ACA Replacement plan
- Thread starter CommuterBob
- Start date
The same way purchasing pretty much any other service or product works.
With Health Insurance though, not everyone pays the same price. You can't just have a sheet right there on the counter because I may pay more than you due to my co-pay or deductible.
Are saying get rid of that health insurance and just have a standardized health plan everyone pays the same for?
Oh, of all people I know.
I just don't understand what Bob is proposing, honestly. We already have what he's saying pretty much. I pay for a certain health insurance, certain doctors who are in-network cost set prices for certain procedures. Regardless of which doctor I go to.
Are you saying the Doctor should choose how much he/she charges the customer?
How do you purchase food from the grocery store? How do you buy clothes? How do you hire an A/C service company? How do you get your car fixed after an accident? Healthcare and health insurance should be the exact same way. No government interference, no price setting/gouging. There needs to be competition between doctors and hospitals like there is competition between Walmart and Target, between A/C companies, between auto body shops. I'm not sure what is so difficult to understand about that.
...but how? Most medicines can't and won't have competition. They are WAY to expensive to produce and each company owns each drug.
You're view on it is completely unrealistic. It might sound fantastic but there's no way anything like you're explaining would ever happen. Even if it did - all health insurance plans that someone would shop for would be different - making the services that each doctor provide different prices.
Do you mean the government shouldn't regulate the drugs that are made? They shouldn't have to go through years of testing?
You don't have a plan, you just have an idea.
OK, so it would be just like WD-40 or Crocs or Luxottica. Companies outside of pharma have exclusive patents/large share of the market for products too. We all seem to be able to buy our lubricant, shoes and sunglasses just fine without the government telling us what we can have. You're off track anyways, I'm not talking about medicine. I'm talking about care from doctors and hospitals.
I'm not even sure what you're talking about. How are you able to go to the store and buy what you want without being told by the government? How are you able to shop prices on cars before buying without the government? People should have choices, doctors should be able to provide whatever services they want and charge what they want and people should be able to choose their doctors based on that. They should be able to have any type of health insurance plan they want and/or can afford. Again this works with every other product outside of health care, why wouldn't work with doctors and hospitals? You provide a service, you have your price, people choose to buy that product based on the price and quality of the service. Just like buying soda, or buying a car, or buying auto insurance, or buying a boat, or buying a house, or buying homeowners insurance, or buying a pair of jeans, or hiring someone to mow your yard, etc, etc, etc, etc.
WTF? When did I ever say anything about pharma and medicine? I'm talking about doctors and their patients.
I do have a plan. It's the same plan that works for every other product and service sold.
Alright homie, I was asking questions in a serious, civil manner. You don't have to get your pu$$y in a tizzy.
Pharma is a BIG part of healthcare. A lot of the problems people run into is medications running too high. You can't just say, I'm not talking about that when it's a HUGE part of healthcare. I'd venture to say for a lot of people, that's where a large chunk of your expenses are coming from. Chemo, HIV medicines, etc.
You can go buy whatever health insurance you want - but it's going to cost you an arm and a leg. That's why people either go with what their employer provides (which they have a choice in which they want to provide to their employees) or can't afford it.
The R&D to make a watch or sunglasses is NO WHERE near the cost to make a drug. You can't even compare the two.
I'm not trying to be a dick, I honestly think what you are saying here makes ZERO sense. It's not feasible.
Pharma is a BIG part of healthcare. A lot of the problems people run into is medications running too high. You can't just say, I'm not talking about that when it's a HUGE part of healthcare. I'd venture to say for a lot of people, that's where a large chunk of your expenses are coming from. Chemo, HIV medicines, etc.
You can go buy whatever health insurance you want - but it's going to cost you an arm and a leg. That's why people either go with what their employer provides (which they have a choice in which they want to provide to their employees) or can't afford it.
The R&D to make a watch or sunglasses is NO WHERE near the cost to make a drug. You can't even compare the two.
I'm not trying to be a dick, I honestly think what you are saying here makes ZERO sense. It's not feasible.
Another problem is that you are free to choose, until you are not. When you are about to go for a ride to the ER isn't really the time to be comparison shopping.
I was being serious and civil in my reply. What pussy is in a tizzy? I am not talking about Big Pharma. That is a problem all on it's own that I am not debating that problem. I'm talking about a doctor, the services they provide and the patient willing to pay for those services. The government and insurance companies should not be in between a doctor and the patient. Just like they aren't in between a driver and their auto body shop or a home owner and their contractor. Prices go up when you have people and/or entities in between a seller and buyer.
So just because you may not be able to choose in an emergency, you shouldn't be given the option every other time? You don't have options when you run out of ink at 3AM in the middle of printing a paper. You don't have options when you need something overnighted and UPS is the only one that can get there.
