KRISTEN'S BOARD
KB - a better class of pervert

News:

American Health Care in Crisis

Lois · 5013

0 Members and 1 Guest are viewing this topic.

Offline Katiebee

  • Shield Maiden POY 2018
  • Burnt at the stake
  • *******
    • Posts: 12,199
    • Woos/Boos: +946/-14
    • Gender: Female
  • Achieving world domination, one body at a time.
Reply #40 on: March 19, 2017, 05:26:21 PM
Joan, the current budget proposal effectively eliminates federal funding for meal on wheels, and other assistance to senior care programs.


There are three kinds of people in the world. Those who can count, and those who can't.


Offline Northwest

  • Freakishly Strange
  • ******
    • Posts: 1,163
    • Woos/Boos: +55/-1
Reply #41 on: March 19, 2017, 06:10:07 PM
Joan, the current budget proposal effectively eliminates federal funding for meal on wheels, and other assistance to senior care programs.

Exactly.

Also, the Republican health care proposal (which Trump has strongly backed) is very hard on seniors, and would result in dramatic cost increases for the elderly.

Quote
...The insurance that people would obtain would have "lower average actuarial values" -- CBO-speak for worse coverage. The high copays and deductibles about which Trump and other critics of Obamacare rail? "They would tend to be higher than anticipated under current law," and would climb even higher for the less well-off after 2020, when cost-sharing subsidies are repealed, "significantly increasing out-of-pocket costs ... for many lower-income enrollees."

The new system would hurt the oldest consumers. Insurers would be free to charge those between 50 and 64 five times as much as younger enrollees; under Obamacare, that differential is limited to three times as much. It would hurt those with lower incomes, because the tax credits would "tend to be smaller" than the subsidies available under current law, which are more generous to those who earn less -- not to mention the extra hit after 2020, mentioned above...

Excerpt from:

http://www.realclearpolitics.com/articles/2017/03/19/trump_deals_his_base_a_double-whammy_133371.html
« Last Edit: March 19, 2017, 06:58:33 PM by Northwest »



Offline Lois

  • Super Freak
  • Burnt at the stake
  • ******
    • Posts: 11,151
    • Woos/Boos: +766/-56
Reply #42 on: March 19, 2017, 10:51:36 PM

Getting the Feds out of local issues, will cause local politicians and citizens to have greater choice about what their local dollars endorse and encourage. If a local jurisdiction wishes to support purchase of a Fire Truck, then there is a process for that among local officials, bond measures, and such.

The Federal Government is a large entity with the power to negotiate prices much better than small local entities. That really is the point being made here.

Local control makes sense in some instances, but it when it makes a difference of paying $90,000 for a new fire truck or $250,000, I think we can give local control a rest.

And yes, NorthWest also makes a very good point about the taxes as well. 



Offline Northwest

  • Freakishly Strange
  • ******
    • Posts: 1,163
    • Woos/Boos: +55/-1
Reply #43 on: March 21, 2017, 09:06:34 PM
Most significant sentence from this article: "The House GOP leadership has decided that their bill is unlikely to survive a longer and more open drafting process, and so they need to jam it through the House as fast as humanly possible." In other words...they need to get it passed before people have a chance to understand what it will mean. Welcome to Potterville.

The new Republican health care bill doesn't fix the old bill's problems
Ezra Klein



There are three problems you could have imagined the manager’s amendment to the American Health Care Act trying to fix:

1. The Congressional Budget Office estimates the AHCA will lead 24 million more Americans to go uninsured, push millions more into the kind of super-high-deductible care Republicans criticized in the Affordable Care Act, and all that will happen while the richest Americans get hundreds of billions of dollars in tax cuts. Voters — including the downscale rural whites who propelled Donald Trump into the presidency — aren’t going to like any of that.

2. Virtually every health policy analyst from every side of the aisle thinks the AHCA is poorly constructed and will lead to consequences even its drafters didn’t intend. Avik Roy argues there are huge implicit tax increases for the poor who get jobs that lift them out of Medicaid’s ranks. Bob Laszewski thinks the plan will drive healthy people out of the insurance markets, creating even worse premium increases than we’re seeing under Obamacare. Implementing this bill, as drafted, would be a disaster.

