Healthcare going forward

[Kulindahr]

Thanks wiz on that inside perspective. The whole audacity of repeal and replace... if it were genuine, you HAVE a well thought out plan that phases in, and no one is at risk to lose coverage or be denied it in the meantime. Both GOP plans, however, take us backwards and put millions in the position of huge increases in spending on premiums and or deductibles (when things are even covered). We need to move to continue with the progress we have achieved... hopefully with the ultimate goal of single payer or a Medicare for all. These GOP plans in both the House and the Senate are awful and as even John Mc Cain predicted recently, will likely die.

What reveals the whole thing as a farce meant to benefit the wealthy is the fact that a number of key GOP congresscritters are already making plays in the market to rake in profits that are there for no reason other than that the GOP is playing with the future of health care.

This also reveals Trump as shallow because he has yet to call the GOP senators on the carpet and demand they write a plan that will do what he promised: cover everyone.

As for phasing in changes, just start raising the amount required to be spent on care by a percentage point a year -- the for-profit companies will either collapse or figure out a way to make the system work for everyone.

 

[Kulindahr]

While we're waiting for the GOP to do their final deals with the devil and pass their bill before the August recess.

I think that if they don't pass it by then, the likelihood of passing it before the 2018 elections starts to look poor.

It would be humorous if it weren't so dismal: with a Democrat in the White House, the GOP in Congress managed to be astoundingly non-productive... and now with a Republican in the White House, the GOP in Congress is managing to be astoundingly non-productive.

 

[KaraBulut]

One would think that after voting 70+ times to abolish the Affordable Care Act (ACA), the Republicans would have the magic plan to replace that they always bragged about each time they voted.

Pages back in this thread, I made the comment that repeal would be easy compared to replace. I was wrong; repeal has become impossible because of the Medicaid issue and the blowback from the 31 states that will lose the money out of their already marginal budgets.

Replace was never in the cards. The focus from the House was timing- to try to get repeal on the anniversary if the passing of the ACA- March 23rd. Never mind that they had no hearings and that there wasn't a bill, there weren't any markups, there weren't any amendments and most House members never even read the bill they were trying to pass.

The problem with being the perpetual opposition is that those who are constantly saying "No" never learn about the subject and never develop a plan. Republicans are great at some subjects like tax law and military budgets. They're not so good on social programs, largely because of that perpetual opposition and rigid ideology that opposes social spending and fair regulation of businesses. The core of the ACA individual market is an old Republican proposal and it's really hard to come up with another creative idea... especially when you don't have the will or the inspiration to look for another way.

It's really hard to do something if you don't believe in it. Asking the current conservatives in Congress to write healthcare legislation would be like asking an atheist to prepare a homily for a church service.

Absolutely, they had 7 years to come up with a replacement. But honestly- replacement was never really what they wanted.

... and now with a Republican in the White House, the GOP in Congress is managing to be astoundingly non-productive.

Be careful with the narrative that they are being non-productive.

There's a lot of shiny objects being held in front of the American public while a lot of deconstruction is going on behind the scenes. There's reasons why thousands of jobs in the executive branch are going unfilled. There's reasons why the Administration constantly brings up the Gorsuch appointment- remaking the courts is a big priority. There's reasons why they're targeting the EPA, the DoE and the Consumer Protection Bureau.

So while the news is all about Russia and healthcare protests, there's a lot of busy beavers who know that they have to get a lot of stuff done because 2018 is just a year away. With the Trump Jr email disclosures, watch McConnell- he's going to extend the session and try to get as much stuff pushed through the Congress before the August recess because he has realized that they're going to be increasingly bogged down in these scandals that are coming out of the White House.

 

[thewiz]

I have to vigorously disagree with "ACA fixed the access problem to health care" -- it eased it, but it didn't fix it, since it left deductibles high enough that many people "covered" still can't afford to get medical care. Access won't be fixed until either deductibles are eliminated or are made a refundable tax credit.

Several things can be done to make the price structure work better. First, require that 87.5% of all premiums be spent on actual care. Second, tax direct-to-public advertising at 20%. Third, allow states to negotiate prices with pharmaceuticals (and to band together to do so).

Of course better would be that 0.1% tax on financial transactions dedicated primarily to pay off the national debt but with a portion, maybe 10%, dedicated to backing Medicare and Medicaid. Trump is an idiot not to push such a tax; it would set his legacy as one of our greatest presidents for not just reducing but paying off the national debt (if he gets a second term).

