by "HammerheadFistpunch" (hammerheadfistpunch)
Published 05/25/2017 at 17:43
by "HammerheadFistpunch" (hammerheadfistpunch)
Published 05/25/2017 at 17:43
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Its about healthcare, so have a fast ambulance.
Just got word that the AHCA passed through passed through financial reconciliation.
The good news is that its expected to reduce the deficit by $119 Billion over 10 years.
The bad news is that its estimated that by 2026 51 million people will be without insurance (versus 28 million at that time under the current ACA), or about 15% of the projected population at that time.
Its now headed to the Senate whatfer people to have opportunity to put their finger in the pie.
Me? I expect that the end product ends up something like nearly as many people uninsured but a much smaller deficit reduction being expected or realized.
Im not optimistic.
"For Sweden" (rallybeetle)
05/25/2017 at 17:56, STARS: 0
By “people without insurance,” does the CBO mean, “people will be kicked off insurance,” or, “without a mandate, people will choose not to buy insurance?”
"crowmolly" (crowmolly)
05/25/2017 at 17:58, STARS: 1
Big mistake. Just shuffles money to a different column in the ledger.
"HammerheadFistpunch" (hammerheadfistpunch)
05/25/2017 at 18:01, STARS: 0
Unclear. Democrats would like you to fear the former, republicans would like you to imagine the later. Its probably a mix of both, though the implication is certainly that people will lose insurance rather than choose not to have it.
"HammerheadFistpunch" (hammerheadfistpunch)
05/25/2017 at 18:02, STARS: 0
Gotta build that wall somehow...
"TahoeSTi" (tahoesti)
05/25/2017 at 18:03, STARS: 0
Maybe we should address the costs. If the costs were low enough then we could afford a doctor’s visit with out insurance, and only use insurance for the unexpected......you know how insurance is supposed to work.(think car insurance)
"Textured Soy Protein" (texturedsoyprotein)
05/25/2017 at 18:05, STARS: 4
The Senate is writing its own entirely different bill which would then need to be reconciled with the house bill, and that new version would need to be voted on by both the house and senate.
There are some GOP members who are straight up wanting to kick people off entitlements and give tax cuts they mistakenly believe will spur economic growth & job creation.
There are other GOP members who want to try and improve actual health coverage but in a vaguely conservative way.
Anything done to appease one of these groups makes it that much harder for the other group to continue to vote for the bill.
There’s no guarantee that anything will pass, and frankly while the house rushed this AHCA bullshit through in spite of the CBO scores because they wanted to notch a “victory” by passing something , I’m cautiously optimistic that when it comes time to really consider the effects of any healthcare bill, they will stop short of fucking a bunch of people over.
Of course, this is the same party that kneecapped Obamacare in multiple ways which is the main source of its problems. It is not “collapsing under its own weight” as GOP likes to say, they broke it. So hey, they could very well still fuck a bunch of people over. They’re good at it!
"HammerheadFistpunch" (hammerheadfistpunch)
05/25/2017 at 18:08, STARS: 0
Thats a tough nut to crack. I work in healthcare and our system is considered a model in keeping costs down and quality up but there is only so much you can take out efficiency wise.
"Shankems" (CraigCulkin)
05/25/2017 at 18:09, STARS: 3
So 119 billion over ten years. Is my understanding correct in that it is an avg of 11.9 billion per year for a cumulative 119? So it might save 4% of each years deficit. Sounds like arguing over pennies.
"HammerheadFistpunch" (hammerheadfistpunch)
05/25/2017 at 18:09, STARS: 0
Like I said, my optimism remains low.
"HammerheadFistpunch" (hammerheadfistpunch)
05/25/2017 at 18:11, STARS: 0
Cost savings would continue forward so long as there were actual savings to be had when its all said and done (they started out saying it was going to save 350 billion) but reconciliation needs to consider it on a 10 year budget.
"TahoeSTi" (tahoesti)
05/25/2017 at 18:13, STARS: 0
It’s simple we start pulling the not for profit status from hospitals who pay off equipment to fast and who have too much administrative over head ....and to help them with that we reduce regulations and tort reform.....lawyers and administrators are the problems.....education costs for doctors isn’t helping either...but we can start to fix that but stopping government subsidized student loans.
"facw" (facw)
05/25/2017 at 18:13, STARS: 2
“without a mandate, people will choose not to buy insurance?”are still people we have to pay for healthcare for. Unfortunately they get care at the emergency room, where it is both massively expensive and often too late to be helpful. The party of “personal responsibility” backs a health plan instead backs a system that undercuts it.
"Textured Soy Protein" (texturedsoyprotein)
05/25/2017 at 18:16, STARS: 2
I’m optimistic they pass nothing, Democrats win back congress in 2018 and focus on making the exchanges more attractive to insurers. Trump will sign it because he just wants to say he did something good for healthcare, he doesn’t know how any of it works anyway.
"Shankems" (CraigCulkin)
05/25/2017 at 18:18, STARS: 0
Gotcha. I hope that we get to single payer at some point and this whole insurance debate is gone. Then we can just argue about one lump sum of national health spending. Hah.
"HammerheadFistpunch" (hammerheadfistpunch)
05/25/2017 at 18:21, STARS: 0
We’re a not for profit and I’ve seen the balance sheets and I can tell you...there really isn’t much profit. As much as our administrators make, its WAAAAY down on other systems. I can’t say what the pay for the new CEO is but our last one took a voluntary pay cut from 1.6 to 1.3 million (yeah I know its still a lot but its crap for company this size).
Its not tied up in administration as much as you think. Capitol cost? sure, but you have to make sure you aren’t dangerously over leveraged in the event of economic downturn given that its REALLY important healthcare exists and doesn’t go bankrupt.
