Featured GOP Candidates backing down on the Affordable Care Act?

That's easy. Rev. is against anything connected with Obama ... part of the "party of no". Thus everything must be protested and labeled as evil ... of course he would use the word liberal.

As he said in another post the word "help" is a code word for liberal. So, no help for anyone.

Is it good that more people have health insurance? I think it is good.
Are there problems? Yes, but there were also big problems with the old system.
Is this a perfect world? Afraid not.

 

I wish people would leave their personal grudges out of their posts...

It is good that more people have health insurance. It is not good that the government forces them to buy it.

 

Under our old system no one was forced to buy insurance. One result, IMHO, was that companies priced the insurance so high that many could not afford to purchase health insurance. So, in your opinion, how would a system work to include everyone with no mandates and still be affordable?

Not arguing, just wondering.

 

TORT reform.

 

What reforms would you like to see put in place?

 

A lot of them. The price of medical care has skyrocketed since LBJ's war on poverty. Third party payers have driven up the cost. Obamacare has driven up the cost.

I would like to see the inter-state ban on purchasing insurance lifted.
I would like to see regulations and cost controls lifted, and return competitiveness to the medical fields.


Health care is expensive because of the pervasive entitlement attitude held by literally everyone in the system: patients, providers, suppliers, insurers. Government insurance (Medicare, Medicaid, veterans, Department of Defense) covers 87 million; tax breaks subsidize 176 million in employer coverage; insurers and other third-party payers take care of the bills for 85 percent of Americans.

http://prescriptions.blogs.nytimes....care-cost-so-much/?_php=true&_type=blogs&_r=0


Many others, but if you can address those, I can safely assume you want to have an honest discussion.

 

I don't think you'll ever get everyone covered, even with a mandate. So, let's change the goal to get as many people covered as possible and as early in their life as possible.

We need people to get away from the entitlement mentality that they're going to get health care insurance provided for them at work and get them back into the mindset that health care insurance is something they need to buy for themselves. That means we need to level the playing field between work-based insurance and individual insurance, and that means equal tax treatment and equal group buying power. As such, individuals should get a tax deduction for buying health insurance equal to the tax break that businesses get for providing health care insurance. (Think about it--businesses get to write health insurance off as an expense against profits and they don't have to pay FICA or Medicare as part of the compensation package they pay to employees.) The ACA is somewhat trying to get people to buy their own insurance through the exchanges but they are using a stick as an incentive and not a carrot.

A couple of by-products of individuals buying their own insurance is:

* The insurance is portable--they don't need to stay at a crappy job for the insurance. The earlier you get them on insurance, say in their 20's, the healthier they will be meaning they will use less health care over the years which will contain costs.
* They become savvy shoppers and will become informed consumers, which will create real competition for their money.

I could go on for hours on this subject but I'll quickly list some things. Basically, it means giving individuals more choices and getting them to be educated consumers. We went through something similar when the traditional pension plan was phased out in favor of 401k plans and IRA's.

1. Give individuals a tax deduction for buying their own insurance. Quite a difference from taxing them for not having insurance, isn't it?

2. Finally, (finally!) allow individuals to form groups to purchase insurance at group rates.

3. Encourage HSA's. Have a PR campaign touting their use.

4. Allow across state border selling of insurance. (This will work for awhile, until a select number of states give incentives and become tax havens for insurance companies.)

5. Allow Medicare patients to spend on private health care services if they desire.

6. Make insurance portable from job to job. You could do this by allowing businesses to give employees the money needed to buy their own insurance without having FICA or Medicare taxes attached. Then the employee would have real choices in insurance rather than choosing the plan from the sole insurance company the company contracted with.

7. As Bro. Curtis said, TORT REFORM. There are too many lawsuits nowadays. These create defensive treatments and therapies (read, unnecessary CYA treatments). And the lawsuits themselves drive up the cost of health care.

8. Shorten the length of patents on new drugs. Not drastically, because pharma companies have the right to profit on innovation, but if it were shortened by a couple of years, patients would benefit by paying less for generics.

