Trump Won, Vows Day 1 Full Repeal. Lets Discuss.

[Ann H]

yup.

As long as they're only talking premium, health care will never be fixed. Premium is a result of cost. They aren't addressing cost, neither party. So health care will continue to piss people off no matter who is in office. We're being told to hate the name attached to the plan, rather than the details of the plan.

I never considered something as simple as a blister could have almost killed me last year. But I am glad I have health insurance.

Wow, what a story. I'm glad you survived it, LGilmore!

Your post is about addressing the true root causes of expensive health care is spot on. Trump seems to have surrounded himself with Physicians, and there are now many Physicians in Congress who are very involved in the Repeal/Replace, so I am worried that their Physician viewpoint will end up in nothing that addresses true costs.

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As of this morning, the plan is to vote to repeal it in early 2017, with an effective date 3 years later, at which point a replacement must be in place. This confirms what we all already knew, no viable replacement solution exists and it will take years to make one.

In some ways it doesn't matter. The market will take care of itself. In AZ, I don't expect any carriers to play ball in 2018, and that is likely in many other states. Any attempts to amputate a limb out of the monster (like repealing the mandate) will just make things worse.

So, I wonder if the market won't just heal itself. Even before Trump won, we saw Doctors listing cash prices, and people with high deductibles choosing the cash price anyway, because it was less than the insurance company's price. Doctors save money with less paperwork, pre-certs, and referrals that way, too.

If Congress doesn't take this seriously and act soon, brace yourself for 2018. It wasn't pretty for 2017, and I don't see 2018 being any better, without major intervention.

 

[kgmom219]

In some ways it doesn't matter. The market will take care of itself. In AZ, I don't expect any carriers to play ball in 2018, and that is likely in many other states. Any attempts to amputate a limb out of the monster (like repealing the mandate) will just make things worse.

So, I wonder if the market won't just heal itself. Even before Trump won, we saw Doctors listing cash prices, and people with high deductibles choosing the cash price anyway, because it was less than the insurance company's price. Doctors save money with less paperwork, pre-certs, and referrals that way, too.

If Congress doesn't take this seriously and act soon, brace yourself for 2018. It wasn't pretty for 2017, and I don't see 2018 being any better, without major intervention.

The market is going to take care of itself..everyone will be gone.

http://www.lifehealthpro.com/2016/11/23/20-biggest-new-aca-risk-corridors-failure-absorber

2018 is definitely going to be worse.

 

[HoosierLife]

Wow, what a story. I'm glad you survived it, LGilmore! Your post is about addressing the true root causes of expensive health care is spot on. Trump seems to have surrounded himself with Physicians, and there are now many Physicians in Congress who are very involved in the Repeal/Replace, so I am worried that their Physician viewpoint will end up in nothing that addresses true costs. ---------- In some ways it doesn't matter. The market will take care of itself. In AZ, I don't expect any carriers to play ball in 2018, and that is likely in many other states. Any attempts to amputate a limb out of the monster (like repealing the mandate) will just make things worse. So, I wonder if the market won't just heal itself. Even before Trump won, we saw Doctors listing cash prices, and people with high deductibles choosing the cash price anyway, because it was less than the insurance company's price. Doctors save money with less paperwork, pre-certs, and referrals that way, too. If Congress doesn't take this seriously and act soon, brace yourself for 2018. It wasn't pretty for 2017, and I don't see 2018 being any better, without major intervention.

I know that's the case with my chiropractor. Their cash price was less than what my insurance would pay and my wife has very very very good insurance. I don't use my insurance until I hit my deductible. I'm sure it would be the case with many other things as well

 

[somarco]

not to do it is to punish the children for the sins of their parents. Meals are cheap,

Yeah, that bothered me too. Until I realized that when I was growing up there weren't any starving kids dying because there was no food to eat at home when school wasn't in session.

we saw Doctors listing cash prices, and people with high deductibles choosing the cash price anyway, because it was less than the insurance company's price.

Providers that charge less than the negotiated rate are usually in danger of having their contracts cancelled.

But then, how does anyone know they are paying less? You won't learn the allowable charge until the claim is filed and adjudicated.

Sometimes adjudicated claims are denied. The cash patient may be paying for something not covered, and the doc is getting revenue they would not otherwise be entitled to.

Just saying . . .

I don't use my insurance until I hit my deductible.

If you are not filing claims, how do you, and your carrier, know you have satisfied the deductible?

 

[VolAgent]

Yeah, that bothered me too. Until I realized that when I was growing up there weren't any starving kids dying because there was no food to eat at home when school wasn't in session.

