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Re: Trump's Full Court Press on healthcare

Posted: Tue Jan 10, 2017 1:20 pm
by RunningMn9
There was a lot of chatter last night from some conservative pundits (Frum, etc) that the effort to repeal the ACA without an actual replacement plan died last night. McConnell doesn't have the votes to repeal and delay in the Senate (they listed at least five R defectors, and expected the number to grow).

Re: Trump's Full Court Press on healthcare

Posted: Tue Jan 10, 2017 1:31 pm
by Defiant

Re: Trump's Full Court Press on healthcare

Posted: Tue Jan 10, 2017 1:37 pm
by malchior
They are *totally* going to have a replacement plan by March. If the electorate had any brains it'd be clear to them that campaigning for years for something and then totally not being prepared to do it is *gross incompetence*.

Re: Trump's Full Court Press on healthcare

Posted: Tue Jan 10, 2017 1:40 pm
by Remus West
malchior wrote:They are *totally* going to have a replacement plan by March. If the electorate had any brains it'd be clear to them that campaigning for years for something and then totally not being prepared to do it is *gross incompetence*.
The electorate gave us Trump.

Re: Trump's Full Court Press on healthcare

Posted: Tue Jan 10, 2017 2:14 pm
by Kraken
Grifman wrote:
malchior wrote:The Republican healthcare "plan" apparently is chaos.The Health lobby doesn't even know what to do at this point. They have the Mad Man in Chief hanging over them.
Some companies, anxious about changes in health policy, said they were afraid to speak out because they feared that Mr. Trump would attack them on Twitter, as he has badgered Boeing, Ford, General Motors, Lockheed Martin and Toyota.
The Republicans have had years to develop a plan to replace the ACA, but instead they chose to have I think it was, 60+ fruitless votes to repeal it under Obama. There's no excuse for them to not have had a plan now to pull off the shelf and implement, or at least form the basis for implementation after hearings and input from the health care industry. Or course, the reason is that this is hard work and they don't really have an agreement among themselves as to what it should be. Such a bunch of doofs.
The excuse is that the ACA is really the only private market approach that will work, and it was originally a Republican plan. Their options are to tinker with it or revert to the chaos that existed before the ACA. Because of its integration, removing just the unpopular bits brings the whole thing down. If one must insist on a system run by and for insurance companies, then one's solution is going to wind up looking like the ACA.

While many Republicans would probably be fine with reverting to chaos, their party would likely take a drubbing for it.

Re: Trump's Full Court Press on healthcare

Posted: Tue Jan 10, 2017 2:26 pm
by LordMortis
Kraken wrote:The excuse is that the ACA is really the only private market approach that will work, and it was originally a Republican plan. Their options are to tinker with it or revert to the chaos that existed before the ACA. Because of its integration, removing just the unpopular bits brings the whole thing down. If one must insist on a system run by and for insurance companies, then one's solution is going to wind up looking like the ACA.

While many Republicans would probably be fine with reverting to chaos, their party would likely take a drubbing for it.
As far as I've can tell, the speculation is to turn the exchanges into FSAs and say that insuring everyone.

Re: Trump's Full Court Press on healthcare

Posted: Tue Jan 10, 2017 2:37 pm
by Grifman
Kraken wrote:The excuse is that the ACA is really the only private market approach that will work, and it was originally a Republican plan. Their options are to tinker with it or revert to the chaos that existed before the ACA. Because of its integration, removing just the unpopular bits brings the whole thing down. If one must insist on a system run by and for insurance companies, then one's solution is going to wind up looking like the ACA
Oh, I agree totally. ACA is a private sector approach to insuring everyone, and any Republican replacement is going to look a lot like it. And yes, removing things like the mandate and penalties and other things that the Republicans have complained about will bring the whole thing crashing down - it either won't work or will crash the budget. This is the problem the Republicans locked themselves into by opposing this from the beginning. They really didn't want to add all these people but now that they are there in the system, they just can't be seen to just dump them all.

