OBAMA/TRUMPCARE MEGATHREAD

[Y2HH]

Im pretty sure that if both parties worked together they could put together some pretty amazing controls that could result in better/cheaper healthcare for everyone.

 

Its unfortunate.

 

The mere idea that the people we elect would work for we the people is absurd.

[pettie4sox]

Im pretty sure that if both parties worked together they could put together some pretty amazing controls that could result in better/cheaper healthcare for everyone.

 

Its unfortunate.

 

Both parties have overlords to serve. Money talks.

[StrangeSox]

Both parties also have very sharp ideological divides on what "works" and what the government should even do in the first place.

[Soxbadger]

The mere idea that the people we elect would work for we the people is absurd.

 

People dont hold their elected officials accountable. Im sure youve read the stories about people using Obamacare who voted for Trump/others who said things like "Oh we just dont believe theyll get rid of it."

 

It will be interesting to see if the Republicans actually go through with it. For a long time they got to score a bunch of political points and basically could "blame Obama." I have a feeling this may be one of those "careful what you wish for" moments in history. Because its impossible to predict the future but I have to imagine if millions lose coverage and premiums dont go down (lets be honest its pretty far fetched to believe the insurance industry will lower rates) there may actually be consequences for once.

 

Both parties have overlords to serve. Money talks.

 

Money only talks because people dont pay attention when they vote. If money didnt get votes or staying power, it would be meaningless. The one thing Trump may have done accidentally was change how campaigns equate money to success. A lot of Trump's message got out to people for free, twitter, etc. I have to imagine that there is someone out there that will realize that in today's society you can get a message out at significantly reduced costs.

[Y2HH]

People dont hold their elected officials accountable.

 

As evident by constantly re-electing a Congress with no almost approval rating...or almost any alderman around Chicago.

[LittleHurt05]

Im pretty sure that if both parties worked together they could put together some pretty amazing controls that could result in better/cheaper healthcare for everyone.

 

Its unfortunate.

 

Isn't that true for almost every issue in government? If both sides were willing to listen to each other and compromise and ignore the lobbyists who control them, then we probably could get some great laws put together.

[StrangeSox]

"My Congressman/Senator is great, it's the other guys who suck!"

[Y2HH]

"My Congressman/Senator is great, it's the other guys who suck!"

 

I'm of the opinion they all suck...

 

Unfortunately, in Chicago, where I happen to reside, almost ALL of the congressmen/senators run unopposed...so I'm not even afforded the illusion of choice.

[StrangeSox]

States Won by Trump Have Highest 'Obamacare' Enrollment

 

A record number of people signed up for health insurance under the Affordable Care Act for the coming year, Barack Obama's administration announced Wednesday, with the most people selecting coverage in states that Donald Trump won in November.

 

Some 6.4 million people signed up by the mid-December deadline — 400,000 more enrollees than the same period last year, according to the Department of Health and Human Services.

 

In a twist, the states with the most people selecting coverage all went for Trump in the presidential election: Florida, with just under 1.3 million selections; Texas, with about 776,000; North Carolina, with 369,077; Georgia, with 352,000; and Pennsylvania, with 290,950.

[Soxbadger]

They do stuff like that with federal funding as well. They dont realize that its generally "blue" states that are "donor" states and "red" states that are "recipient states".

 

Perception distorts reality.

[Iwritecode]

I hate that people still insist on calling this Obamacare, because the Republicans successfully branded it as such.

 

The ACA needs fixes, but that doesn't mean it needs to be repealed because of reasons...

 

I think more control needs to be exerted over drug and healthcare prices if this is ever going to work.

 

 

People dont hold their elected officials accountable. Im sure youve read the stories about people using Obamacare who voted for Trump/others who said things like "Oh we just dont believe theyll get rid of it."

 

Then you have people like this:

 

[Brian]

I've talked to someone in the past who thought that same thing. It was surreal.

[caulfield12]

Isn't that true for almost every issue in government? If both sides were willing to listen to each other and compromise and ignore the lobbyists who control them, then we probably could get some great laws put together.

 

http://www.cnn.com/2017/01/13/health/obama...-aca/index.html

 

Let's call Obamacare a C, the premise of the article.

Why can't it be improved to at least a B?

 

Older, more traditional family practice doctors who trend conservative and want more time with their patients dislike it. The younger generation of doctors under 40 or 45 is much more willing to acknowledge the ends justify the means for coming up with a program much closer to universal coverage.

