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View Diary: Abbreviated Pundit Round-up: More on ACA and Oregon ERs (109 comments)

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  •  the media is NOT covering them. (6+ / 0-)
    •  The GOP "plan" is as hard to find (12+ / 0-)

      and unicorns and leprechauns...

      Filibuster reform, 2013 - woulda, coulda, shoulda.

      by bear83 on Sat Jan 04, 2014 at 05:32:20 AM PST

      [ Parent ]

    •  The media has covered the Republican (13+ / 0-)

      health insurance plan for years - since the days of their working against Hillarycare.  It's the same plan it's always been, except the first step now is the complete repeal of Obamacare:
      *  Allows individuals to buy insurance plans across state lines
      *  Tort reform
      *  Allows individuals to deduct health care costs from income taxes
      *  Allows individuals to put more money into Health Savings Accounts
      *  "Bolsters" state high-risk pools for those with pre-existing conditions
      *  Forbids federal funding of abortions.

      How many stories can the media air when the Republican "plan" hasn't changed in thirty years?

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Sat Jan 04, 2014 at 05:39:48 AM PST

      [ Parent ]

      •  So true! (8+ / 0-)

        Maybe we're more attuned to it because we live in red states?
        John McCain was big on the health savings account which is great when you have a job where you make enough money to put some money away every month.

        Your beliefs don't make you a better person. Your behavior does.

        by skohayes on Sat Jan 04, 2014 at 05:45:36 AM PST

        [ Parent ]

        •  and get cheated ... (2+ / 0-)
          Recommended by:
          SueDe, skohayes

          We had one of those HCAs that mysteriously billed us for a charge that neither the medical center nor we found to be correct. We were out of town when the supposed 'charge' occurred, saw no medical professionals and then medical center combed their records and found none. They sent a letter to that effect to the HMA people, who still demanded $264.00 from us or they would go to collection. We paid. Not only that, they made us xerox and mail to Georgia from California, copies of all our medical bills... Scam city.

          As for using the ER. If the people are insured, the ER people are getting PAID, so they don't have to raise rates on the rest of us to cover their unpaid costs. But no mention of this in the study ...

      •  First step: repeal Obamacare. Final step... (12+ / 0-)

        repeal  Medicare and Medicaid.

        There's no such thing as a free market!

        by Albanius on Sat Jan 04, 2014 at 06:34:00 AM PST

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      •  I'm all for Obama care even though... (0+ / 0-)

        I expect my insurance premiums to increase substantially (I'll know for sure next month). However, some of the things you list are attractive to me, i.e., numbers 1, 3, 4, & 5.

        As with every issue I see good and bad ideas from each side of the political divide. It's too bad we can't take the best of both.

        I'm not paranoid or anything. Everyone just thinks I am.

        by Jim Riggs on Sat Jan 04, 2014 at 07:44:45 AM PST

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        •  Buy insurance across state lines....... (4+ / 0-)

          so that you can buy worthless insurance policies issued in Alabama and Mississippi?  

          Really?

          That is going to help ANYONE?

          And while SOME aspects of tort reform may be needed, don't kid yourself:

                 a.  It isn't going to lower the cost of health care delivery by any meaningful amount.
                 b.  It is only reasonable IF it is coupled with REAL sanctions against the bad apples practicing medicine (and having served on a medical review board in a progressive state, believe me, there are a significant number of HORRIBLE doctors out there who need retraining and/or prohibitions against practicing medicine).

          •  I live in MD and my doctor, (0+ / 0-)

            who I have had for over 20 years, is in Pennsylvania. I also own a company in PA and have offered health insurance, which I also am on, to all employees since I started it 17 years ago. If I wanted to see a doctor in MD they wouldn't be in the network. It's an Aetna PPO with $40 co-pays, which the employees chose. It wouldn't have been my choice. There are other reasons to support health insurance across state lines besides buying cheap policies.

            Totally agree on tort reform. Btw, it's #2. I said 1, 3, 4, 5.

            I'm not paranoid or anything. Everyone just thinks I am.

            by Jim Riggs on Sat Jan 04, 2014 at 08:59:23 AM PST

            [ Parent ]

            •  That speaks to an altogether different issue (3+ / 0-)
              Recommended by:
              Aquarius40, TheMeansAreTheEnd, Tackle

              has NOTHING to do with the idea of buying insurance across state lines in the way the GOP has proposed.  