Re: Trump's Full Court Press on healthcare

Posted: Wed Jan 11, 2017 12:20 am
by Victoria Raverna
RunningMn9 wrote:That's the price. That's not what I'm looking for. What is the cost of the procedure, on the supply side?
Gallblader removal cost patient around US$ 750 - US$ 1500 in Indonesia.

You can also check Singapore's cost which varies depend on the class of the hospital and room (kinda like in Indonesia where cost of procedure is based on the room, staying in a single patient VIP room will cause your operation procedure cost much higher than if you stay in a room with 7 other patients)

https://www.moh.gov.sg/content/moh_web/ ... copic.html

Lowest price in Singapore is around S$ 1673 or around US$ 1165.

Re: Trump's Full Court Press on healthcare

Posted: Wed Jan 11, 2017 10:59 am
by RunningMn9
Victoria Raverna wrote:
RunningMn9 wrote:That's the price. That's not what I'm looking for. What is the cost of the procedure, on the supply side?
Gallblader removal cost patient around US$ 750 - US$ 1500 in Indonesia.
If I recall my original question correctly, I would say the same thing. I wasn't looking for the patient cost to the surgeon for performing the surgery. I was wondering how much it "costs" the surgeon to perform the surgery.

Since this is a service, I agree that it's almost impossible to answer the question (which is the entire problem), but what I'm asking is akin to what is the cost (to Apple) to produce and sell an iPhone? I know the price that they charge consumers to buy an iPhone, that's not what I was looking for.

If I pay $5000 to a surgeon to remove my necrotic gallbladder, how much of that is profit for him?

Re: Trump's Full Court Press on healthcare

Posted: Wed Jan 11, 2017 9:15 pm
by Smoove_B
Trump just screwed up repeal even more:
The new criterion Trump threw into the mix is that nothing at all will happen until Tom Price is confirmed as secretary of HHS. Price has to go through two confirmation hearings. The first is on January 18, at the Health, Education, Labor, and Pensions Committee. The second and “voting” committee on his confirmation is Finance, which hasn’t even scheduled a hearing. But the Senate is voting on amendments to the basic blueprint for Obamacare repeal right now; final passage in that chamber will probably occur tomorrow after votes today and tonight on literally more than a hundred amendments that could shape the repeal. If Trump thinks nothing should happen for weeks, he should have probably shared that sentiment with congressional Republicans, who have been talking for months, publicly and privately, about moving on Obamacare before Trump’s inauguration.
It's almost like...they're not working together.
Trump is also suggesting “we” will be “submitting” a “plan” for the whole set of problems. Who is “we?” HHS? The White House? The Republican Party?
Indeed.
Surely someone has told him by now that anything worth calling a “replacement” for Obamacare, with its many insurance regulations and other non-budget features, cannot be done via a budget measure, and thus will require 60 Senate votes. How is that going to happen? It won’t if it resembles any of the plans that Republicans are currently discussing.
So awesome.

Re: Trump's Full Court Press on healthcare

Posted: Wed Jan 11, 2017 9:27 pm
by LordMortis
Smoove_B wrote:Trump just screwed up repeal even more:
The new criterion Trump threw into the mix is that nothing at all will happen until Tom Price is confirmed as secretary of HHS. Price has to go through two confirmation hearings. The first is on January 18, at the Health, Education, Labor, and Pensions Committee. The second and “voting” committee on his confirmation is Finance, which hasn’t even scheduled a hearing. But the Senate is voting on amendments to the basic blueprint for Obamacare repeal right now; final passage in that chamber will probably occur tomorrow after votes today and tonight on literally more than a hundred amendments that could shape the repeal. If Trump thinks nothing should happen for weeks, he should have probably shared that sentiment with congressional Republicans, who have been talking for months, publicly and privately, about moving on Obamacare before Trump’s inauguration.
It's almost like...they're not working together.
Trump is also suggesting “we” will be “submitting” a “plan” for the whole set of problems. Who is “we?” HHS? The White House? The Republican Party?
Indeed.
Surely someone has told him by now that anything worth calling a “replacement” for Obamacare, with its many insurance regulations and other non-budget features, cannot be done via a budget measure, and thus will require 60 Senate votes. How is that going to happen? It won’t if it resembles any of the plans that Republicans are currently discussing.
So awesome.
While I endorse it, The republican Congress is going to have a fit. Trump suggests his replacement is going to leverage treatments with the weight of the population of the US. You know where government negotiates on behalf of its people rather than letting the free market determine how much it can get for your health....

