Posted on 12/08/2025 10:02:45 AM PST by SeekAndFind
It’s not just am insurance mess.
We need to bring back independent providers.
When you look an HCP employed by a health system, you might be the patient, but you are not the boss.
The only thing that makes sense is going back to catastrophic healthcare insurance only. Ninety percent-plus of healthcare spending should be direct.
I’m a little skeptical about the GOP “overhaul.” No one in Republican leadership, including Trump, has been building momentum or PR for comprehensive reform of the Obamacare mess. I suspect they will patch some holes and call it an amazing, conservative overhaul of Obamacare.
Relief from mandatory enrolment to a health plan at least would remove that out of pocket burden. Individuals need to be given the opportunity to decide their coverage needs. A 20 something is pretty healthy and has fewer needs that a 60 something person.
Republican Leadership is an oxymoron.
“Current law blocks them from pooling resources to negotiate like Fortune 500 companies do”
It is my understanding that the Fortune 500 mainly self-insure, with insurance companies only negotiating pricing and moving money from the employer to the providers.
The individual mandate WILL be activated again at a future date.
It's still part of the law - they just removed the penalty.
We’re really going to do it... this time! /s
LOL
We’ve been doing nothing on this since the infamous McCain thumbs down.
[my proposals]
PPACA AFFORDABILITY
Silver plans would be limited to a maximum deductible of three times the Medicare Part A amount [2026: $1736].
I would also make bronze plans low cost by having $10,000 50% co-pays with $10,000 paid up front to the insurance company by the insured. Unused amounts of the $10,000s would be refunded after the policy is closed out.
I would also make copper plans low cost by only covering Part A scope items plus what Part B would pay for any general or regional anesthesia surgery.
I would allow Federal PPACA exchanges to offer Interstate Class Drug Plans,
exempt from state control that cover under contract at the time of policy issue at least:
1. 80% of all FDA-approved recombinant drugs by key active entity
2. 80% of all key FDA breakthrough chemical active entities under patent as of January 1 of the coverage year
used in a drug approved by the FDA by August 1 prior
3. 80% of all key chemical active entities under patent as of January 1 of the coverage year
used in a drug approved by the FDA by August 1 prior
4. 90% of all WHO “essential” drugs
This system would allow for genuine negotiation between drug plans and drug companies. Drug plans would have an incentive to try to buy drugs from drug companies and drug companies would have an incentive to make deals to make sales.
Plan in-network drugs would be supplied at on an all-the doctors prescribe basis. The co-pays would be roughly equal to mere manufacturing cost.
For drugs not in a plan, there would be payment voucher issued to patients based on drug class: biologic large volume, biologic small volume, etc. The Secretary of HHS would compute recommended amounts annually. There would be a ten-day plan purchase cooling off period for plans not offering to pay the recommended amounts or more. Let the patients wave the voucher at Walgreen’s and CVS. The drug companies will gladly take $500 for a monthly prescription that might cost them $100.
As for pharmaceutical product liability, insurance coverage might be purchased at the pharmacy. Would you like pharmaceutical product liability coverage for that Covid vaccine jab? Yeah!
Medical and drug plans would not have fixed premiums; the monthly premium would change based on claim payouts. In that way, the insureds would bear the financial risks collectively and plan providers won’t have a strong financial incentive to deny claims.
Maybe if Congress had a vested interest in solving the problem they would do something about it.
However, seeing that their on a different health care plan than the average American, they don’t care unless it effects them getting reelected.
Reform medical education by breaking down medicine and dentistry into simpler chunks and start it in the first year of college.
Separate out drug coverage so hospital systems can run care coverage systems and cut out insurance company overhead and meddlers.
Our elected officials are treated as royalty, as you say, that's the problem. They simply do not experience life as an every day American.
As long as the Senate is occupied by the likes of Murkowski, Collins and McConnell nothing will pass.
I think that your assessment is optimistic.
Yes. I worked for the county. They were self insured but they hired Blue Cross to manage and process everything. So our insurance card said Blue Cross even though I knew the county self insured.
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