You are correct on the access problem not being totally eliminated. Insurance companies, finally limited on what they could pay for non-benefit services (CEO salaries, advertising, promo, gifts) found a loophole in deductibles. Closing those would be relatively easy -- allow individuals to move to a single payer plan. Insurance companies would either respond and become competitive or they would become dinosaurs. Of course, given the amount they give to individual Congressional members (of both parties), I wouldn't hold my breath.

It is also why the language was inserted to the Bush era prescription drug expansion that joint purchasing and bulk purchases were forbidden. States and others could not do what other countries regularly do -- and it shows with their vastly lower prices paid for every form of prescription drug. In the US, we not only contribute to R & D, we also turn around and pay the highest price for the created product while providing exclusive patents for years that ensure the same companies rake in the profits. Add language that removes such protections when unwarranted pricing takes place, and some sanity may come to the markets. In the meantime, doctors, hospitals, associations, insurers and elected officials are handsomely rewarded from the pharmaceutical companies to use and purchase their products.

I like the idea of paying down the debt and funding the Medicaid/Medicare systems well into the future.

 

[frankfrank]

So while the news is all about Russia and healthcare protests, there's a lot of busy beavers who know that they have to get a lot of stuff done

McConnell- he's going to extend the session and try to get as much stuff pushed through the Congress before the August recess because he has realized that they're going to be increasingly bogged down in these scandals

And while the news is all about Russia and healthcare protests, I also worry what kind of shit is being passed in the STATE capitals while nobody is watching. I'm hearing/reading nothing about any state politics in any of the major media (I'm including MSNBC, Fox News, etc. in this); I could keep up by reading every major newspaper from every state but even that has to assume they will choose to cover state issues adequately.

Once in a while something like the extreme anti-LGBTQ stuff passed in Mississippi comes up, but it usually comes up *HERE* - not on TV or my other news sources - and JUB is NOT "major media."

Democracy Now (a TV program barely known by more than a tiny shred of a sliver of the population) covers state issues SOMETIMES, but not much. I really haven't seen a prominent "state issue" atop the news all year that I can remember at this moment, because all this Trumpshit is stealing the oxygen in the room...and he's definitely the Republican "elephant" in the room. The North Carolina bathroom bill was high up on the headlines for a while, but recent tries in Texas to do the same thing got no real press at all.

Extreme anti-voting, antigay, ecology-wrecking laws could be getting passed state by state, and we might not even hear about it.

 

[Stardreamer]

Most of the states are waiting to see how the Federal fight over the ACA pans out. There is not a lot they can do without knowing that outcome. California's push for Single Payer being an exception since that is an effort that is an effort that can go forward either way.

 

[Stardreamer]

Senate Republican John Thune commented today that Senate Republicans may skip the CBO on getting an analysis of the latest healthcare bill and instead ask the White House to provide an analysis from HHS.

“I think we’ll get other feedback from HHS, [the White House Office of Management and Budget] and others who also have models that can take into consideration” the impacts of the bill, Sen. John Thune (R-S.D.) said Thursday.
The unusual move would be highly controversial and a major departure from using the CBO, which has been the traditional scorekeeper for legislation. Thune said CBO would probably take too long to analyze Cruz’s provision, since the language was only sent to CBO last week.

Senate GOP may not use CBO to score Cruz amendment

Cause that is how the game works right? If you can't get the ruling you want find a friendly referee.

 

[kallipolis]

How to vote against your own best interest....vote Trump.

I quote the priceless words of the American writer and satirist H.L. Mencken:

“Democracy is the theory that the common people know what they want, and deserve to get it good and hard.”

 

[Kulindahr]

I like the idea of paying down the debt and funding the Medicaid/Medicare systems well into the future.

It's my conservative streak showing: don't be in debt, plan ahead.

 

[Benvolio]

You are correct on the access problem not being totally eliminated. Insurance companies, finally limited on what they could pay for non-benefit services (CEO salaries, advertising, promo, gifts) found a loophole in deductibles. Closing those would be relatively easy -- allow individuals to move to a single payer plan. Insurance companies would either respond and become competitive or they would become dinosaurs. Of course, given the amount they give to individual Congressional members (of both parties), I wouldn't hold my breath.

It is also why the language was inserted to the Bush era prescription drug expansion that joint purchasing and bulk purchases were forbidden. States and others could not do what other countries regularly do -- and it shows with their vastly lower prices paid for every form of prescription drug. In the US, we not only contribute to R & D, we also turn around and pay the highest price for the created product while providing exclusive patents for years that ensure the same companies rake in the profits. Add language that removes such protections when unwarranted pricing takes place, and some sanity may come to the markets. In the meantime, doctors, hospitals, associations, insurers and elected officials are handsomely rewarded from the pharmaceutical companies to use and purchase their products.