https://www.bloomberg.com/news/articles ... ce-bidding
We’re the largest buyer of drugs in the world and yet we don’t bid properly and we’re going to save billions of dollars.”
Does he mean it? Or is it market manipulation? Fortunes being made and lost. Still, I hope he means it.

Re: Trump's Full Court Press on healthcare

Posted: Thu Jan 12, 2017 10:15 am
by Jeff V
A government negotiating prices on behalf of its citizens? Sounds suspiciously socialist to me. :ninja:

Re: Trump's Full Court Press on healthcare

Posted: Thu Jan 12, 2017 11:14 am
by pr0ner
Jeff V wrote:A government negotiating prices on behalf of its citizens? Sounds suspiciously socialist to me. :ninja:
Might as well say it again: Trump is not a Republican.

Re: Trump's Full Court Press on healthcare

Posted: Thu Jan 12, 2017 11:50 am
by El Guapo
LordMortis wrote:
We’re the largest buyer of drugs in the world and yet we don’t bid properly and we’re going to save billions of dollars.”
Does he mean it? Or is it market manipulation? Fortunes being made and lost. Still, I hope he means it.
Does he mean anything he says? He so readily contradicts his past statements without shame that nothing he says is worth anything.

Re: Trump's Full Court Press on healthcare

Posted: Thu Jan 12, 2017 12:19 pm
by LordMortis
El Guapo wrote:
LordMortis wrote:
We’re the largest buyer of drugs in the world and yet we don’t bid properly and we’re going to save billions of dollars.”
Does he mean it? Or is it market manipulation? Fortunes being made and lost. Still, I hope he means it.
Does he mean anything he says? He so readily contradicts his past statements without shame that nothing he says is worth anything.
Until we have actions to judge him (us?) by, I only accept this approach if we apply it to everything he says, brushing off all of the stuff that makes me want to pull my hair out. It's hard to say "Does he mean anything he says?" without applying it as an axiom and I am too quick to judge too many things he says harshly to not be happy when he says something that aligns with my vision of how things ought to be.

Re: Trump's Full Court Press on healthcare

Posted: Thu Jan 12, 2017 12:21 pm
by Jeff V
pr0ner wrote:
Jeff V wrote:A government negotiating prices on behalf of its citizens? Sounds suspiciously socialist to me. :ninja:
Might as well say it again: Trump is not a Republican.
Very true, and I will say it again, the Dems ought to be praising the GOP conversion to Socialism from the highest pulpit (by running TV ads on the stations airing the televangelist shows the fundamentalists are so fond of). While they are at it, suggest that the other great Socialist policy position - extreme gun control, is most certainly next. They need to seize the opportunity to use those same buzzwords that have long been used against them in Idiot America.

Re: Trump's Full Court Press on healthcare

Posted: Thu Jan 12, 2017 12:31 pm
by El Guapo
LordMortis wrote:
El Guapo wrote:
LordMortis wrote:
We’re the largest buyer of drugs in the world and yet we don’t bid properly and we’re going to save billions of dollars.”
Does he mean it? Or is it market manipulation? Fortunes being made and lost. Still, I hope he means it.
Does he mean anything he says? He so readily contradicts his past statements without shame that nothing he says is worth anything.
Until we have actions to judge him (us?) by, I only accept this approach if we apply it to everything he says, brushing off all of the stuff that makes me want to pull my hair out. It's hard to say "Does he mean anything he says?" without applying it as an axiom and I am too quick to judge too many things he says harshly to not be happy when he says something that aligns with my vision of how things ought to be.
I'll give Trump credit for anything he does as president that is actually good. And hey, maybe he'll do this. I'm just saying that him saying now that he will do it is pretty much worthless.

