Healthcare going forward

[rareboy]

So this is a nice move on the way out for the Biden administration:

FACT SHEET: Vice President Harris Announces Final Rule Removing Medical Debt from All Credit Reports | The White House

Today’s final rule will remove $49 billion in unpaid medical bills from the credit reports of 15 million Americans. In addition, the Vice President is

www.whitehouse.gov

 

[Kulindahr]

So this is a nice move on the way out for the Biden administration:

FACT SHEET: Vice President Harris Announces Final Rule Removing Medical Debt from All Credit Reports | The White House

Today’s final rule will remove $49 billion in unpaid medical bills from the credit reports of 15 million Americans. In addition, the Vice President is

www.whitehouse.gov

That number just shows how the elimination of $1bn in medical debt is barely a scratch on the issue.

Which reminds me -- I have to go humiliate myself to apply for financial aid from the Adventist clinic and hospital this week.

 

[rareboy]

^ Not humiliating at all. Millions of Americans are now having to look for assistance.

The majority of Go Fund Me's now are for medical financial assistance.

And the Hospitals are just as guilty as any part of the system for no getting this under control decades ago.

The aid you need? A non-profit hospital puts aside a portion of the fees it charges fully insured and richer full pay patients for this need.

People are entitled to healthcare in a normal functioning society. It is good business and good investment by the community.

Don't let them make you ever feel less than.

 

[KaraBulut]

...Which reminds me -- I have to go humiliate myself to apply for financial aid from the Adventist clinic and hospital this week.

Don't think of it in those terms.

Not-for-profit hospitals (note: not the same as non-profit) don't pay income taxes, even though they make millions of dollars per day in revenue. In order to get out of paying corporate income taxes on the billions in profits they make, are required by law to prove that they provide financial assistance and lowered cost to any patient who qualifies under federal poverty guidelines.

So, when you're filling out the forms, think of it as the price that the healthcare provider pays in order to avoid paying income taxes like the rest of us have to pay.

 

[Kulindahr]

Not humiliating at all. Millions of Americans are now having to look for assistance.

The amount of information they want is invasive. And they changed how they do things: it used to be an interview once every six months, now it's an interview for every single expense.

The aid you need? A non-profit hospital puts aside a portion of the fees it charges fully insured and richer full pay patients for this need.

Adventist does even better than that, but I fear their aid system has fallen into the clutches of money managers.

So, when you're filling out the forms, think of it as the price that the healthcare provider pays in order to avoid paying income taxes like the rest of us have to pay.

That would be easier if they hadn't decided to make the process more difficult and very impersonal.

 

[rareboy]

I am very sorry that you may have to deal with the worst of bean counters who want to drive you away.

If it seems that they are going beyond their remit, seek out the ombudsman for the corporation. If Adventists are responsible, they will also provide someone to help you with their system if it is traumatizing.

Pull out all the stops.

But always remember. It isn't you. It is the system that is failing.

 

[Kulindahr]

Doesn't look good that just as they were saying "We are transforming to be a more consumer-focused health care system to better meet the needs of those we care for and the communities we serve" they made it harder to get help. I used to be able to just walk down the street and talk to their financial office; now their financial offices are in one central location.

seek out the ombudsman for the corporation

I got pointed to an online form I can fill out for assistance. A bunch of information I need is on a PDF, but it won't read without the software that made it. So I found where I could download that for free (fifteen-year-old software that serves me just fine), so I downloaded the zip file and extracted it. But when I tried to install that failed -- "insufficient memory to perform this task". So I closed most open programs and tried again, but the install failed for some technical reason.

I hate setting up new computers.

 

[KaraBulut]

The amount of information they want is invasive. And they changed how they do things: it used to be an interview once every six months, now it's an interview for every single expense.

It's because all of the Adventist facilities (something like 30 hospitals and over 400 clinics) on the West Coast are on a system called Epic. Epic has an integrated Financial Assistance module that makes it much easier for FAP documentation to be collected. With that ease of collection and the automation, they can collect for more detailed information than they used to.

Some of the FPL information like citizenship status is required now by Federal Law but the documentation requirements that have changed the most are State requirements that have been tacked on as part of State Medicaid FPL requirements.