You also had responsible parents. Sadly, many children now do not. Many parents have no business being parents.

 

[Ann H]

I know that's the case with my chiropractor. Their cash price was less than what my insurance would pay and my wife has very very very good insurance. I don't use my insurance until I hit my deductible. I'm sure it would be the case with many other things as well

This has been true for Chiropractors for many years.

It has been true for many prescriptions for about 5-10 years or so, ever since pharmacies started their $4 prescriptions.

It has been emerging in the general population over the last couple of years. Studies show that the price for a procedure are widely different depending on if it is cash price, Medicare, Medicaid, or commercial insurance. Commercial insurance gets hit really hard. One of my clients needed a sleep study for possible Sleep Apnea, and it cost $475 cash, but $649 insurance company discounted price. That sort of thing is common. A lot of people with high deductibles are paying cash, figuring they would probably never hit the deductible anyway. With an HSA, paying cash discount prices can be a great strategy (I do it, since my family has NEVER hit a deductible.)

Most importantly, a lot of doctors are publishing their prices, and like the idea of the direct-to-consumer model.

A grass roots solution could very easily come about. Carriers withdraw, leaving a lot of uninsured. Doctors and clinics start publishing their cash prices on their websites, as do facilities that do MRIs, and other medium-priced services. People shop. Businesses insist on getting the better rates for their commercial insurance (they are already able to do this with partially-self-funded plans).

Final result........ grass roots overhaul at the supply/demand level. Prices would be transparent.

I am really afraid of what I see firming up in Washington. Trump is surrounding himself with a lot of doctors as his healthcare reform experts. Price transparency would be very disruptive to them at the beginning, so it's not their focus. I am concerned that Congress is going to A) not repeal/replace in time before carriers withdraw; B) amputate legs of the monster (repeal the mandate, take away the subsidies) which leaves an unusable system; C) refuse to address underlying costs of healthcare because they are relying too much on solely the Physician's viewpoint.

If Washington doesn't act, the IFP insurance market will collapse and a grassroots answer will find a way. I sure wish they would just wipe out all the crazy complexities, and cost-shifting shell games, and go straight to the free market system of supply/demand at the outset. Otherwise, it's just torturing the process.

 

[LGilmore]

Yeah, that bothered me too. Until I realized that when I was growing up there weren't any starving kids dying because there was no food to eat at home when school wasn't in session.



Well.... I would hate to think it takes kids in America dying of starvation for you to go "Ok I guess there's a problem."

Underfed kids, underperform, their brains don't develop as well, their bodies don't develop as well. Learning and general health are effected by lack of quality healthy food.

So while you don't see them dying, you see them grow up to be stupid. So then you pay for them as adults. So feeding them properly (key word properly) as children increases the odds in your favor that you won't be subsidizing them later as adults because their brain functions were stymied as children. Lots of studies to verify that.

Ever wonder why some kids come back to school after summer break and seem worse mentally than when school ended? Sorry, wife is an elementary educator of 38 years. We see first hand what happens to kids and their ability to learn if the things most of us take for granted are limited or removed from their lives.

People often talk about "breaking cycles", but then want to do so by cutting services. Well, just makes the next cycle worse cause we're removing or limiting something from those kids lives that would help them in the learning process. So long run, costs more money than less.

 

[somarco]

A wise person said "The poor will always be among us".

In 1964 LBJ declared war on poverty. We now have more people in poverty than we did then. DC has created a modern plantation where people expect the govt to provide for their every need.

This has got to stop.

 

[goillini52]

A wise person said "The poor will always be among us".

In 1964 LBJ declared war on poverty. We now have more people in poverty than we did then. DC has created a modern plantation where people expect the govt to provide for their every need.

This has got to stop.

The war on poverty's worked about as well as the war on drugs.

 

[LGilmore]

A wise person said "The poor will always be among us".

In 1964 LBJ declared war on poverty. We now have more people in poverty than we did then. DC has created a modern plantation where people expect the govt to provide for their every need.

This has got to stop.

So what's your solution?

The complaining part is easy we can all do that and depending on the subject we do.

This thread started out as complaining about Obamacare. Now it's shifted to the value of free school lunch for the poor and now it's about poverty. All complaints very few solutions are being offered though.

Since a corporation is a person now, is carrier one of those expecting the government to provide for their wellbeing?

One man's government welfare cheat is another man's corporate leader and the money they receive shouldn't be questioned.

Just a matter of who has the ball, determines what the game will be. We subsidize people and those we consider to be people (corps). So what's the solution? I can argue the value of both and argue the problem with both. Can I fix them? probably not.