Armed Polite Society
Main Forums => Politics => Topic started by: Ben on March 07, 2017, 09:02:30 AM
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So, goodbye Obamacare, hello American Healthcare Act (or possibly Obamacare Lite). I haven't delved deeply into it yet, but from the executive summary, I think I like it (at least for something they could expeditiously get through).
Part of that is selfishness. It appears a couple of the "benefits" directly benefit Ben. Instead of subsidies by income, they are doing tax credits by age. It looks like I won't be able to take advantage of them for a couple of years, but when I get things squared away to where I'm making <$48K AGI*, it will be a nice help between now and 65. Though I do realize a tax credit vs deduction is still something of a handout. The other "plus" is what looks like doubling the HSA cap. From what it sounds like, people my age can move an extra $4K/yr into tax deferred income.
They kept the "26 and under" clause. They also kept the "pre-existing condition" clause. I realize the latter is not really "free market", but IMO, it was the right thing to do.
The Dems are going ballistic (as expected). Rand Paul is not happy (as expected). Whether fair or not, it does look to me like the R's have changed things to benefit those that were "lost" in the Obamacare fiasco - that is, people who have to pay for their own healthcare, but while not by any means wealthy, not qualified for subsidies, and in fact having their insurance premiums bumped up to pay for the subsidy people. I'm hoping that this will have a side benefit of reducing people's premiums from Obama's artifical rate spike.
http://www.foxnews.com/politics/2017/03/06/house-republicans-release-obamacare-replacement-bill.html
https://housegop.leadpages.co/healthcare/
* The $48K is for other tax purposes. This Act puts, it looks like, a $75K/yr cap on tax credits.
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Oh, just caught one other negative. No buying insurance across state lines. That's going to make reducing premium prices a lot more difficult.
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If both the Demoncrats and Rand Paul hate it, it can't be too bad. Apparently some of the RINOs also don't like it, so it must be an improvement.
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The new individual mandate (but don't call it that) is interesting to say the least.
individuals will get a 30 percent penalty, i.e. a fine, if they do not keep insurance. That is the individual mandate in all but name. In fact, this is actually of questionable constitutionality because the government imposed fine would be paid to the insured person’s previous insurance company when they subsequently try to buy a new policy.
Unfortunately it's necessary if you're mandating coverage of pre-existing conditions, and once you've got those two things then you've pretty much given up on a free market.
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Sounds like garbage to me. The republicans are keeping everything that makes Obamacare so expensive.
I support federalism in health care. Every state should make its own rules.
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I wish we could just go back to the pre-ACA days. There were an estimated 60 million Americans without health insurance, roughly 50% of whom were young people who didn't buy it because they didn't think they needed it. I think we could have found a way to provide health insurance for 30 million Americans without changing the lives of the other ~300,000,000.
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I wish we could just go back to the pre-ACA days. There were an estimated 60 million Americans without health insurance, roughly 50% of whom were young people who didn't buy it because they didn't think they needed it. I think we could have found a way to provide health insurance for 30 million Americans without changing the lives of the other ~300,000,000.
I'd be happy with that if they just tweeked it to be able to deduct 100% of your health care costs, regardless of income. The deduction limitation has always been a burr under my saddle, especially since not even the R's have ever pushed for a better deal. If you care about "working class" Americans that don't have employer provided insurance, that should be a no-brainer.
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It's not perfect but I'll take an improvement over Obamacare that is a step in the right direction. I'd really like to remove anything even remotely resembling a mandate and adding insurance across state lines, as well as mobility between jobs, those being the big ones that jump immediately to mind.
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It's not perfect but I'll take an improvement over Obamacare that is a step in the right direction. I'd really like to remove anything even remotely resembling a mandate and adding insurance across state lines, as well as mobility between jobs, those being the big ones that jump immediately to mind.
It's two steps toward socialism and one step back.
It's crap.
26 years old on their parent's insurance?
Yes, LET'S continue to encourage young people not to be self-sufficient. Brilliant.
It's now pretty clear that we're going to be a European socialist state. At about the same time that all of them collapse because of their own stupidity.