Re: Trump's Full Court Press on healthcare

Posted: Thu Jan 12, 2017 12:46 pm
by Defiant
The U.S. Senate took the first major step toward repealing the Affordable Care Act after a marathon voting session that started Wednesday evening and extended into early Thursday.

The vote does not repeal President Obama's signature achievement, but it does set the stage for Republicans to clear the first procedural hurdle for repeal of the massive health care law. The bill will now go to the House of Representatives for a vote expected to take place on Friday.
link

Re: Trump's Full Court Press on healthcare

Posted: Thu Jan 12, 2017 1:47 pm
by malchior
If you look under the hood of what they passed they dropped preexisting conditions and covering contraceptives. A disaster for Healthcare looms and the media is too preoccupied to call it out. These guys are pure pond scum. I can only hope it comes around to bite the but i doubt it.

Re: Trump's Full Court Press on healthcare

Posted: Thu Jan 12, 2017 2:23 pm
by Smoove_B
malchior wrote:These guys are pure pond scum.
And they did at it 1am this morning. It's Medicare Part D all over again.

Re: Trump's Full Court Press on healthcare

Posted: Thu Jan 12, 2017 2:38 pm
by El Guapo
Defiant wrote:

“This is our opportunity to keep our campaign promise,” said Senator Roger Wicker, Republican of Mississippi. “This is our opportunity to help the president-elect and the vice president-elect keep their campaign promises and show to the American people that elections have consequences.”
That it certainly will.

Still, the GOP seems to be careening down without a real plan. They have this non-binding deadline of January 27th to come up with a replacement plan, which isn't going to happen. Then.... ??

Re: Trump's Full Court Press on healthcare

Posted: Thu Jan 12, 2017 3:02 pm
by LawBeefaroni
El Guapo wrote:
Defiant wrote:

“This is our opportunity to keep our campaign promise,” said Senator Roger Wicker, Republican of Mississippi. “This is our opportunity to help the president-elect and the vice president-elect keep their campaign promises and show to the American people that elections have consequences.”
That it certainly will.

Still, the GOP seems to be careening down without a real plan. They have this non-binding deadline of January 27th to come up with a replacement plan, which isn't going to happen. Then.... ??
Then? Then they're going to unveil their perpetual motion machine in front of the newly opened unicorn petting zoo.

Re: Trump's Full Court Press on healthcare

Posted: Thu Jan 12, 2017 3:24 pm
by Grifman
malchior wrote:If you look under the hood of what they passed they dropped preexisting conditions and covering contraceptives. A disaster for Healthcare looms and the media is too preoccupied to call it out. These guys are pure pond scum. I can only hope it comes around to bite the but i doubt it.
I hate to state the obvious but isn't this a complete contradiction of what Trump just said. That there would only be a repeal if there was a replace? Not that I expect any consistency from him and the Republicans at this point.

And yes, taking out the mandate is a recipe for an insurance market disaster. What insurance company is going to offer a plan in the marketplace now? This is pure idiocy.

Re: Trump's Full Court Press on healthcare

Posted: Thu Jan 12, 2017 3:35 pm
by El Guapo
Grifman wrote:
malchior wrote:If you look under the hood of what they passed they dropped preexisting conditions and covering contraceptives. A disaster for Healthcare looms and the media is too preoccupied to call it out. These guys are pure pond scum. I can only hope it comes around to bite the but i doubt it.
I hate to state the obvious but isn't this a complete contradiction of what Trump just said. That there would only be a repeal if there was a replace? Not that I expect any consistency from him and the Republicans at this point.

