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Thread: The health care debate thread.

  1. #451
    Sam the Sheepdog LA Ute's Avatar
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    How the Freedom Caucus Is Undermining the G.O.P.

    https://mobile.nytimes.com/2017/03/3...com/?state=nwa

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  2. #452
    Administrator U-Ute's Avatar
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    Quote Originally Posted by LA Ute View Post
    How the Freedom Caucus Is Undermining the G.O.P.

    https://mobile.nytimes.com/2017/03/3...com/?state=nwa

    I think everyone on both sides of the aisle hates those guys now.

    But they've gerrymandered themselves into the gig. They'll be hard to remove.

  3. #453
    Quote Originally Posted by U-Ute View Post
    I think everyone on both sides of the aisle hates those guys now.

    But they've gerrymandered themselves into the gig. They'll be hard to remove.
    A key point about the Freedom Caucus is they're not geared at all to be pragmatic - they (and their supporters) value principles more than effectiveness. If they're in safe districts, they'll be done only when they decide to give their seat to somebody else... kind of like Orrin Hatch.

  4. #454

  5. #455
    https://www.theguardian.com/us-news/...lcolm-turnbull

    On Friday, Trump stuck to his guns – with a clarification. “Of course the Australians have better healthcare than we do – everybody does,” he wrote on Twitter. “Obamacare is dead! But our healthcare will soon be great.”
    But Trump told Turnbull: “We have a failing healthcare. I shouldn’t say this to our great gentleman and my friend from Australia, because you have better healthcare than we do.”
    Last edited by tooblue; 05-05-2017 at 10:56 PM.

  6. #456
    Sam the Sheepdog LA Ute's Avatar
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    The claim got 4 Pinocchios.

    Despite critics’ claims, the GOP health bill doesn’t classify rape or sexual assault as a preexisting condition

    https://www.washingtonpost.com/news/...=.9e5391e36c6d

    The bill is flawed and won't come out of the Senate looking much like it does now. Still, the debate over it needs to be fact-based.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  7. #457
    Interesting editorial. According to the author, the AHCA is about cutting taxes, not health care policy.
    https://www.nytimes.com/2017/05/06/o...dayspaper&_r=0

  8. #458
    Sam the Sheepdog LA Ute's Avatar
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    Quote Originally Posted by Irving Washington View Post
    Interesting editorial. According to the author, the AHCA is about cutting taxes, not health care policy.
    https://www.nytimes.com/2017/05/06/o...dayspaper&_r=0
    That's a thoughtful piece. I hope Senate staffers on the GOP side are reading it.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  9. #459
    Sam the Sheepdog LA Ute's Avatar
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    This piece has a political edge to it, but ignore that, it's right about the law.

    The Pre-Existing Lie

    http://www.nationalreview.com/articl...ts-are-telling

    The legislation is going to look a lot different after the Senate gets done with it, but I doubt the pre-existing condition part will change much.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  10. #460
    Administrator U-Ute's Avatar
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    Quote Originally Posted by LA Ute View Post
    This piece has a political edge to it, but ignore that, it's right about the law.

    The Pre-Existing Lie

    http://www.nationalreview.com/articl...ts-are-telling

    The legislation is going to look a lot different after the Senate gets done with it, but I doubt the pre-existing condition part will change much.
    I think it is fair to say that the pre-existing condition clause affects a minimal number of people - right now.

    The problem is that as people lose their jobs, are unable to find new jobs and are unable to afford private insurance, that number will grow.

    The idea of having your insurance tied to employment and having the handling of pre-existing conditions tied to continuous insurance is what makes the situation so unpalatable. Those in Congress either are unable or don't want to understand that not being able to continuously have insurance is a serious problem.

  11. #461
    Quote Originally Posted by U-Ute View Post
    I think it is fair to say that the pre-existing condition clause affects a minimal number of people - right now.

    The problem is that as people lose their jobs, are unable to find new jobs and are unable to afford private insurance, that number will grow.

    The idea of having your insurance tied to employment and having the handling of pre-existing conditions tied to continuous insurance is what makes the situation so unpalatable. Those in Congress either are unable or don't want to understand that not being able to continuously have insurance is a serious problem.
    Ironically one of the two good things with Obamacare was the requirement to cover pre-existing conditions. The other was allowing someone to stay on their parents insurance until they were 26.


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  12. #462
    Quote Originally Posted by Rocker Ute View Post
    Ironically one of the two good things with Obamacare was the requirement to cover pre-existing conditions. The other was allowing someone to stay on their parents insurance until they were 26.