 

And if we go back to a system where 1 in 7 or even 1 in 6 Americans is without insurance, premiums will continue to rise on those who can afford to pay. Pre-existing condition patients will be screwed because no insurance company wants the added pool risk. The overall cost or negative externalities cost to society will be much higher because preventive care will be thrown out the window for so many poor people...and the system will continue to be reactive rather than proactive.

 

Unless we are comfortable allowing millions of people to die due to purely economic reasons, what does it say that those Congressman want nothing to do with helping their fellow Americans have the same standard of care they're privileged to enjoy as elected representatives subsidized by OUR tax dollars? In the end, the system will leave the poor more vulnerable (again) and the rest of America paying even more until costs are controlled (See Big Pharma and the insurance lobby.)

 

But Donald Trump made some vague promise about drug companies and competitive bidding, so surely they've got it under control 100%.

Edited January 14, 2017 by caulfield12

[caulfield12]

http://sports.yahoo.com/news/matt-garza-se...-161115262.html

 

Matt Garza might have just put himself on Trump's radar for a job.

 

Also some great suggestions every hospital in America greets you with Lee Greenwood's "Proud to be an American" when you come in to register for TrumpCare.

Edited January 14, 2017 by caulfield12

[caulfield12]

Cory Booker, 12 other Dems put local interests over national ones...could have taken a step towards potentially lowering prescription drug prices significantly.

 

http://www.vox.com/policy-and-politics/201...rats?yptr=yahoo

 

http://www.usatoday.com/story/news/politic...-newstopstories

Full list of all the senators who went against 72% national approval for allowing importation to lower prices/increase competition.

Edited January 15, 2017 by caulfield12

[caulfield12]

http://www.cnn.com/2017/01/15/politics/tru...care/index.html

 

Trump promises "INSURANCE FOR ALL"

 

Don't see how this can possibly go wrong.

 

 

Republicans have long slammed Obamacare, saying its high premiums and deductibles leave enrollees feeling like the don't have insurance. They have vowed to lower the cost, primarily by lifting Obamacare's insurance regulations that require carriers to provide comprehensive benefits.

 

Ryan and Price have unveiled frameworks for replacement plans that rely on tax credits based on enrollees' age, not income. However, health policy experts have said those credits will have to be generous in order to make coverage affordable. And that could run afoul of Republicans' promise to lower federal spending on health care.

 

 

while also vowing to force drug companies to negotiate directly with the government on prices in Medicare and Medicaid.

 

Trump said he will target pharmaceutical companies over drug prices.

“They’re politically protected, but not anymore,” he said of pharmaceutical companies.

 

 

In general, congressional GOP plans to replace Obamacare have tended to try to constrain costs by reducing government requirements, such as the medical services that must be provided under health plans sold through the law’s marketplaces and through states’ Medicaid programs. House Speaker Paul D. Ryan (R-Wis.) and other Republicans have been talking lately about providing “universal access” to health insurance, instead of universal insurance coverage.

 

“The Congress can’t get cold feet because the people will not let that happen,” Trump said during the interview with The Post.

 

Trump said his plan for replacing most aspects of Obama’s health-care law is all but finished. Although he was coy about its details — “lower numbers, much lower deductibles” — he said he is ready to unveil it alongside Ryan and Senate Majority Leader Mitch McConnell (R-Ky.).

 

“It’s very much formulated down to the final strokes. We haven’t put it in quite yet but we’re going to be doing it soon.”

 

 

“We’re going to have insurance for everybody,” Trump said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” People covered under the law “can expect to have great health care. It will be in a much simplified form. Much less expensive and much better.”

 

Trump did not say how his program overlaps with the comprehensive plan authored by House Republicans. Earlier this year, Price suggested that a Trump presidency would advance the House GOP’s health-care agenda.

 

When asked in the interview whether he intends to cut benefits for Medicare as part of his plan, Trump said “no,” a position that was reiterated Sunday on ABC by Reince Priebus, Trump’s incoming chief of staff.

