one is just as awful as the other. and undermines coverage for pre-existing conditions.

https://www.nytimes.com/2017/04/04/upshot/freedom-caucus-health-care-pre-existing-conditions.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region&region=top-news&WT.nav=top-news&_r=0

http://www.huffingtonpost.com/entry/house-gop-health-care-alive_us_58e30030e4b0f4a923b14b10?a2sj8jrudq0bpgb9&

[Simon Dog]

It is a di-helical screw (goes in no matter which way you turn it) since those with the pre-existing conditions are, in general, going to be those least likely to be able to afford the higher premiums.

Remember the slogan "From each according to his ability; to each according to his needs".

[KarenInWA]

What's laughable is these same people were rolling on the floor crying a temper tantrum fit over "death panels" when end-of-life care appointments were brought up as a covered benefit on the ACA. What in the honey-loving world do you call this??? How can one support this and still call themselves "pro-life" When will these honkey-tonk hypocrites stop their lying and just call themselves "pro-fetus", because once that baby takes its first breath, the poor thing is on its own in "Repubdiculous Republicon" world.

KarenInWA

[Michael Murphy]

The same basic problems  face Comrade Trump the moderate conservative divide, please one side to get the votes loose votes on the moderate  side.  But even if they bridge the house gap it's doubtful the end product would be acceptable to the Senate.  Only 3 moderate Senators of Republican ilk would need to oppose the bill to cause it to fail.  Now is when popular pressure on Republicans can keep this bill from see the light of day.

[Shaks24]

Well the public despised the original AHCA that was pulled. Now they are working on the Zombie Trumpcare plan that would gut protections of pre existing conditions and essential health benefits. I'm sure that will go over real well. Some good news though is a very recent Kaiser Health poll shows that the public will hold Trump/GOP accountable for whatever happens to the ACA because they control all the power. Most want fixes made to the ACA. I imagine the plans they have floated have made the ACA even more popular. Letting the ACA explode like Trump has said may backfire on them. They are still clinging to that big fat tax cut for the rich gained by pushing  tens of millions out of heathcare with medicaid cuts  and lousier more expensive policies. They are still having problems in the house bridging the divide between moderates and the Freedom Caucus. God willing they will fail again. Its funny how none of them want to claim leadership for this crappy bill.

http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-april-2017-the-fall-of-the-ahca-and-next-steps-for-the-aca/

[Simon Dog]

The fundamental problem with Obamacare is that it attempts to keep prices down by overcharging a subset of the population (those healthy individuals not on employer plans) to balance out the difference.  The problem is that those people are the ones most likely to be on employer plans and not part of a population group with a lot of high $$ patients.

They should have just spread the redistribution charge across the entire population, rather than sticking it to a small percentage of the population.

Remember, no law mandates that insurers participate in the exchanges, and we are going to see more states either price people out of the exchange market or lose all exchange providers.

The  "broken" nature of Obamacare will only become apparent when someone is told "No subsidized policy for you, market rate only" because the exchange in that person's state is empty.

You know the govt is lying to you when it comes up with a fancy title .

Bank secrecy act: an act requiring the banks to disclose info to the feds
Nixon monetizing the dollar: revoking the redeemable in metal nature  of gold and silver certificates
Affordable care act: Affordable? Really?
Patriot act: Yeah, patriotic stuff like secret courts and secret dockets for existing federal courts

[Michael Murphy]

The one thing that makes sense is to keep Obamacare but make Medicare one of the choices .  And if the insurance companies want to play have them sell advantage, hmo, or medigap policies. 

[Simon Dog]

The one thing that makes sense is to keep Obamacare but make Medicare one of the choices .  And if the insurance companies want to play have them sell advantage, hmo, or medigap policies.

The medical system could collapse if a larger portion of the public than now starts paying Medicare rates.

My $450 wrist xray (that would probably be private insurance paid at $200 or so) was about $55 Medicare paid.   Hospitals are not going to tolerate a double digit percent increase in the number of patients treated at that fee schedule.