Probably the best way to do it would be for patients to be able to pay cash for services, bypassing the insurance company altogether. I can imagine ads by clinics for MRI's, or colonoscopies, or cardiovascular stress tests with a cash price listed. I can also imagine the patient negotiating prices.

 

Not meant to be argumentative... just a few comments:

1. I believe that working individuals who earn less are getting tax credits for purchasing Obamacare. Small businesses are also getting tax credits for offering Obamacare. At least my business is.

4. Cross state policies are part of Obamacare - to be introduced in 2016.

5. I didn't know that you couldn't buy private health care services if you were on Medicare. If that's true, my parents have been breaking the law.

6. Sort of a sideways comment: Before Obamacare, I had one plan and one price to offer my five employees. With Obamacare, I had three providers and well over 20 plans that they could pick and choose individually from. Each person picked what they wanted.

8. Having been involved with pricing of Pharmaceuticals, if you shorten the patent, the price under patent will be increased to make up for that loss.

 

GAR! How is it that you watch the stock market, implying that you have some sort of business acumen, and you can't see the problems in front of your nose?

Doctors now have to see more patients, because those patients can "afford" to be seen. The number of hours per day hasn't changed; but somehow the doctor needs to see more patients.

Resolution: shorten the amount of time each patient is seen. This still doesn't completely resolve the problem, so appointments are still backing up. So not only is each patient being rushed through, increasing the potential of missed and mis-diagnoses; they're also increasingly finding themselves waiting longer and longer to see the doctor for a rushed visit.

As well, the increased number of patients means increased paperwork for insurance filing; which means more people and/or systems to accomplish the paperwork, which means more indirect-care overhead costs. OR, in order to keep the costs down, longer delays in processing.

Which boils down to: people are still not getting seen.

Let's face it, CTB: you want to see things your way; I see things a different way. It's possible that somewhere in the middle is the truth.

But having been at the mercy of the Great Britain healthcare system, and the military healthcare system, and now the VA healthcare system--some of the systems the ACA was modeled after for their "successes"--you'll pardon me if I have a much more cynical and pessimistic outlook on the ACA.

 

Don, your suggestion is logical.

We've known for a long time that the U.S. is facing a critical shortage of Primary Care Physicians. This is partially driven by the AMA and protections doctors have put in place for their profession. PA's were introduced (if I recall correctly) in the early 1970's as a way to begin to address the problem before it emerged, but Physicians effectively blocked the original PA's role in medicine. They have similarly hamstrung Nurse Practitioners. And there is no sight in end of the shortage.

IBISWorld projects a shortage of 52,000 PCPs by 2025. 63% of that is due to nothing more than US population growth. 19% is due to higher demand from the aging population. And 15% is expected from the introduction of ACA.

I do expect to see an increase in the use of PAs and Nurse Practitioners as the crisis deepens, along with new efficiencies in the delivery mode. An example is how many people are now getting flu shots from their pharmacist rather than from their PCP.

Urgent care centers are expanding, and several major drug store chains have announced their intention to enter the health care delivery market. The transformation of distribution (some call it "retailization") will bring market efficiencies that do not exist inside the traditional delivery model.

Of course anything this large will not happen smoothly, but I do believe that there are several reasons to be optimistic about the future.

 

There is nothing optimistic about a federal government program that robs you of your freedom. People have come to the point they are willing to sell out the founding principles of this country to have the government take care of them.

 

Yes. More immediate care facilities. Scope of care will change more maybe.....more nurse practitioners taking the load for the simple things. I wonder who else will get to write RX in order to speed things up?

Personally, I was diagnosed with Hodgkin's lymphoma on January 2nd 2014. Both my wife and I work and I have double coverage. My out of pocket will be $330.00. Both insurances together will have paid out $100,000. My policy is a high-deductible policy, which is what u want when u have cancer. Her insurance picked up 70% of what I spent before hitting the deductible. My point: glad we both work and have insurance!