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    Reducing the number of uninsured by 10-14 million wasnt a good thing?

  13. #463
    Quote Originally Posted by Rocker Ute View Post
    Ironically one of the two good things with Obamacare was the requirement to cover pre-existing conditions. The other was allowing someone to stay on their parents insurance until they were 26.
    And the bad thing was that people had to pay more. The good and bad are a package deal, aren't they?

  14. #464
    Quote Originally Posted by concerned View Post
    Reducing the number of uninsured by 10-14 million wasnt a good thing?
    At what cost and could it have been done better? I was never uninsured, but I am on substantially worse insurance at triple the cost now because of Obamacare, but at least my preventive care visits are covered now.

  15. #465
    Quote Originally Posted by Rocker Ute View Post
    At what cost and could it have been done better? I was never uninsured, but I am on substantially worse insurance at triple the cost now because of Obamacare, but at least my preventive care visits are covered now.
    Very good point, of course. But the current Repub experience shows how hard it is to do it better and at less cost.

  16. #466
    Quote Originally Posted by concerned View Post
    Very good point, of course. But the current Repub experience shows how hard it is to do it better and at less cost.
    Let me make it clear that I in no way am defending the Republican bill, in fact just the opposite. Instead of working on mending the other issues, they are taking away one of the good things about Obamacare.

  17. #467
    Administrator U-Ute's Avatar
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    Quote Originally Posted by Rocker Ute View Post
    At what cost and could it have been done better? I was never uninsured, but I am on substantially worse insurance at triple the cost now because of Obamacare, but at least my preventive care visits are covered now.
    The real question isn't "at what cost" as much as "who will pay for it".

    Someone has to pay for it. Healthcare costs are not coming down, insurance companies don't want to pay for it, and the people who need it can't afford it.

  18. #468
    Quote Originally Posted by U-Ute View Post
    The real question isn't "at what cost" as much as "who will pay for it".

    Someone has to pay for it. Healthcare costs are not coming down, insurance companies don't want to pay for it, and the people who need it can't afford it.
    The healthy pay for it.

    And that is fine, that is the way to pay into it. I look at the hundreds of thousands I pay into healthcare over a lifetime with the hope that my relative non-utilization will cover me when I do need it. But how can we make that healthy pool bigger?

    Long ago I worked for SelectHealth. We spent a lot of time developing some online programs aimed at improving people's health. We had health trackers, health assessments, programs for employers to execute to reduce their utilization. Preventive care visits, which I mock that I now get for free (for only triple the premium I used to pay) are also a good thing. Exposing people more to the actual cost of care will also reduce utilization and ultimately cost. Prevention and better utilization are a big way to help, yet nobody really does much about that.

    One example from back in the day: The discussion was around a new gamma knife that basically improved recovery time by a day, but was massively more expensive than the current gamma knife they had. The question was should the new knife be covered by insurance or was it elective. Now if you don't pay directly for that knife, then recovering a day faster seems awesome. If the patient was asked if they'd pay $10k extra to use that knife, suddenly an extra day didn't seem so bad at all.

    Those are just a few of the problems with the utilization and cost of healthcare that seem relatively easy to fix, but nobody addresses that.

  19. #469
    We keep saying, "who will pay for it?"

    Yet, we currently pay more for healthcare and get the worst results.

    Why don't we take the money already being spent, and spend it better.

    Yeah, your taxes might go up. But your healthcare costs will go down, creating a wash, at worst.

    Odds are, costs would go down overall under single payer, because we already pay more than everyone else.

  20. #470
    Sam the Sheepdog LA Ute's Avatar
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    Just for fun:

    Judd Gregg: How the GOP can win on healthcare

    http://thehill.com/opinion/judd-greg...-on-healthcare

    It won't happen, but the op-ed is a good read and is dead-on accurate about the ACA and why it was designed as it was.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  21. #471
    Quote Originally Posted by Utah View Post
    We keep saying, "who will pay for it?"

    Yet, we currently pay more for healthcare and get the worst results.

    Why don't we take the money already being spent, and spend it better.

    Yeah, your taxes might go up. But your healthcare costs will go down, creating a wash, at worst.

