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Post Reply U.S. House of Representatives Passes Obamacare repeal bill
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Posted 5/4/17

MysticGon wrote:
Considering this is one of the issues that people voted for their candidate on I'm not convinced the majority just changed their mind because news outlets, celebrities and democrats are freaking out.


https://www.vox.com/policy-and-politics/2017/4/25/15419512/obamacare-poll-popular

More than a dozen recent polls have shown the Affordable Care Act becoming increasingly popular as Republicans work to dismantle it. Obamacare is now more popular than the Democratic Party, Republican Party, House Speaker Paul Ryan, and President Trump himself.

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Posted 5/4/17

MysticGon wrote:

Considering this is one of the issues that people voted for their candidate on I'm not convinced the majority just changed their mind because news outlets, celebrities and democrats are freaking out.


The Freedom Caucus is a noisy, but relatively small minority within the GOP. Mainstream and moderate republicans that don't hide from their constituents are in for an earfull.
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Posted 5/4/17

mittemeyer wrote:



I understand how you feel about abortion, but favoring the AHCA because it does something about abortion while ignoring the dollars and cents difference it makes to other ordinary Americans feels narrow-minded.

Repeating this might not help, but, about the AHCA,



--It enacts drastic cuts to Medicaid, amounting to $370 billion over 10 years.
--AHCA will lead to higher premiums in many cases, especially for people with the largest objective financial or health care needs, in which case premiums could rise by as much as 750 percent.
--Far from covering everybody, the original version of AHCA is forecast to increase the ranks of the uninsured by as much as 24 million. Nobody is quite sure how much the deregulatory provisions added this week will alter that because House Republicans haven’t bothered to take the time to get a new score of the bill.
--Deductibles are forecast to rise by about $1,500 on average.

https://www.vox.com/policy-and-politics/2017/5/4/15542342/ahca-promises-broken


I'm confident with pre-existing conditions and extended coverage for young adults under parents plant will remain. Medicaid might not see an expansion(which I think it should) but you don't always get what you want.
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Posted 5/4/17 , edited 5/4/17

mittemeyer wrote:


MysticGon wrote:
Considering this is one of the issues that people voted for their candidate on I'm not convinced the majority just changed their mind because news outlets, celebrities and democrats are freaking out.


https://www.vox.com/policy-and-politics/2017/4/25/15419512/obamacare-poll-popular

More than a dozen recent polls have shown the Affordable Care Act becoming increasingly popular as Republicans work to dismantle it. Obamacare is now more popular than the Democratic Party, Republican Party, House Speaker Paul Ryan, and President Trump himself.



Same polls that predicted a Hillary presidency I wonder...

Sorry couldn't help myself. Trump ran on repealing it, that's what got him into office.
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Posted 5/4/17 , edited 5/4/17

MysticGon wrote:
I'm confident with pre-existing conditions and extended coverage for young adults under parents plant will remain. Medicaid might not see an expansion(which I think it should) but you don't always get what you want.


https://www.vox.com/policy-and-politics/2017/5/2/15523262/voxcare-republicans-preexisting-conditions

Republicans have tried to patch together a policy to address these concerns, but the result is still a bill with weaker protections for people with preexisting medical conditions than those provided by Obamacare.

The MacArthur Amendment, the latest change to the health bill, would change the rules for these people in a few ways:

--States could apply for a waiver to opt out of Obamacare's rule that prohibits health insurers from charging sick people more than healthy people. So insurance for people with preexisting conditions might technically still be on the market, but premiums could be so high that many of those people couldn't afford it. That's the big problem for many moderates (and therefore House leaders).
--Ryan's release says states would have to argue the change would, for example, lower premiums in order to get the waiver approved. The bill itself, though, makes approval effectively automatic unless the federal government stops it.
--States would also be required to set up a high-risk pool, where sick people could buy coverage, in exchange for a waiver. But the historic problem for high-risk pools has been that they didn't have enough money to cover sick people, and Larry Levitt at the Kaiser Family Foundation told me the AHCA has the same problem. The money included in the bill is also less than what conservatives have projected is necessary for high-risk pools to work.
--People could also not be discriminated against if they maintained health coverage, another defense deployed by the bill's defenders. But if you do let your insurance slip, you're out of luck. So that still isn't the same level of protection that Obamacare offers.


https://www.vox.com/2017/4/25/15422478/gop-ahca-amendment

The American Health Care Act that House Speaker Paul Ryan introduced into the House last February dismantled parts of Obamacare. It also left popular provisions, like a ban on preexisting conditions and the requirement that insurers cover things like maternity care, intact.

This new amendment, offered by Rep. Tom MacArthur (R-NJ), would allow states to waive out of those key Obamacare regulations too.

In particular, this amendment would allow some states to charge higher premiums to Americans with preexisting conditions. States would also have the choice to opt out of the Affordable Care Act’s essential health benefits requirement, as well as the possibility of charging older Americans significantly higher premiums.