Nice to see we're learning.
(https://media0.giphy.com/media/sRWf3Oa9vW6Xu/200_s.gif)
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It's not perfect but I'll take an improvement over Obamacare that is a step in the right direction. I'd really like to remove anything even remotely resembling a mandate and adding insurance across state lines, as well as mobility between jobs, those being the big ones that jump immediately to mind.
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You could greatly improve the mobility between jobs by making everyone get their own health insurance/coverage with an income tax deduction for it rather than employer pre-tax withholding. Then it is yours and not tied to your employer.
If everyone was buying their own, I think you would see health insurance commercials competing with car insurance commercials for TV air time.
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State lines are in the works for part two or three. This is just part one of the plan.
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If everyone was buying their own, I think you would see health insurance commercials competing with car insurance commercials for TV air time.
And insurance companies actually competing for customers. In the mostly-employer-provided model, they only had to convince the employers, which is a lot different from having to draw in the individual consumer.
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You could greatly improve the mobility between jobs by making everyone get their own health insurance/coverage with an income tax deduction for it rather than employer pre-tax withholding. Then it is yours and not tied to your employer.
If everyone was buying their own, I think you would see health insurance commercials competing with car insurance commercials for TV air time.
This would be even better.
It's a step in the right direction, but far from perfect. Course it'll probably get royally *expletive deleted*ed with amendments.
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If there is a mandate to buy insurance, then it is junk.
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It's a step in the right direction, but far from perfect. Course it'll probably get royally *expletive deleted*ed with amendments.
Herb Cain said this morning, "It will be a workable plan if the Republicans don't mess it up." So I guess it won't be a workable plan. :lol:
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I don't think Trump ever said he was going to give us a libertarian free market plan to replace Obamacare. He didn't run on that, promise that and I'm not aware of any time he said that was his preference.
We'll get a marginally better (maybe), government dictated solution, with a few more market realities taken into consideration.
The Republicans in congress are mostly big government guys and Trump can be something of a big government guy himself.
That's what we have and so far it's been better than the alternative.
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I don't think Trump ever said he was going to give us a libertarian free market plan to replace Obamacare.
Personally, I think that libertarian free market plan is about as likely as a write-in vote getting elected president. It would be nice to have that theoretical perfect plan, just like it would be nice for everyone to have their theoretical perfect candidate. Just not gonna happen.
There are things I like in the new plan that other people hate. There are things I hate in the new plan that other people like. In some ways I feel sorry for the politicians in that there is simply no way for them to create a universally (or heck, even majority) accepted plan. That's for either side of the aisle. The country is simply too split for single payer to get accepted for the one side, or free market for the other side.
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You could greatly improve the mobility between jobs by making everyone get their own health insurance/coverage with an income tax deduction for it rather than employer pre-tax withholding. Then it is yours and not tied to your employer.
Every place I've worked, the insurance was partially paid by the employer. The only way your plan would work is for that to stop AND the money spent on your behalf put into your pay. That ain't gonna happen.
Chris
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Every place I've worked, the insurance was partially paid by the employer. The only way your plan would work is for that to stop AND the money spent on your behalf put into your pay. That ain't gonna happen.
Chris
Some employers pay below market wages already. It would still be better in the long run.
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Every place I've worked, the insurance was partially paid by the employer. The only way your plan would work is for that to stop AND the money spent on your behalf put into your pay. That ain't gonna happen.
Chris
You haven't been in the job market for awhile, have you? There are fewer and fewer employers every day who offer health insurance.
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You haven't been in the job market for awhile, have you? There are fewer and fewer employers every day who offer health insurance.
My employer pays a big chunk of my healthcare plan with United. Just a couple weeks ago, I finished my benefits election. Company pays 2/3 of the total monthly cost.
Chris
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I am senior enough that I am at the top end of the salary cap for the past two years and I get no more raises. I am bringing home less per month than I did two years ago: my salary has remained essentially the same but the monthly health insurance premiums have increased over that time, resulting in lower take home pay.