Also glad that my PET scan came back all clear halfway thru the four months of chemo! So hopefully it won't come back.

Here is one thing I discovered: formy bone marrow biopsy the hospital billed $27,000, but the insurance company had a contracted maximum amount and only had to pay $3,800.00. Now THAT is quite the spread! They'll bill 27,000 but the insurance company gets by with paying only $3,800.00. If I didn't have insurance and paid with cash or credit, I'd owe them $27,000.00....might get a cash discount. So, do we need an ACA? Or do we need to be allowed to pay the amount insurance companies pay?

 

Max, I don't know anything about you. I remind you that I also made the statement that the ACA is very similar to what I've personally dealt with in Great Britain, the military, and the VA. The military extensively used PAs for most of the 25 years I was a member. As a recipient of that care, along with the hundreds (if not thousands) I worked with those 25 years, I can tell you it's a hit-or-miss thing...with a lot more misses.

You know why a lot of PAs went into the military? Because it paid for their education, and because they didn't have to pay malpractice insurance or worry about malpractice complaints. Pretty much the same with the VA.

Has anyone checked on malpractice insurance rates to see if they're stable or rising?

What you see as a solution? Isn't. At best, an RN will see you and prescribe what you need (I trust RNs a LOT more than I trust PAs) and you'll be okay. More than likely, you'll be referred to a doctor -- which means that you really just went through a screening step, but which makes the system look good because you were seen by someone, although in reality your wait time to see him/her was just extended because of the intermediary step. (Consider: you call for a doctor and are told it'll be a week. OR, you call for an appointment with a PA or an RN and are told it'll be a week; whereupon they refer you to a doctor; upon which, you call a doctor and tell them you have a referral, to which they tell you it'll be a week. Total: 2 weeks instead of one.)

Sound ludicrous or extreme? I've lived it. And it continues, even after I retired: VA sent me a note a few weeks ago telling me to come in for an appointment; I called them, because there was no way I could get there on the day/time they had scheduled me. Next available appointment because I was voluntarily cancelling? September.

Let's watch the system for a while longer. I pray I'm wrong, but again: I'ved lived it.

So, knowing nothing about you: have you? Or are you just optimistic that it'll all work out?

 

"Well thank goodness someone ELSE is getting taken care of instead of you, sweetheart!"
Wait no, I didn't say that.
Of course I'd rather see my own family member get care first.

 

Yesterday I signed up at StatDoctors.com. It's a free (no-copay) service of my ACA policy. It's a way to talk to a physician quickly to deal with non-life threatening illness. They are claiming I can talk to a doctor in 10 to 15 minutes of a request.

Does anyone remember having the opportunity to talk to a doctor in 10 to 15 minutes about a cold?

My data from Unitedhealthcare (a client of mine) estimates over 60% of a doctor's time is taken up with non critical issues that can be dealt with be other health care personnel.

It reminds me of the time I spend with a city police officer. I rode with this guy for a full day, and we spent the entire time dealing with petty domestic conflicts and minor thefts - filling out tons of paperwork as we went. It occurred to me that we should hire inexpensive social workers to cover those calls.

 

I can call my health care provider and speak to the doctor's nurse about minor maladies and they advise me on some things I can do. Sometimes I can get prescriptions refilled this way without incurring the charges of an office visit. They typically call back within an hour. But no, I don't speak directly to the doctor.

 

Who cares if they backed down? They are on the way to hell. Let's deal with THAT.

 

There have always been good parts, but the bill is overwhelmingly ill written and poorly thought out.

Obama has rewritten massive parts of it illegally in the oval office. Even his "fixes" are politically motivated and geared to last just until he can get out of office.

If it's such a hot bill, why the hundreds of exceptions and exemptions for his political cronies and special interest groups?

Overall, it's a piece of trash legislation. Doing it over and starting from scratch is the only real way to fix it. Otherwise we'll be dealing with these "exemptions" and and changes for decades.