Posted on 07/19/2017 12:45:30 PM PDT by Brian Griffin
I would like truly affordable coverage.
Put a bill in the hopper:
1. Allowing insurance companies to sell mandatory issue during PPACA open season, lower-cost coverage for a insurer-set number of days (24-hour periods), of at least 5, of hospital care coverage (EMTALA scope, essential newborn congenital surgery, operative tumors, pallitative cancer surgery, fractures of major bones), with a $1,000 hospitalization deductible,
with available riders, only mandatory issue and federal law exempt from previous condition restrictions with the purchase of at least five, for coverage:
a. up to $1,000 for outpatient/ER insurer-selected, Medicare Part B covered tests with patient Medicare Part B level co-insurance in-network and insurer reimbursable at Part B federal 80% amounts out-of-network
b. of primary drugs with insurer-set patient co-pays selected from $4, $10, $20, and $50 per 30-day prescription/course/treatment episode for insurer-selected, policy-listed drugs
c. of secondary drugs/appropriate infusion services with insurer-set patient co-pays selected from $100, $200 and $500 per 30-day prescription/course/treatment episode for insurer-selected, policy-listed drugs
d. up to $600 for Medicare Part B scope office care reimbursable at Part B federal 80% amounts out-of-network, in full (and subtracted at just 80% of Part B rates from the $600) with Medicare Part B 20% patient co-insurance in-network
e. up to $1,200 for Medicare Part B scope office care reimbursable at Part B federal 80% amounts out-of-network, in full (and deducted at just 80% Part B rates from the $1,200) with Medicare Part B 20% patient co-insurance in-network
f. up to a second $1,000 for outpatient/ER insurer-selected, Medicare Part B covered tests with patient Medicare Part B level co-insurance in-network and insurer reimburseable at Part B federal 80% amounts out-of-network
g. of one emergency terrestrial ambulance ride with a maximum insurer payout of $500 and minimum 20% patient co-insurance
h. of a second emergency terrestrial ambulance ride with a maximum insurer payout of $450 and minimum 30% patient co-insurance
i. of one ER visit (and ER treatment) with patient co-pays of $200 in-network, insurer payout(s) of at least Medicare Part B amount(s) out-of-network
j. of a second ER visit (and ER treatment) with patient co-pays of $200 in-network, insurer payout(s) of at least Medicare Part B amount(s) out-of-network
k. of up to an insurer-limited number, of at least five, of Part A equivalent days in a nursing home, with $50/day patient co-pays
[The riders are designed to have cost-control characteristics.]
2. Allowing purchase of any such coverage to be considered qualifying coverage for PPACA penalty avoidance
3. Providing a federal subsidy of:
a. 50%, plus
b. 3% for each rider a-e and 1% for each rider f-k listed above bought, plus
c. 1% for each hospital day above 5, up to 4, plus
d. .5% for each hospital day above 9, up to 7, of the person's PPACA “silver plan” maximum allowable amount.
[The coverage for an insured would cost Uncle Sam 50% to 78.5% of what PPACA coverage normally would.]
A customer must buy a primary rider of a kind before a secondary rider of the kind.
Insurance company created packages of required offer riders may be discounted.
[This would allow policy buyers to get cheaper risk-based pricing rather than just insurer wholesale purchase pricing.]
An insurance company may only label a hospital or doctor as in-network only if contracted as such for the calendar year(s) of the policy.
An insurance company may only describe a drug as covered only if contracted as such for the calendar year(s) of the policy.
Many of you want the choice to buy just traditional hospitalization coverage. Some of you will want to max out on rider coverage.
I simply want a choice and a chance to save my life.
Put the right to a choice in coverage up for a vote.
Make the RINOs (and Democrats) vote (by roll call) to refuse to allow Americans to buy good quality, lower-cost coverage.
Unlike Obama and many senators, most Americans don't live in a mansion.
Many of us can only afford a Ford or Chevy.
To call a health coverage 'Cadillac' "affordable" just shows how unrepresentative our politicians are.
Why does it have to be a government solution? How about government get out altogether?
Too late. Get past Murkowski and then come to us.
You sound like someone who wants to reduce the cost of healthcare, e.g. not a member of Congress who is more interested in protecting special interests and giving away free stuff.
The reason the industry can’t do all of these things alone is there are regulatory, legal, and other barriers.
“Fixing Obamacare” means DON’T replace unconstitutional ACA AKA Government healthcare with more unconstitutional government healthcare.
The answer is NO GOVERNMENT healthcare AKA THE FREE MARKET!!!!
The voluntary cooperation directly between patients and doctors in the marketplace free from government interference is the best healthcare system in the world which America had until the feds started unconstitutionally screwing it up in the 60’s.
