Healthcare going forward

[TX-Beau]

Donald will go after McCain.

 

[Kulindahr]

It depends on whether you think Obama care can survive without improvement. I think it is circling the drain.

Of course it needs improvement -- but you oppose anything that resembles it.

It could be improved by requiring insurance companies to spend at least 87.5% of premiums on actual care. It could be improved by hefty incentives for organizations to establish fraternal, not-for-profit insurance companies. It could be improved by providing funding for fifty new medical schools over the next ten years. It could be improved by making the cost of an annual physical a refundable tax credit. It could be improved by banning the advertising of pharmaceuticals and requiring the money instead to be devoted to lowering prices. It could be improved in a lot of ways, but the GOP isn't interested in improving it.

 

[Kulindahr]

Until they throw in the towel and admit that they have to join with Democrats and provide actual reform, let us hope so.

That's what McCain's vote was about -- that and reminding Trump what he promised about health care, namely not to destroy it but to improve it.

 

[Kulindahr]

I will second Gsdx here, Obama care may or may not be able to survive and may even be circling the drain but none of that is relevant if the efforts to deal with the situation does not IMPROVE it. Republicans have turned repealing Obamacare and to a lesser degree, everything else Obama has done into a fetish just like they did with tax cuts. Until they are willing to set that aside and work with the Congress as a whole to solve the problems they deserve to fail.

The GOP seems to be perfectly content with spending $220bn a year on absolutely nothing, essentially just throwing it away. If they had the balls to stand up and pay off the debt, they could take that same money and throw it at health care instead.

 

[Kulindahr]

No the only goal, but allowing ACA to collapse from its inherent flaws is one way to keep his promise to the American people if he cannot get it repealed.

So by making people lose their insurance, he's helping everyone get coverage? Because his campaign promise was that they were going to cover everyone.

 

[Kulindahr]

Donald will go after McCain.

I don't think the Donald will like the result. I've already heard some people who had no use for McCain saying he turned into a real hero finally. Going after McCain will just point to the fact that what McCain did was defend the Donald's campaign promise to improve things and get coverage for everyone, so Trump will be doing the proverbial shooting himself in the foot.

 

[KaraBulut]

I don't think the Donald will like the result. I've already heard some people who had no use for McCain saying he turned into a real hero finally. Going after McCain will just point to the fact that what McCain did was defend the Donald's campaign promise to improve things and get coverage for everyone, so Trump will be doing the proverbial shooting himself in the foot.

He took one for the team so that the others could vote "Yes". It helps them avoid those commercials from the right-wing 501c organizations.

 

[Kulindahr]

He took one for the team so that the others could vote "Yes". It helps them avoid those commercials from the right-wing 501c organizations.

Now that's an interesting angle.....

 

[smokeshadow]

To those of you whose health care premiums will be going up next year (and that will include a majority of Americans with health insurance) you can thank the Donald Gestimates range from 1.2% to 20% increases.

http://americablog.com/2017/08/trum...nsurance-premium-increases-per-new-study.html

 

[Julian89]

Eye of the storm. The Deplorable-in-Chief will let Obamacare collapse under its own weight. As early as now, the Democratic Party and their allies must mobilize grassroots forces on red states that are highly vulnerable to Obamacare collapse and rally people there to lobby their Representatives and Senators to come out with a workable solution to address the upcoming collapse.

At this point, we need to discuss what solutions can the Democrats offer that will pass the Republican House and Senate before the 2018 mid-term elections.

My spider sense is telling me that Big Health Insurance will still have a hand in writing the law on this one. Nonetheless, Democrats must push firmly the conversation towards Medicare for All. As for Republicans, they will push this on market-based principles. What I am seeing at the moment is if the Democrats will pull very strong towards Medicare for All, the most realistic outcome they can work with the Republicans is that from state-based insurance exchange, there will be nationwide-based insurance exchange. Instead at the state level, the risk pool and the market for competing insurers will be way much larger at the national level. If the rules of the level playing field of the market goes as theorized, premiums must go low.

