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Author Topic: Election Day 2016!!!!!  (Read 2707 times)

yannessa_is_god

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Re: Election Day 2016!!!!!
« Reply #90 on: November 09, 2016, 09:48:22 PM »

The "let's allow insurance companies to cross state lines...that will make things more competitive" is a perfect example of rhetoric that would be nearly impossible to pull off. The biggest problem is the local contracts that insurance companies have with doctors and health care systems. So repealing it an replacing it with that if it is half assed will not work at all. Now, if they want to overhaul the entire system (something that Obamacare did not.go far enough) then do that but, gasp, that would mean MORE government involvement.

What BALDWINTRACK said makes sense. Use Obamacare as a framework and force utilization of the marketplace. Otherwise, you repeal it and have nothing in place like before  (which was was worse system than most second world countries) or go single payer (which Trump was once for...maybe he has the clout to push that through?)
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BALDWINTRACK

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Re: Election Day 2016!!!!!
« Reply #91 on: November 09, 2016, 11:00:52 PM »

YIG, we both know forced utilization is the only way to save the system. I just have no idea how to force it other than to incentivize employers who pay the current majority of revenues that private insurance companies generate.

But it's like the polar bear club jumping into the river on New Year's Day. Who wants to go first? Maybe the government can take the lead and force their own employees first. It's too bad Obama didn't think of this because if he had we may be at the point of no return and possibly even seeing the benefits of flooding the system.

The other issue is you have these conglomerates like upmc or highmark that own the insurance and the hospitals. To truly get fair rates from hospitals some competition needs to be formed. They need to decouple insurance companies and medical facilities to create this. Much easier said than done. All of a sudden you have hospitals offering more reasonable rates of service to fill beds and insurance companies steering patients towards those reasonable rates.

Recently in the non profit sector in Pennsylvania we had such a thing. Non profit agencies that provide a number of services were also involved in coordinating those services for individuals with disabilities. Upmc could coordinate a number of services for an individual like occupational therapy, job training and in home care. Well upmc just happens to provide those same services so the service coordinators are pushing the consumer to use the other wings of upmc to provide them these services instead of allowing them to search for other non profits who provide the same services. Governor Corbett decoupled the service coordination segment of any agency who also was providing these services that they coordinate and it has been largely successful. 
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Downriver

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Re: Election Day 2016!!!!!
« Reply #92 on: November 09, 2016, 11:36:41 PM »

YIG, we both know forced utilization is the only way to save the system. I just have no idea how to force it other than to incentivize employers who pay the current majority of revenues that private insurance companies generate.

But it's like the polar bear club jumping into the river on New Year's Day. Who wants to go first? Maybe the government can take the lead and force their own employees first. It's too bad Obama didn't think of this because if he had we may be at the point of no return and possibly even seeing the benefits of flooding the system.

The other issue is you have these conglomerates like upmc or highmark that own the insurance and the hospitals. To truly get fair rates from hospitals some competition needs to be formed. They need to decouple insurance companies and medical facilities to create this. Much easier said than done. All of a sudden you have hospitals offering more reasonable rates of service to fill beds and insurance companies steering patients towards those reasonable rates.

Recently in the non profit sector in Pennsylvania we had such a thing. Non profit agencies that provide a number of services were also involved in coordinating those services for individuals with disabilities. Upmc could coordinate a number of services for an individual like occupational therapy, job training and in home care. Well upmc just happens to provide those same services so the service coordinators are pushing the consumer to use the other wings of upmc to provide them these services instead of allowing them to search for other non profits who provide the same services. Governor Corbett decoupled the service coordination segment of any agency who also was providing these services that they coordinate and it has been largely successful.

Baldwintrack, Corbett screwed the entire consumer base as well as a ton of valuable non profits across the state when he pulled that stunt.  I chaired the Finance Committee for the PA Provider Coalition which represented all these non profits.  We were getting people services they needed in a timely manner and really making a difference.  Folks were able to stay in their homes at 10% if the cost of plunking them in a nursing home and living longer, more active lives.  This entire thing was rigged so none of the 36 major non profits could bid on it and the contract was awarded to a handpicked outfit from out of state at an exorbitant cost that was difficult for the consumers to navigate.  It also put thousands of employees in the unemployment ranks as all of these non profits had to close their departments that had state and federal contracts.  I was also CEO of one of these non profit companies and had to take early retirement 2 years early in 2013.  Fortunately for me, I was also the parent corporations only attorney that could practice tax law, so they hired me back as an at will consultant for two additional years.  I was one of the lucky ones.

Since I'm over 65 I'm not affected by Obamacare or whatever Trump does since I have Medicare.  I don't understand why Jerry is saying his rate is going to skyrocket.  I have a Medicare advantage plan that covers everything including dirt cheap prescriptions and I'm only paying $109 a month (as is my wife).  When I was working I had exactly the same coverage (HealthAmerica PPO) that I have now and was paying $500 a month for the two of us.  In fact my deductibles were higher than Medicare is.  Also Medicare is locked in by law and cannot increase more than your Social Security annual cost of living.  So our Social Security income every year either increases or stays the same.  Not to mention we both draw max SSI and pay no taxes on it.  Getting old has its benefits.  Our monthly take home dollars are equivalent to grossing $100K per year and that's not counting anything I make on the side. 

Now, that said, I also understand people without insurance as I took a year off work several times through my career and had to go buy those benefits out of my pocket and it was expensive.   
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Jerry

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Re: Election Day 2016!!!!!
« Reply #93 on: November 10, 2016, 12:14:05 AM »

  I don't understand why Jerry is saying his rate is going to skyrocket. 

I guess I've seen him pull so many dirty tricks the last 25 years, I don't trust him as far as I can throw a stone. Hopefully every thing goes ok, but I just don't have faith.

I don't pay that much more than you, about $75 but it's gone up with age almost every year, actually nothing the two prior years but up starting in January again and I have about 8 years on you. Also had a higher rate when I started because of being on insulin and having other disabilities at the time I first got it.
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bfgrad

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Re: Election Day 2016!!!!!
« Reply #94 on: November 10, 2016, 01:15:56 AM »

The ACA was based on FEHB, the federal employee health benefits program. I myself would have just let the uninsured buy into FEHB as there are both state and national plans. It would have helped both sides, FEHB gets more enrollees and the uninsured have an already established federal market in place.

But, if you go and read the law, it is possible to form regional healthcare markets. The states forming a regional market don't even have to be contiguos. So Vermont and Indiana could go together for example. Theoretically all states could join together to offer one big unified market. Then insurers would be able to spread their risks across many more customers and be more interested in participating.

I thought that given enough time businesses would start giving employees a set amount of money to buy coverage on their own as it would save the company money from having to go and get bids for insurance and manage the plan. And it would allow employees to get the level of coverage for their specific needs.

The ACA does have a lot of good things, though, like insurers not being allowed to reject customers based on previous conditions, allowing kids to stay on parents' insurance until age 26, capping out of pocket expenses and mandating that insurers spend at least 80% of premiums on coverage to limit the incentive of insurers to cut benefits so they can raise or maintain profits.

But honestly, healthcare shouldn't even be a "for profit" industry. We should have a single payer system. I heard Lawrence O'Donnell who was chief of staff for the senate finance committee say if just a single phrase in the medicare law (no one under 50, iirc) was removed, that would allow "medicare for all".
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bfgrad

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Re: Election Day 2016!!!!!
« Reply #95 on: November 10, 2016, 01:16:52 AM »

Since we were talking about the electoral college earlier, found this interesting: https://en.wikipedia.org/wiki/National_Popular_Vote_Interstate_Compact
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