Before a full response as I need to start PT right now, if the GOP so favors pre-existing coverage why does every single replacement bill allow it to be dropped?
-edit autocorrect on PT.
So this new health care bill
- Thread starter zeke4ahs
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Before a full response as I need to start PT right now, if the GOP so favors pre-existing coverage why does every single replacement bill allow it to be dropped?
-edit autocorrect on PT.
I dunno. I don't even know if your assertion is true. But my speculation is that the GOP plans diminish the centralization, power and authority of Washington D.C. and allows the states autonomy in that field. Colorado had a very workable system prior to the ACA. It was an assigned risk pool. The problem was the cost. Additional funding to subsidize the pool was needed and appropriate from my POV. I think that kind of subsidy is more efficient than the myriad of subsidies folded into the ACA. Unrestricted block grants would be a big help.
No, they most certainly did not try to go it alone. They spent a year holding meetings, town halls, having it scored, etc. The GOP refused to work with them. You honestly don't see the difference here? It's mainly burning to the ground, because the GOP refused to cooperate to make it successful. They care more about getting a W than the American people, and those supporting this bill certainly prove that.
Show me the five jack wagons that wrote the bill and the pubs that supported the atrocity. Show me what policy the pubs actually had a hand in. Just because a hand full of rhinos in Congress support one policy or another over decades means nothing as a whole. The ACA is an entire democrat bill rammed down the throats of Americans with ZERO support by pubs. You libs own the atrocity. Quit acting as though pubs somehow had a hand in the ACA.
Righties haven't read their current bill they're proposing, or even waiting for the CBO to score it, yet are bragging how AWESOME it it.
Obama got the idea for the mandate from the Heritage Foundation, the most conservative think tank around.
Even Newt said he loved it because it "promoted personal responsibility".....which is what Righties brag non-stop they are for and liberals aren't.
It only became SOCIALISM after Obama said he liked it too.
Sounds like the state waivers might get Byrd ruled (along with other stuff), so that's a pretty sizable roadblock.
If I put my "conservative" hat on, it seems like the right way to go would be to have block grants where the states who do a better job of providing quality/affordable care to the most people versus the baseline for their state get bonus money/incentives and not start it up until 2022 to give states time to get their ducks in a row. Then you give the amount of money out that would have been sent out if Medicaid got expanded by every state. There should be some other mechanism to duplicate the stuff that works particularly well at the state level and allow other states to build off of that.
The current bill just redistributes the wealth from states that took the medicaid expansion to those states which didn't (instead of fully giving out all that money) before cutting spending versus the current law. And it starts in 2020 which isn't enough time for states to legislate their own systems and spin them up.
If I put my "conservative" hat on, it seems like the right way to go would be to have block grants where the states who do a better job of providing quality/affordable care to the most people versus the baseline for their state get bonus money/incentives and not start it up until 2022 to give states time to get their ducks in a row. Then you give the amount of money out that would have been sent out if Medicaid got expanded by every state. There should be some other mechanism to duplicate the stuff that works particularly well at the state level and allow other states to build off of that.
The current bill just redistributes the wealth from states that took the medicaid expansion to those states which didn't (instead of fully giving out all that money) before cutting spending versus the current law. And it starts in 2020 which isn't enough time for states to legislate their own systems and spin them up.
I doubt that matters. I also don't think, generally speaking, that townhall frustration is much of a metric. After all, the townhalls in 2009 (?) were filled with angry, misinformed voters who contributed to the compromised end product of Obamacare. Townhalls are relatively small affairs, easily organized, especially when the 100 or so attendees are easily instigated. It's a positive thing that sometimes they're attended by informed, rightfully angry voters, but I'd surmise that's as much the exception as the rule. On top of that, I think Congresspeople have constituencies, but I'm skeptical the voters are the more important ones.
I am sorry, I find your comment about Colorado's success except for the cost problem funny. It is like me saying I have solved cold fusion, except for the part of it working. Cost is the problem, everything else flows from there. We know how to fail the cost problem.
All I can go by are the news reports, the House Bill, the Senate Bill, and this bill all allow states to end exemptions for pre-existing and lifetime caps. That is a problem for me. The major funding cuts is also a problem, but a little less for me.
You still see the GOP as you always have, i get that. It is not the party of Ike or Reagan any more. Sure, a lot of you are still in it but you lost and do not yet realize it. The modern GOP would view them as RINOs. It is now the old Goldwater and current Koch faction in charge. I know you are not a libertarian, we have discussed this. Your modern elected officials ARE.