 

 

 

 

Moving ahead, Trump said that lowering drug prices is central to reducing health-care costs nationally — and that he will make it a priority as he uses his bully pulpit to shape policy. When asked how exactly he would force drug manufacturers to comply, Trump said that part of his approach would be public pressure “just like on the airplane,” a nod to his tweets about Lockheed Martin’s F-35 fighter jet, which Trump said was too costly. Trump waved away the suggestion that such activity could lead to market volatility on Wall Street. “Stock drops and America goes up,” he said. “I don’t care. I want to do it right or not at all.” He added that drug companies “should produce” more products in the United States.

 

 

The question of whether the government should start negotiating how much it pays drugmakers for older Americans on Medicare has long been a partisan dispute, ever since the 2003 law that created Medicare drug benefits prohibited such negotiations. Trump’s goal is uncertain, however, with respect to Medicaid, the insurance for low-income Americans run jointly by the federal government and states. Under what is known as a Medicaid “best price” rule, pharmaceutical companies already are required to sell drugs to Medicaid as the lowest price they negotiate with any other buyer.

 

 

 

https://www.washingtonpost.com/politics/tru...m=.487eeaecbdcd

 

 

 

Edited January 16, 2017 by caulfield12

[greg775]

If we're going to go down the tubes, we could have at least gone down the tubes with Bernie. Free healthcare; free college. s***, we could have given that a try, since like SNL said, we're all going to die in the next four years with Trump as president.

I'm sick of our health care system. It plain sucks. I challenge any middle class American to survive a one week or 10 day stay in the hospital. Can you say BANKRUPT?

 

(I have to give an addendum to all my posts saying I STILL am glad Hillary has been denied the oval office)

[caulfield12]

https://www.yahoo.com/finance/news/valeant-...-153344072.html

 

Syprine is considered the gold standard for treating Wilson’s (Disease), in part because it has relatively few side effects. But from 2011 to 2015, as Valeant hiked the price of Syprine from less than $1000 for 100 capsules to $21,266.80 for the same 100 capsules, according to documents Valeant provided the government, the drug came to have an inordinate impact on the company’s profits—and far more importantly, on the lives of those who suffer from Wilson’s disease. Syprine was featured prominently in the report about price gouging that was released last month by the Senate Special Committee on Aging.

 

Syprine drug price increases. Source: US Senate — Special Committee on Aging

 

All the negative press doesn’t appear to have done much to change Valeant’s tactics. One patient just received her three-month supply of Syprine at a total cost of $72,338.58, or almost $300,000 a year. The Senate Committee on Aging says that current Valeant CEO Joseph Papa told them that the company had not reduced the price of Syprine and didn’t plan to do so. (Valeant argued to me that it effectively has reduced the price of Syprine by creating patient assistance programs under which commercially insured patients will pay no more than $25 per month for their prescription, and those without insurance whose household income is below 500% of the federal poverty level will get free medication. That, of course, still leaves the insurance system, i.e. all of us, paying for Valeant’s profiteering.)

 

 

In recent years, the Federal Trade Commission has been increasingly aggressive about using antitrust laws to challenge deals between drug companies that may keep a lower-priced drug off the market. In 2013, the Supreme Court ruled, over howls of protest from drug companies, that these deals are subject to antitrust scrutiny. “These business arrangements sometimes serve as a fig leaf to disguise harms to the market and price increases,” says Michael Carrier, an expert on antitrust law at Rutgers Law. But not all such deals are unlawful.

 

The not-so-benign view is that Valeant gave Kadmon 10% of Syprine’s gross profits so that Kadmon wouldn’t undercut Valeant’s pricing by launching its own competing drug. After all, as one lawyer says, “Kadmon isn’t Pfizer,” meaning that a tiny company that was hemorrhaging money and didn’t have a massive sales force doesn’t seem like a choice partner. “If I were still at the FTC, I would investigate,” says a former FTC lawyer.

 

Good luck, Trumpicans!

Edited January 16, 2017 by caulfield12

[Jerksticks]

It's asking the low middle class, independent contractor guy with no subsidies to sock away 6k to cover his deductible and OOPMax that is insane. Forget it if he has a family and his wife gets sick for awhile. Lemme go grab that 15k real quick..meanwhile the average American has less than 6k in savings. God forbid the anesthesiologist for your surgery is out of network. Out of network caps can be 30k if I'm not mistaken. Each carrier decides.

 

I work with 100s of these people. What sucks is that deducts all used to be $500-$1000. Now you gotta pay to play. People aren't going to get things checked out because they are probably going to have to foot the whole bill with these high-ass deducts.