Leaders of the staunchly conservative Freedom Caucus have reportedly endorsed this proposal. That makes sense: This amendment would take apart key Obamacare regulations the group has spent years rallying against.
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Posted 5/4/17

MysticGon wrote:

Sorry couldn't help myself. Trump ran on repealing it, that's what got him into office.


Trump ran on "repeal and replace with something that serves the American people better".This current proposal only satisfies 2/3 of those requirements. The problem with repeal and replace is that is is a great idea until people start trying to turn it into legislation. The republican party has acknowledged this many times. No one should be happy with "repeal and replace" unless it gives us something better.

This bill simply is not better for the American people.
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Posted 5/4/17

sundin13 wrote:

I feel like making a big to-do about health insurance is missing the main core of the problem. The reason healthcare insurance costs are high is because healthcare costs are way too high. Switching between insurance plans does little to address that problem. We are spending all of this time arguing about how best we can ignore the symptoms of a bigger issue.


Finally. Someone else who thinks about the big picture when it comes to health care.

Insurance premiums reflect the cost of healthcare. If the cost of healthcare goes down premiums go down. If it goes up the price of insurance goes up. Lower costs in the healthcare system and everyone benefits.

Not so fun fact. It used to be you would have family practitioners going between small towns on different days of the week. Every weekday they would go to a different town and check people out, referring them to a specialist if needed. People paid with cash and they didn't deal with tons of lawsuits and bureaucracy, prices were low and everyone won. Then insurance companies pushed heavily to get people on insurance and it went from people self-paying to everyone wanting stuff ran/charged through their insurance. These small doctors then had to hire people exclusively to handle the insurance companies. The insurance companies then brought these doctors to court all of the time to dispute payments then used legal nonsense to delay the actual hearing just to deny the doctor the ability to treat patients that day. Eventually the doctors spent more time in court than treating patients that they stopped making money and it all became too stressful. Those doctors gave up and joined a giant medical complex in order to be able to use their teams of lawyers to fight the insurance companies teams of lawyers. Going and seeing this doctor now costs many times what it used to and you get the same care as before but at highly inflated prices.

This is an actual story I've heard from 2 former doctors who retired because they got sick of the nonsense and not being able to just do their job.
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Posted 5/4/17
Remember the days when 'Women and children first' didn't mean they were the ones to suffer first?
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Posted 5/4/17 , edited 5/4/17

BlueOni wrote:
Whatever you say. We won't know for sure where things are going for a bit yet, anyway. There's still the Senate to go. Just saying, this looks like a tactical blunder.


Both the Democrats and the Republicans are pretty bad when it comes to healthcare. Too scared/corrupt to kill the for-profit insurance companies.

One issue is that Trump listens to other people too much. He knew insurance was shit and that places like Scotland have a decent national health service, but this has become just one more issue where people tell him it won't work, or that he doesn't have the power to implement it, so he's just pushing whatever instead.

I'm hoping midterms won't be based purely on partisanship like people are anticipating. We'll never get anywhere with that.
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Posted 5/4/17 , edited 5/4/17

Rujikin wrote:


sundin13 wrote:

I feel like making a big to-do about health insurance is missing the main core of the problem. The reason healthcare insurance costs are high is because healthcare costs are way too high. Switching between insurance plans does little to address that problem. We are spending all of this time arguing about how best we can ignore the symptoms of a bigger issue.


Finally. Someone else who thinks about the big picture when it comes to health care.

Insurance premiums reflect the cost of healthcare. If the cost of healthcare goes down premiums go down. If it goes up the price of insurance goes up. Lower costs in the healthcare system and everyone benefits.

Not so fun fact. It used to be you would have family practitioners going between small towns on different days of the week. Every weekday they would go to a different town and check people out, referring them to a specialist if needed. People paid with cash and they didn't deal with tons of lawsuits and bureaucracy, prices were low and everyone won. Then insurance companies pushed heavily to get people on insurance and it went from people self-paying to everyone wanting stuff ran/charged through their insurance. These small doctors then had to hire people exclusively to handle the insurance companies. The insurance companies then brought these doctors to court all of the time to dispute payments then used legal nonsense to delay the actual hearing just to deny the doctor the ability to treat patients that day. Eventually the doctors spent more time in court than treating patients that they stopped making money and it all became too stressful. Those doctors gave up and joined a giant medical complex in order to be able to use their teams of lawyers to fight the insurance companies teams of lawyers. Going and seeing this doctor now costs many times what it used to and you get the same care as before but at highly inflated prices.

This is an actual story I've heard from 2 former doctors who retired because they got sick of the nonsense and not being able to just do their job.


My dad is a small town internist and I can tell you that most of what you say is false. I do agree that the cost of healthcare is a major issue though.

For one, family practice and internist types love it when people have healthcare because it increases the chance they actually get some type of payment, instead of working for free. Can insurance companies say "hey we don't like what you charge so we'll give you this much." Sure, but it's better than nothing. As far as hiring new staff, well EHR systems are mandated and many of them have billing built in. You might need a person to transcribe but the offset cost of actually getting reimbursed for your time now covers that. Also paying cash for treatment didn't mean a patient couldn't sue you, and when cash doesn't lower the cost either.

