Obamacare is a mess

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  • rgambs
    rgambs Posts: 13,576
    PJPOWER said:

    rgambs said:

    PJPOWER said:

    Halifax2TheMax said:

    PJPOWER said:

    Halifax2TheMax said:

    https://www.nytimes.com/interactive/2017/03/09/us/politics/100000004915797.mobile.html

    3% of Americans impacted by premium increases.

    .3% of Americans identify as transgender, yet plenty of people support regulations and laws specifically to fit them...so what's your point? 3% is actually a pretty large number of people.
    As many as the 26 million that will lose health insurance under Trump per CBO? What's your point?
    Didn't have one, just trying to figure out what your was...I've never been one to buy into the whole "a bad plan is better than no plan" rhetoric. Obamacare was a bad plan. Trumpcare is a bad plan. Health insurance is a scam. Pharmaceutical companies and healthcare providers abuse insurance to an insane degree. Kill the healthcare providers and monopolistic pharmaceutical companies' desire or ability to charge outrageously for their products or services and you might someway get back on the right track. Taxpayers pay out the ass for medical and pharmaceutical research and then allow the pharmaceutical companies to patent their taxpayer funded product? That product should be publicly owned and readily available to all taxpayers. Private research may be a different beast, but medical patents should be seriously scrutinized.
    Some parts of this comment make it seem like you fundamentally misunderstand the complexity and scope of the issues facing health care providers, insurers, and consumers.
    I don't remember if it was you or mace, but I corrected a huge misconception about rates for insured vs uninsured patients a while back but my connection was shaky and it was lost in a deluge of posts.
    That's not much of an elaboration...what parts are being misunderstood? The fact that healthcare providers and monopolistic pharmaceutical companies abuse the healthcare system?
    I think it's unfair to say that healthcare providers abuse the healthcare system. Of course there are abuses, but the insurance system is far more abusive to providers than vice versa.
    Pharmaceutical companies, yeah, they are incredibly abusive and corrupt, I agree with you there.
    The entire system was fucked from the beginning, single payer systems are the only kind that can effectively control runaway costs and prevent widespread abuses. Capitalistic, free market principles just don't work inside a socialistic risk pool system, it's foolish to try to jam the two together. Everybody loses.
    Monkey Driven, Call this Living?
  • mace1229
    mace1229 Posts: 9,831
    rgambs said:

    PJPOWER said:

    Halifax2TheMax said:

    PJPOWER said:

    Halifax2TheMax said:

    https://www.nytimes.com/interactive/2017/03/09/us/politics/100000004915797.mobile.html

    3% of Americans impacted by premium increases.

    .3% of Americans identify as transgender, yet plenty of people support regulations and laws specifically to fit them...so what's your point? 3% is actually a pretty large number of people.
    As many as the 26 million that will lose health insurance under Trump per CBO? What's your point?
    Didn't have one, just trying to figure out what your was...I've never been one to buy into the whole "a bad plan is better than no plan" rhetoric. Obamacare was a bad plan. Trumpcare is a bad plan. Health insurance is a scam. Pharmaceutical companies and healthcare providers abuse insurance to an insane degree. Kill the healthcare providers and monopolistic pharmaceutical companies' desire or ability to charge outrageously for their products or services and you might someway get back on the right track. Taxpayers pay out the ass for medical and pharmaceutical research and then allow the pharmaceutical companies to patent their taxpayer funded product? That product should be publicly owned and readily available to all taxpayers. Private research may be a different beast, but medical patents should be seriously scrutinized.
    Some parts of this comment make it seem like you fundamentally misunderstand the complexity and scope of the issues facing health care providers, insurers, and consumers.
    I don't remember if it was you or mace, but I corrected a huge misconception about rates for insured vs uninsured patients a while back but my connection was shaky and it was lost in a deluge of posts.
    I am curious. If it was a response to me it was lost like you said. What is the misconception of insured vs insured?
    I know I have commented about the uninsured before. I believe it is a total scam, and far more would benefit by not having any. The problem is that now doctors have so many contracts with insurance companies that few, if any, will have the cash prices they had just a few years ago that are a fraction of what they bill insurance.
  • rgambs
    rgambs Posts: 13,576
    mace1229 said:

    rgambs said:

    PJPOWER said:

    Halifax2TheMax said:

    PJPOWER said:

    Halifax2TheMax said:

    https://www.nytimes.com/interactive/2017/03/09/us/politics/100000004915797.mobile.html

    3% of Americans impacted by premium increases.

