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UNLV2001

CBO scores Senate health bill

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5 hours ago, Old_SD_Dude said:

Turtle Head has delayed the vote until after the break.

 

Every time I look at him I wonder where his chin went. 

thelawlorfaithful, on 31 Dec 2012 - 04:01 AM, said:One of the rules I live by: never underestimate a man in a dandy looking sweater

 

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Insurance should be scalable based on your needs.  I don't need a plan that covers pregancy right now (and hopefully not anytime soon).  Many women don't need plans that cover male health issues.  A one size fits all approach isn't the way to go. 

thelawlorfaithful, on 31 Dec 2012 - 04:01 AM, said:One of the rules I live by: never underestimate a man in a dandy looking sweater

 

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5 hours ago, NMpackalum said:

I think you greatly underestimate the role of insurance companies and why physicians take government plans. As I have argued before. We will never be able to deliver healthcare without insurance companies in a single payer system. The government has no infrastructure to deliver healthcare. No physicians, hospitals, plan administrators, pharmacy benefits management etc.. 

Secondly, qualified ACA plans have excessive coverage that many people don't need. And really, hi deductible plans like the exchange plans and now commercial plans are defacto dramatically reduced coverage plans as most people can't afford to use their coverage. Statistically there is decreased utilization with the current system because of the large cash deductibles in most plans now. I have also seen this in my practice as at least 30 percent of people cancel their surgeries after finding out their out of pocket expense.

Thirdly, the 400 billion cost of a single payer plan in California is based on Medicaid rates which is significantly lower than even Medicare rates and about 25-35 percent of insurance national reimbursement. At least double that cost if you are going to pay enough to have out of network docs and hospitals participate. So it's not a huge assumption considering the ACA plans generally reimburse at Medicaid rates now.

Finally, a large part of the problem for both physicians and hospitals are that many of the people who qualify for Medicaid or subsidized care don't bother to sign up and this leaves the care providers holding the bag unpaid which results in continued cost shifting.Fix human nature and you can go a long way to fix the problem.

Thats Fine.  Germany, France, and Canada have private health insurance companies

 

I agree that many health plan coverages are not needed and need to be an option people can add or drop to cover what is important to them.

 

I wonder how many drop a needed or critical surgery.  I know a few who did.

 

Yes I think it is a huge assumption and shows a bias to think it will be at medicaid rates.  In a germany like system only a base level is guaranteed by a government or private insurace plan that is non-profit to the company.  Everything else is paid out of pocket or by private insurance above and beyond that basic coverage sold by private companies.  There is no way to predict how this could play out in the US should we ever attempt it.  too many assumptions on your part on who is providing the basic coverage and how it is managed

 

I certainly agree that people not signing up for coverage they are eligible for is a real problem as are unpaid bills.  Those bills will greatly increase under the republican plan, and that leaves everyone else with higher bills.

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Just now, mugtang said:

Insurance should be scalable based on your needs.  I don't need a plan that covers pregancy right now (and hopefully not anytime soon).  Many women don't need plans that cover male health issues.  A one size fits all approach isn't the way to go. 

Yep.  A huge flaw in ACA that needed to be fixed almost right away

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As soon as the ACA is replaced or repealed, I'm going with the "Trump" plan. I'll pay as I go for any little shit I need but if something catastrophic shows up, I'll shield my assets as much as possible and seek bankruptcy protection. Isn't that what a good business man would do? 

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36 minutes ago, Billings said:

Thats Fine.  Germany, France, and Canada have private health insurance companies

 

I agree that many health plan coverages are not needed and need to be an option people can add or drop to cover what is important to them.

 

I wonder how many drop a needed or critical surgery.  I know a few who did.

 

Yes I think it is a huge assumption and shows a bias to think it will be at medicaid rates.  In a germany like system only a base level is guaranteed by a government or private insurace plan that is non-profit to the company.  Everything else is paid out of pocket or by private insurance above and beyond that basic coverage sold by private companies.  There is no way to predict how this could play out in the US should we ever attempt it.  too many assumptions on your part on who is providing the basic coverage and how it is managed

 

I certainly agree that people not signing up for coverage they are eligible for is a real problem as are unpaid bills.  Those bills will greatly increase under the republican plan, and that leaves everyone else with higher bills.

I think you're naive if you think a single payer health system that's tax payer funded and government managed would not be based on a Medicare relative value scale as is Medicare/Caid/Tri-Care is. And certain best practices as determined by US Task Force on Preventative Care that meet Hedis criteria and the rest of the government alphabet soup of regulations would certainly be the basis of practice management in this system. Show me a government plan that doesn't use their own CMS reimbursement schedule.

Huge difference between German Medical system and the US system in that the German Federal and municipal governments own the hospital and medical infrastructure paid for by a 15 percent tax split by employer and employee. Private insurance (10 %) is purchased only by people making over 50k euro that is a lifetime rate. Insurance companies only act like a third party administrator. Unfortunately  revamping our system in their fashion is inconceivable unless the government decides to nationalize and take assets from private entities like Venezuela would do.

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We hear the GOP healthcare plan debate is a disaster...The Dems have completely taken themselves out of the debate and are not criticized at all.  Debate (bad)  vs abandonment of the American people and not doing their jobs (good) .  Thats f'd up.

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1 hour ago, Jackrabbit said:

We hear the GOP healthcare plan debate is a disaster...The Dems have completely taken themselves out of the debate and are not criticized at all.  Debate (bad)  vs abandonment of the American people and not doing their jobs (good) .  Thats f'd up.

Bet you celebrated it when your boys did it, though. 

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2 hours ago, Jackrabbit said:

We hear the GOP healthcare plan debate is a disaster...The Dems have completely taken themselves out of the debate and are not criticized at all.  Debate (bad)  vs abandonment of the American people and not doing their jobs (good) .  Thats f'd up.

Have any Democrats been invited to the table? I don't think so. It's kinda like when the ACA was passed; how many Republicans voted for it?

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7 hours ago, NVGiant said:

Bet you celebrated it when your boys did it, though. 

 

6 hours ago, renoskier said:

Have any Democrats been invited to the table? I don't think so. It's kinda like when the ACA was passed; how many Republicans voted for it?

 They knew it was a cluster+++++ and no one read it.   At least the Republicans debate each other...something the Dems are not allowed to do.

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42 minutes ago, Jackrabbit said:

 

 They knew it was a cluster+++++ and no one read it.   At least the Republicans debate each other...something the Dems are not allowed to do.

Oh baloney.  Several demo just stood and voted with republicans to sell arms to Saudi Arabia.  Happens more then you want to admit.  This bill was written by 10 guys in secret.  Hell their own party members had not seen it until the put it on the floor.  The dems are also just as bad but as least call out both sides for totally bypassing the committee system and putting power in a small subset of people with this whole majority of the majority crap

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1 hour ago, Jackrabbit said:

 

 They knew it was a cluster+++++ and no one read it.   At least the Republicans debate each other...something the Dems are not allowed to do.

Good grief. BTW, which one of these are you? 

usafreedomkids-750x400.png

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1 hour ago, Billings said:

Oh baloney.  Several demo just stood and voted with republicans to sell arms to Saudi Arabia.  Happens more then you want to admit.  This bill was written by 10 guys in secret.  Hell their own party members had not seen it until the put it on the floor.  The dems are also just as bad but as least call out both sides for totally bypassing the committee system and putting power in a small subset of people with this whole majority of the majority crap

Almost all bills are written by less than 10 guys and always in secret.

The public portion comes when the bill is presented in hearings and debated.  Which granted the republicans are trying to limit.

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