I like the idea of paying down the debt and funding the Medicaid/Medicare systems well into the future.

Correction. You like the idea of taxing other people heavily and using their money to apply it to the debt and fund medicare etc. Paying down the debt assumes that the politicians will not simply spend more.

 

[DantheManFL]

‘Simply Unworkable’: Insurers Blast New Provision In Senate Health Bill

Two organizations representing the U.S. health insurance industry just called a new provision of the Senate Republicans’ health care proposal “simply unworkable in any form” and warned that it would cause major hardship, especially for middle-class people with serious medical problems.

The amendment, crafted by Sen. Ted Cruz (R-Texas), would allow insurers to resume sales of policies that leave out key benefits, such as prescription drugs or mental health. More important, it would allow insurers to discriminate among customers based on medical status, charging higher premiums or denying policies altogether to people with existing medical problems ― from the severe, like cancer, to the relatively mild, like allergies.

http://www.huffingtonpost.com/entry/senate-health-bill-insurers-unworkable_us_59697eb7e4b0d6341fe9111c?4wz&ncid=inblnkushpmg00000009

 

[Benvolio]

‘Simply Unworkable’: Insurers Blast New Provision In Senate Health Bill



http://www.huffingtonpost.com/entry/senate-health-bill-insurers-unworkable_us_59697eb7e4b0d6341fe9111c?4wz&ncid=inblnkushpmg00000009

They really mean that they need to gouge healthy young people very high premiums to give insurance to those already ill. Selling reasonable policies to the healthy would undermine the whole scheme.

 

[Kulindahr]

Correction. You like the idea of taxing other people heavily and using their money to apply it to the debt and fund medicare etc. Paying down the debt assumes that the politicians will not simply spend more.

If you consider a 0.1% tax "heavy", you have serious issues. Really.

 

[ballcaphair]

I believe that the debt, medicare, and paying it down indicates how skilled politicians with our money.

 

[Benvolio]

If you consider a 0.1% tax "heavy", you have serious issues. Really.

Wiz did not limit it to 1%, and that tax on existing taxpayers would not pay down the debt and fund medicare and medicare. Taxes always start low and grow.

 

[gsdx]

^ It's always easier to spend other people's money than one's own.

 

[ballcaphair]

^ It's always easier to spend other people's money than one's own.

It is ironic that the Republicans spoke so often of "Obamacare death squads." At our clinic two ER patients bolted, one for fear of cost due to complications and another for an unknown reason. Perhaps he was an alien. Now even medical services are part of an actual death squad.

 

[Kulindahr]

Wiz did not limit it to 1%, and that tax on existing taxpayers would not pay down the debt and fund medicare and medicare. Taxes always start low and grow.

A 0.1% tax on financial transactions would provide enough revenue in two presidential terms to pay off the existing debt, bring the entire interstate highway system up to quality, and drop roughly a trillion into a trust fund for Social Security, Medicare, and Medicaid. I presented the math once before.

And taxes don't have to start low and grow". The law could be written for the tax to last until the debt is eliminated and a $1tn surplus accumulated in a trust fund, and then end. The Bush tax cuts set the example; we just have to follow it.

 

[Kulindahr]

It is ironic that the Republicans spoke so often of "Obamacare death squads." At our clinic two ER patients bolted, one for fear of cost due to complications and another for an unknown reason. Perhaps he was an alien. Now even medical services are part of an actual death squad.

The GOP congresscritters are the death squad.

 

[thewiz]

A 0.1% tax on financial transactions would provide enough revenue in two presidential terms to pay off the existing debt, bring the entire interstate highway system up to quality, and drop roughly a trillion into a trust fund for Social Security, Medicare, and Medicaid. I presented the math once before.

And taxes don't have to start low and grow". The law could be written for the tax to last until the debt is eliminated and a $1tn surplus accumulated in a trust fund, and then end. The Bush tax cuts set the example; we just have to follow it.

The problem as Ben sees it is that all taxes are bad; all government is bad; kill the beast.

It has been the Republican mantra going back at least 16 years and is one of the reasons the Republican party left me. Government is the people; if one finds it bad, evil, and worthy of destruction -- what does that say about the party that espouses such beliefs? And no wealthy person pays the highest tax rates unless they are an ignoramus. Most have accountants and have "encouraged" Congress to carve out loopholes in the tax codes that often provide them refunds (see largest companies and taxes paid in prior posts). Welfare, low taxes, and not paying federal income taxes are not limited to the working poor; the working wealthy are just as guilty.