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Healthcare going forward

The House plan proposes replacing the ACA's income based subsidies with a refundable tax credit based on age. However, Republicans from the Tea Party right are already saying they will oppose the plan as they see any subsidy as the creation of an entitlement program.
 
The Republicans have had seven years to come up with their magical replacement for the ACA. They now admit they never considered anything since they knew their 72 votes to repeal wouldn't be signed by the president (one wonders what they would have done had he turned the tables and signed one of them). When faced with actually legislating a solution, they are finding that healthcare is complicated (which shows their combined intelligence is just shy of a rock).

ACA was largely taken from the work in Massachusetts (by a Republican governor) and the Heritage Foundation (not known for being liberal by any means). Rather than bragging how they will "finish the job" started by the Democrats, the 30 second sound bite sounds better with "REPEAL, REPEAL, REPEAL." Unfortunately if you repeal, the replacement is going to have to include much of what you just threw out and how do you make changes without sinking the markets?

One of the reasons ACA has been struggling is because of mines that were laid by people like Marco Rubio that would have compensated co-ops and health plans for losses covering pre-existing conditions and elimination of lifetime caps. Most of the co-ops started with the idea that they would be compensated for losses in the early years and it would settle out as healthier people joined as the law matured.

Now the Republican plan is to give tax credits -- great if low and moderate income folks have a tax liability. However, if you aren't making enough to have to pay federal income taxes (which a large part of the population does); tax credits do little since you have nothing to credit. Their plan further encourages "Health Savings Accounts" which are great for wealthier people or business owners like me who can put my cash into such a plan and then pay for my insurance and any other costs from that HSA without tax liability. I'll likely put more into it than I now pay for insurance so I can cover dental, optical, and any other expenses even remotely connected to health care. For those who are living paycheck to paycheck, an HSA will do little since they have no income to save now; what makes anyone think they'll suddenly have a thousand dollars each month for their insurance?

The replacement also includes creating insurance pools for those with pre-existing conditions. That sounds a lot like the existing Health Insurance exchanges run by the individual states. So if you put people all together who have a likelihood of using insurance -- the math and history shows they will not get magic affordable rates. Rather, they'll be priced out of their lives or it would require massive subsidies. The existing ACA anticipated those costs being reduced by healthy people either buying plans or paying penalties (and would have worked if continued and the market allowed to exist). The same condition and costs exist for continuing to allow children staying on parents plans, etc. Those are expensive options and who is going to pay? The reason Arizona's prices are going up so greatly is because it has a large elderly population that uses a lot of prescription coverage; you need younger people who do not use services to offset or else the market works -- prices rise to cover the costs.

ACA could likely be assisted if State Health Exchanges were allowed to merge (having one in DC, one in Maryland, and one in Virginia could likely save money if combined). Same for states like Alaska or Wyoming with small populations. I do know health insurance (and health costs generally) in Michigan are quite affordable; not so much in places like California or New York. Sharing overhead makes sense and the larger market can spread costs of those using healthcare.

Neither ACA or the Republican plan do one damn thing to deal with a common complaint -- that patients have to wait for treatment. Most new doctors are not going into family practice but, instead, look to specialize. Why would someone spend 10 years and hundreds of thousands of dollars to get a job that provides no set hours, no paid vacations, no benefits, and will likely require work on weekends, holidays, etc, etc. Instead, continuing into a specialized area allows them to likely be recruited into group practices (surgeon, cardiac, cancer specialists) that provide for all of those things. The reimbursement rates are also better from insurance companies and government plans. Nursing admissions are also limited by availability of schools this creates shortages (in Michigan, many nurses come from Canada).
 
From the Hill:
Hoping to prevent a second leak from sinking the legislation, Republican leaders have reportedly stashed the latest the version of the bill in a secured room of the Capitol, where members of the Energy and Commerce Committee can peruse the details.

The secrecy has stirred up controversy, and Sen. Rand Paul (R-Ky.) stalked the Capitol hallways Thursday in an unsuccessful search for the bill.

“I have been told that the House Obamacare bill is under lock & key, in a secure location, & not available for me or the public to view,” Paul tweeted. “This is unacceptable.”
Click to expand...

It seems many Congressmen including Nancy Pelosi are also searching for the mysterious elusive Replacement Plan! Some are filming themselves wandering the corridors checking room after room to find it.

Coming soon to YouTube: Rand "Indiana Jones" Paul and the Healthcare Plan of Doom!!!!

http://thehill.com/homenews/house/3...are-repeal-bill-will-be-revealed-like-a-genie

Of course Pelosi "We have to pass the bill to find out what is in it" just adds to the hilarious irony of it all.
 
Stardreamer said:
From the Hill:


It seems many Congressmen including Nancy Pelosi are also searching for the mysterious elusive Replacement Plan! Some are filming themselves wandering the corridors checking room after room to find it.

Coming soon to YouTube: Rand "Indiana Jones" Paul and the Healthcare Plan of Doom!!!!

http://thehill.com/homenews/house/3...are-repeal-bill-will-be-revealed-like-a-genie

Of course Pelosi "We have to pass the bill to find out what is in it" just adds to the hilarious irony of it all.
Click to expand...

Latest update:
GOP leaders say the legislation will be released when it is final.
Click to expand...