 

 

Saying Obamacare needs tweaks is an understatement. Not being partisan, just American. Please correct any misinformation on my end.

 

 

 

 

 

[caulfield12]

This is a pretty logical summary of the problem, in one long paragraph.

 

Avatar

Thomas 15 hours ago

 

WrongFreedomHawk. Your assertion that the government caused the escalation of college tuition and the fees charged by physicians i simply not true. College tuition has increased, because universities and colleges are treated as a business, there to make money, and the government has systematically reduced its contribution to school aide, grants, and scholarships, resulting in more and more students having to rely on high interest loans to pay their college tuition, which continues to escalate faster than inflation. The single most important factor in the rise of physicians fees, was the eventually acceptance of assignments of benefits and third party payments by doctor's offices back in the 1960's and 1970's. Prior to this period, patient's had insurance, provided by employers, but few if any doctors offices accepted the insurance. The patient would pay the doctor his established officer fee, and the doctor's office might help the patient complete the insurance forms, so that the patient could get reimbursed by the insurance company for the payment to the doctor. However, in the 1960's and 70's there were many medical and professional lecture series dedicated to teaching doctors how to bill insurance companies for their fees, and the advantages of doing so, in expanding the patient pool seeking medical care. Many doctor's offices began accepting insurance assignment of benefits permitting them to bill the insurance company directly for their services provided insured patients, sparing the patient from having to pay for the medical services. This systems created a disconnect between the patient and the fees charged by the providers, allowing doctor's offices to greatly increase their fees, because the patient's were no longer paying. Government had no pony in this race. The patients did not seem to care or concern themselves with the cost of the care they were receiving, that was now solely the responsibility of the insurance companies. The doctors, realizing the discontent, raised their fees dramatically over a number of years, and reaped huge economic rewards, while insurance carriers were expected to pay for any and all services billed regardless of their efficacy or patient outcome. I can recall a time when colleagues of mine, being newly trained in arthroscopic surgery began charging insurance carriers $15,000.00 for what was in effect a 20-25 minute minimally invasive procedure and would schedule 15-20 of these surgeries per day. You do the math. These surgeons were making $200,000.00-$300,000.00 per day. Hospitals loved these high volume surgeons, because they were a cash cow generating huge revenues for the hospitals. Almost like printing money. Medicare, Medicaid, and other government programs have actually had a very negative effect on doctor's fees and income. Medicare pays only a fraction of a doctor's usual and customary fees. Medicaid pays fees at such an artificially low level, that few doctors will accept medicaid patients, and those that do may feel compelled to commit insurance fraud, as a rationalized justification of the mistreatment and underpayment of fees by the government. Third party insurance carriers attempt to use the extremely low fees paid by Medicare to negotiate down doctor's usual and customary fees.

 

Note: I have lived through and had to adapt to the changes in our healthcare delivery system, the multitude of changes of healthcare reimbursement, and I own 4 healthcare companies, and a medical billing company.

 

 

 

SO, BASICALLY, you've got the doctors/hospitals, insurance companies and drug companies all fighting for a diminishing piece of the pie. Who's going to be willing to sacrifice any of their profits, and WHY?

 

 

http://www.cnn.com/2017/01/15/politics/ran...ment/index.html

Rand Paul presents his plan.

 

 

On Sunday, Paul gave a preview of his and argued that in requiring insurers to offer more robust plans, Obamacare drove up prices and pushed people out of the market.

 

1) "One of the key reforms that we will do is, we're going to legalize the sale of inexpensive insurance," he said. "That means getting rid of the Obamacare mandates on what you can buy. We are going to help people save through health savings accounts, as well as a tax credit." Those less expensive options, which were prevalent on the market before the 2010 reform was signed into law, would offer less robust care but also, as supporters argue, be more neatly tailored to what consumers view to be their specific needs.

 

 

2) Under Paul's program, the bargaining power created by the state and federal exchanges would be replaced with a provision that allows individuals and associations like small businesses to create their own markets.

 

"There's no reason why (a business owner) with four employees shouldn't be able to join with hundreds and hundreds of other businesses that are small to become a large entity to get leverage to bring your prices down," Paul told Tapper.

 

He added that those negotiations with insurance companies could also be used to guarantee the availability of policies that "can't cancel you and guarantees the issue of the insurance even if you get sick."