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My employer pays a big chunk of my healthcare plan with United. Just a couple weeks ago, I finished my benefits election. Company pays 2/3 of the total monthly cost.
Chris
I've hardly noticed a change in my health insurance costs (through my employer) since Obamacare was instituted as well. I pay a little more for a little less.
We are mistaken if we conclude everyone has had the same experience though.
If we on the right make that mistake we may get another "surprise" like Donald Trump except with a candidate that holds a less favorable view of our ideas about the country. Think Obama v2 or the return of Hillary (whether in the flesh or spirit).
The folks that flipped to Trump can just as easily flip back to the Democrats.
Pragmatism dictates we don't abandon them to "market forces". We shouldn't take away what they think the Democrats have given them.
There needs to be better options available that cause government mandated options to die on the vine.
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It's a step in the right direction, but far from perfect. Course it'll probably get royally *expletive deleted*ed with amendments.
Make doctors work for $3/hour plus tips. Healthcare becomes affordable and bedside manner gets a hell of a lot better.
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In some ways I feel sorry for the politicians in that there is simply no way for them to create a universally (or heck, even majority) accepted plan.
And therein lies the problem. The government shouldn't be trying to make everyone have health insurance. The government should set the standards and laws for everyone to follow and let the people decide what they want.
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And therein lies the problem. The government shouldn't be trying to make everyone have health insurance. The government should set the standards and laws for everyone to follow and let the people decide what they want.
That's not what the electorate wants though.
Whether we like it or not we are subject to the oligarchy and them trying to appease the mob.
Lex Rex is dead.
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It's absolute junk. It's Obamacare with a few minor tweaks. Everything that was in Obamacare that was offensive or drove up the cost of insurance and deductibles is still in there. Insurance premiums are going to continue their double-digit increases every year, and deductibles will continue rising.
It's completely obvious to even the weak minded, lame and lazy that The Stupid Party® never had any intention of repealing Obamacare.
What's worse is that Trump will go along with it.
State lines are in the works for part two or three. This is just part one of the plan.
Uh, huh. Sure. I've got a bridge for sale if anyone is interested.
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It's absolute junk. It's Obamacare with a few minor tweaks. Everything that was in Obamacare that was offensive or drove up the cost of insurance and deductibles is still in there. Insurance premiums are going to continue their double-digit increases every year, and deductibles will continue rising.
It's completely obvious to even the weak minded, lame and lazy that The Stupid Party® never had any intention of repealing Obamacare.
What's worse is that Trump will go along with it.
Uh, huh. Sure.
My first clue was that they were "working" on the repeal/replacement even though they had already sent a repeal/replacement to Obama.
The Republicans are the bigger problem than the Democrats right now. I think they are actually pulling Trump to the left on this issue.
We'll get a marginally better replacement at best.
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My first clue was that they were"working" on the repeal/replacement even though they had already sent a repeal/replacement to Obama.
They Republicans are the bigger problem than the Democrats right now.
Agreed.
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Ann is not amused
http://www.mediaite.com/online/ann-coulter-wants-to-know-who-wrote-this-piece-of-crap-obamacare-replacement-bill/
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When the Republicans pass this American Health Care Act piece of excrement, they will effectively hand the House and Senate to the Democrats. They will have proven once again that there is not a dime's worth of difference between the GOP leadership and the Democrats.
The Republican base will see that their suspicions have been accurate all along, that "GOP" really means "Grand Old Prevaricators". The Republican lies have been so blatant and obvious this time around that they have guaranteed their fall to minority status during he next two election cycles. The base will simply not turn out for them any more.
There has been much post-election speculation among the punditry that the Democrat party is on it's death bed. If it ever was, it is not now. The Republicans just provided CPR and saved the patient with Obamacare Lite.
When Trump signs this bill, (and make no mistake, he will sign it) he becomes a one term president. There is no way in hell he will be elected to a second term.
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I think it would be a mistake to think that the majority of the "GOP Base" (whatever that is)is quite as small gov/conservative as the majority of this board.
I know a LOT of hard core GOP partisan voters that agreed that healthcare should be provided (or at least guided and subsidized) by the fed.gov. Their issue with O-care wasn't the concept, but the implementation.