Adventist might be collecting more documentation and collecting it more often but it's the Feds and Oregon State that mandate what they collect for the FPL calculations for sliding scale aid.

Federal Poverty Level (FPL) - Glossary

Learn about the Federal Poverty Level (FPL) by reviewing the definition in the HealthCare.gov Glossary.

www.healthcare.gov

And yes... healthcare is getting less personal. Part of it is automation (Epic now has about 60% of the market in the US). But the big driver is that these healthcare organizations went on merger sprees in the past decade and they are big, bureaucratic monopolies. Biden's FTC was working to slow the consolidation but all the suits that were filed will be dropped in February unless the Trump Administration wishes to target a particular organization.

Elections have consequences.

 

[rareboy]

Well Americans. Another battering ram likely being taken to healthcare in the US.

The Supreme Court said Friday it will review the constitutionality of the Affordable Care Act’s no-cost coverage mandates for certain preventive care services, putting the landmark health care law in front of the justices again just as President-elect Donald Trump – who tried to repeal the law during his first presidency – returns to the White House.

While not an existential threat to Obamacare, the case could imperil access Americans have to cost-free preventive treatments and services, including HIV prevention medications, heart statins and various screenings for cancers and other diseases.

Supreme Court to review Obamacare’s no-cost coverage of cancer screenings, heart statins and HIV drugs | CNN Politics

The Supreme Court said Friday it will review the constitutionality of the Affordable Care Act’s no-cost coverage mandates for certain preventive care services, putting the landmark health care law in front of the justices again just as President-elect Donald Trump – who tried to repeal the law...

amp.cnn.com

 

[cityboy-stl]

Well Americans. Another battering ram likely being taken to healthcare in the US.

Supreme Court to review Obamacare’s no-cost coverage of cancer screenings, heart statins and HIV drugs | CNN Politics

The Supreme Court said Friday it will review the constitutionality of the Affordable Care Act’s no-cost coverage mandates for certain preventive care services, putting the landmark health care law in front of the justices again just as President-elect Donald Trump – who tried to repeal the law...

amp.cnn.com

Again, what republicans don't like about Obamacare is Obama. They're obsessed with hate for Obama and undoing anything Obama did for the American people. That's why we have not seen a republican replacement health plan in 15 years, and we won't see a plan. Because undoing ACA and putting everything back the way it was before Obama is their one and only plan. Fuck the American people, stick it to Obama.

 

[rareboy]

It goes deeper than that. The insurance industry hates Obamamcare because it threatens their industry.

It is directly competing for their customers.

And the SC is now controlled by corporate interests like the insurance industry.

 

[KaraBulut]

It goes deeper than that. The insurance industry hates Obamamcare because it threatens their industry.

Except that it's really a privatization of Medicaid, which has added millions of people (and billions of dollars) to the insurance companies' rolls.

The real issue was Obamacare said, "We're going to give you millions of new customers but you can't ask them about pre-existing conditions, you can't kick them off their insurance when they get expensive and you can't say, 'If you get up to $1 million in claims, you've maxed out your policy and we won't pay anymore'." And they really don't like, "You must devote most of your premium income to paying claims and not on corporate overhead".

The reason that you don't see insurance companies putting out ads against Obamacare is that since the Affordable Care Act passed in 2010, the market has consolidated to five major insurance companies and they've earned over $380 BILLION dollars in profit. After Mangione killed the UHCG CEO, it came out that UHCG's profits have increased 400% since the ACA passed.

Weakening the ACA is going to be a losing issue and it's a repeat of the abortion debacle. After 15 years of getting free colonoscopies and free mammograms, it's going to be difficult for the health insurance companies to unring that bell.

 

[smokeshadow]

another issue. . .people who need prosthetics for either leg, arm, hand or other missing limb just to be able to live are being denied coverage

MSN

www.msn.com

 

[Kulindahr]

The insurance industry hates Obamamcare because it threatens their industry.

The concept does, but in practice they're getting government money and not having to cover anything they don't feel like. I know all too many people who can't afford to use the insurance anyway because the deductibles and copays are so high.