And yes, taking out the mandate is a recipe for an insurance market disaster. What insurance company is going to offer a plan in the marketplace now? This is pure idiocy.
Obamacare hasn't been repealed yet. This was a (mostly non-binding) budgetary framework that doesn't become law. What this does is allow the Republicans to mostly repeal Obamacare at a later date via a budget reconciliation bill, which can't be filibustered. Of course, they can't "replace" via budget reconciliation, so any replacement plan could be filibustered, and the democrats have no incentive to sign off on any bare bones "replacement".

Except there is one possible escape hatch wherein they repeal most of Obamacare via reconciliation, then pass a "replacement" that is 90% of Obamacare with tweaks (which democrats might sign off on), and then call it a day.

Re: Trump's Full Court Press on healthcare

Posted: Thu Jan 12, 2017 8:16 pm
by gilraen
malchior wrote:If you look under the hood of what they passed they dropped preexisting conditions and covering contraceptives. A disaster for Healthcare looms and the media is too preoccupied to call it out. These guys are pure pond scum. I can only hope it comes around to bite the but i doubt it.
When you have Duterte pushing free contraceptives in the Phillipines while American politicians are taking them away from poor women that need them most - that's when you know that the world has gone completely insane.

Re: Trump's Full Court Press on healthcare

Posted: Fri Jan 13, 2017 12:36 pm
by Enough
Some Guy on the Internets wrote:They say a Republican is a Democrat who got mugged.

Sounds like a Democrat is a Republican who got sick.

Re: Trump's Full Court Press on healthcare

Posted: Fri Jan 13, 2017 3:05 pm
by Defiant
Enough wrote:
Some Guy on the Internets wrote:They say a Republican is a Democrat who got mugged.

Sounds like a Democrat is a Republican who got sick.
Speaking of

Re: Trump's Full Court Press on healthcare

Posted: Fri Jan 13, 2017 7:25 pm
by malchior
So I learned something infuriating tonight - Trump kept referring as 2017 as the year that the ACA would blow up. He also spoke at his press conference about how they were saving the Democrats from their own failure passing the ACA. So I started digging around to figure out where this statement came from. And it I think it goes back to reprehensible and intentional sabotage of the ACA.

First off - there was a concept in the ACA called risk corridors that was intended to smooth out the transition for pre-existing coverage. The simple reason was that no one could accurately predict accurate premiums because it was unknown how much the plans would need to take in. They didn't know what adding in people with pre-existing conditions would cost. So they established the risk corridor. From 2014 to 2016 if a plan made too much money they had to pay a 'user fee' back into the government. If they didn't take in enough money, then they would be paid money by the government. It was a short-term measure to make sure premiums wouldn't explode. Unfortunately the payments *from* the Government weren't budgeted (intentionally) and then the Republicans actively blocked any appropriations from HHS even if they had the extra money. Essentially the Insurer could only get back money if someone made too much. And you can guess what happened. To date, the Government owes 8 Billion dollars to insurers with the Republicans calling risk corridors a 'bailout'. Funny thing was something very close to this exact mechanism was used by...the Republicans when they passed Medicare Part D. Go figure. So circling back to Trump, this is the year that the risk corridor program was to end. You'd expect that the markets were moving closer to the steady state premium levels after 3 years of level setting. Unfortunately the insurers were also pricing in expected payments. Payments that they won't receive and will pass on to the consumer. A ticking time bomb courtesy of the nihilists.

So they actively undermined healthcare and helped cause premiums in some plans to skyrocket. Then complained about them for political gain because the media is useless at explaining anything. Until tonight I'd never even heard of a risk corridor or heard about the machinations there. It is a piece of the failure of co-ops and a share of the large premium increases that we've been seeing to claim the ACA is failing. The worst part is that this was calculated and underhanded and hurt their fellow countrymen. Sad!

;tldr Republicans intentionally sabotaged the insurance market and then complained when the insurance market hitting the flaming tires they threw out on the road

Re: Trump's Full Court Press on healthcare

Posted: Fri Jan 13, 2017 11:15 pm
by Defiant

Re: Trump's Full Court Press on healthcare

Posted: Fri Jan 13, 2017 11:19 pm
by geezer
Defiant wrote:
For real.