I suspect many of them will be happier with this incarnation, and rather than being upset will see this as a campaign promise that was actually fulfilled. I also expect the GOP lawmakers to hide or put off any drastic downsides until after the next election to allow true believers to continue deluding themselves.
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You haven't been in the job market for awhile, have you? There are fewer and fewer employers every day who offer health insurance.
I went new job hunting 24-18 months ago, every job posting that fit my education or experience had health insurance as a benefit. Public and private sector.
Still do a bit of looking, never know if there is a better offer, but everyone still offers health insurance. Usually paid at 90% of the premium.
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1. The ACA is hereby repealed.
2. Healthcare and Insurance costs are fully deductible. (Until we pass the Flat Tax.)
3. Health Insurance can be purchased across state lines.
Why is that so hard?
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Perfect. Wrap it up, I'll take it.
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1. The ACA is hereby repealed.
2. Healthcare and Insurance costs are fully deductible. (Until we pass the Flat Tax.)
3. Health Insurance can be purchased across state lines.
Why is that so hard?
Add a quadrupling of the annual HSA contribution and I'll bite.
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Add a quadrupling of the annual HSA contribution and I'll bite.
Ummm, that would be a "healthcare cost" that would be fully deductible... ;)
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Ummm, that would be a "healthcare cost" that would be fully deductible... ;)
https://youtu.be/MOThcFqoMT0?t=328
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1. The ACA is hereby repealed.
2. Healthcare and Insurance costs are fully deductible. (Until we pass the Flat Tax.)
3. Health Insurance can be purchased across state lines.
Why is that so hard?
4. Patients who pay their bills with cash must be charged by the provider at the cheapest rate they bill insurance for the same care.
If you don't have insurance hospitals DOUBLE your bill versus patients with insurance. It is sickening.
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4. Patients who pay their bills with cash must be charged by the provider at the cheapest rate they bill insurance for the same care.
If you don't have insurance hospitals DOUBLE your bill versus patients with insurance. It is sickening.
I've heard the exact opposite - you can negotiate a better price paying cash vs having them deal with insurance. Maybe that's only if you're dealing with smaller clinic or a specific doctor though? I have no personal experience doing so.
Anyway if you have to mandate what they charge in a specific situation, there's probably a regulation or requirement elsewhere in the system that needs addressing.
Treat the root cause, not the symptom.
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I've heard the exact opposite - you can negotiate a better price paying cash vs having them deal with insurance. Maybe that's only if you're dealing with smaller clinic or a specific doctor though?
That's also what I heard. My only experience is when the ophthalmologist stopped taking my insurance, they offered me a 20% discount to pay up front. A previous dentist also offered me a discount on the "above what my crappy dental insurance would pay*" amount to replace an old filling. I think it was 10% or something.
* Tangent: I no longer have dental insurance. Doing the math for my healthy mouth, twice a year preventative care via cash is actually cheaper than the twice a year "free" cleanings via insurance. If I do run into a problem, or need a filling replaced or whatever, paying cash is probably a wash to what little the insurance would pay for that kind of stuff. For dental insurance that covers everything, I think cash is probably cheaper. Then (given gov gets its act together on health care deductions) paying out of the HSA and deducting it is probably even more of a bonus.
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That's also what I heard. My only experience is when the ophthalmologist stopped taking my insurance, they offered me a 20% discount to pay up front. A previous dentist also offered me a discount on the "above what my crappy dental insurance would pay*" amount to replace an old filling. I think it was 10% or something.
* Tangent: I no longer have dental insurance. Doing the math for my healthy mouth, twice a year preventative care via cash is actually cheaper than the twice a year "free" cleanings via insurance. If I do run into a problem, or need a filling replaced or whatever, paying cash is probably a wash to what little the insurance would pay for that kind of stuff. For dental insurance that covers everything, I think cash is probably cheaper. Then (given gov gets its act together on health care deductions) paying out of the HSA and deducting it is probably even more of a bonus.