              We have similar issues here where I live because of the fact that so many people live on the CT side of the line and work in the NY side of the line.  Your insurance should cover you regardless of whether you are being treated in the state you live in or the state you bought your insurance in otherwise nobody would be able to leave the state lest they get sick.  That's just stupid.  You're talking more specifically about in network and out of network issues.  I'm not even sure how allowing insurance companies to sell across state lines would improve this since it would hand insurance companies more power to dictate who is in network and who isn't.  It would exacerbate the problems not make them better.

              Again, I'll reiterate what I said before, these issues with in network and so on would ALL be eliminated if we had a basic single payer heath care system that was funded by our taxes the same way other countries have.  Why anyone would support a system that would essentially keep the same shit we have only on steroids when the alternative would end all these issues is beyond me.  

              This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

              by DisNoir36 on Sat Jan 04, 2014 at 09:09:31 AM PST

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              •  I think single-payer might be a good thing. (0+ / 0-)

                But I'd have to see what my premiums would be.

                I'm not paranoid or anything. Everyone just thinks I am.

                by Jim Riggs on Sat Jan 04, 2014 at 10:01:00 AM PST

                [ Parent ]

                •  You wouldn't have premiums (2+ / 0-)
                  Recommended by:
                  Tackle, Jim Riggs

                  That's the point.  A single payer government run program would be funded by our taxes.  

                  Since there is no profit motive or shareholders to satisfy the costs would be significantly less.  Private insurers are being dragged tooth and nail to use 80% of the premiums they collect on paying for healthcare.  That means for every dollar they get from you in premiums, they're using only 80 cents to actually pay for your healthcare.  The other 20 cents are being used to pay shareholders dividends, to pay their executives lucrative payouts and so on.  That's a new requirement under the ACA.  Prior to the ACA private insurers were using as little as 60% of your premiums to actually pay for your insurance.  That's why they used every means legally possible to avoid paying providers.  The less they paid out the more they were able to keep in their pockets.

                  A Medicare type system only has a 3% - 5% overhead.  That means out of every dollar you pay into the system via taxes 95 to 97 cents go to pay for your healthcare.

                  Do the math.  If you visit the ER and have a $2,000 medical bill, that means you will have to pay $2,100 in taxes to pay for that bill and overhead.  With a private insurer you'd have to pay $2,400 in premiums for the same service because the extra $300 goes to shareholders and exec pay.  This is a very simplistic example and omits out alot in the equation but it should give you a basic idea how it works.  

                  Other factors like the fact that the govt would have tremendous negotiating leverage over providers to reduce costs and they could implement policies which would reduce other costs and you can begin to understand how a Medicare type system will be far cheaper than the system we have today.  Not to mention the fact that We the People have the ultimate power in choosing who runs our healthcare as oppose to allowing private insurers to make the decisions.  After all we are the govt.  

                  I guess what I'm saying is that your 'premiums' or rather what you're paying for healthcare would be far less under a Medicare for All type system than what they are now.    

                  This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

                  by DisNoir36 on Sat Jan 04, 2014 at 10:24:14 AM PST

                  [ Parent ]

                  •  Sounds good but I don't believe it. (0+ / 0-)

                    I was under the impression that my costs under the ACA wouldn't go up significantly but I was wrong. And I have very good coverage, which used to cost around $7,000/yr.

                    I bought into Obamacare completely and it may yet prove to be a good thing. But I'll be a much tougher sell the next time politicians come pushing the next great health care plan.

                    I'm not paranoid or anything. Everyone just thinks I am.

                    by Jim Riggs on Sat Jan 04, 2014 at 01:41:24 PM PST

                    [ Parent ]

                    •  Well sorry Jim (0+ / 0-)

                      I don't know your particular circumstance but it's hard to argue with the results from a system that is in place in just about every other industrialized nation and costs significantly less than the system we have.  I don't like the ACA for many reasons but it IS better than the bullshit system we had, even if just a bit better.  At the very least we are heading in the right direction and with some tinkering hopefully we will improve upon it until it gets significantly better.  What we cannot do is go back and the GOP with their crap ideas represent a step back.  They're the ones who fucked up our healthcare system in the first place.  Their Medicare D has cost us trillions in additional and unnecessary spending.  Medicare Advantage is a big we kiss to private insurers and is another huge source of extra and unnecessary costs.  The ACA was their idea in the first place, which is why it sucks big hairy elephant balls.  But if we use that as a starting point we can end up with something resembling the liberal idea.  