They are not seeking a government solution, any government solution, because they do not believe one exists. Thus we do not hear of how many will be covered, or even for what. We only hear how much less will be spent. I have always been center left, but I have always hated the Democratic Party. I have volunteered and donated to insurgents like Gary Hart, Bernie, (and even Republican John Anderson). I do not say this lightly, for the first time in my life the Democratic Party is the sane party. Anarchism, er "libertarianism", never can succeed.
What is so funny about it? Like business, good governmental ideas need capital and funds to operate. The fundamental design of assigned risk pools I think is superior to the ACA design which specifically burdens a certain portion of the public, and not all the public. A pool subsidy should be funded by general fund dollars.
Lifetime caps are a cost control. It also limits unlimited and maybe futile end of life care. Any system will require these cost controls.
I have no idea what you are talking about. The Colorado assigned risk pool was supported by both parties. Moreover, I have no single "always have" view of the GOP. My view evolves. In many respects, I wish any POTUS would be more like Ike in terms of understanding the job description. Reagan had too much of a libertarian streak for me, but he did a lot of good things and he knew how to get things done with democrats. The Koch bros are self-described traditional liberals. I'm kinda like them.
What is so special about a government solution? In any event, there is no such thing as a complete government solution. No matter what system you employ, including something like the UK's NHS, there will be a myriad of private entities providing goods and services in the system.
Of course there are private entities, I mean Any Rand 101. Your party has a lot of her zealots (choked full of them actually). People who accept that no government is the best government.
As a comparison, Indiana expanded Medicaid with HIP 2.0. It uses HSA's. I have no issue with trying a private public partnership like that, and note, the Obama admin approved Indiana's waiver for it.
My complaint is what your reps are discussing. Someone linked an example early in this thread if I recall. No mention of how many people will be covered. Nothing but how much money is saved (which we both know is for the future tax cuts). There is the fundamental problem.
If we only want to save money, if that is the only metric we judge by, I cannot beat the "pay nothing for anyone ever" position. We need other metrics introduced. ACA uses number covered. Ok, you may not like that, so give me something else.
As to lifetime caps, what do we do with the baby needing $5 million in surgeries and a $1 million cap (The Jimmy Kimmel test)? I do not think any pro-life Republican will say "let the kid die", bit what else is there? This is not personal responsibility, tons of responsible people cannot afford $5 million.
I have no problems with block grant's, HSA's, and other ideas. But how do we judge success? Is it only cost? Is it number with access to care? For me, that has to be in the mix somewhere or we just write a bill guaranteeing one person perfect healthcare and slap ourselves on the back for solving the problem and saving billions.
Zealotry is bipartisan. I am registered with the GOP, but I don't own it or control it. It isn't "my party" any more than Denver is "my city" because I chose to live here.
My reps? There are a lot of proposals, negotiations, and deals. I guess you need to explain what "my reps" are doing.
So what? Cost control and saving money has been a mantra for health care reform for both parties. The problem is that the ACA didn't take a serious stab and saving money. If not now, when do we do something to save money?
Where did you find all that straw? Is there a bumper harvest in Indiana?
More straw. As far as I know, CHIP is not threatened. Do know something different? I'd be happy to review any details about that.
We need to figure out why we want to measure success before we design a measurement for it. What is your objective here? More people covered? More coverage for sniffles? Or is it basic individual health.
Finally, you keep talking about "healthcare". That's fine, but it forces your thinking into issues about access, delivery, and costs. The objective here is a healthy population. Improving healthcare is part of that, but it isn't the gold ring.
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The Graham-Cassidy-Heller-Johnson amendment seems to be saying..."Since A.C.A. has so many flaws, why not go back to what we had before A.C.A.?"
Going back includes: (1) Tens of millions without health insurance, (2)Medicaid help for the less affluent depends on the state in which you reside, (3) Emphasis on HSA accounts for those able to save money and invest, (4) Increase in the use of emergency rooms, (5) A country which still spends almost 20% of its GDP on health care with a shift away from the fee- for- service model moving at a snail's pace.
By the way, the one A.C.A. item which survives if for those age 26 and under being able to remain on their parent's coverage.
My advice to those under the age of 65, live a healthy life style and pray your genetic makeup doesn't include some surprises if you cannot afford high priced coverage. Try to become fairly rich and practically self insured, or you will pay an arm and a leg for coverage. Hope through innovation and miracles we can somehow get a handle on reducing health care costs.
Going back includes: (1) Tens of millions without health insurance, (2)Medicaid help for the less affluent depends on the state in which you reside, (3) Emphasis on HSA accounts for those able to save money and invest, (4) Increase in the use of emergency rooms, (5) A country which still spends almost 20% of its GDP on health care with a shift away from the fee- for- service model moving at a snail's pace.