 

 

3) Paul's plan did not directly address the future of states that signed on for expanded Medicaid offered as part of Obamacare. Kentucky, which had a Democratic governor when the law went into effect, was among those to accept the funds. The majority of the more than 400,000 Kentuckians insured under the law were brought into the fold by Medicaid expansion.

 

"That's the big question," Paul said of their fate. "And I don't think that's going to be in the replacement aspect."

The future of Medicaid expansion would then be decided during the repeal process, which will run through a budget reconciliation vote -- one that requires only a simple majority for passage.

 

"What we have to decide is what can be kept and what can't be kept," Paul said, suggesting that the states should raise taxes if they want to maintain their current expenditure levels.

 

So that's two reasonable enough ideas, although not sure why it took since 1994...of course, you have to deal with the pre-existing conditions (addressed in point 2, although not comprehensively, it's a bit vague, as insurance companies won't voluntarily cover the most expensive pre-existing conditions) AND under 25/26 year olds staying on the insurance plans of their parents as well as who continues to pay for the CHIP plan/Medicaid (states? Federal government? higher taxes on individual families?)

 

Of course, independent auditors/CBO are going to have to look at these Medical/Health Savings Accounts, vouchers and tax credits and score how much money it's actually going to cost compared to the current system...

Edited January 16, 2017 by caulfield12

[Balta1701]

It's asking the low middle class, independent contractor guy with no subsidies to sock away 6k to cover his deductible and OOPMax that is insane. Forget it if he has a family and his wife gets sick for awhile. Lemme go grab that 15k real quick..meanwhile the average American has less than 6k in savings. God forbid the anesthesiologist for your surgery is out of network. Out of network caps can be 30k if I'm not mistaken. Each carrier decides.

 

I work with 100s of these people. What sucks is that deducts all used to be $500-$1000. Now you gotta pay to play. People aren't going to get things checked out because they are probably going to have to foot the whole bill with these high-ass deducts.

 

 

Saying Obamacare needs tweaks is an understatement. Not being partisan, just American. Please correct any misinformation on my end.

The big problem with those low deductible packages available before the ACA was that you don't note any case of a person actually getting ill and needing it, and then discovering the yearly or lifetime caps (now banned) or that what they needed covered simply wasn't included. There's an offset in every bit of this and prior to 2009 insurers were happy to sell you a low deductible plan that you're paying for...but it's basically worthless if you actually have a major illness. Or have a kid. That was the other side and it was probably buried in 1 out of 25 or 1 out of every 50 contractors on those types of plans.

[Jerksticks]

The big problem with those low deductible packages available before the ACA was that you don't note any case of a person actually getting ill and needing it, and then discovering the yearly or lifetime caps (now banned) or that what they needed covered simply wasn't included. There's an offset in every bit of this and prior to 2009 insurers were happy to sell you a low deductible plan that you're paying for...but it's basically worthless if you actually have a major illness. Or have a kid. That was the other side and it was probably buried in 1 out of 25 or 1 out of every 50 contractors on those types of plans.

 

For sure. And I think that's a problem that hasn't been fixed. I'm more concerned these days with just low-to-mid-level medical needs. People aren't flocking to the doctor any more in fear they might need x-rays and a few tests.

 

Would you agree that a phrase such as "ahh, I'm probably ok" is used more since ACA and the introduction of $3000 deducts? I would say more people are self-medicating and interent-diagnosing more than ever and I'm not sure that's a good thing.

[illinilaw08]

For sure. And I think that's a problem that hasn't been fixed. I'm more concerned these days with just low-to-mid-level medical needs. People aren't flocking to the doctor any more in fear they might need x-rays and a few tests.

 

Would you agree that a phrase such as "ahh, I'm probably ok" is used more since ACA and the introduction of $3000 deducts? I would say more people are self-medicating and interent-diagnosing more than ever and I'm not sure that's a good thing.

 

Honestly, I think it happened more previously when 16M fewer people had health insurance, and physicals weren't completely covered.

 

The ACA "fixed" the problem of low dollar catastrophe policies, or low dollar, low deductible plans that weren't adequate to cover a person if they ultimately had cancer or another catastrophic illness.

 

The goal of insurance in this country should be (1) greater access; and (2) lower cost. The ACA addressed (1), it did not adequately address (2).

[StrangeSox]

Didn't the ACA lower copays for annual checkups to $0?

[illinilaw08]

Didn't the ACA lower copays for annual checkups to $0?

 

Yes.