Republicans are starting the process to repeal Obamacare, damage to follow

[abenjami]

4 minutes ago, TitanDuckFan said:

I don't think so.  The only healthcare in the US truly run by the government is the VA health system.

And they've gotten pretty low marks in recent years.

Yeah that's why I asked what he was talking about.  We have lots of VA here and I hear it's pretty bad for anything non-routine.  The VA in general seems incompetent. I've met disabled soldiers who went years before they started receiving their disability checks.

Medicare is pretty great actually.  You get unlimited solid healthcare for free. 

The problem is our government can't afford to give everyone Medicare, nor should it be expected to. 

[Titans279]

Probably meant Medicare. Most people who are talking about "gov run universal healthcare" in the current context mean single payer.

[TitanDuckFan]

7 hours ago, Titans279 said:

Probably meant Medicare. Most people who are talking about "gov run universal healthcare" in the current context mean single payer.

If that's the case then just like a multitude of discussions over the last 7 years over obamacare, it's apparent some people don't know the difference between medical care and medical insurance.

[oldschool]

7 hours ago, Titans279 said:

Probably meant Medicare. Most people who are talking about "gov run universal healthcare" in the current context mean single payer.

Or the ridiculously good plans Congress has.

[Justafan]

This is where people get confused I think.  Just because the government would pay for it doesn't mean they have to run it.  It can be a blended system that isn't mutually exclusive and still be competitive in my opinion.  Even more so if everyone can all of a sudden go wherever they want to get healthcare.  Now, ratings actually matter and not just the cost of care and whatever deals the insurance company set up behind the scenes.

If you look at my tricare statements for instance, the doctor charges 100's of dollars for a visit but tricare has a negotiated rate that is set by law so they pay a set amount no matter what.  The government would obviously want to do this for everything under a single payer system.  If I want to be able to go to doctors not in my network, that's fine, I just have to pay a little extra that I normally wouldn't.  I think that's all pretty reasonable compared to what we have now.  

Letting the government negotiate these prices with health insurance providers automatically would drive prices down for everyone dramatically.  Everyone is worried about paying for it but the truth is your paying for it no matter what as long as medicaid is around and insurers are required to not turn people away.  Since neither of those things are going to change, you might as well go with the cheapest most reliable option that allows the most people to get coverage.

In other words, a single payer system.  Expecting insurance companies to be altruistic and look out for the common welfare of Americans is unacceptable responsibility placed on them and laughable to anyone with any common sense.

[pat]

It's much easier to promote preventive care with a single payer approach.

[9 Nines]

23 minutes ago, Justafan said:

This is where people get confused I think.  Just because the government would pay for it doesn't mean they have to run it.  It can be a blended system that isn't mutually exclusive and still be competitive in my opinion.  Even more so if everyone can all of a sudden go wherever they want to get healthcare.  Now, ratings actually matter and not just the cost of care and whatever deals the insurance company set up behind the scenes.

If you look at my tricare statements for instance, the doctor charges 100's of dollars for a visit but tricare has a negotiated rate that is set by law so they pay a set amount no matter what.  The government would obviously want to do this for everything under a single payer system.  If I want to be able to go to doctors not in my network, that's fine, I just have to pay a little extra that I normally wouldn't.  I think that's all pretty reasonable compared to what we have now.  

Letting the government negotiate these prices with health insurance providers automatically would drive prices down for everyone dramatically.  Everyone is worried about paying for it but the truth is your paying for it no matter what as long as medicaid is around and insurers are required to not turn people away.  Since neither of those things are going to change, you might as well go with the cheapest most reliable option that allows the most people to get coverage.

In other words, a single payer system.  Expecting insurance companies to be altruistic and look out for the common welfare of Americans is unacceptable responsibility placed on them and laughable to anyone with any common sense.

A big problem with cost are the consolidation of insurers and providers.  They keep leap frogging each other in consolidation to gain power of the other, with each cycle raising prices.   Insurers consolidate to threaten excluding hospitals.  Then instead of lowering prices to join the bigger insurer, the hospitals merge resulting in large hospitals system so that employers will not buy policies that exclude them because the employees want to be able to go to those hospitals. 