[Rerun]

The hospital is STILL making money at $55.  That is the part that has to be drawn down.  FAKE Prices.

[Rerun]

What's laughable is these same people were rolling on the floor crying a temper tantrum fit over "death panels" when end-of-life care appointments were brought up as a covered benefit on the ACA. What in the honey-loving world do you call this??? How can one support this and still call themselves "pro-life" When will these honkey-tonk hypocrites stop their lying and just call themselves "pro-fetus", because once that baby takes its first breath, the poor thing is on its own in "Repubdiculous Republicon" world.

KarenInWA

This is a cold hateful post.  I thought you ALL were inclusive and diverse and tolerant....  BS!      WOW nice!

[Simon Dog]

The hospital is STILL making money at $55.  That is the part that has to be drawn down.  FAKE Prices.

Only on an incremental cost basis, not on a fully burdened cost basis.

Do you think the clinics we use could survive if every patient paid the Medicare rate?

I know when I travel, Medicare pays the  MD less than $8.00 to prescribe my treatment - and that's before taxes and overhead are taken out.   Probably nets the MD enough for a coffee and Dunkins and maybe a muffin.

[cattlekid]

I think the truth is somewhere in the middle.  For example, when I go for my monthly labs, Quest Diagnostics bills my insurance $374.  They get paid $38.  If everyone only paid $38, I doubt the clinic could stay open.  But is the right answer $374?  Doubtful. 

The hospital is STILL making money at $55.  That is the part that has to be drawn down.  FAKE Prices.

Only on an incremental cost basis, not on a fully burdened cost basis.

Do you think the clinics we use could survive if every patient paid the Medicare rate?

I know when I travel, Medicare pays the  MD less than $8.00 to prescribe my treatment - and that's before taxes and overhead are taken out.   Probably nets the MD enough for a coffee and Dunkins and maybe a muffin.

[Michael Murphy]

Well they just left town for two weeks.  Back to the districts. Let the town hall roasts begin.

[Simon Dog]

I think the truth is somewhere in the middle.

QFTMFT

[cattlekid]

For the first time in my life, I signed up to attend our Congrescritter's town hall.  It's specifically on Health Care but he is a bright shiny blue Democrat so I am not sure what really he is going to say other than he's going to vote no on anything the GOP proposes.  I'm mostly going just to see what it's like to attend a town hall.

Well they just left town for two weeks.  Back to the districts. Let the town hall roasts begin.

[iolaire]

For the first time in my life, I signed up to attend our Congrescritter's town hall.  It's specifically on Health Care but he is a bright shiny blue Democrat so I am not sure what really he is going to say other than he's going to vote no on anything the GOP proposes.  I'm mostly going just to see what it's like to attend a town hall.

Good, this whole healthcare debate will last for years into the future.  Its good for friendly people to hear views on the issues because if they stay in power they will have ample opportunity to help improve things for their constituents.

[Simon Dog]

I signed up to attend our Congrescritter's town hall.

Do you get to ask real questions, or are questions screened, approved and scheduled advance?

Remember Hillary was told about a town hall question in advance, right down to the rash on the face of the person who would be asking.  This could not have happened if they were impromptu unstaged questions.

I am reminded of when Lisa Simpson was instructed to say "Mr Burns, you campaign has the momentum of a runaway freight train.  Why are you so popular?"

[cattlekid]

So far, all I have read is that the town hall is free and open to the public.  You could register online if you wanted (which I did) but I have not seen anything yet that says that questions are only supposed to be approved in advance.  I'm just curious to see if anyone who opposes ACA shows up and what our Rep. has to say to him/her.

I signed up to attend our Congrescritter's town hall.

Do you get to ask real questions, or are questions screened, approved and scheduled advance?

[Michael Murphy]

Here in New Jersey in a place called Morristown there is a Republican Congressman named Frelinghausen ( Not sure of the spelling but I think I am in the Ballpark) Since the ACA raised its head citizens have been packing his local office demanding that he met with them they even paid for a bus to go to Washington to see him at his office.  They. Saw him as he ran out.  This group is getting larger and larger.  And none of these people are being paid to do this.  Basically is the absolute reverse of the tea party with a more moderate bent. If

[Bill Peckham]

The one thing that makes sense is to keep Obamacare but make Medicare one of the choices .  And if the insurance companies want to play have them sell advantage, hmo, or medigap policies.