Re: Trump's Full Court Press on healthcare

Posted: Fri Jan 13, 2017 11:30 pm
by El Guapo
geezer wrote:
Defiant wrote:
For real.
It's going to be grimly hilarious when I hear people making this argument again in 2020.

Re: Trump's Full Court Press on healthcare

Posted: Sat Jan 14, 2017 1:40 pm
by LordMortis
El Guapo wrote:
geezer wrote:
Defiant wrote:
For real.
It's going to be grimly hilarious when I hear people making this argument again in 2020.
If democrats insist on running Clinton again then we've already lost.

Re: Trump's Full Court Press on healthcare

Posted: Sat Jan 14, 2017 2:31 pm
by Max Peck
LordMortis wrote:If democrats insist on running Clinton again then we've already lost.
That's not going to happen, but if the left/progressive/not-right continues to be fragmented into warring factions instead of making common cause against their actual ideological foe, the Democrats start at a disadvantage.

Re: Trump's Full Court Press on healthcare

Posted: Mon Jan 16, 2017 1:24 pm
by Moliere
How to Replace Obamacare
You can't swing a dead cat these days without hitting someone who has made fun of congressional Republicans for not having a plan to replace Obamacare. And the critics are right: Republicans don't have a plan. They have a whole bunch of plans. House Speaker Paul Ryan has one. Texas Sen. Ted Cruz has another. HHS nominee Tom Price not only has a plan, he has a bill: The Empowering Patients First Act. The trouble is that Republicans haven't collated all those plans into one single, omnibus proposal.

Re: Trump's Full Court Press on healthcare

Posted: Mon Jan 16, 2017 1:37 pm
by Blackhawk
The Empowering Patients First Act

God, I hate that kind of language. In almost every case it is intended as a manipulative distraction from what it really does (see also: Patriot Act. You are a patriot, aren't you?)

Re: Trump's Full Court Press on healthcare

Posted: Mon Jan 16, 2017 1:40 pm
by Rip
What? You are against empowering patients?

:mrgreen:

Re: Trump's Full Court Press on healthcare

Posted: Mon Jan 16, 2017 1:49 pm
by Max Peck
Rip wrote:What? You are against empowering patients?
My name is Max Peck, and I approve this act.
Enlarge Image

Re: Trump's Full Court Press on healthcare

Posted: Tue Jan 17, 2017 5:13 am
by Victoria Raverna
gilraen wrote:
malchior wrote:If you look under the hood of what they passed they dropped preexisting conditions and covering contraceptives. A disaster for Healthcare looms and the media is too preoccupied to call it out. These guys are pure pond scum. I can only hope it comes around to bite the but i doubt it.
When you have Duterte pushing free contraceptives in the Phillipines while American politicians are taking them away from poor women that need them most - that's when you know that the world has gone completely insane.
Duterte is pro-Death and US is pro-Life.

Re: Trump's Full Court Press on healthcare

Posted: Tue Jan 17, 2017 10:15 am
by TheMix
Victoria Raverna wrote:
gilraen wrote:
malchior wrote:If you look under the hood of what they passed they dropped preexisting conditions and covering contraceptives. A disaster for Healthcare looms and the media is too preoccupied to call it out. These guys are pure pond scum. I can only hope it comes around to bite the but i doubt it.
When you have Duterte pushing free contraceptives in the Phillipines while American politicians are taking them away from poor women that need them most - that's when you know that the world has gone completely insane.
Duterte is pro-Death and US is pro-Life.
Are you suggesting that contraception is equivalent to killing a "life"? i.e. that by not allowing the sperm and egg to hook up, it's the same as aborting a fetus? That may be the most extreme viewpoint I've ever encountered.

Re: Trump's Full Court Press on healthcare

Posted: Tue Jan 17, 2017 10:31 am
by Holman
I assume the joke is based more on Duterte's enthusiasm for extrajudicial killing.