The way insurance companies actually screw doctors is malpractice insurance. They can raise premiums as they see fit and doctors cannot practice without it. Would my dad tell you that all the bureaucratic red tape took a lot of the joy out of being a doctor? Yes. That doesn't mean working in the medical field being like an episode of Andy Griffith is beneficial to them. Contrary to popular belief, not many doctors want to barter with you and take your prized hog to treat you.
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Posted 5/4/17

rawratl wrote:
The way insurance companies actually screw doctors is


by existing. They will always rig the system to make a profit and cover their overhead, unless they are nonprofit organizations, which is what we should transform all our current insurance companies into.
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Posted 5/4/17 , edited 5/5/17

rawratl wrote:
My dad is a small town internist and I can tell you that most of what you say is false. I do agree that the cost of healthcare is a major issue though.

For one, family practice and internist types love it when people have healthcare because it increases the chance they actually get some type of payment, instead of working for free. Can insurance companies say "hey we don't like what you charge so we'll give you this much." Sure, but it's better than nothing. As far as hiring new staff, well EHR systems are mandated and many of them have billing built in. You might need a person to transcribe but the offset cost of actually getting reimbursed for your time now covers that. Also paying cash for treatment didn't mean a patient couldn't sue you, and when cash doesn't lower the cost either.

The way insurance companies actually screw doctors is malpractice insurance. They can raise premiums as they see fit and doctors cannot practice without it. Would my dad tell you that all the bureaucratic red tape took a lot of the joy out of being a doctor? Yes. That doesn't mean working in the medical field being like an episode of Andy Griffith is beneficial to them. Contrary to popular belief, not many doctors want to barter with you and take your prized hog to treat you.


So your saying that retired doctors who were in the field for 30+ years are all wrong? The people I am talking about are people that were doctors in the 70's and before. Before all this insurance shit. They say the exact same thing as being the issue.
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Posted 5/4/17 , edited 5/4/17

Rujikin wrote:

Finally. Someone else who thinks about the big picture when it comes to health care.

Insurance premiums reflect the cost of healthcare. If the cost of healthcare goes down premiums go down. If it goes up the price of insurance goes up. Lower costs in the healthcare system and everyone benefits.

Not so fun fact. It used to be you would have family practitioners going between small towns on different days of the week. Every weekday they would go to a different town and check people out, referring them to a specialist if needed. People paid with cash and they didn't deal with tons of lawsuits and bureaucracy, prices were low and everyone won. Then insurance companies pushed heavily to get people on insurance and it went from people self-paying to everyone wanting stuff ran/charged through their insurance. These small doctors then had to hire people exclusively to handle the insurance companies. The insurance companies then brought these doctors to court all of the time to dispute payments then used legal nonsense to delay the actual hearing just to deny the doctor the ability to treat patients that day. Eventually the doctors spent more time in court than treating patients that they stopped making money and it all became too stressful. Those doctors gave up and joined a giant medical complex in order to be able to use their teams of lawyers to fight the insurance companies teams of lawyers. Going and seeing this doctor now costs many times what it used to and you get the same care as before but at highly inflated prices.

This is an actual story I've heard from 2 former doctors who retired because they got sick of the nonsense and not being able to just do their job.


People simply aren't going to be able to pay for healthcare as they go if they expect to receive the standard of quality people in developed countries have come to expect, particularly if they're referred to specialists. Insurance, like it or not, is necessary. The question from there becomes what agents provide it and what incentive structures are motivating them. The problems you've pointed to are the consequences of a private, for-profit insurance market.

In the private insurance market the profit motive provides insurers with an incentive to limit their own liability and payouts as much as possible while extracting as much as they can from clients to direct toward not only paying for outstanding claims but also to invest. This is the underpinning of the pre-existing condition problem, it's something insurers devised to limit their liabilities and risks. The legal proceedings you've pointed to are simply them using that lever against healthcare providers and clients as the profit motive naturally demands they do. It's why deductibles are so high, too: they want to limit their own payouts and are happy to pass that cost on to their clients. All of this does exactly what you say it does: drives up healthcare costs and creates an enormous burden on the insured.

In an atmosphere where insurance isn't driven by the profit motive, but instead is provided on a sort of for use basis, the incentives are changed. Now instead of trying to limit liability and payouts the incentive is to try to negotiate for the best possible deal with healthcare providers, medical manufacturers, and so on. There's no need for healthcare providers to either chase down the people they need to in order to collect payment or hire an enormous staff to settle who is liable for what treatments when, because there is a single payer whose terms are already well-understood. Deductibles are replaced with either nothing or appreciably lower nominal fees. Premiums are replaced with taxes which, if structured properly, impose a dramatically lower burden than the alternative.
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Posted 5/4/17

ninjitsuko wrote:
Them pushing through a bill at this speed is no different than when ACA was first formed.


ACA took a year and went through months of bipartisan negotiation before Yertle decided to play politics with it.

This, I don't know what the fark is going on with this. They're throwing reason to the wind just to get something checked off the list.
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