The trouble isn’t overhead, at least not here. I can’t speak to other systems.
"For Sweden" (rallybeetle)
05/25/2017 at 18:23, STARS: 0
True, but that’s quite different from having it “taken” from them.
"HammerheadFistpunch" (hammerheadfistpunch)
05/25/2017 at 18:23, STARS: 0
single payer sounds great, but they you have nothing to prevent them from charging what they want, or suppliers charging what they want because they know you are the only buyer.
"wiffleballtony" (wiffleballtony)
05/25/2017 at 18:28, STARS: 1
My expectation is death panels that use The Oregon Trail game to decide who lives.
"190octane" (admiralcb)
05/25/2017 at 18:29, STARS: 1
If they can’t afford it without subsidies, I would still consider that taken.
"HammerheadFistpunch" (hammerheadfistpunch)
05/25/2017 at 18:31, STARS: 1
false, ACTUAL Oregon trail marches.
"Shankems" (CraigCulkin)
05/25/2017 at 18:32, STARS: 1
Maybe, but we spend more per capita and have lower life expectancy. Our current bang for buck is obviously poor. Single payer has better overall outcomes, so why not give it a shot?
"Highlander-Datsuns are Forever" (jamesbowland)
05/25/2017 at 18:32, STARS: 3
Single payer, eliminate the insurance companies, regulate prescription drug prices.
"190octane" (admiralcb)
05/25/2017 at 18:33, STARS: 1
The rich need tax cuts, can’t you see how badly they are suffering?
"HammerheadFistpunch" (hammerheadfistpunch)
05/25/2017 at 18:33, STARS: 0
Integrated systems save money and have better outcomes, single payer is just one company calling the shots.
"wiffleballtony" (wiffleballtony)
05/25/2017 at 18:34, STARS: 0
That might count as exercise and I think the game is probably harder.
"HammerheadFistpunch" (hammerheadfistpunch)
05/25/2017 at 18:37, STARS: 0
Even if that cut costs in half (it wouldn’t) it would still be ruinously expensive to be sick. My family didn’t have a single overnight stay in a hospital last year and we still hit our high out of pocket max on our HDHP. No babies born or anything, just a couple of specialists will do it. And no, you can’t have cheap specialists.
"TahoeSTi" (tahoesti)
05/25/2017 at 18:38, STARS: 2
The data seems to tell another story....at least nationwide. There are other things the show the market is broken too like The fact that most hospitals publish no price lists for standard procedures.
"HammerheadFistpunch" (hammerheadfistpunch)
05/25/2017 at 18:38, STARS: 2
good point, if its its encouraging American’s to get exercise then Michelle Obama wins...tough call for trump.
"HammerheadFistpunch" (hammerheadfistpunch)
05/25/2017 at 18:40, STARS: 0
I don’t argue that other systems are way out of whack, Im saying that there is more to it than overhead. Price listing is hard mostly because of coding nuance and regulation, as well as a law that keeps changing its mind as to what it can charge for and what it can’t. Supply and demand.
"Shankems" (CraigCulkin)
05/25/2017 at 18:47, STARS: 0
If integrated systems do save money and have better outcomes, is that not reflected by our per capita spend and life expectancy?
In any case, I don’t realistically expect much to change. I’m not one of the elderly, sick, or poor that will be left out.
"Highlander-Datsuns are Forever" (jamesbowland)
05/25/2017 at 18:49, STARS: 0
When I think single payer I think tax rate based on income like medicare tax but that is what you pay for your medical. Kids and retired folks don’t pay. That tax could be 5-10%. Wild idea, but I think for profit insurance has alot to blame for this.
"HammerheadFistpunch" (hammerheadfistpunch)
05/25/2017 at 18:51, STARS: 1
Just a reminder that Medicare and Medicaid are two of the largest unfunded portions of our national debt. It’s just too easy for politics to ruin a perfectly good system in theory. Social Security is another great example.
"gmporschenut also a fan of hondas" (gmporschenut)
05/25/2017 at 20:06, STARS: 0
https://fivethirtyeight.com/features/the-4-big-changes-to-health-care-in-the-latest-gop-bill/
Also a lot of seniors will be charged whatever the insurance company feels like. Thus a lot won’t be able to afford it.
Also the fund for pre-extisting conditions will not be funded to prevent primuims from skyrocketing.. the 8 bil for 4 years will nowhere near be enough. Wisconsin and a number of other states have tried and and either the fund has had to be bailed out or in the case of Utah, annual limits drastically lowered.
http://www.commonwealthfund.org/publications/blog/2017/mar/high-risk-pools-preexisting-conditions
The return of lifetime limits will be the killer. For anyone with cancer a million can go up in no time, especially with drug prices skyrocketing.
http://www.newsweek.com/2015/07/31/high-cost-cancer-care-your-money-or-your-life-356369.html
"JQJ213- Now With An Extra Cylinder!" (jqj213)
05/25/2017 at 20:52, STARS: 0
Only good thing, I guess, is that by 2026 we will have a different president who will try and pass yet another health care bill.
"Cash Rewards" (cashrewards)
05/25/2017 at 22:36, STARS: 0
That year increase is likely notable, though, if I had to guess, as the start of IT in health care. Hospital websites, email networks, then networked devices, EPIC and other electronic health records systems, and now (if they’re smart) some sort of cyber security. Those are all under administration, but are necessary increases out of proportion with doctors as the nature of healthcare has changed since the 90s.
"NojustNo" (front24200)
05/26/2017 at 10:40, STARS: 1
people won’t necessarily be kicked off but won’t be able to afford it. Dropping subsidies for the high-risk pool will cause this. that was one of the best things about Obamacare. the high-risk pool was actually affordable.
and the plan does cut Medicare up to 47% too. So people will be kicked off as well.