    Odds are, costs would go down overall under single payer, because we already pay more than everyone else.
    If only it were that easy. Remember when Medicare Part D was being debated and everyone thought "oh if we make it so Drug companies have a single payer from the government it will save costs" Drug prices havent gone down for seniors. Their is an inherent problem with just saying whatever you are paying now just has to go to the government. For most of the commercial business companies pay 75% - 80% of premiums. If you tried to regulate and say oh you now have to pay what is essentially a tax on what you were giving as a benefit companies will find ways to get around it. A lot of companies are also self insured so it would be really hard to keep tabs on what the were paying. The old saying of "you build a better mouse trap..." is applicable.

    The reality is if we go to single payer like Canada we are going to have to ration care. Whether that is by panels or pricing it will have to happen. Additionally, one of the strongest lobby groups (The AMA) would fight everything tooth and nail. Cutting reimbursement to physicians would be a long ardous battle. Every year they try and cut the Medicare Fee schedules and pass a silly bill only for it to be rescinded when the budget is passed. IMO the only way to straighten this out is give people skin in the game and let them push the market. But it has to be everyone person with skin in the game. Only then can market forces push prices down. The incentives hospitals have right now is to keep builidng new stuff.

    I've mentioned my plan before but I'd like to add some things to my list:

    Medical school, Nurse Practitioner and PA schools tuition is capped at $2k per year. Most universities are not for profit and get a massive benefit from the government. If we are going to cut physician's pay we shouldn't make them take out 500k in loans to become a doctor.
    "Be a philosopher. A man can compromise to gain a point. It has become apparent that a man can, within limits, follow his inclinations within the arms of the Church if he does so discreetly." - The Walking Drum

    "And here’s what life comes down to—not how many years you live, but how many of those years are filled with bullshit that doesn’t amount to anything to satisfy the requirements of some dickhead you’ll never get the pleasure of punching in the face." – Adam Carolla

  22. #472
    Administrator U-Ute's Avatar
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    I recently had back fusion surgery. The EOB's are just starting to show up.

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  23. #473
    Quote Originally Posted by U-Ute View Post
    I recently had back fusion surgery. The EOB's are just starting to show up.

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    Let the ridiculous amount of confusing paper work and billing mistakes begin!


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  24. #474
    Quote Originally Posted by Rocker Ute View Post
    Let the ridiculous amount of confusing paper work and billing mistakes begin!


    Sent from my iPhone using Tapatalk
    My wife recently had some treatment for some nerve pain in her neck and back of her head. IHC apparently used the wrong billing code for part of the treatment, which prevented Medicare from paying that portion. Often multiple phone ccalls and faxes to both IHC billion department and Medicare over two months, we were no closer to getting it resolved. Medicare told us that the way that IHC coded the line items was incorrect and even illegal. We told IHC this, but they didn't offer any help, and started threatening to to send us to collections and having our credit rating affected.

    Finally, I noticed on the back of the bill a procedure to dispute billing items. There was only one way to do this, by using a communication method that I could have used 200 years ago, sending a letter by mail within 60 days. Ther is no option to use new-tangled technology like phone, fax, or internet.

    We we sent the dispute letter certified mail, and the department that received it resolved the issue the day they received it. I guess the lesson is that in bureaucracy, following the rules if more effective than screaming and shouting.
    Dyslexics of the world, untie!

  25. #475
    Quote Originally Posted by Mormon Red Death View Post
    If only it were that easy. Remember when Medicare Part D was being debated and everyone thought "oh if we make it so Drug companies have a single payer from the government it will save costs" Drug prices havent gone down for seniors. Their is an inherent problem with just saying whatever you are paying now just has to go to the government. For most of the commercial business companies pay 75% - 80% of premiums. If you tried to regulate and say oh you now have to pay what is essentially a tax on what you were giving as a benefit companies will find ways to get around it. A lot of companies are also self insured so it would be really hard to keep tabs on what the were paying. The old saying of "you build a better mouse trap..." is applicable.

    The reality is if we go to single payer like Canada we are going to have to ration care. Whether that is by panels or pricing it will have to happen. Additionally, one of the strongest lobby groups (The AMA) would fight everything tooth and nail. Cutting reimbursement to physicians would be a long ardous battle. Every year they try and cut the Medicare Fee schedules and pass a silly bill only for it to be rescinded when the budget is passed. IMO the only way to straighten this out is give people skin in the game and let them push the market. But it has to be everyone person with skin in the game. Only then can market forces push prices down. The incentives hospitals have right now is to keep builidng new stuff.

    I've mentioned my plan before but I'd like to add some things to my list:

    Medical school, Nurse Practitioner and PA schools tuition is capped at $2k per year. Most universities are not for profit and get a massive benefit from the government. If we are going to cut physician's pay we shouldn't make them take out 500k in loans to become a doctor.
    I don't believe Medicare can negotiate drug prices, which is just stupid. You can't say it isn't working when you won't let it try to work in the first place.