3. As written, the AHCA is unlikely to pass the House, and so GOP leadership needs to give House conservatives more reasons to vote for the bill, even if those reasons leave the legislation less likely to succeed in the Senate. For this bill to fail in the House would embarrass Speaker Paul Ryan and President Trump.

Of the three problems in the AHCA, the third is by far the least serious — but it’s the only one the manager’s amendment even attempts to solve. These aren’t changes that address the core problems the GOP health care bill will create for voters, insurers, or states; instead, it’s legislation that tries to solve some of the problems the bill creates for conservative legislators. It might yet fall short on even that count.

This is a trap for Republicans. Both the process and the substance of the American Health Care Act have revealed a political party that has lost sight of the fact that the true test of legislation isn’t whether it passes, but whether it works.

Republican leaders have moved this bill as fast as possible, with as little information as possible, and with no evident plan for what will happen if the bill actually becomes law and wreaks havoc in people’s lives. This is not the health reform package Donald Trump promised his voters, it’s not the health reform package conservative policy experts recommended to House Republicans, and it’s not the health reform package that polling shows people want.

About the only thing that can be said for the revised bill is this might be the health reform package that can pass the House. And that appears to be the only problem Republicans care to solve right now.

What changes are Republicans making to the AHCA?

The major changes to the bill, which were first reported Politico and which Vox has now confirmed, are:

* A change in the tax deductibility of medical expenses that the Senate could harness to boost tax credits for older Americans, to the tune of an estimated $85 billion

* More flexibility for states to add work requirements to Medicaid

* More flexibility for states to take their Medicaid funding as a lump-sum block grant rather than a per-person check

* Accelerating the repeal of Obamacare’s tax increases by one year

* Restricting people from rolling unused tax credit money into health savings accounts (apparently to ease concerns of anti-abortion groups)

* Changing Medicaid reimbursement procedures in a way that advantages county governments over state governments (for idiosyncratic reasons, Republicans from New York are high on this provision)

* Changing Medicaid reimbursement rates for the elderly and disabled

* States that haven’t accepted Obamacare’s Medicaid expansion will no longer have the opportunity to do so.

None of these provisions meaningfully change the underlying legislation, nor any of its flaws. These are mostly tweaks meant to win over hardcore conservatives and Congress members from New York.

Will these changes push the bill through the House?

The locus of effective opposition to the American Health Care Act has been the House Freedom Caucus. Monday night, its leader, Rep. Mark Meadows, sounded a pessimistic note.

"There are some small tweaks that are good tweaks, but there's not substantial changes in the manager's amendment that would make anybody be more compelled to vote for this," he said. "I don't think that the bill will pass without substantial changes."

Quote
Meadows & Amash have both told me w/ full confidence that the GOP Obamacare replacement bill won't have enough votes despite Ryan's changes
    — Haley Byrd (@byrdinator) March 21, 2017

Meadows may, of course, be wrong. Trump is lobbying individual House Republicans hard, and it’s possible a critical number of conservatives will be swayed by Ryan’s argument that this is their last, best, and only chance to repeal Obamacare.

But it’s also possible that the bill fails in the House. Some conservatives think they can get a better deal by holding strong, even though the better deal they seek would ensure the legislation is dead on arrival in the Senate, if it even makes it to the Senate.

One dynamic that may work against Ryan and the legislation is the secrecy, speed, and unilateralism of the process. The bill hasn’t been heavily debated or seriously amended in the committees. The changes to the bill were made by leadership, and they were made fast. Long legislative efforts are annoying for everyone involved, but the reason they’re undertaken is that the process leaves members feeling heard, and feeling bought into the end result.

Quote
Other than pressuring Ryan, rest of the membership has no direct control over bill text or votes for the remainder of the AHCA debate. |6
    — Josh Huder (@joshHuder) March 20, 2017

The House GOP leadership has decided that their bill is unlikely to survive a longer and more open drafting process, and so they need to jam it through the House as fast as humanly possible. It took the House more than five months to pass the first iteration of the Affordable Care Act. Republicans are trying to clear their bill in mere weeks. (See this excellent Sarah Kliff piece for more on the stunning hypocrisy at play here.)

