ACA Running Thread

[WakeandBake]

Can we not build some of that oversight into Medicare? That seems like not an unreasonable obstacle to overcome.

 

[2&2 Slider To Leyritz]

2&2
Repealing does terminate insurance for people on the govt. subsidy unless they can then foot the full bill themselves, further, as has been repeatedly pointed out you have had 8 years to craft a viable replacement even if it was only done in committee that could have been floated on the first day of the new congress but we are still hearing about the possibility of someone releasing their plan soon with no concrete replacement. Better to have a competent plan that the repubs can then own and do all at once.

But that is the key. Presumably your dude on chemo or cardiac surgery is going to make that payment as it is a hell of a lot less expensive than the procedures themselves and should be their #1 payment priority over anything else. And if they can't afford to make that their #1 payment under the circumstances, then they should be on Medicaid.
And for somebody who is not undergoing that type of major procedure, they can make the decision of how they want to prioritize paying for health insurance over their other expenses if they like their plan so much that they want to keep it.
Look, I'm all for healthcare reform, but Obamacare was a disaster from the beginning and should never have been enacted. Ending it will shit on some people, the same way some people were similarly shit on when it was enacted (which is conveniently forgotten). But get rid of it and fix it right, don't hang on to it out of irrational fear of going back to the way it was before it existed, which wasn't the end of the world.

 

[TheTwinAndreBen]

Can we not build some of that oversight into Medicare? That seems like not an unreasonable obstacle to overcome.

We have and it has been a fucking disaster. RAC and ZPIC audits, intended to cut down on Medicare fraud, have only served to put many small providers out of business and now the government is fighting a billion dollar lawsuit from the AHA.

 

[PhDeac]

In my admittedly simple world view, I just cant understand the compulsion of the ownership class to condemn and refuse a single-payer healthcare solution - granted, that mostly they shoulder through higher taxes on themselves - that results in a healthier and more robust labor force and consumer base with more cash in their pockets. Isn't it an investment that they would ultimately financially benefit from in the long run, in the same way my company benefits from providing good health care for its employees? And why wouldn't the working class voters in Michigan, Wisconsin, Ohio, and Pennsylvania also not demand this from the ownership class? And wouldn't ownership also find it attractive to stave off union influence? Doesn't it also simplify the administration process for providers?

Seems to me that single-payer solves a lot of issues for all parties involved. what the fuck is wrong with us? Is protecting tax rates for the top 5% important enough to pass all this shit downhill to us regular folks?

Good post. Single payer would pass the burden of providing health insurance from employers to everybody.

I don't think the government Has a moral obligation to treat every illness. I think we have a utilitarian duty to treat our society and a moral desire to do it in the best most efficient way possible. That way we have the kind of society that can provide excellent benefits for centuries to come.

In some ways I look at it like my farm. I am not morally obligated to provide them healthcare but I have the desire to see them succeed in life and therefore we offer a comprehensive plan to make sure that it is affordable. We don't cover everything but we do cover a large portion and for about half we cover 100%. Not because I am obligated but because I am interested. But I can't cover health to the point where it causes me to go bankrupt or cover it foolishly and waste a bunch of money because in the end that will cost my employees 10 years from now. I have to be smart now so that I am sustainable.

Our current model isn't sustainable. It is a black hole.


Sent from my iPad using Tapatalk

Medical professionals are obligated to treat every illness. The people they treat can't always pay them.

 

[CHDeac]

2&2,
Don't think a coaching search is analogous to 20000000 people having insurance terminated at once(some of whom are no doubt having chemotherapy or Cardiac surgery at the time of discontinuence) without some thought to their lives. No, here you need to step up to the plate and get your best plan together and repeal and pass simultaneously.

Except of course this isn't going to happen. I hope people realize repeal and replace means means repeal today (effective 1.1.19 or later) then replace in the next ~ year (effective 1.1.19 or later). No one is losing their coverage mid surgery. Now some things could go away right away (mainly the mandate) but coverage and subsidies are beyond incredibly unlikely to be pulled

 

[CHDeac]

Can we not build some of that oversight into Medicare? That seems like not an unreasonable obstacle to overcome.

They do and even have an entire product built around it, Medicare Advantage, which is essentially private Medicare. Its very popular and I think ~1/3rd of Medicare enrollees are on it.

I've said it before and I'll say it again. This country would have a civil war if we tried to implement single payor. The ACA impacted maybe 3.5% of the population in a truly negative way, and half the country hates it.

 

[PhDeac]

Half the country hates Obamacare, not ACA.

 

[Deacfreak07]

Half the country hates Obamacare, not ACA.

The American Camping Association really never did anything to anybody.