By the way, the one A.C.A. item which survives if for those age 26 and under being able to remain on their parent's coverage.
My advice to those under the age of 65, live a healthy life style and pray your genetic makeup doesn't include some surprises if you cannot afford high priced coverage. Try to become fairly rich and practically self insured, or you will pay an arm and a leg for coverage. Hope through innovation and miracles we can somehow get a handle on reducing health care costs.
What does the GOP bill do to improve the health of the population? Please describe all the details published as how it does this. I have yet to hear one GOP rep suggest this touches on population health. We know for a fact it will reduce number covered, so how does the bill more than offset that in achieving a healthy population?
I have no idea if HIP is in trouble, but Indiana is one of 34 states that will lose money if this becomes law (all pretty much lose so Texas can profit). Can HIP survive the money lost? I have not seen our leaders say. But Indiana will lose money and I wonder, if you administered a program such as HIP could you envision a scenario where you testify that you could improve care with less money?
Many of those millions are those who choose to not have it, or as is more likely, those who choose coverage that is only for catastrophic events.
So? Medicaid costs is a serious issue for states. Must balance the budget. They must prioritize spending among social services, infrastructure, criminal justice, k-12 education, and much much more. At the rate we are going, medicaid would eat up everything in its path.
So? We have other programs who can't afford to save money and invest. Those who save money and invest have health care cost issues too.
That seems to be a red herring. Since the ACA was enacted, Colorado has seen a boom in stand alone emergency room services. These are nothing more than urgent care facilities, true emergencies are sent to hospitals. They are called emergency rooms because of a quirk in the ACA makes those very profitable. An M.D. explained that to me, but I don't recall enough about that to comment now. There are two new "emergency" facilities within a 10 minute drive, and a third under construction within a 10 minute walk of my house.
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This is an issue. We went to capitation plans for mental health. We should do the same for physical health.
That's an issue under the ACA. The ACA's answer isn't working.
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I don't think it does. The GOP is also operating within the framework of "healthcare" not health. But the states do operate public health facilities that offer limited services. These do improve health. Hopefully giving the states more authority and more money will help develop these things. One other thing I'm seeing that seems to be entirely the result of private entrepreneurship--walk-in blood screening. We are seeing these in grocery and drug stores. Anybody can walk in, without a doctors order, and for a very nominal fee, have a blood draw and screening for heat disease, diabetes, and maybe more.
With homeless advocates claiming mentally ill make up a sizeable number of our homeless, are you sure capitation is successful? It seems millions are not at all being helped ( and that is just in downtown Indianapolis).
I am curious, what is in place to prevent overuse? Blood tests every week, for example. In debates some often complain overuse drives our costs. If Wal-Mart and Kroger are offering discounts to get you to test your blood (assuming they and Target et al can find a way to profit like your Kroger card), might we hit an overuse scenario?
Yes, I am being silly because there is so little documentation overuse is a problem.
So the USA isn't your country either?
Then how can there be illegals if it isn't "our" country?
And I guess we need to get rid of the line, "My country tis of thee......"
Millions likely are not being served. Many of those don't want to be served. In other cases, there is not enough money. The county jail is often the emergency room for those with mental health issues. It is a huge problem. Again, I don't think the issue is necessarily the system, but how much money do we throw at it.
I have a hard time accepting anyplace with you in it as my place.
I've been in a wheelchair for 4 years (Oct 2 will be my anniversary).
I've had problems with my knees and feet for 18 years where one of them will swell up and HURT LIKE HELL for a week or so then go away. Then every 2 or 3 months, it would rotate. One time the left knee....another time the right foot....and so on.
Saw several doctors and had several tests done and they had no idea what was wrong with me.
4 years ago, all 4 of them went at the same time.......which had never happened before. It also didn't go away for 6 months....which hadn't happened before.
The pain was so bad, I literally wanted to cut my legs off and got 2 hours of sleep each night because I was sobbing from the pain (it was always worse at night). I didn't/couldn't even get outside my door for 6 months.
Had no insurance and they told me there was no help for me.....I just had to deal with the pain. Then, after a few months I got a call saying because of Obamacare, I now qualified for Medicaid.
For 2 years they bounced me around to about 20 doctors and did countless more tests. They still don't know what's wrong with me and 5 nurses said they're going to name something after me.
I don't get the PAIN like I used to......about every 6 months now......because they have me on all kinds of medication.....but I still get flare-ups. The last time, my feet got so big, people told me it looked like I had flippers.