    .3% of Americans identify as transgender, yet plenty of people support regulations and laws specifically to fit them...so what's your point? 3% is actually a pretty large number of people.
    As many as the 26 million that will lose health insurance under Trump per CBO? What's your point?
    Didn't have one, just trying to figure out what your was...I've never been one to buy into the whole "a bad plan is better than no plan" rhetoric. Obamacare was a bad plan. Trumpcare is a bad plan. Health insurance is a scam. Pharmaceutical companies and healthcare providers abuse insurance to an insane degree. Kill the healthcare providers and monopolistic pharmaceutical companies' desire or ability to charge outrageously for their products or services and you might someway get back on the right track. Taxpayers pay out the ass for medical and pharmaceutical research and then allow the pharmaceutical companies to patent their taxpayer funded product? That product should be publicly owned and readily available to all taxpayers. Private research may be a different beast, but medical patents should be seriously scrutinized.
    Some parts of this comment make it seem like you fundamentally misunderstand the complexity and scope of the issues facing health care providers, insurers, and consumers.
    I don't remember if it was you or mace, but I corrected a huge misconception about rates for insured vs uninsured patients a while back but my connection was shaky and it was lost in a deluge of posts.
    I am curious. If it was a response to me it was lost like you said. What is the misconception of insured vs insured?
    I know I have commented about the uninsured before. I believe it is a total scam, and far more would benefit by not having any. The problem is that now doctors have so many contracts with insurance companies that few, if any, will have the cash prices they had just a few years ago that are a fraction of what they bill insurance.
    I'm not certain who it was, maybe neither of you so here is the gist.
    I can't dig in too deep here today, but billing insurance providers more for care than self-pay patients is illegal. Some doctors do it, to the tune of millions every year, but it isn't legal or smart. A discount for paying same-day is applicable, but that's it.
    The providers have contracts that stipulate what they will pay for a given procedure. Usually that agreement is a flat rate per service, but sometimes that pay is a percentage, so that drives professionals to raise their prices to bring in a little more from those particular providers, and everyone suffers from those inflated prices.
    The government pays the essential care for uninsured people at hospitals, that is another reason single payer makes sense.
    Monkey Driven, Call this Living?
  • mace1229
    mace1229 Posts: 9,831
    edited March 2017
    rgambs said:

    mace1229 said:

    rgambs said:

    PJPOWER said:

    Halifax2TheMax said:

    PJPOWER said:

    Halifax2TheMax said:

    https://www.nytimes.com/interactive/2017/03/09/us/politics/100000004915797.mobile.html

    3% of Americans impacted by premium increases.

    .3% of Americans identify as transgender, yet plenty of people support regulations and laws specifically to fit them...so what's your point? 3% is actually a pretty large number of people.
    As many as the 26 million that will lose health insurance under Trump per CBO? What's your point?
    Didn't have one, just trying to figure out what your was...I've never been one to buy into the whole "a bad plan is better than no plan" rhetoric. Obamacare was a bad plan. Trumpcare is a bad plan. Health insurance is a scam. Pharmaceutical companies and healthcare providers abuse insurance to an insane degree. Kill the healthcare providers and monopolistic pharmaceutical companies' desire or ability to charge outrageously for their products or services and you might someway get back on the right track. Taxpayers pay out the ass for medical and pharmaceutical research and then allow the pharmaceutical companies to patent their taxpayer funded product? That product should be publicly owned and readily available to all taxpayers. Private research may be a different beast, but medical patents should be seriously scrutinized.
    Some parts of this comment make it seem like you fundamentally misunderstand the complexity and scope of the issues facing health care providers, insurers, and consumers.
    I don't remember if it was you or mace, but I corrected a huge misconception about rates for insured vs uninsured patients a while back but my connection was shaky and it was lost in a deluge of posts.
    I am curious. If it was a response to me it was lost like you said. What is the misconception of insured vs insured?
    I know I have commented about the uninsured before. I believe it is a total scam, and far more would benefit by not having any. The problem is that now doctors have so many contracts with insurance companies that few, if any, will have the cash prices they had just a few years ago that are a fraction of what they bill insurance.
    I'm not certain who it was, maybe neither of you so here is the gist.
    I can't dig in too deep here today, but billing insurance providers more for care than self-pay patients is illegal. Some doctors do it, to the tune of millions every year, but it isn't legal or smart. A discount for paying same-day is applicable, but that's it.
    The providers have contracts that stipulate what they will pay for a given procedure. Usually that agreement is a flat rate per service, but sometimes that pay is a percentage, so that drives professionals to raise their prices to bring in a little more from those particular providers, and everyone suffers from those inflated prices.
    The government pays the essential care for uninsured people at hospitals, that is another reason single payer makes sense.
    I have never heard it was illegal. In fact, I spent a few minutes reading several articles to see if it was and none of them mentioned it was. I did find a few articles that did talk about cash discounts. In the first article I read quoted the LA Times:
    "1) A recent article in the Los Angeles Times reported a CT scan of the abdomen costs about $2,400 for patients insured by Blue Shield of California, while the Los Alamitos (Calif.) Medical Center cash price is only $250. That is a 89% discount by my calculation."
    That has been my experience. Going through insurance the prices are increased by a factor of 10. So someone who has a hospital visit, or a CT scan, sees the bill for $2500 and is glad they only pay 20% of that (which is still $500!) thinking "how could I afford this without insurance."
    While Joe Uninsured walks in, does the same thing, and pays only $250, less than the copay of the previous guy with insurance. The real kick in the nuts is the first guy also pays nearly $2,000 a month for the privilege of over paying. So he's really out over 2 grand in tat scenario.
    What laws make that illegal? Any state laws?
    I have read scenarios where the cash discounts are going away due to the contract the hospitals have with the insured companies, some of the contracts state they must charge the same price even to the uninsured. But that isn't the law, it is in the contracts they have with the insurance companies, and they are pretty much forced to sign since everyone is now forced to have insurance, so without those contracts they cant do business.
    Post edited by mace1229 on
  • Cliffy6745
    Cliffy6745 Posts: 34,029
    Solid healthcare joke on wait wait, don't tell me this past week. Good f'ing god I am getting old just typing that...