The biggest problem with Obama care is it included rules that ran Insurance rates thru the roof, and did 0 to bend the cost curve of health care. Pre existing is a perfect example, if a company has to sign up for 10's to 100's k of outlays every year with no chance of recovering the money, that is not insurance. Business should not be mandated to provide insurance, They pay you, it is your job to buy food housing, fuel, clothing etc.. not theirs. If they wish to provide that benefit, great that is their choice. My newest grandson was born a little over a year ago. Her maternity coverage had a cap on it. she found a Midwife/nurse practitioner/Dr. where she normally saw the nurse, and had the Dr. available if needed. She delivered at home with a mid wife, where the nurse kept in touch throughout and Dr. was on standby for emergencies. She had no Hospital bill, a smaller Dr. bill. She was very happy with the care, saved a lot of $$$. There are health care co-ops out there that provide all your regular care at pre agreed rates. then you only need ins for catastrophic care.
Medicare for all.
Employers especially small business owners would lose the additional cost of healthcare policies and workers comp insurance freeing up more money for employees.
The private insurance market could go back to being that....private....allowing them to operate how they wish and giving them and actual free market place to make competitive rates. People with the means could then advance their health care with private plans; the same way people with the means send their kids to private school.
But that's just my socialist view.
Employers especially small business owners would lose the additional cost of healthcare policies and workers comp insurance freeing up more money for employees.
The private insurance market could go back to being that....private....allowing them to operate how they wish and giving them and actual free market place to make competitive rates. People with the means could then advance their health care with private plans; the same way people with the means send their kids to private school.
But that's just my socialist view.
So what needs to really happen is a hard and fast repeal with the most derogatory denouncement of the socialistic evils of the plan. We need to stop pussy-footin' around and get tough. All the liberal leftist crap that has built up over the years needs to be drop-kicked into the nearest latrine. Screw them, screw their f'd up plans and projects, screw liberalism/marxism/socialism/ and all the libtards that have been screwing this country over and stealing from it left and right.
It's time to get fed up, pissed, and proactive.
That said the cucks in Congress will tinker around the edges of it.
It's time to get fed up, pissed, and proactive.
That said the cucks in Congress will tinker around the edges of it.
Health insurance has expanded beyond what insurance is designed for. Insurance is intended to help cover the cost of something you might otherwise not be able to afford. If you apply that principle to healthcare then majority of services (such as dr visits and out patient procedures) should not be covered through insurance but paid at the time of service. Reserve health insurance for catastrophic incidents. Overhead costs for providers should go down due to less insurance claims which should lower cost of care.
CBO report on AHCA is out.
https://www.cbo.gov/sites/default/f...7-2018/costestimate/americanhealthcareact.pdf
Cliff's: It could save about $300B in future deficits over 10 years, but 24M people would lose coverage, and in the short-term, expect premium increases.
https://www.cbo.gov/sites/default/f...7-2018/costestimate/americanhealthcareact.pdf
Cliff's: It could save about $300B in future deficits over 10 years, but 24M people would lose coverage, and in the short-term, expect premium increases.
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I fully understand there was no easy way to "fix" or alter ACA....but Trump will have a lot of explaining to do. His claim for "insurance for everybody" is becoming more and more of a stretch, the same for his promise for lower premiums.
I'm really curious how this vote will go down. Slapping your name on this bill seems extremely risky for mid term candidates.
I'm really curious how this vote will go down. Slapping your name on this bill seems extremely risky for mid term candidates.
It does, it is called the individual mandate. An idea originated by the conservative Heritage Foundation and fully supported by every single insurance company. Even allowing adult children to stay on the parent's plan to age 26 is actually a risk management provision as it encourages more young, healthy people to be enrolled.
The problem is, due to political pressure, they didn't go far enough with the penalty. With premium increases and subsidies being as they have been post-implementation, too many people are choosing to go with the penalty than get coverage.
Yea, that would have shown them! Increase the penalties by 4x to force people into exchanges to pay for exuberant health care plans they don't need, at premiums they can't afford to begin with! Obamacare!*
We always knew people would have to "lose" insurance to some degree if you scaled back the massive new deficit spending included with Medicaid expansion. (which, by the way, is nothing more than a liberal trapdoor into eventually pushing for expansion and single payer). The question now isn't who is "losing" insurance but what will fill the void once these mostly Medcaid expansion people have to find a new plan.
The CBO said that virtually no one on the private individual plans would get hit.