If Righties get their way, I'm sure it won't be long before I'm back to the pain where I literally want my legs cut off.
There's no doubt many on here will take great joy if I'm back in that pain again............
Now it looks as if they are trying to convince Murkowski to vote yes by basically telling her they can keep ACA. This is all the definition of insanity. And it's all because Trump is pushing them to get something, now matter how horrible, on his desk.
I hate to suggest this, we need the courts to revisit commitment. We know this system is not working, but unfortunately "Your decisions are killing them" is not a legal argument. Hence why replacing judges with scientists would be an improvement. Go where the facts lead.
It's a conundrum. Even the mentally ill have a right not to be incarcerated against their will. Involuntary commitment requires proof of immediate danger to themselves or others. Otherwise the mentally ill end up on the streets because families usually don't want to be involved.
Frankly this issue needs more bandwidth than it gets. The question I have, is choosing to live the homeless lifestyle a danger to one in and by itself? I think a case can be made it is.
At the same time, we all know of professional panhandling. I would like to see more cracks taken at that. Bloomington tried signs urging people to instead give to social services, but they were mysteriously torn down.
Mental health has always been a problem. There are many reasons for this, the least of which is not that it is an extremely difficult and complicated issue. That doesn't lend itself to politics which has turned into policy by simpleton sound bite.
More details on why this bill is a political stunt, not serious policy.
The chaos that would ensue if this is passed.....hard to believe they've really thought this through.
The G.O.P. Bill Forces States to Build Health Systems From Scratch. That’s Hard.
https://nyti.ms/2jM2aXm
The chaos that would ensue if this is passed.....hard to believe they've really thought this through.
The G.O.P. Bill Forces States to Build Health Systems From Scratch. That’s Hard.
https://nyti.ms/2jM2aXm
You've been shown multiple times why you're wrong. You either don't bother to learn or you're lying.
They don't care. They don't even pretend to care.
I call scoreboard. Anyone who claims that the GOP has a serious health care reform agenda is an idiot, a liar, or both.
As if this could get any more absurd, the GOP is essentially trying to sell Alaska's Senators on the Obamacare repeal bill...by promising that Alaska can effectively keep Obamacare.
http://ijr.com/2017/09/979983-republicans-attempt-buy-murkowskis-vote-new-draft-health-care-bill/
Really, every Republican that still supports this atrocity can burn in hell.
It absolutely guts medicaid/medicare. Which is about 1/5 of the health care coverage provided now in this country. I think combined it's an even higher percentage.
And, it rewards the states that refused to expand medicaid and punishes those that expanded it.
Of this goes through, it will absolutely devastate elder Care. Which means that older folk's kids will end up bearing the burden- if they are able to do so. If not, their parents are screwed.
It's funny how the ACA was born from a right wing think tank, and the foundation of it is PERSONAL RESPONSIBILITY in the form of requiring people to buy coverage as they able (subsidies fill the gap).
Why is it that the party that views itself as the party of personal responsibility completely disowns the ACA? In life, there are two guarantees- taxes and death/falling Ill at some point. If something is certain, and you don't plan for it, how is that not shirking personal responsibility???
Literally every major medical association opposes this bill- it wipes out all the protections the ACA afforded.
Again, why is the ACA so opposed? Oh yeah. Obama's name was on it. And the pubs need to score political points- nevermind that this will hurt their states and people horribly.
It's madness. Still holding out hope that someone joins Collins and Murkowski as a hold out. If McCain is serious about the Senate going back to the old ways, he will vote no again. But, even he appears to be wavering.
There's no way this doesn't devastate a LOT of people. No way.
And I can't believe you even believe what you typed. It's so far from reality, its Trumpian.
Not to mention that this repeal isn't, of course, a repeal, since a repeal would require 60 votes. Instead, it's giving states the ability to apply for waivers to gut ACA provisions on their own, waivers which will be decided by whoever happens to be in the White House at the time. Giving even more discretionary power to the executive is also a Republican principle. *eyeroll*
McCain's on board, solely because his old Neocon slapdick pal Lindsey came up with this shit.
Per the 2014 numbers from the Kaiser Family Foundation, these are the people who receive Medicaid
Children (43%)
Aged (65 & older) (9%)
Disabled (14%)
Adults (19-64) (34%)
There is a category listed as “unknown” because this group has an “unknown basis of eligibility”.
Anyways, children, adults over 65, and the disabled make up at least 2/3 of Medicaid recipients.
I ask you, how is this current healthcare bill either Christian or pro life?
And people wonder why I almost never vote for a republican candidate in any election. Probably less than 1% of all votes I’ve ever cast.
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