Another battle will be how much of the contribution will go to medical expenses and that of overhead costs and profit. As claimed by the America's Health Insurance Plans (AHIP), 17.8% of the contributions go to operating cost and 2.7% to profit. Perhaps the Obamacare's medical loss ratio (MLR) provision has something to do with it where it requires health insurers in the individual and small group market to spend 80 percent of their premiums (after subtracting taxes and regulatory fees) on medical costs.. But unfortunately, some states requested for waivers due to non-competitiveness of the health insurance industry in the area. A good example provided by the healthcare blog is Maine

Why did these States receive waivers? For a variety of reasons, but one of the reasons is due to the fact that some states have a less competitive medical market. Maine, for instance, requested a MLR of 65%. The reason was that State only has two large commercial insurers, Anthem Blue Cross Blue Shield (with 49% of the market) and MEGA Life and Health Insurance Company (with 33% of the market). A public-private partnership, DirigoChoice, makes up most of the rest of the market. Three HMO’s have less than 1% of the market combined between them. To avoid the case where a large insurer would leave the market due to minimum MLR requirements and create a near monopoly, HHS decided to approve Maine’s request.

Given what happened to Maine, genuine advocates of free market approach to healthcare must be amenable to a nationwide-based insurance exchanges where the pool will be so large that with the right regulation will depress prices of health care premiums.

But still if Democrats would strongerly play hardball, they must move that healthcare insurers who will enter the nationwide-based insurance exchange to have their MLR at 85%-90%. Put the Republicans to task of draining the swamp in the health insurance industry. To put things in perspective, the Democrats must argue that health insurers must be as efficient as Medicare. In 2015, the total expenditure for Medicare is US $646.2 B. The administrative costs for Medicare on the same period amounts to US $41.219 B or 6.38%. Is that a deal or no deal to Big Health Insurance?

Now the question is are Democrats will have the spine of steel to play hardball against the Republicans? That is what we have to see.

So Senator Bernie Sanders are proposing 4 things:

In the short-term
1. State-based public option
2. Extending minimum age eligibility for Medicare to 55 years old
3. Importation of prescription drugs from Canada and other countries

In the long-term, Medicare for All Single Payer.

I think state-based public option will not work given the peculiarities of state governments especially on the ones controlled by Republicans. So I will still argue for a nationwide-based public option.

More than importation of cheap prescription drugs, what must be proposed is that government can negotiate prices with Big Pharma.

If Democrats play hardball on these proposals, perhaps the outcome would be as what I stated above.

 

[Benvolio]

So Senator Bernie Sanders are proposing 4 things:

In the short-term
1. State-based public option
2. Extending minimum age eligibility for Medicare to 55 years old
3. Importation of prescription drugs from Canada and other countries

In the long-term, Medicare for All Single Payer.

I think state-based public option will not work given the peculiarities of state governments especially on the ones controlled by Republicans. So I will still argue for a nationwide-based public option.

More than importation of cheap prescription drugs, what must be proposed is that government can negotiate prices with Big Pharma.

If Democrats play hardball on these proposals, perhaps the outcome would be as what I stated above.

Medicare only works because the government is able to collect the monthly premium from the insured from his Social Security check. Since people under 62 and most under 65 are not receiving social security, that option is not available.
There is no need to import from Canada. The only reason drugs are cheaper there is because they impose price controls. We can do that but it will limit development of new drugs.Negotiating is just another way of saying you are imposing price controls.

 

[gsdx]

There is no need to import from Canada. The only reason drugs are cheaper there is because they impose price controls. We can do that but it will limit development of new drugs.Negotiating is just another way of saying you are imposing price controls.

That is bullshit, and it has been proved to you time and time and time again. It is a wasted argument and only supports your country allowing the drug companies to own your government. Your argument about R&D and advertising have also been proved wrong time and time and time again. And we have proved time and time and time again that Canadian drug companies survive with a healthy profit and still have money left over for developing new drugs.

Your drug companies OWN you. Admit it.

 

[Benvolio]

That is bullshit, and it has been proved to you time and time and time again. It is a wasted argument and only supports your country allowing the drug companies to own your government. Your argument about R&D and advertising have also been proved wrong time and time and time again. And we have proved time and time and time again that Canadian drug companies survive with a healthy profit and still have money left over for developing new drugs.