What do Republicans think will happen if they actually pass this into law?

I keep thinking about something that New York Times columnist Ross Douthat wrote today. “Republican politicians may offer pandering promises of lower deductibles and co-pays, but the coherent conservative position is that cheaper plans with higher deductibles are a very good thing,” he said. It’s a gently written sentence, but it’s damning beyond measure.

Republicans have been promising the literal opposite of the bill they are trying to pass. Trump swore he’d oppose Medicaid cuts — but this law has more than $800 billion of them. He said everyone would be covered — but the CBO estimates this bill will push up the ranks of the uninsured by 24 million people. Republicans everywhere said they would replace Obamacare with a plan that ensured more competition, lower premiums and deductibles, and an end to skyrocketing annual increases — but this bill will have the opposite effect for most of those affected.

So what happens when voters realize their new tax credit doesn’t cover anything close to the insurance they had? What happens when they find themselves with fewer choices, paying much higher premiums after their smaller subsidies, and being told by insurers that costs are doubling because Republicans changed how much more the old could be charged than the young?

Voters will notice all this. And what are Republicans going to say then? That it’s all Barack Obama’s fault? That high deductibles are actually good, they just forgot to mention it? That they needed something they could pass quickly so they could move on to tax reform?

This bill has always seemed like an answer to the question, “What can we pass that would count as repealing and replacing Obamacare?” But that’s not the right question. The right question is, “What can we pass that will actually make people’s lives better?” Given the truncated, fearful process Republicans have retreated behind, I’m not persuaded even they believe this bill is the answer.

http://www.vox.com/policy-and-politics/2017/3/20/14991750/republican-health-bill-ahca-amendments-changes



Offline Northwest

  • Freakishly Strange
  • ******
    • Posts: 1,163
    • Woos/Boos: +55/-1
Reply #44 on: March 22, 2017, 05:05:20 PM
According to numerous sources this morning, the Ryan and Trump lack the votes to get passage of the health care act in the House.

I'm pretty sure they'll cancel the vote tomorrow, rather than face the certainty of a defeat. And I can't guess where it will go after that. But it will still be counted as another major defeat for Trump, who's having the worst week of his troubled presidency.



Offline watcher1

  • POY 2010
  • Burnt at the stake
  • *******
    • Posts: 16,710
    • Woos/Boos: +1575/-56
    • Gender: Male
  • Gentleman Pervert
Reply #45 on: March 22, 2017, 06:53:34 PM
Let us thank those Republican Moderates who refuse to march to the Trump and Ryan beat.  Plus all the Democrats who will not go along with the proposed bill, as did their GOP counterparts when the ACA was voted in.

Emancipate yourself from mental slavery, none but ourselves can free our minds.


Offline Northwest

  • Freakishly Strange
  • ******
    • Posts: 1,163
    • Woos/Boos: +55/-1
Reply #46 on: March 23, 2017, 07:12:06 PM
Poll: Just 17 percent of voters back ObamaCare repeal plan

Just one in six want this piece of nightmare legislation to pass (click link above for article).



Offline Northwest

  • Freakishly Strange
  • ******
    • Posts: 1,163
    • Woos/Boos: +55/-1
Reply #47 on: March 23, 2017, 10:31:33 PM
They've canceled the House vote for this afternoon.

I understand that they will keep trying, but I don't see how more time is going to make much difference. When they move left, votes peel off from the right. When they move right, votes peel off from the left.

The public is against the bill by a margin of five to one, and Representatives don't want to vote on an unpopular bill that can't clear the Senate -- where chances of passage are even worse.

They're going to put the best face on this, and claim that all they need is a little more time (because, you know, who wants to admit defeat) but the more time people have to look at this abortion the worse it looks.

I think health care reform is effectively dead unless and until something major happens which changes the calculus -- like a new Congress or President.