 

[ImTheCaptain]

The American Camping Association really never did anything to anybody.

 

[WFU71]

We have and it has been a fucking disaster. RAC and ZPIC audits, intended to cut down on Medicare fraud, have only served to put many small providers out of business and now the government is fighting a billion dollar lawsuit from the AHA.

I'm glad I got out of healthcare before that crap started. Here's an almost year old article on RACs and the AHA lawsuit: http://www.policymed.com/2016/04/courts-to-finally-take-up-cms-recovery-audit-contractors-appeals-backlog.html

RACs are paid a percentage off the improper payments the find or collect. Anyone think that might lead to some questionable audits?

Another charlie fox

 

[bcobbdeacs]

2&2,
As with almost everything we will have to understand that we do not agree.

 

[CHDeac]

Man Who Understands 8% Of Obamacare Vigorously Defends It From Man Who Understands 5%

http://www.theonion.com/article/man-who-understands-8-of-obamacare-vigorously-defe-34022

 

[PhDeac]

Man Who Understands 8% Of Obamacare Vigorously Defends It From Man Who Understands 5%

http://www.theonion.com/article/man-who-understands-8-of-obamacare-vigorously-defe-34022

That's hilarious.

 

[DistrictDeacon]

Could we not have a base government option hat covered everyone minimally but effectively and then put in incentives for companies to offer excellent secondary coverage? This would untie us from the corporate model but at the same time encourage good faith efforts from business to invest in their employees.


Sent from my iPad using Tapatalk

I believe that in broad strokes this is the model that several European countries use.

 

[awaken]

https://www.yahoo.com/finance/news/5-doctors-most-likely-stick-002149027.html

The study looked at physician charges across 54 specialties. It found that the average anesthesiologist, radiologist, emergency physician, pathologist, and neurosurgeon charge for their services at least four times what Medicare reimburses. In anesthesiology, the average charge was almost six times as high as what Medicare pays.

There is some Congressional interest in change. In December, Sen. Bill Nelson, D-Fla., asked the Federal Trade Commission to look into surprise medical bills in emergency room situations where patients are treated at in-network hospitals by out-of-network doctors. Consumer Reports also supports national legislation—the End Surprise Billing Act, introduced by Rep. Lloyd Doggett, D-Texas—which protects consumers from balance bills in emergency situations. Doggett plans to reintroduce the bill this year.

 

[CHDeac]

https://www.yahoo.com/finance/news/5-doctors-most-likely-stick-002149027.html

I want to say the average commercial reimbursement is approx. 160% or so of Medicare. Of course, there is regional and specialty variability here. But, any form of single payer would no doubt push us towards the 100% level.

I like the idea of states/the feds setting reimbursement at a % of Medicare +. So if you are an exchange plan, the feds will require providers to accept 120% of medicare from private insurers. Kind of a private based public option.

 

[CHDeac]

Lots more inside chatter that we will see a big push to the states and in some ways this may make sense so long as their are some broad rules that protect consumers woth federal $ for subsidies.

Also lots of chatter about an opt out program to increase enrollment. Im still worried about funding of the high risk pools and subsidies to cover people. We have to cap what insurance should cost as a % of income.

The situation is very fluid but the people in charge in COngress are fully aware of whats at stake.

My bet is full repeal is effective 2019 though I wouldn't be surprised to see this shift to 2020.

Very interesting days ahead....

 

[ThinkingWithMyDeac]

I saw something today that one of the options contained a three option choice with one of the choices gutting everything and another keeping ACA in place and letting the states choose which options they want. That would certainly be interesting as it clearly would break down into blue states have it and red states don't.

 

[myDeaconmyhand]

Huge surprise here
http://www.latimes.com/business/hiltzik/la-fi-hiltzik-aetna-obamacare-20170123-story.html

U.S. judge finds that Aetna deceived the public about its reasons for quitting Obamacare:

"In fact, says Judge John D. Bates, Aetna made its decision at least partially in response to a federal antitrust lawsuit blocking its proposed $37-billion merger with Humana. Aetna threatened federal officials with the pullout before the lawsuit was filed, and followed through on its threat once it was filed."

 

[CHDeac]

I saw something today that one of the options contained a three option choice with one of the choices gutting everything and another keeping ACA in place and letting the states choose which options they want. That would certainly be interesting as it clearly would break down into blue states have it and red states don't.

I hadn't seen this but just read an article. Thanks for sharing. Seems like a long shot based on how the House Rs want to handle. Perhaps its step 1 in our country breaking up into micro nations....When that happens Im hoping Alta elects Jon Huntsman as their President and makes me their Health care Czar (or more PC name).