KICK THE POLITICIANS OUT OF HEALTHCARE. They don’t care about your health, only their political careers.
We need government bailouts and guarantees for health insurance companies!!
The purpose of “The Affordable Care Act”, AKA “ObamaCare”, is NOT to make healthcare affordable, but partly to control you, anf everyone else in the country, and partly to fund the healthcare for the literally millions of
ILLEGALS pouring over our open borders for the last eight to twenty years.
The purpose of the ‘Act’ was to FAIL, thus prompting President Hillary Rodham Clinton to call for SINGLE PAYER, AKA GOVERNMENT RUN HEALTHCARE.
But a funny thing happened on November 8, 2016.........................................
Red Badger’s Postulate of Political Power:
Every political party wants to increase it’s base, so as to increase it’s power.
Example:
The Democrats are ‘for the poor’ and the Republicans are ‘for the rich.’
Each party wants to increase their constituency by the largest numbers possible...........................
Or a two tired system - market incentives for most Americans (everything from doctor concierge care to group health plans etc) AND ‘healthcare options - NOT INSURANCE OPTIONS - but ‘healthcare options’ for medicaid citizens.
Your proposal seems to cover less than catastrophic expenses, and not catastrophic.
I’d rather pay into a cumulative health care savings account and cover my own expenses less than 20K/year, with a catastrophic policy. To succeed at that I would need to be able to get the same preferred pricing that insurance companies negotiate.
It’s my guess that at least a quarter of medical costs come from insurance and government paper work, and the zero-sum maneuvering with charge books and DRG billing - squeeze out more money! keep payments down!, and the ever-more complicated bills that ensue.
I just want a 50k deducable and a unlimited HSA with travel expenses qualified
I don’t trust anyone anymore
“How about government get out altogether?”
Modern medicine is in large part Article I, Section 8 patented drugs, some of which are very expensive.
TV commercials advertising patented pills and potions costing insurance companies and employers $10,000 to $125,000 per year per patient fill the airwaves.
I think my friend Don takes over a dozen different drugs.
Government isn’t getting out of health care.
Doctors will be state licensed for decades to come.
Prescriptions will still be required by law on thousands of drugs.
Labs must be certified to government enforced standards.
All the rules of government come at a stiff price, which tens of millions can not pay themselves. Millions never will be, no matter even if the GOP actually tried to make progress.
We do need to introduce market force, slowly and safely, back into health care.
The opportunity to roll back the welfare state by bringing back factory work to the USA isn’t even in the works, sorry to say.
“The voluntary cooperation directly between patients and doctors in the marketplace free from government interference is the best healthcare system in the world”
Your doctor, if educated in the USA, only paid a fraction of the cost of his medical schooling. Governments, state and federal, paid more than he did.
Residencies are paid for by the federal government. A residency is where a medical school graduate learns to be an effective healer.
The malpractice coverage for the resident is paid for by the federal government.
Health care is more than doctors, it is also hospitals. Most hospital construction after WW2 until the 1970s was financed by the federal government. The hospitals repaid the construction cost by taking care of the poor.
Without Medicare, most hospitals would find themselves in bankruptcy.
One of the first steps needs to be a law that allows all health insurance companies to sell policies across state lines. If Americans (and their employers) are free to shop for the best rates nationwide it’ll be good for us all. The increased competition will get rid of the price gougers and get rates down to a supply and demand happy medium.
And we need a caveat that allows for a la carte policies that don’t bundle in unneeded coverage. Men don’t need OBGYN coverage, old people don’t need insurance covering childbirth, etc.
Shift the control away from the feds and back to the patients, their doctors and the insurance companies.
“And we need a caveat that allows for a la carte policies that don’t bundle in unneeded coverage. Men don’t need OBGYN coverage, old people don’t need insurance covering childbirth, etc.”
I still do not understand why all of this is such a big deal. What does it cost me (male) to have OBGYN coverage? The cost of the ink and the paper it is printed on?
Gee, why weren't most hospitals bankrupt before 1965 when LBJ signed unconstitutional Medicare and started America down Hayek's Road to Serfdom?
“To succeed at that I would need to be able to get the same preferred pricing that insurance companies negotiate.”
That’s is primarily a state controlled matter.
States don’t want to do anything to help you.
Governments, state and federal, want you to overpay for health insurance so you pick partially up the tab for others.
Governments realize that the power of taxation isn’t infinite.
Governments now also try to make you pay for others whenever you buy, such as health care coverage for large employer employees, “affordable” housing in the same housing development, health insurance, etc.
I’m an engineer by education. I know how badly working Americans are getting fleeced.
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