    Someone said something along the lines that who knew 50 Cent was a healthcare expert when he named his album "get rich or die trying"

    Yep, I am old. Carry on
  • mace1229
    mace1229 Posts: 9,831
    edited March 2017
    Heres the LA Times article mentioned.

    http://www.latimes.com/business/healthcare/la-fi-medical-prices-20120527-story.html

    Another story in there is:
    "In perhaps the most interesting reaction to cash discounts, a patient who was unaware of the discounted cash pricing last month filed a lawsuit against Blue Shield of California for unfair business practices, breach of good faith and misrepresentation over her medical bills after she was charged $2,336 for a CT scan that would have cost her $1,054 in cash.

    Blue Shield said it “cannot promise or represent that there could not be providers who will charge someone less out-of-pocket cost for a service than she would pay if the Blue Shield contract rate applies.” '
    The whole article states that the total bill was $6700, of which her copay was $2336, then the hospital has a cash price of $1054 for the same thing! Not to mention her monthly premium would have probably covered most, if not all, of that cash bill to begin with. So even after having what most would consider expensive medical bills for that month, she still would have saved over $2,000 by not having insurance. Isn't insurance suppose to be helpful when you use it? That's what car insurance is for, don't need it most of the time, but in your one accident youre glad you had it. Health insurance is the opposite, you don't want it, and when you use it you got screwed even worse.

    Ridiculous. What is the point of insurance then?

    I realize that article is 5 years old, but that has been common practice for years. And if there is a new law that prevents the cash discount, that just means hospitals are forced to overcharge everyone, making the insurer super rich, and that law is just wrong. But I've had the same experience on a smaller scale. Every time I get a prescription filled I ask about the cash price, and far too many times the cash price is $11 while my copay is $30, as recent as just a couple months ago. And even though they have my insurance info on file, they let me pay cash.
    Post edited by mace1229 on
  • rgambs
    rgambs Posts: 13,576
    It's illegal because it is fraudulent, but that isn't easy to pursue. For Medicare and Medicaid there is a cap on the amount of cash discount, but I don't know where it is specifically. The whole thing is a mess, the prices are jacked up to drive the negotiated rates up, and some services are severely overcharged to make up for others which are severely underpaid.
    Billing and coding is a nightmare when it comes to negotiated services, you have dozens of providers with handfuls of different rules on what services and procedures can be combined and billed in given situations.

    Single payer is the only fix.
    Monkey Driven, Call this Living?
  • rgambs
    rgambs Posts: 13,576
    The idea that competition will drive prices down is rational argument that is disconnected from the reality of healthcare.
    Monkey Driven, Call this Living?
  • rssesq
    rssesq Fairfield County Posts: 3,299
    I see bills from hospitals daily that are so laughable. the very same hospital will charge an uninsured person $2,200 for a CAT scan.
    The same person with bc/bs, the carrier pays a "negotiated" price of around $400, hospital eats the rest
    The same person on Medicaid, state pays about $200, hospital eats the rest.

