Posted on 03/27/2017 7:04:20 AM PDT by Sean_Anthony
I have been saying for almost a decade that it is “the Ralph and Sam” show. Sam Sheepdog (the democrats or GOP depending on what party you belong to) fights with Ralph Wolf for our benefit. At the end of the day they go have cocktails and laugh at their “fights.” And we fall for it...thinking they are really fighting for us.
For the patient, if the out-of-state insurer can figure out how to lower the patient’s costs and still make a profit.
One law to consider would be to require service providers publish a cash/list price. Not sure how to compel that Constitutionally, but does seem a systemic problem is that providers don’t actually know _what_ their price is without having created an impenetrable list of negotiated costs.
Just because we can’t immediately see how it would work doesn’t mean that someone with connections & motive won’t make it work. Heck, one solution could be: insurer contacts provider and says “we’ll pay fair price $X for this, and if you don’t agree (or negotiate with us in good faith) you’ll have to get thru our enthusiastic lawyers to get anything out of our client who, by the way, doesn’t have anywhere close to $X.”
“You have to have a transition plan or you leave people in the lurch.”
Fair warning works. Issue a date for outright repeal, giving insurers a chance to offer alternative plans and patients to transition. There’s been plenty of warning that a repeal could very well happen; insurers should already have sufficient plans waiting should it happen.
“If you thought Trump was going to leave a lot of people uninsured, then you didn’t listen to him.”
Trump is a hardcore capitalist. I expect his solution to “a lot of people uninsured” is “slash hindering regulations and let insurers offer something for _everyone_, even if it’s catastrophic coverage for $1/day.” (I’ve had some big medical bills, which could be paid with $10/day for life - not a bad deal, cheaper if duly pooled as catastrophe insurance.) The reason people aren’t insured (outright refusal to pay, common for young & healthy) is because insurers aren’t allowed to offer something those people can afford.
If i understood it correctly, this bill removed federal regulations on what insurers had to include. That would have put it back to the states. And would have allowed more variety.
I’m not sure that’s entirely a good idea. Individuals are not actuaries and don’t have sufficient information about what the real risks are. And they aren’t lawyers and they don’t have time to understand all the lawyer speak in insurance policies.
Insurance companies have actuaries and can remove coverage for things that are expensive and people are likely to need. And they bury those exclusions under tons of legalese.
That’s why every state chooses to regulate insurance. It’s not a conspiracy. (most of the time). It is problematic, in that the insurance regulators and the insurance industry tend to get to cozy.
If i understood it correctly, this bill removed federal regulations on what insurers had to include. That would have put it back to the states. And would have allowed more variety.
I’m not sure that’s entirely a good idea. Individuals are not actuaries and don’t have sufficient information about what the real risks are. And they aren’t lawyers and they don’t have time to understand all the lawyer speak in insurance policies.
Insurance companies have actuaries and can remove coverage for things that are expensive and people are likely to need. And they bury those exclusions under tons of legalese.
That’s why every state chooses to regulate insurance. It’s not a conspiracy. (most of the time). It is problematic, in that the insurance regulators and the insurance industry tend to get to cozy.
I think we have to include Trump as an actor in this drama as well. He convincingly played the part of "the stern leader who demanded action!", while Paul Ryan turned in a great performance as "the lieutenant who just couldn't get it done, even though he really, really tried". Ryan did a great job playing the heavy, one of those "villains you love to hate".
“I feel like I’m living in Dr. Zhivago, but without the love story.”
LOL!
I do think that the notion of “people will be hurt....” by repealing the ACA is a HUGE lie.
If one thinks it through, a repeal means: We are no longer FORCED to buy health INSURANCE, under the penalty of a huge fine.
Nobody gets “hurt”. We just no longer are FORCED to buy insurance.
Albert Brooks wrote a book called 2030 that (somewhat) realistically deals with a world in which cancer is cured a fat-reducing pill are introduced to America in the late 2010s.
Basically, by 2030, all the Baby Boomers are still alive and still getting all their Medicare and Social Security Benefits.
Eventually everyone under 40 starts looking for a way out of endlessly paying for their parents to live the high life.
I’m with you. However, I’m thinking of it in the same way one could argue that repealing welfare could hurt people. Those most helped by a free handout will be most hurt when it is eliminated.
That’s really all I was talking about.
Do you think the average American lives in the world of the F Caucus cloud of philosophical nuances and doctrinaire ghost dancing?
The American people look at their pocket book and their money. They give someone or some Party the place and time to come through on promises that their pocket book and money and their jobs will be good.
Then they look at the results of whoever were given this power.
Period. They want to see results.
Thanks to the F Caucus idiots, it now looks like the markets will tank. Obamacare as the law of the land means small business will not only continue to struggle, but these struggles will get worse, LESS JOBS. Americans will see the markets tank if tax cuts are delayed, delayed, delayed, watered down.
They will look at the results and say “these results suck”. They have no time for philosophy. Only results.
The F Caucus have F’d EVERYTHING up now. They are the Dems best friend.
Wanna bet a bunch of RINOs get behind Bernie’s “Medicaid for All” bill?
The future is VA care for us, and elite care for our masters in the government.
Hey, it worked for 8 years! [sardonic chuckle]
Not true. Pres. Trump's EO requires the IRS to state on the tax return that answering the "mandate" question is optional. If anyone chooses to answer the question and tell the IRS that they do not have insurance then they have only themselves to blame.
It sounds like I may be wrong. I’ll have to check the form. I thought you were supposed to check the box if you had insurance, and if you didn’t you had to either pay a penalty or submit another form (as I have done) to show why you are exempt from the penalty.
If all I have to do is completely ignore the box, I’m golden - until some other president reverses his order. But by that time I’ll be on Medicare whether I want it or not.
That is what I understood from the start. The option lies with the taxpayer not the IRS. Whether they had time to change the form or not I don’t know.
I think your wish (and mine) has come true since the option to ignore the question effectively nullifies the mandate. Our President has given us official permission to the tell the IRS to #@&! 0&&. (on this one thing)
So, this means obamacare will collapse MUCH faster than predicted. This is a good thing.
A lot of people may find out, as I did, that there is health care after health care insurance, and it is amazingly cheap.
A very good thing!
I get a 25% discount for paying cash when services are rendered at the local medical clinic. Thankfully I have only had a few minor problems in the last year and none before that. Some kind of insurance would be in my best interest before the inevitable knocks on my door.
I work in hospital collections.
There is nothing in the world worse than an out of state payer. We don’t know how to authorize. We have no contract. They pay whatever they want, and THEN we negotiate. The bill stays on the active A/R forever because we don’t want to send the patient a $10,000 bill 5 months later, but we inevitably do.
No hospital in Texas wants to deal with insurers in all 50 states. It would drive administrative costs through the roof.
Why is the out of state any different?
What can be done to make out of state coverage work? (I have no problem with billing the patient directly if the insurer doesn’t follow thru fast.)
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