As usual pointless noise and all about making sure the (((medical industry))) gets theirs :::rubs hands vigorously:::
I was convinced trump was not trustworthy when I heard his campaign promise on healthcare. Now I can only hope this issue won't push people to vote for candidates who praise and parade criminals' moms.
Just to be clear, I'm not taking a stance on the Individual Mandate. I was simply responding to @goodknightfl 's comment the ACA didn't have any cost containment provisions to offset the removal of Pre-ex. The opportunity to dramatically increase enrollment and spread of risk was the main reason the insurance companies (albeit begrudgingly) went along with the ACA.
The essential health benefits mandated under the ACA are hardly "exuberant" and aligned pretty much with a standard, vanilla plan available in the market when it was passed.
Certainly richer than the bare bones, catastrophic stop loss plans that were all the rage back then (and will be once more once the ACA is repealed), but nowhere near the ridiculous union plans the liberals lost their spine over when it came time to implement the Cadillac tax.
I don't know why you're putting losing coverage in quotation marks, because both the CBO and White House's analysis show over 20 million people will lose coverage under the AHCA. Since the majority of those will be people who gained coverage under the ACA's Medicaid expansion, what replaces their current coverage will likely be what they had beforehand: nothing.
How many of those 20 million wanted health insurance, how many were coerced into by the penalty? Is Healthcare a right, a privilege, or mandatory requirement for citizens of this country?
Wrong- young people under Obamacare have been forced into buying health care plans with bells and whistles that they absolutely do not need. Roughly 5 years ago my premiums even through work went up nearly 2.5x for a new plan that featured a bunch of shit that I never, ever used. I've touched my personal insurance maybe 3 times over the past 5 years and yet I'm still paying a premium that is approaching 3x as high as it was before Obamacare.
For people like this, it would absolutely be better to put them into catastrophic type plans where premiums are low, deductibles are high, but they have access to a HSA where they can stash away money tax-free to compensate.
I put "lose" in quotes since most people hear that and think people will have absolutely no pathway to insurance ever again. Bernie Sanders is already making this fear mongering case. But we all know that's wrong. And this new plan's aim is to encourage States to develop their own programs to cover those people who jumped on Medicaid expansion, except the States will be able to do it as they want, and make it something they can actually afford without the Feds writing them checks every year.
Obamacare got more people insured because they put a figurative gun to people's heads and said "buy or we shoot". I'd rather have a system whereby people are incentivized to have insurance, and rewarded for it, rather than forced into buying a product that doesn't actually fit what they want or can afford.
Lots of people got insurance through Medicaid expansion, and with the help of subsidies. It's not so much the penalty that drove them to insurance, as playing the penalty was far lower than buying insurance even with subsidies, but rather the opportunity to get affordable plans. But now that the plan subsidies will halve (or lower), expect more people to drop out. It's really not that hard to understand.
And healthcare is a right - laws passed decades ago call for ERs to treat everyone regardless of ability to pay. Health insurance, however, is not.
According to the White House's analysis (more dire than the CBO's at 26 million), nearly 2/3 will lose it due to Medicaid cuts, leaving 6 million in individual and 3 million in group markets. Without having data or evidence to hazard a guess of how many, I would imagine some of those indeed do currently have coverage in lieu of paying the penalty. However, it's reasonable to assume those who could afford coverage but didn't want it are far in the minority compared to those who wanted it but couldn't afford it.
To answer your second question, yes I absolutely do believe healthcare is a right. The most fundamental individual human right is the right to life and a government's fundamental responsibility it's to protect that right for it's citizens. Nothing is as much a threat to that right than not being able to receive care for an illness or injury due to lack of access or funds. In practicality in our country, that right is hardly a right.
The biggest problem with this discussion is that conservatives are making the same mistake with Trumpcare that liberals did with Obamacare: conflating health insurance coverage with healthcare. Neither plan is going to address the underlying reason for soaring health insurance premiums: soaring healthcare prices.
Except the plans weren't affordable. And the "solution" to the skyrocketing premiums was just to continually increase the Subsidy, but that in turn creates an entitlement that will spiral out of control. You shouldn't respond to skyrocketing insurance rates by simply dishing out more subsidies to cover that- you should go after WHY these plans were so expensive to begin with.
The CBO is off on their projection for the number Obamacare would insure by almost 8M people. Because they totally missed just how expensive these exchange plans would be and just how reluctant people would be to pay them when they can simply pay a penalty.
No. The CBO estimate is off on enrollment numbers because 19 states have yet to participate in the Medicaid expansion.
But the AHCA does little to stop premium increases, and having 20M people fall out of the enrolled will not help bring them down.
And don't buy into the Part 1 of 3 BS. Parts 2 and 3 may never pass if they even exist.
And this is just the House. I can't believe they think they can get this through the Senate if the House is this divided on it.