 

[Kulindahr]

another issue. . .people who need prosthetics for either leg, arm, hand or other missing limb just to be able to live are being denied coverage

MSN

www.msn.com

That's why I stick with my insurance instead of getting into the 'marketplace': what I could find there all consider hip replacements "elective", but my insurance that carried over from my disability considers them "quality of life" operations. I won't even guess how many other conditions are that way.

If they want to change the ACA, they should add in subsidies for anyone earning under 200% of the poverty level who is enrolled with a fraternal insurance organization (or any other kind of NFP one).

 

[cityboy-stl]

It goes deeper than that. The insurance industry hates Obamamcare because it threatens their industry.

It is directly competing for their customers.

And the SC is now controlled by corporate interests like the insurance industry.

Ok, other reasons are in play as well. But I still think the conclusion is correct. Republicans have no health care plan and will never have a replacement health plan because their actual plan is to put everything back the way it was before Obama.

Since they've come up with utterly nothing else, that's where everything they're doing leads, is the only thing I see. Am I missing anything?

 

[KaraBulut]

Ok, other reasons are in play as well. But I still think the conclusion is correct. Republicans have no health care plan and will never have a replacement health plan because their actual plan is to put everything back the way it was before Obama.

Since they've come up with utterly nothing else, that's where everything they're doing leads, is the only thing I see. Am I missing anything?

Backing up a step.

There's three things that are in the ACA that affect commercial insurance companies:

1. An expansion of the State government-funded Medicaid programs.
2. Privitization of the individual market with government-funded premiums.
3. Minimum standards for what a health insurance policy must cover.

The reason that I disagree with the statement in the quote above is reason #2. Obamacare doesn't compete with private insurance. It expands and funds it. A person with a modest income who takes out an Obamacare individual policy is likely to get 60% or more of their premium (which is paid to an insurer like Blue Cross) paid by the US government.

The individual market in the ACA looks very much like Medicare Advantage. In Medicare, you can take the standard government insurance (Medicare B - the "public option") or you can take out an insurance plan (Medicare C) from a commercial insurer (like United Healthcare) which the US government underwrites. What happened with the ACA is that the "public option" was removed and what remained was commercial insurance.

The reason that Republicans don't have a replacement plan for the ACA is that the ACA was originally a Republican plan. Large sections of the ACA were based upon a proposal that came from Heritage Foundation. The Heritage Foundation's plan is what Massachusetts implemented when Mitt Romney was governor (aka RomneyCare). The Republican Party has moved so far to the right that they now oppose their own ideas from the 1980s and 1990s!

In 2013, Romney and Newt Ginrich got into a discussion at a Republican Leadership Conference:

How the Heritage Foundation, a Conservative Think Tank, Promoted the Individual Mandate

Jim Taranto, who writes the Wall Street Journal’s excellent “Best of the Web” column, put forth a lengthy and informative discussion yesterday on the conservative origins of the individual mandate, whose inclusion in Obamacare is today its most controversial feature on the Right.

www.forbes.com

ROMNEY: Actually, Newt, we got the idea of an individual mandate from you.

GINGRICH: That's not true. You got it from the Heritage Foundation.

ROMNEY: Yes, we got it from you, and you got it from the Heritage Foundation and from you.

GINGRICH: Wait a second. What you just said is not true. You did not get that from me. You got it from the Heritage Foundation.

ROMNEY: And you never supported them?

GINGRICH: I agree with them, but I'm just saying, what you said to this audience just now plain wasn't true.

(CROSSTALK)

ROMNEY: OK. Let me ask, have you supported in the past an individual mandate?

GINGRICH: I absolutely did with the Heritage Foundation against Hillarycare.

ROMNEY: You did support an individual mandate?

ROMNEY: Oh, OK. That's what I'm saying. We got the idea from you and the Heritage Foundation.

GINGRICH: OK. A little broader.

ROMNEY: OK.

 

[rareboy]

I suspect that the only thing that Trump really wants out if it is for it to be relabelled TrumpCare.

 

[Alistair]

I suspect that the only thing that Trump really wants out if it is for it to be relabelled TrumpCare.

The talking heads say the same thing.

 

[KaraBulut]

The talking heads say the same thing.

Yes, it's kind of like what other countries with autocrats do with renaming things to rewrite history. Tsaritsyn... err Stalingrad... err Volgograd. Petrograd ... err Leningrad... err St Petersburg.