Spirits the comedy of it all!

http://thehill.com/policy/healthcare/322016-rand-paul-creates-storm-over-obamacare-access
 
Stardreamer said:
From the Hill:


It seems many Congressmen including Nancy Pelosi are also searching for the mysterious elusive Replacement Plan! Some are filming themselves wandering the corridors checking room after room to find it.

Coming soon to YouTube: Rand "Indiana Jones" Paul and the Healthcare Plan of Doom!!!!

http://thehill.com/homenews/house/3...are-repeal-bill-will-be-revealed-like-a-genie

Of course Pelosi "We have to pass the bill to find out what is in it" just adds to the hilarious irony of it all.
Click to expand...

Priceless....
 
I keep wondering if they're going to tinker with Medicaid to make it even more regressive than it is -- at the moment, Medicaid is really a hidden inheritance tax, because it will go after the estates of those who use it once they die. That fact has given my mom an interesting choice: get help from Medicaid, or leave me homeless when she dies.

I'm actually surprised that Obama didn't change the rules there so that Medicaid for people whose incomes are less than 150% of the federal poverty level comes free.
 
No matter what the Republicans do they will be viciously savaged by the democrats. It makes perfect sense to reach agreement among themseves before presenting it as "the Republican plan", for review, criticism and voting. It is not at all the same as Pelosi passing it first.
 
Here's a thought.

Single payer.

Public option.
 
One of the reports says that Paul and several other congressmen all arrived at one room they had been assured was the room that the secret replacement plan could be found but there was NOTHING there. One suspects they actually found the right room.
 

Stardreamer said:
One of the reports says that Paul and several other congressmen all arrived at one room they had been assured was the room that the secret replacement plan could be found but there was NOTHING there. One suspects they actually found the right room.
Click to expand...
They'll pass the replacement plan, and when the secret lockbox with the treasured replacement is opened up, the only wording in the replacement plan will be:

"PEACE ON EARTH."

 
http://www.pbs.org/wgbh/pages/frontline/obamasdeal/etc/cron.html

The link is quite interesting. It details the problems with ACA: death of Ted Kennedy, intransigence and outright hostility by Republicans, deal with pharmaceutical industry. I'm suspecting the Republicans are now running into the same things. The ACA would work if one dealt with pharmaceutical industry and insurance companies but given the recent meetings held with Republicans and the White House, I'm guessing that will not again be the case. Look for exploding prices, more declines in offerings, millions of more uninsured, closings of hospitals (particularly rural) and an explosion in the price of Medicaid. Of course the Medicaid price explosion will give Paul Ryan the perfect opening to offer "vouchers" instead of coverage.

I think I'll get the popcorn and watch the implosion that is or about to take place.
 
Bernie Sanders is thinking of introducing a bill that would enable Americans to bring in cheaper meds from Canada.

There are several problems with this.

Let's detour to China first. Not more than 10 years ago, China's baby formula was found to contain fake ingredients which caused babies to become ill. The fear about fake baby products lead to many mainland Chinese to acquire holiday visas to Hong Kong across the border to enable them to buy more trusted products there. This lead to a baby formula shortage for Hong Kong residents and it drove up the price of baby food and supplies enormously. The HK government reacted after the horse had bolted, by restricting any visitor who crossed the border to an allowance of 2 tins of baby formula only. This stablised the market in HK somewhat, but did lead to more resourceful visitors with multi entry visas to come in and go day after day into Hong Kong to get the two tin quota. The HK Gov came to realise that, and they began to restrict visa entry, causing a local loss of mainland tourist business.

Now back to Canada. If a large enough proportion of Americans will be making the trip north to buy medical supplies, it will probably cause a shortage of those supplies in Canada, and force them to act by placing either an quota system or possible denial of entry into their borders by American citizens.

Americans should seek to solve their problems locally before they affect their neighbour, Canada.
 
star-warrior said:
Now back to Canada. If a large enough proportion of Americans will be making the trip north to buy medical supplies, it will probably cause a shortage of those supplies in Canada, and force them to act by placing either an quota system or possible denial of entry into their borders by American citizens.

Americans should seek to solve their problems locally before they affect their neighbour, Canada.
Click to expand...

Actually, this was common practice for a long time until the American drug companies lobbied the government to put a stop to it. I know seniors in the north-eastern states used to ride charter buses quite regularly to buy their meds. Even with the cost of the bus tickets, they saved enough to make the trips worth while.
 
gsdx said:
Actually, this was common practice for a long time until the American drug companies lobbied the government to put a stop to it. I know seniors in the north-eastern states used to ride charter buses quite regularly to buy their meds. Even with the cost of the bus tickets, they saved enough to make the trips worth while.
Click to expand...

It is a workaround that attempts to make Canada provide a loophole for failed American competition and regulation.
A bandaid that doesn't address the core problem of profiteering by pharmaceutical companies in the USA.
 
thewiz said:
closings of hospitals (particularly rural) and...
Click to expand...
another reason I'm glad to be moving to Chicago within the year. I can imagine losing the hospital in this town. With no other real hospital within about fifty miles, that could be a rather horrific thing. At the very least, what limited access there is to specialists here, could start whittling away.
 
Stardreamer said:
One of the reports says that Paul and several other congressmen all arrived at one room they had been assured was the room that the secret replacement plan could be found but there was NOTHING there. One suspects they actually found the right room.
Click to expand...

:rotflmao:
 
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