Offline Katiebee

  • Shield Maiden POY 2018
  • Burnt at the stake
  • *******
    • Posts: 12,199
    • Woos/Boos: +946/-14
    • Gender: Female
  • Achieving world domination, one body at a time.
Reply #48 on: March 24, 2017, 01:18:30 AM
Or an actual resolution to the problems.

There are three kinds of people in the world. Those who can count, and those who can't.


Offline Northwest

  • Freakishly Strange
  • ******
    • Posts: 1,163
    • Woos/Boos: +55/-1
Reply #49 on: March 24, 2017, 01:37:00 AM
Actually, Katiebee, I don't think that's something they are even looking at, or care about.



Offline joan1984

  • Burnt at the stake
  • *******
    • Posts: 11,273
    • Woos/Boos: +613/-270
    • Gender: Female
  • Co-POY 2011
Reply #50 on: March 24, 2017, 01:52:19 AM
   What is necessary is to repeal the 2010 ACA in it's entirety, rip it out, root and branch.

Not to try and keep the taxes and regulations, and the thousands of bureaucrat enforcers of such. Not to keep the IRS as enforcer... get the IRS 'OUT'  of our Health Insurance, and Health Care.

   Did hey mean it when they said they would uproot Obamacare in 2010? How about in 2014? How about in 2016, when they virtually all ran on such action?
Were they lying then, or are they lying now?  What do these RINO legislators, in both the House and the Senate, not understand about this?

   I know there are supposedly 'three phases' to the process, and not everything can be addressed via "reconciliation", per the Senate Parliamentarian. Makes no difference that this leviathan was passed under "reconciliation"... grrrr...

   So anyway, the three phases for Congress, with further Regulations to be cut in another Bill, and then the 'goodies' of elimination of state lines for insurance and other items to follow, later in this congress, supposedly and along with the three 'phases', and with Secretary Price forcing changes at the Agency level, and the President mopping up with EO's as needed... all sounds like a 'stall' to me.

   Fire the Parliamentarian is one option, or replace the Parliamentarian, or ignore the Parliamentarian, dammit, and just get it done. Worried about Sixty Votes? Get rid of the filibuster now, just do it, and pass what is necessary to get this stuff moving.

   Finally, move on the Tax Cuts soonest... then the rest of the necessary US business can be done via regular order, to finish the session.

Some people are like the 'slinky'. Not really good for much,
but they bring a smile to your face as they fall down stairs.


Offline Shlong Connery

  • Pervert
  • **
    • Posts: 83
    • Woos/Boos: +6/-1
Reply #51 on: March 24, 2017, 05:41:15 AM
REPEAL! Sounds great until you realize this means killing off your voters.

 :emot_rotf:



Offline Northwest

  • Freakishly Strange
  • ******
    • Posts: 1,163
    • Woos/Boos: +55/-1
Reply #52 on: March 24, 2017, 06:09:01 PM
   Makes no difference that this leviathan (Obamacare) was passed under "reconciliation"... grrrr...

No it wasn't, Joan. Obamacare was passed 'regular way' with 60 votes. It was later amended via the reconciliation process, and the Democrats were encumbered with the same restrictions which Republicans now face.

Amazing the double standards which you support or gloss over, Joan. It's almost like you don't actually have any principals at all.



Offline watcher1

  • POY 2010
  • Burnt at the stake
  • *******
    • Posts: 16,710
    • Woos/Boos: +1575/-56
    • Gender: Male
  • Gentleman Pervert
Reply #53 on: March 24, 2017, 07:10:21 PM
I like how Trump is threatening his fellow Republicans.  Vote for his new healthcare bill or be stuck with Obamacare.  We know what is Obamacare. It is not perfect and needs tweaks and things. I dread what the GOP health bill will do to seniors and others.  The GOP had eight years to come up with a health plan. Seems all they cared about was to repeal Obamacare if a Republican was elected president. They look more and more like the gang that couldn't shoot straight.

Emancipate yourself from mental slavery, none but ourselves can free our minds.


Offline Northwest

  • Freakishly Strange
  • ******
    • Posts: 1,163
    • Woos/Boos: +55/-1
Reply #54 on: May 05, 2017, 05:21:17 PM
Unless you've been living in a cave, or on a sailboat (And if a sailboat, where's my invite?) you already know that Health Care Removal Act has passed the House. It's time to start planning for the possibility of eventual passage:

This Website Will Mail Your Ashes To The GOP If Trumpcare Kills You. Really.