[9 Nines]

Another problem with cost is all these profit motives in healthcare.  I am not sure if this is happening in other parts of the country, but for-profit emergency rooms are popping up all over the place where I live.  There are a dozen within a radius of 5 miles from my house (I am not kidding, I actually counted them - there are 3 within a mile of each other in one section.)  Their business model is designed around the technicality that if in the opinion of the patient the patient views the visit as an emergency, then it gets classified as an emergency and therefore your insurance has to cover it as an emergency.  Reporters have done investigations of the many that are popping up in the Houston area, and found that none of the ones they reviewed have used any of their truly emergency equipment in over two years.   In other words, they do not treat true emergencies, yet they charge for emergency overhead for all treatment.  In one case for example, a guy with a sprained finger was interviewed.  His bill was over $1200.  ~$200 or less of it was for the actually treatment of his finger, the rest was a line item for emergency overhead. 

Think of all the moms who take their kids, with sniffles, to those places.  Then insurance gets hit with $1000+ bill so a lazy doctor can take the kids temperature and give the mom some minor prescription. 

One opened next to the bank I use.  I know the manager of the bank. When the emergency outfit first opened, I talked to him about it. He said the guy behind the emergency place, some young doctor, fairly fresh out of residency, came into the bank to open an account. He said the doctor was bragging that it was a franchise and he was going to be so rich from it.  He bragged that with just a few patients a week, he will likely make more than his peers who went into normal practice.   About a year later, I was talking to the manager.  He confessed that he actually went to facility one day. He said he had terrible stomach cramps or something and was worried it was his appendix or something. He said it turned out to be just muscle cramps but he said the doctor wanted to run all kinds of tests.  He did some of them but declined others.  He said the tests seemed fairly routine and he was only there for about an hour yet the doctor presented a bill to his insurance company for over $5K. 

I joked with the manager that I bet if there was a huge emergency in the area, like a massive car wreck or something, the doctor would shut all his blinds and put a closed sign on the door while he hid in fear that real emergency patients might come to his operation. 

Note: this is not a knock on urgent care centers or other clinics.  Those seem like legitimate practices and a service to communities. Above, I am referring to the for profit ones truly labeled emergency centers and seem to be complete rip offs to communities. 

[Jamalisms]

Markets don't want profit, they want ever-increasing profit. For profit healthcare and reasonably priced healthcare will never work together properly

[pat]

2 minutes ago, Jamalisms said:

Markets don't want profit, they want ever-increasing profit. For profit healthcare and reasonably priced healthcare will never work together properly

... except if there is a single payer.

[9 Nines]

Republican attempts might fall apart.   http://www.forbes.com/sites/stancollender/2017/02/12/gop-grand-scheme-on-obamacare-repeal-tax-reform-quickly-going-south/#2f7a18a67ec7

This article explains.  Basically what Republicans were going to try since they can not pass repeal legislation in the Senate outright was a double dose of reconciliation. Budget reconciliation was needed because it can't be filibustered. (Also of note and an example of how conniving Republicans are being on this, a double reconciliation has never been done in the history of the Senate.  So it likely would be hard to maneuver as it would be completely going against the core of the Senate filibuster.)

First, would be instructions/guidelines to repeal that pretended to have tax implications, a requirement to use reconciliation, yet really do not because they do nothing - just guidelines. That would be a fiscal year 2017 reconciliation measure.  Then soon after that they would try to do a fiscal year 2018 reconciliation that would accept the FY2017 guidelines passed in the first reconciliation.   To do both they would have about a three month window, as the whole process would need to be concluded by May/June. If they miss that deadline, then to repeal then for the upcoming year would mean doing all that in one reconciliation process which would be a huge and messy task that would have many challenges to Senate rules.  

Also, All this likely headed to a fiscal year 2018 budget not being passed before October when the FY2018 starts (either that or quit this ACA repeal stuff) which would mean no budget and Congress and the President would have to pass short term continuing budget resolutions to keep the government running. In other words, complete control of Congress and the WHite House, yet Republicans cannot do something as basic as pass a full budget.  In addition, Republicans have always harped on passing budgets as a very basic function of government, noting how incompetent it was to not pass one, yet with complete control, they are headed to that scenario.