I do the same thing. Only my plan, should there ever be a problem is head over to a local Dental School and let some of the Almost-Doctors get in some practice on my mouth. It's usually free or a nominal charge for "parts".
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I've heard the exact opposite - you can negotiate a better price paying cash vs having them deal with insurance. Maybe that's only if you're dealing with smaller clinic or a specific doctor though? I have no personal experience doing so.
Disclaimer: Uncle Sam has covered me since I was a young adult under Tricare. My brother, though, spent some time without insurance.
It is indeed if you're working with a smaller clinic or a specific doctor that you can often negotiate the lower rates with if you pay cash up front. Many, however, won't even see if you if you don't have insurance or pay up front. My brother did manage to negotiate deals of up to 50% off of what insurance would have ultimately paid. Some will work with you, some won't.
Meanwhile, hospitals and larger clinics have complex deals with insurance companies, can't figure out your bill until well after you've been discharged, and won't accept cash up front even if they could figure out an estimate for the services you are going to receive. It's a mess.
So as long as you can stay out of the hospital, are willing to shop around and yes, haggle a bit, you can get healthcare cheaper than what insurance pays.
The problem is what happens when you end up in a hospital anyways, don't have negotiating power until you're threatening bankruptcy, and the hospital charging you double of their average insurance payout is the best you can hope for.
Anyway if you have to mandate what they charge in a specific situation, there's probably a regulation or requirement elsewhere in the system that needs addressing.
Treat the root cause, not the symptom.
I see the problem as that, unlike nearly every other industry, they're not required, by market forces if nothing else, to post prices or give estimates before providing services. Not even hourly labor rates.
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And they don't have a money back policy if they are wrong. You just keep getting to pay until they run enough test to figure it out, you run out of money or die.
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I've heard the exact opposite - you can negotiate a better price paying cash vs having them deal with insurance. Maybe that's only if you're dealing with smaller clinic or a specific doctor though? I have no personal experience doing so.
Anyway if you have to mandate what they charge in a specific situation, there's probably a regulation or requirement elsewhere in the system that needs addressing.
Treat the root cause, not the symptom.
I'm giving my experience- when the hospital found out I did have insurance they cut the bill in HALF. They were trying to screw anyone paying cash.
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And they don't have a money back policy if they are wrong. You just keep getting to pay until they run enough test to figure it out, you run out of money or die.
Just about the only place where you still have to pay up even if they completely screw up. Then you get to pay some more to get their screw up fixed, if you're lucky.
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I'm giving my experience- when the hospital found out I did have insurance they cut the bill in HALF. They were trying to screw anyone paying cash.
Well, they had to charge the rates negotiated with the insurance company once they found out who you were with. There are some sorta-insurance programs that all they really do is get you the negotiated rates.
And even then, the insurance probably settled up for some fraction of the bill.
Just about the only place where you still have to pay up even if they completely screw up. Then you get to pay some more to get their screw up fixed, if you're lucky.
Yeah, you pretty much have to get them for outright malpractice. If they misdiagnose you and do something not necessary, but not really harmful, you still have to pay up. If it's actively harmful, then they might have to pay to fix that.
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1. The ACA is hereby repealed.
2. Healthcare and Insurance costs are fully deductible. (Until we pass the Flat Tax.)
3. Health Insurance can be purchased across state lines.
Why is that so hard?
I like it. How do we sell it to Paul Ryan RINO?
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Note to the GOP, aka The Stupid PartyTM:
The people who want/get free stuff (including health care) won't vote for you no matter WHAT you do.
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I like it. HowWho do we sell it to Paul Ryan RINO to?
FTFY.
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Nobody knew that health care could be so complicated
:'(
So is the vote on this today just too depressing to discuss?
It's apparently causing traumatic flashbacks for some people
In my district, right now there’s a lot of misunderstanding as to what it is we’re doing. And once we get it done, and then we can have the chance to really explain it.
If they were serious about this, it seems like they could have just started with the Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 (http://www.speaker.gov/press-release/for-the-first-time-congress-will-send-an-obamacare-repeal-bill-to-the-presidents-desk) which they already managed to agree on before. Right?