Your drug companies OWN you. Admit it.

Hogwash. You merely fantasize that if you disagree with something you have disproven it. What we have shown is that Canadian companies get their healthy profits from selling in the US without the price controls at home.

 

[Stardreamer]

So in a bit of quiet news slipping under the radar, the countries that were in danger of having no Obamacare providers are being covered. It seems the doomsayers are forgetting a basic aspect of marketplaces, where there is scarcity there is an opportunity. Some small insurers are stepping in to fill the gaps left by the larger insurance companies withdraw from the less profitable regions.

Now admittedly this is not ideal as they are basically taking advantage of being in a monopoly position but it does show that the markets are more resilient than Republicans have been saying.

 

[Sausy]

So in a bit of quiet news slipping under the radar, the countries that were in danger of having no Obamacare providers are being covered. It seems the doomsayers are forgetting a basic aspect of marketplaces, where there is scarcity there is an opportunity. Some small insurers are stepping in to fill the gaps left by the larger insurance companies withdraw from the less profitable regions.

Now admittedly this is not ideal as they are basically taking advantage of being in a monopoly position but it does show that the markets are more resilient than Republicans have been saying.

The answer always has been building on the ACA(and eventually adding a public option or going single payer entirely for basic health care with a private upgrade complimentary market that exists even I most countries with single payer primary systems) all the work to kibbosh it by the GOP to replace with a laughably "market" oriented mess...it just is an awful indictment of the pettiness, foolishness, and basic morally bankruptcy of bastardized conservatism we have today.

 

[thewiz]

The answer always has been building on the ACA(and eventually adding a public option or going single payer entirely for basic health care with a private upgrade complimentary market that exists even I most countries with single payer primary systems) all the work to kibbosh it by the GOP to replace with a laughably "market" oriented mess...it just is an awful indictment of the pettiness, foolishness, and basic morally bankruptcy of bastardized conservatism we have today.

I believe what we have here is proof that the current system is market driven (much to the horror of people like Ben). Insurance companies saw an open market, saw a customer base and stepped in. The better way would be single payer.

 

[Benvolio]

I believe what we have here is proof that the current system is market driven (much to the horror of people like Ben). Insurance companies saw an open market, saw a customer base and stepped in. The better way would be single payer.

When did I say it was not market driven? It is socialist in that most people will require subsidies from the government to pay their premiums. Whether companies survive on this basis remains to be seen. They have little ability to limit the number and amount of policies covering pre existing illnesses, with the result that there is no ability to make their premiums commensurate with their liabilities.

 

[KaraBulut]

I believe what we have here is proof that the current system is market driven (much to the horror of people like Ben). Insurance companies saw an open market, saw a customer base and stepped in. The better way would be single payer.

Some of the recent studies speculated that insurers took a loss in the first couple of years because many people who had been without healthcare were coming in, getting things like screening colonoscopies (which the ACA covers at 100% for patients over 50 years old) or they were getting diagnosed with previously untreated conditions like diabetes, heart disease or cancers.

The projects said that these costs were temporary and that the plans would become more profitable as the costs leveled off.

So, it will be interesting to see if these payers coming in now will have a better margin. Let's hope so.

 

[ballcaphair]

Healthcare under the ACA does not have insurance companies swimming in debt.

https://www.nytimes.com/2017/03/18/business/health-insurers-profit.html

 

[Benvolio]

Healthcare under the ACA does not have insurance companies swimming in debt.

https://www.nytimes.com/2017/03/18/business/health-insurers-profit.html

Very complicated, but it does not support your claim. It includes the following;
"In November 2015, UnitedHealth made an adjustment on its balance sheet, setting aside an initial “premium deficiency reserve” of $200 million for expected losses in those marketplaces.

Those losses have cumulatively swelled to more than $1 billion, Ms. Skolnick said, but because they have been segregated in the company’s accounting, and because the company has been leaving those markets, investors have been able to easily assess the company’s value “entirely separately from the problems it’s had with the exchanges,” she said. Other managed care companies have made similar provisions.