    Obviously they are earning off the $400 price or they wouldn't have agreed to it, right?

    Only in the united states where the AMA, big pharma and Hospital Assoc. run shit, would the person who needs the biggest break, be charged 500% more than the guy who can afford private insurance.
    #RIPOFFS
  • InHiding80
    InHiding80 Upland,CA Posts: 7,623
    Love how Joe Kennedy III slammed Paul Ryan for his bs plan.

    https://www.bostonglobe.com/metro/2017/03/08/kennedy-rips-gop-health-plan/IWpUdBxaIrjA50ooQ1z43J/story.html

    Just found out he has the same birthday and year of birth as me which is nice. Surreal that someone my age is considered for 2020.
  • josevolution
    josevolution Posts: 31,659
    InHiding80 said:

    Love how Joe Kennedy III slammed Paul Ryan for his bs plan.

    https://www.bostonglobe.com/metro/2017/03/08/kennedy-rips-gop-health-plan/IWpUdBxaIrjA50ooQ1z43J/story.html

    Just found out he has the same birthday and year of birth as me which is nice. Surreal that someone my age is considered for 2020.

    Yeah he could be someone to keep an eye on ..
    jesus greets me looks just like me ....
  • CM189191
    CM189191 Posts: 6,927
    Thanks Obama
    US infant mortality rates down 15%
  • Cliffy6745
    Cliffy6745 Posts: 34,029
    So let's assume this bill passes the house tonight. I figure it has to otherwise they wouldn't be pushing this vote so hard. What then? It's not going to pass the Senate as is, so how does it get changed at that point?
  • jeffbr
    jeffbr Seattle Posts: 7,177
    Doesn't sound like they have the numbers, so they are going to delay the vote until Friday or next week: http://thehill.com/policy/healthcare/325459-gop-lawmakers-say-vote-unlikely-on-thursday

    A new poll shows only 17% approve of the Obamacare repeal, and 56% disapprove. That is probably causing some GOP holdouts from supporting it. http://thehill.com/policy/healthcare/325448-poll-majority-of-voters-disapprove-of-gop-obamacare-repeal-plan
    "I'll use the magic word - let's just shut the fuck up, please." EV, 04/13/08
  • Cliffy6745
    Cliffy6745 Posts: 34,029
    Alright yeah, so no vote today and it looks like it's getting harder and harder to see.

    That said, what does happen if this were to get out of the house? I still don't understand. Can it be re-written without going back to the house because it's not passing the Senate?
  • Halifax2TheMax
    Halifax2TheMax Posts: 42,313
    Cliffy6745 said:

    Alright yeah, so no vote today and it looks like it's getting harder and harder to see.

    That said, what does happen if this were to get out of the house? I still don't understand. Can it be re-written without going back to the house because it's not passing the Senate?

    The senate could pass a similar, modified bill and then it would go to reconciliation committee to have the differences hammered out. Then it would go back to both houses for a vote and presumably pass and go to the president for signature. Unless political pressure kills it in one of the houses or the differences cant be ironed out in committee (I think as its been a long time since I watched conjunction junction and bill into a law on Saturday morning).
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  • Cliffy6745
    Cliffy6745 Posts: 34,029
    Halifax2TheMax said:

    Cliffy6745 said:

    Alright yeah, so no vote today and it looks like it's getting harder and harder to see.

    That said, what does happen if this were to get out of the house? I still don't understand. Can it be re-written without going back to the house because it's not passing the Senate?

    The senate could pass a similar, modified bill and then it would go to reconciliation committee to have the differences hammered out. Then it would go back to both houses for a vote and presumably pass and go to the president for signature. Unless political pressure kills it in one of the houses or the differences cant be ironed out in committee (I think as its been a long time since I watched conjunction junction and bill into a law on Saturday morning).
    This makes sense. I got it.

    Freedom Caucus seems to think it will get done.
  • Go Beavers
    Go Beavers Posts: 9,569
    "freedom caucus"? Freeing people from the burden of decent health insurance?
  • rgambs
    rgambs Posts: 13,576
    Go Beavers said:

    "freedom caucus"? Freeing people from the burden of decent health insurance?

    Extremist looney toons
    Monkey Driven, Call this Living?
  • CM189191
    CM189191 Posts: 6,927
    Here's a photo of the GOP discussing the ACA. Including ending abortion coverage, Planned Parenthood funding, maternity and contraceptive coverage, and the gender rating

    I can't quite put my finger on it, but something seems to be missing from this discussion....
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