Ashes to ashes, dust to dust, to House Republicans.



Washington, D.C., college student Zoey Salsbury has insurance today, thanks to a provision in the Affordable Care Act that allows children to stay on their parents’ health care plan up to age 26.

She said she watched in horror Thursday as House Republicans passed an Obamacare repeal bill called the American Health Care Act, either unaware their legislation would kill people, or simply unsympathetic enough to care.

So, Salsbury set out to make GOP politicians face the consequences of their vote, launching mailmetothegop.com, a website that pledges to send the ashes of your cremated body to a member of Congress, should you die because of the Republican health plan.

The National Funeral Directors Association says it’s illegal to ship cremated remains via any carrier other than the U.S. Postal Service, which put together a helpful guide, including a photo of what your remains might look like:


United States Postal Service

“Yes, it is real,” Salsbury, a junior at American University, told HuffPost Thursday, shortly after her new website was overwhelmed by traffic and crashed.

“Many of my friends will die” if this becomes law, she said. “People will literally die, and they don’t see that that’s going to happen.”

The GOP bill, which has no chance of passing the Senate, would cast millions off insurance, undermining Obamacare protections for the sick and poor, including those with pre-existing medical conditions. It would keep the popular provision that allows children to remain on parents’ policies until age 26.

Salsbury explained she made MailMeToTheGOP.com on a whim after chatting with some of her friends who would be affected.

“It’s really morbid and not fun to talk about,” she added. “But that’s the reality of passing a health care bill like this.”

http://www.huffingtonpost.com/entry/mail-ashes-trumpcare_us_590b9bc3e4b0d5d9049ad475



Offline Northwest

  • Freakishly Strange
  • ******
    • Posts: 1,163
    • Woos/Boos: +55/-1
Reply #55 on: May 22, 2017, 06:25:03 AM

The healthcare topic does tend to generate some strong feelings. I don't think I'd want to be a Representative who voted for Trump/Ryan care com mid-terms.



IdleBoast

  • Guest
Reply #56 on: May 22, 2017, 11:53:48 PM
In all honesty, healthcare is *the* thing preventing me moving to San Francisco (my favourite city on the planet).

2012;

In San Francisco for a month, working. Family is with me. Youngest has kidney issues, normally under control, but something blocked a tubule. So we call 911, an ambulance turns up promptly, but then we sit by the kerb as the paramedics go through our insurance documents, trying to work out which hospital to take him to while our boy lies screaming on the gurney as he slowly passes a stone.

Eventually I just tell them to take him to the nearest hospital, we'll sort the paperwork later.

All the hospital did was give him an oral opiate and set us off to walk back to our apartment.

For a 5 minute ambulance ride and two painkillers, we got a bill for $1300.

We let our insurance pay it.



Offline Northwest

  • Freakishly Strange
  • ******
    • Posts: 1,163
    • Woos/Boos: +55/-1
Reply #57 on: May 26, 2017, 04:33:42 PM
It's time to get to the core issues, and to make some basic rational decisions about how health care will be delivered in America.

Why Republicans can't fix health insurance

The Congressional Budget Office analysis of the Republican health care and tax cut bill that passed the House of Representatives last month is full of striking facts. But here’s a particularly telling one: The regulatory changes made at the behest of the far-right Freedom Caucus do succeed in yanking insurance coverage from 1 million fewer people than would have lost coverage under the original version of the American Health Care Act.

In exchange, government spending increases by $218 billion over a 10-year period — $218,000 per additional insured person. That’s a lot of money.

To really understand how much money it is, consider the AHCA’s provisions related to Medicaid. Here, 14 million people are expected to lose coverage, which ends up saving the government $884 billion. That comes out to about $60,000 per person — a far lower figure. In other words, if Republicans were willing to spend an extra $150 billion to reduce coverage loss by making their Medicaid cuts less savage, they could have earned themselves a far better CBO score on both coverage and deficit reduction.