                      This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

                      by DisNoir36 on Sun Jan 05, 2014 at 01:09:37 PM PST

                      [ Parent ]

        •  Only problem is (2+ / 0-)
          Recommended by:
          Aquarius40, TopCat

          #1, #3, #4 and #5 do nothing to help insure more people and they're all fucked up ideas.  

          Infact #1 would only lead to a patchwork of state laws governing health insurance and 50 insurance commissioners who would enforce/not enforce them.  That would inevitably lead to a race to the bottom exactly like the credit card companies where insurance companies would race to states with the least onerous laws and more easily corruptible insurance commissioners.  The end result would be insurance companies would be free to do what they wanted to when they wanted to.  Pre-existing conditions would return with gusto, caps and rescission would be the name of the game.  The same way credit card companies can now charge any interest rate they want despite certain state usury laws prohibiting them form charging say above 15%, insurance companies would be unburdened of any state law they didn't agree with.  They'd get around it by simply relocating to a state with minimal or no laws, a weak commissioner with no desire or power to enforce the laws or worse a corrupted commissioner and they would sell insurance across state lines with the laws of the state they relocated in being the ones they would have to follow.

          Anyone who says they support insurance companies across state lines is woefully ignorant of what that actually means and is only repeating a great sounding talking point or they are a shill for the insurance companies and stand to benefit from this proposal.  PLAIN AND SIMPLE.  

          #3 and #4 are simply giveaways to the rich who can both afford high cost plans and be able to put more money away into HSA's and would thus benefit more from being able to deduct them from their taxes.  The HSA is nothing more than a tax shelter the same way the IRA's have become.  It's nice for the average person but even better for someone like Romney who has millions tucked away in them sheltered nicely from taxes.  We would need neither of these if we simply had a basic single payer heath care system that was funded by our taxes the same way other countries have.

          #5 is basically admitting that you want pre-existing conditions to return.  Under Obamacare they no longer exist.  I don't even know why anyone would support this. It's basically admitting you want to go back to the old system prior to Obamacare.

          This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

          by DisNoir36 on Sat Jan 04, 2014 at 08:01:45 AM PST

          [ Parent ]

          •  As I said, I'm all for Obama care. (0+ / 0-)

            I believe all of these things could have been addressed and melded into the ACA if the Republicans hadn't been such dickheads.

            There must be millions of people in this country who live in one state and work and/or have healthcare in another.

            If HSAs are "nice for the average person" why couldn't the law have been designed with them in mind? Other than the dickhead thing. IMO if Democrats keep saying that everyone who thinks they pay too much in taxes is evil it's going to bite them in the ass one day.

            Obamacare is better than what we had but it could have been much better for everyone.

            I'm not paranoid or anything. Everyone just thinks I am.

            by Jim Riggs on Sat Jan 04, 2014 at 09:16:57 AM PST

            [ Parent ]

            •  HSA's are pointless (0+ / 0-)

              if there is a basic single payer heath care system that was funded by our taxes the same way other countries have.  What would you use HSA's for?  Extra care?  It would simply be a vehicle for the rich to shelter money under the guise that they need it for care not provided and paid for by the system in place.  

              Obamacare would have been better if we got rid of insurance companies altogether and just had Medicare for all.  All the issues you raise would at that point have been moot.    

              As for the people working in one state and live in another, selling insurance across state lines does nothing to help people in those situations, even if there is a problem.  As I said elsewhere, giving insurance companies the power to choose which state they want to do business out of and then sell insurance outside of that state will only exacerbate our problems with the system not improve it.  Free of burdensome regulations they would probably even be free to charge more of people who work in one state and live in another.  I don't understand how allowing insurance companies to sell across state lines will help and supporter of this proposal have never given any reasonable explanation how it will.

              This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

              by DisNoir36 on Sat Jan 04, 2014 at 10:09:33 AM PST

              [ Parent ]

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