The medical system could collapse if a larger portion of the public than now starts paying Medicare rates.

This is why Medicare for all is not a simple solution, just look at dialysis. The most recent numbers are available in DaVita's 10-K filing: Davita's average dialysis and related lab services revenue per treatment was approximately $352 in 2016

So if the goal is for everyone to pay the same rate and not change anything else about the provision of dialysis then everyone would have to pay about $350 per treatment all in. So if everyone paid Medicare rates, medicare's allowed rate would need to go up by 30% - from ~$270 to ~$350. Medicare's budget would blow a hole in the US budget year after year

There is another way to look at this from these numbers - divide total operating expenses and charges by number of treatments and their cost per treatment was ~$271 which as they say they break even on Medicare's allowed payment rate. There would be savings from many fewer insurance billers and such but if everyone paid what it cost you'd be massively shrinking one sixth of the US economy and disrupting today's medical care for some more efficient tomorrow.

Some added fun with math on a Friday night using Davita's filings, they say about 12% of their patients have commercial insurance and that nearly all of their profit comes from them ... so then 13,259,505 treatments were provided to commercial pay patients, divide that into total profit ... each commercial pay treatment generated ~$545 in profit add that to average treatment cost ... on average commercial payers PAID ~$816 per treatment.

[iolaire]

Quiet here after yesterday's vote.  Seems like the death panel met and picked who will live and die...

I like this idea Want to take immediate revenge on House Republicans who voted to destroy health care? Here's how.  I contributed $20 to each of the funds to unseat the at-risk republicans who supported the choice proposed by the death panel.  Also tweeted each one of them individually with message "I sent $20 to any dem to unseat you b/c of healthcare vote. I'm employed w/chronic conditions, I paid $xxk federal tax '16."

[MooseMom]

I wanted to mention town halls.  I went to a question and answer event held by the League of Women voters and attended by our Republican representative.  He had received a LOT of flak about not having organized a town hall, so he reached out to the LWV and together worked out this event.  I applaud him for that.  While it wasn't technically a town hall, it was good enough for me.  It was PACKED with people!

Volunteers from the LWV doled out cards for anyone to write their question(s).  In the end, over 400 questions were submitted.  The League had a panel that sorted through all of the questions to make sure there were no redundancies because many people had some of the same concerns.  I don't define this as "screening", rather, I'd say they were attempting to hone the queries to a manageable level.

NONE of the questions were of the soft ball variety.

Many of the questions focused on health care.  Our representative made the solemn vow before us all that he would protect people with pre-existing conditions.

He posted on FB yesterday on why he voted for the new bill and posted a scripted Q&A.  As we all know, the devil is in the details.  I have a particular concern about the MacArthur Amendment which would allow states to opt out of funding the provision of certain "essential benefits" as long as they presented their own plan on how they would cover this particular population with pre-existing conditions or any other population covered under these core benefits (like a husband and wife who are expecting a child).  These states could then be granted a "waiver".

My question is who would determine what kind of entity would be formed to grant these waivers?  Who would decide who would be in this entity?  What criteria would be used to decide whether or not a waiver would be granted?  Who gets to decide these things?  Anyone know?

[cassandra]

Iolaire and all friends on your side of the pond, I'm so sorry. I couldn't believe that news. I'm just gobsmacked.

Love, Cas


       

[MooseMom]

Well, the Senate still has to pass it, but they will make some pretty significant changes after taking a harder look at it.  Once that is done, they will send it back to the House, and I'm not sure the House will pass it with the Senate's changes.  So, things are still very much in the air.  It's really scary.

[Simon Dog]

on average commercial payers PAID ~$816 per treatment.

DaVita in Kent, WA billed, and collected $5050 for each of two transient treatments while I was  on commercial insurance.