    Let Medicare negotiate drug prices. Watch how fast those costs drop.

    Canada has better healthcare than we do. So, even if that is what we did, it would be an improvement.

    We ration healthcare as well by cost.

    Also, we are seeing the benefits of a shitty, yet improved healthcare under the ACA. Costs have risen slower than before and bankruptcies are down 50% since then...and a large reason why is because people are insured.

    https://www.google.com/amp/www.marke...6-40342CF4B8E3

    We've seen so much good from the ACA but it's not enough.

    I think it's crazy that we ignore the good, don't try to improve the bad and want to go back to a system am that we know is worse and more expensive

    Let's move forward. Keep the good, improve the bad. Let's not move backwards.

    "Make America Great Again" is nothing more than backwards movement. Let's move forward.
    Last edited by Utah; 05-23-2017 at 12:08 PM.

  26. #476
    Quote Originally Posted by chrisrenrut View Post
    My wife recently had some treatment for some nerve pain in her neck and back of her head. IHC apparently used the wrong billing code for part of the treatment, which prevented Medicare from paying that portion. Often multiple phone ccalls and faxes to both IHC billion department and Medicare over two months, we were no closer to getting it resolved. Medicare told us that the way that IHC coded the line items was incorrect and even illegal. We told IHC this, but they didn't offer any help, and started threatening to to send us to collections and having our credit rating affected.

    Finally, I noticed on the back of the bill a procedure to dispute billing items. There was only one way to do this, by using a communication method that I could have used 200 years ago, sending a letter by mail within 60 days. Ther is no option to use new-tangled technology like phone, fax, or internet.

    We we sent the dispute letter certified mail, and the department that received it resolved the issue the day they received it. I guess the lesson is that in bureaucracy, following the rules if more effective than screaming and shouting.
    Single payer. You'd gone through none of that.

  27. #477
    Quote Originally Posted by Utah View Post
    Single payer. You'd gone through none of that.
    Yep. Putting the government in charge always results in more speedy, accurate, and less bureaucratic processes.
    Dyslexics of the world, untie!

  28. #478
    Quote Originally Posted by chrisrenrut View Post
    Yep. Putting the government in charge always results in more speedy, accurate, and less bureaucratic processes.

    Should've tripped to Cuba. Worlds best health care for dirt cheap and zero paperwork.
    “Children and dogs are as necessary to the welfare of the country as Wall Street and the railroads.” -- Harry S. Truman

    "You never soar so high as when you stoop down to help a child or an animal." -- Jewish Proverb

    "Three-time Pro Bowler Eric Weddle the most versatile, and maybe most intelligent, safety in the game." -- SI, 9/7/15, p. 107.

  29. #479
    Quote Originally Posted by chrisrenrut View Post
    Yep. Putting the government in charge always results in more speedy, accurate, and less bureaucratic processes.
    And yet, every other first world government in the world provides better, cheaper healthcare.

    Hell, the ACA has reduced costs and bankruptcies. So, our government has done it better.

    Finally, the government is speedy Gonzalous compared to for profit insurance company that their whole business model is about not paying for healthcare.

    See the example above. Everything in our medical system is to not give patients what they have paid for (insurance) and then charge patients on the back end. It's a poor system and it shows in how much we pay and how little we get for it.

    Look at Chris. He paid for insurance. He should have acces to the care he paid for. Yet, he had to put in countless hours fighting to get what he paid for.

    And how many people don't do the work that he did and just pay the bill (so the insurance company and Dr's office have stolen from them)? How bad does that impact our economy? How many bankruptcies come about from this (about half, we are discovering)?

    How many dollars are taken away from people that they could have spent somewhere more effectively, like at a local, small business?

    How many jobs are lost?

    Healthcare is such a no brainer. Provide affordable healthcare. Free people up to be healthy, make money, innovate and progress.

    That's the Republican Party. Take the most intelligent, efficient way to do something and make it expensive, inefficient and profitable for you and your friends then whine about it all while invoking Jesus and something about abortions and marriage.

  30. #480
    Quote Originally Posted by mUUser View Post
    Should've tripped to Cuba. Worlds best health care for dirt cheap and zero paperwork.
    For the cost of a hip replacement in the USA, you could move to Spain, get your replacement, live for a year, get another replacement then move back.

    'Merica. The best healthcare in the world, right?

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