The revised GOP plan is somehow even worse than the original. Still leaves millions uninsured, yet somehow costs more and saves only $150B from the deficit over 10 years instead of $337B, but it *could* get another $90B in cost savings over 10 years when revised (yet again) by the Senate.
http://money.cnn.com/2017/03/23/new...ublican-bill0109PMVODtopPhoto&linkId=35805025
"The House purposely made legislation more expensive so the Senate could provide more generous tax credits to older consumers shopping in the individual market. House GOP lawmakers have come under fire because their bill would cause premiums to spike for those in their 50s and early 60s.
Funding for the additional tax credits -- which will be crafted by the Senate -- would come by allowing taxpayers to deduct medical expenses that exceed 5.8% of their income, according to a House staffer. The change would give the Senate $90 billion over 10 years to work with, the CBO found.
The original GOP bill set that threshold at 7.5%. Under Obamacare, taxpayers could only deduct medical costs greater than 10% of their income."
http://money.cnn.com/2017/03/23/new...ublican-bill0109PMVODtopPhoto&linkId=35805025
"The House purposely made legislation more expensive so the Senate could provide more generous tax credits to older consumers shopping in the individual market. House GOP lawmakers have come under fire because their bill would cause premiums to spike for those in their 50s and early 60s.
Funding for the additional tax credits -- which will be crafted by the Senate -- would come by allowing taxpayers to deduct medical expenses that exceed 5.8% of their income, according to a House staffer. The change would give the Senate $90 billion over 10 years to work with, the CBO found.
The original GOP bill set that threshold at 7.5%. Under Obamacare, taxpayers could only deduct medical costs greater than 10% of their income."
lol aborted. And Ryan openly admitting the GOP existed to obstruct and not govern for last 10 years. 7 years to come up with a plan. And with control of the executive and legislative, failed to get it done.
The best part is that this defeat makes it much harder to move on tax cuts - which depended on this trash healthcare proposal.
The best part is that this defeat makes it much harder to move on tax cuts - which depended on this trash healthcare proposal.
It was an awful bill and should be tabled. The Dems force fed an awful bill in Obamacare and look at what we have now, there is zero reason to rush this. Obamacare failing is around the Dems necks, trying to fix Obamacare would just put the noose on the GOP.
Tax cuts didn't depend on it though. They just wanted to get healthcare done first. They can table this and move on to tax cuts with the FY17 budget and do healthcare in the FY18. Tax cuts are something that can get done easily, they all agree on that.
Tax cuts didn't depend on it though. They just wanted to get healthcare done first. They can table this and move on to tax cuts with the FY17 budget and do healthcare in the FY18. Tax cuts are something that can get done easily, they all agree on that.
I don't think people are going to go for the "let it fail" tactic - not when it comes to their basic healthcare. And to blame Dems after the GOP harped on this for 7 years and now have the legislative and executive branches. If 7 years is "rushing," then ok... GOP also ran on immediate repeal - within 100 days. The funding "saved" by this health care law was supposed to be able to fund tax cuts - which now isn't an option. It'll be difficult.
Speaker Ryan already said that tax cuts will be next, but will now be more difficult. Certainly not easy at all. Also, will the GOP want to bring up healthcare yet again next year, in an election year?
Speaker Ryan already said that tax cuts will be next, but will now be more difficult. Certainly not easy at all. Also, will the GOP want to bring up healthcare yet again next year, in an election year?
I'm not saying it's not going to hurt the GOP for not getting this right the first time, I'd rather they lose seats in Congress than pass another rushed shit bill like Obamacare. They should have gone with tax cuts first to get some good feelings going and then moved on to healthcare. At the end of the day though we still have Obamacare, the Dems are still saying it's the best thing since sliced bread and they have been losing because of it for seven years.
Healthcare will absolutely have to take this up again before the 2018 elections, I say it will have to be done this year. Not doing anything will hurt a lot more in the elections.
At the end of the day this is how our government is supposed to work. There should be infighting and debate and negotiations to get what is best for the country, not having awful one sided partisan legislation slammed through without reading it just for the sake of passing something and creating a legacy.
Healthcare will absolutely have to take this up again before the 2018 elections, I say it will have to be done this year. Not doing anything will hurt a lot more in the elections.
At the end of the day this is how our government is supposed to work. There should be infighting and debate and negotiations to get what is best for the country, not having awful one sided partisan legislation slammed through without reading it just for the sake of passing something and creating a legacy.
The GOP was included in the ACA process - it's partly why it was so watered down in the first place. And moderate Dems forced other compromises, which nuked a public option. So the notion that the ACA was just passed with no debate or revision is simply false.