But to do that they’d have to admit something that Republicans seem incapable of admitting: When it comes to health insurance, market-oriented solutions are the most expensive option.
Big government provides health insurance on the cheap

This is a reality centrist Democrats found themselves facing awkwardly when they sat down to write the Affordable Care Act in 2009.

Moderates liked the idea of subsidizing the purchase of private insurance more than they liked the idea of expanding a government insurance program. But they also liked the idea of spending less money rather than more. And it turned out that on a per patient basis, expanding Medicaid was cheaper than extending subsidies to buy private insurance. Democrats had to choose between their ideological aversion to government insurance and their ideological aversion to higher spending, and ultimately wound up deciding that a hefty dose of Medicaid expansion was a better idea than pushing the spending total up.

But this is exactly the point that Republicans — who are much more averse to federal social spending than even the most centrist Democrat — consistently refuse to acknowledge.

Almost across the board, government solutions are cheaper:

* Medicaid and Medicare both cost less on a per patient basis than similar private insurance.

* In most counties, traditional government-run Medicare is cheaper than private plans purchased through Medicare Advantage.

* Adding a public option to the Affordable Care Act would reduce premiums and federal spending.

* Internationally, more statist national health care systems like Canada’s are cheaper than more market-oriented ones like Switzerland. The extremely statist UK system is cheapest of all.

* Even a system like Singapore’s that conservatives are sometimes inclined to praise actually entails massive government intervention, with over 80 percent of the hospital beds in government-run hospitals.


Health care is complicated, but the source of the big government price advantage is not. When the government acts as a giant health care buyer, it either formally through regulation or informally through purchasing power imposes price controls on the sellers of health care services.

The ordinary push and pull of consumer action in a marketplace isn’t able to do nearly as well because patients neither can nor want to approach health decisions like ordinary commercial transactions. It’s true that a free market approach works well enough for purely discretionary health services like Lasik or breast enhancement surgery, but these are exceptions that prove the rule — medical procedures that don’t address core health needs function fine as consumer commodities. Essential health care doesn't.

The Republican trilemma

None of which is to say that there’s no rational basis for opposing a purely state-run approach to health care. The more market mechanisms you put in place, the more choices consumers will have. More variety gives room for more innovation and more emphasis on customer service.

And, indeed, the higher costs of a private approach aren’t necessarily a bad thing. Higher costs for some mean higher profits for others, which ultimate incentivizes more R&D spending and other investments.

But there is a fundamental three-way tradeoff here between the amount of money that you spend, the number of people that you cover, and the extent to which you rely on market mechanisms. What conservative ideologues want to do is choose minimal government spending and maximum reliance on free markets, letting coverage wither in the wind. That’s why Michael Cannon of the libertarian Cato Institute launched his “Anti-Universal Coverage Club” 10 years ago to try to rally the faithful behind the cause of letting tens of millions of Americans go uninsured.

Practical Republican politicians don’t want to go there, however, because it’s morally hideous. Nobody who has to face the voters wants to own up to favoring a free market system in which huge swathes of the population can’t get care when they are sick. On the contrary, when GOP politicians need to make the case against Obamacare, what they normally do is complain that premiums are too high and coverage isn’t generous enough. But there are only two ways to address those issues: lean less on government solutions, or spend more money backed up by higher taxes.

Neither option is acceptable to Republicans, so they’re left with the AHCA solution — massive rollbacks in coverage that they try to paper over with a lot of handwaving.

https://www.vox.com/health-care/2017/5/25/15688408/government-insurance-is-cheaper
« Last Edit: May 26, 2017, 05:59:26 PM by Northwest »



Offline Lois

  • Super Freak
  • Burnt at the stake
  • ******
    • Posts: 11,151
    • Woos/Boos: +766/-56
Reply #58 on: May 26, 2017, 08:06:19 PM
Indeed, their free market based ideology makes it impossible for them to see that some things can be done more efficiently and better by the government. 



IdleBoast

  • Guest
Reply #59 on: May 29, 2017, 04:10:58 PM
« Last Edit: May 29, 2017, 09:28:42 PM by IdleBoast »