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Thread: And ACA dismantlement starts

  1. #71
    Simpleton Alan's Avatar
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    Quote Originally Posted by JaneV2.0 View Post
    Blame endlessly greedy insurers, Pharma, hospitals, etc. that keep pushing prices ever higher.
    You're right! Health care was a bargain when it consisted of leeches and poultices.
    "Things should be made as simple as possible, but not one bit simpler." ~ Albert Einstein

  2. #72
    Senior Member jp1's Avatar
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    Peter Schiff recently posted a column where he came to the conclusion that the AHCA will actually kill the health insurance industry. Basically he believes that without the mandate many healthy people will simply go without insurance until they become sick, at which point it will make sense to pay the 30% penalty. Taking that a step further he predicted that without the employer mandate some employers, possibly many, will choose to self insure low levels of healthcare but then if an employee develops a more serious illness simply buy them insurance at the 30% penalty rate, thus keeping all the 'healthy' employees out of the health insurance system. The result being only the sickest people buying insurance and Trumpcare being responsible for the 'death spiral' that the republicans have been expecting since the ACA started.

  3. #73
    Senior Member JaneV2.0's Avatar
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    Quote Originally Posted by Alan View Post
    You're right! Health care was a bargain when it consisted of leeches and poultices.
    Health care was affordable in my lifetime--which admittedly is a long one--before insurance got involved. And you had choices back then. Ancient history.

    But most civilized countries provide affordable health services now. Just not this one.

  4. #74
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    Peter Schiff recently posted a column where he came to the conclusion that the AHCA will actually kill the health insurance industry. Basically he believes that without the mandate many healthy people will simply go without insurance until they become sick, at which point it will make sense to pay the 30% penalty.
    I'm not sure that it was that hard to avoid the mandate now, if basically one played games with their taxes and under-withheld. It did require some game playing (it's kind of why anyone can be made to hate D.C., when the advantages go not to honest normal time-crunched people who mostly play very directly by the rules, but instead those best at gaming the system).

    Taking that a step further he predicted that without the employer mandate some employers, possibly many, will choose to self insure low levels of healthcare but then if an employee develops a more serious illness simply buy them insurance at the 30% penalty rate, thus keeping all the 'healthy' employees out of the health insurance system.
    well the employer mandate has NEVER been enforced. So is there really that significant a difference from a law they seem never to plan to enforce and not having one at all? I guess one could always fear they might decide to enforce the former someday ...

    The result being only the sickest people buying insurance and Trumpcare being responsible for the 'death spiral' that the republicans have been expecting since the ACA started.
    speculation about a death spiral are not purely a Republican thing (I didn't say it's true, I honestly have no idea, but it is not just Republican):
    http://www.politico.com/story/2017/0...rtolini-235041
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    IL: how it affects my friend is that he wants to cut Medicaid and where would that leave people like her?

  6. #76
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    Yea cuts MediCAID and MediCARE. I hope no one was planning or knows anyone who is planning to use MediCARE for anything serious in the next decade. (These trust funds are often complicated and I don't know how they work, the truth is in reality the government could just pay for this stuff out of deficits the same way it funds anything it really WANTS to fund (like a new war), but there may be laws that tie their hands for actually doing so. Or with general taxes also but there may political issues doing so).

    http://thehill.com/policy/healthcare...t-fund-at-risk

    People not loving the plans offered on the exchanges, ok I get it, for many better than what came before, and for some worse. But Medicaid and Medicare are really the only safety nets we have in this country as far as healthcare.
    If you want something to get done, ask a busy person. If you want them to have a nervous breakdown that is.

  7. #77
    Senior Member Rogar's Avatar
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    Quote Originally Posted by JaneV2.0 View Post
    Health care was affordable in my lifetime--which admittedly is a long one--before insurance got involved. And you had choices back then. Ancient history.

    But most civilized countries provide affordable health services now. Just not this one.
    I don't think a person can blame insurance for the total rise in health care. Alan is sort of right. Now we have expensive equipment to do things like CAT scans and MRI's, cancer treatments that can cost 10's of thousands a year, all sorts of joint replacements, and other things that we didn't have a few years ago.

    I don't know about the second part. We probably pay less than other countries and maybe have less positive outcomes but other countries have affordable health care for individuals because it is heavily subsidized by governments through taxes and government regulation of the industry.

    As far as Medicaid goes, the figures that have come out have been an eye opener. One out of five Americans are on Medicaid and half of all pregnancies! I really don't know enough of the details to say that is bad or good, it's just an amazing number to me. It will be interesting to see how the bill gets modified to be more or less generous, among all the criticisms. If the fiscal conservatives get their way it could well pave the way for Medicare reform. It would be a sad day if we can no longer provide for the poor elderly and disabled but can afford to boost military spending by large amounts.

    The news has not given much about how states would be expected to pick up the Medicaid slack created by the reductions. I think that is the expectation that goes along with the reductions, though Im not seeing yet how that could work.

  8. #78
    Senior Member JaneV2.0's Avatar
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    Quote Originally Posted by Rogar View Post
    I don't think a person can blame insurance for the total rise in health care. Alan is sort of right. Now we have expensive equipment to do things like CAT scans and MRI's, cancer treatments that can cost 10's of thousands a year, all sorts of joint replacements, and other things that we didn't have a few years ago. ... .
    Insurance, Pharma and their incessant pushing of overpriced drugs, employer-based "wellness programs" that are just a marketing ploy for Pharma and a way to push up insurance costs, and health professionals on the take are much of it, but I'd add the willingness of people to overuse doctors, and participate in the ordering of endless scans and tests and antibiotics and other, more useless and dangerous drugs--designed to be taken indefinitely--are certainly part of the problem.

  9. #79
    Senior Member herbgeek's Avatar
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    and other things that we didn't have a few years ago.
    We are also much more litigious than other nations. I'm sure that is a factor in there too: cost of malpractice premiums, the lawsuits, and the extra tests run to try and avoid that.

  10. #80
    Senior Member catherine's Avatar
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    Quote Originally Posted by JaneV2.0 View Post
    Insurance, Pharma and their incessant pushing of overpriced drugs, employer-based "wellness programs" that are just a marketing ploy for Pharma and a way to push up insurance costs, and health professionals on the take are much of it, but I'd add the willingness of people to overuse doctors, and participate in the ordering of endless scans and tests and antibiotics and other, more useless and dangerous drugs--designed to be taken indefinitely--are certainly part of the problem.
    I never agree with Jane more than when she talks about healthcare. Yes, Pharma has to recoup their R&D investment costs, but the nature of capitalism and being accountable to shareholders is that you drive up prices as high as you possibly can. And when no one person is pulling the money out of their own pocket, "what the market will bear" is horrifically inflated prices.

    Do we have great medical advances to avail ourselves of? Yes. But if we didn't have other market forces pushing processed foods, cigarettes, alcohol, environmental toxins and a "grab and go" culture, we probably wouldn't need half the drugs and medical interventions too many of us depend on.
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