Healthcare Predictions

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Re: Healthcare Predictions

Postby ToddStarnes » Thu Sep 21, 2017 6:42 pm

phosphide wrote:
Kane wrote:lol and again the insurers are against it as well.

https://www.nytimes.com/2017/09/20/us/p ... epeal.html


1. Insurance companies like essential benefits because they can charge premiums for them and patients don't use them. So naturally they are against having that taken away from them.


1. Ambulatory patient services (outpatient care you get without being admitted to a hospital)
2. Emergency services
3. Hospitalization (like surgery and overnight stays)
4. Pregnancy, maternity, and newborn care (both before and after birth)
5. Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
6. Prescription drugs
7. Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
8. Laboratory services
9. Preventive and wellness services and chronic disease management
10. Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

List of essential benefits required under the ACA. Of these, I bet 99.99999% of the population uses 6 and 8 at least every year. A big chunk also uses 1, 2, 3, 5, 9 and 10. Where are you getting your information?

2. This bill has little or nothing to do with commercial or managed health plans (aka insurance companies) considering most have backed out of Obamacare.
I....but.....wha?
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Re: Healthcare Predictions

Postby Kane » Thu Sep 21, 2017 8:14 pm

phosphide wrote:
Kane wrote:lol and again the insurers are against it as well.

https://www.nytimes.com/2017/09/20/us/p ... epeal.html


1. Insurance companies like essential benefits because they can charge premiums for them and patients don't use them. So naturally they are against having that taken away from them.


I don't think you know what that means...

phosphide wrote:2. This bill has little or nothing to do with commercial or managed health plans (aka insurance companies) considering most have backed out of Obamacare. So it's pointless for them to even come out against it and it's not worth accepting their opinions anyways considering they basically own our legislators.


...what?

phosphide wrote:3. From one of the groups: "The legislation could hurt patients by “further destabilizing the individual market” and could potentially allow “government-controlled single payer health care to grow." You should be happy with that.


I don't know the intended context of that delivery but this passing could very well lead to the next Democratic reign pulling heavily for single payer...the consequences of this bill on the whole market is immense. Funding outright decreases by hundreds of billions and then gets block granted and then it totally gone by 2026.

This bill is insane.
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Re: Healthcare Predictions

Postby phosphide » Thu Sep 21, 2017 10:23 pm

ToddStarnes wrote:1. Ambulatory patient services (outpatient care you get without being admitted to a hospital)
2. Emergency services
3. Hospitalization (like surgery and overnight stays)
4. Pregnancy, maternity, and newborn care (both before and after birth)
5. Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
6. Prescription drugs
7. Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
8. Laboratory services
9. Preventive and wellness services and chronic disease management
10. Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

List of essential benefits required under the ACA. Of these, I bet 99.99999% of the population uses 6 and 8 at least every year. A big chunk also uses 1, 2, 3, 5, 9 and 10. Where are you getting your information?


I'm aware the essential benefits are required under the ACA. Hence why I brought up it being removed in the proposal (or rather the states being able to control it). Essential benefits were added to fill the void for a small number of Americans who didn't have coverage or couldn't afford coverage. Except coverage is not the same as those who actually need the services. Healthy people by and large do not use these services, which is why skinny plans were entirely eliminated under the ACA. You needed healthy people to pay for the sick who do need the coverage in the ACA (which didn't happen).

At the end of the day, people who don't use the services paid for the small minority of people who do. The major exception is maternity care, which is a beast of it's own and usually requires temporary disability insurance (which of course explains why most plans didn't include coverage for it). If we had a better paid maternity system in the US, we wouldn't have this problem. For everything else, pay for your own damn substance abuse, mental health, and chronic issues.

I....but.....wha?

The bill is mostly concerned with Medicaid benefits which primarily effects the hospital networks. Barely has shit to do with employer health insurance (which is the bulk of our coverage) and the individual market is already raped by the ACA.

Summary: poor and old people are f**k just as they always are and the ACA didn't make a dent in helping that either. Healthy people can get their cheap plans again (maybe) but premiums will still go up because the insurance companies are shifting higher deductibles and out-of-pocket costs regardless of what happens with the ACA.

This bill is f**k just like the ACA is f**k because healthcare blows in the country. **==
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Re: Healthcare Predictions

Postby phosphide » Thu Sep 21, 2017 10:35 pm

Kane wrote:I don't think you know what that means...

I think you don't know much of anything, so you might want to step off the subject before you debate something you know nothing about.

...what?

The bill is primarily concerned with Medicaid funding and will hardly effect the bulk of health insurance in this country. It effects the individual market for sure, which is already f**k.

I don't know the intended context of that delivery but this passing could very well lead to the next Democratic reign pulling heavily for single payer...the consequences of this bill on the whole market is immense. Funding outright decreases by hundreds of billions and then gets block granted and then it totally gone by 2026.

This bill is insane.


As I said to Dylan, the ACA is f**k and so is this bill. It doesn't matter which one is in place, we are still screwed. You can only hope this fails because it's what the Democrats need to win.
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Re: Healthcare Predictions

Postby phosphide » Thu Sep 21, 2017 11:20 pm

If you want to fix our broken ass healthcare system, I recommend the following for starters:

1. Eliminate state lines - not for the same reasons you are use to hearing. Consolidate insurance companies and turn them into national companies instead of regional/state companies. This would make it easier from an administrative standpoint for hospital networks. We don't need 15 different BCBS and it ultimately increases administrative costs trying to maintain contracts with so many different payers.
2. Contractual Obligations - require all insurance companies to have one set of standards and all hospitals are required to be contracted with it. All claims must be settled between hospital/insurance company within 120 days. Place a fine every day for each claim not resolved on both the hospital network and insurance company. Would eliminate out-of-network plans and would save massive amounts of administrative costs trying to settle claims with insurance companies.
3. Incorporate Deductibles/Co-Pays into Premiums - would eliminate bad debt collection activities from hospitals and patients don't pay them anyways. Patients in this country obviously don't care about taking their healthcare seriously, not like a deductible would reduce risky behavior.
4. Consolidate billing - it's stupid you get 10 bills from 10 different doctors after a visit. Your explanation of benefits doesn't make sense anyways.
5. Taxes - implement a tax based system onto hospital networks and insurance companies based off the quality/value of healthcare services and key population health metrics.
6. Maternity care - implement a true maternity care system. Jesus christ I can't believe we don't have this.
7. Fraud - increase fraud investigations on government funding. Medicare/Medicaid wouldn't be so difficult if it weren't for the massive amounts of fraud we see each year.
8. Fix Patent System - would save a ridiculous amount of money on prescriptions and other medical technology

Single payer isn't happening any time soon and I wouldn't support paying into a system that rewards our unhealthy country anyways.
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Re: Healthcare Predictions

Postby exploited » Fri Sep 22, 2017 6:42 am

I really don't even get it... If you are interfering in the market that much, just go single payer. It seems like what you are doing now is actually worse, because it combines the inefficiencies of both private and public insurance, with none of the efficiencies of either...
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Re: Healthcare Predictions

Postby John Galt » Fri Sep 22, 2017 9:40 am

we need to have a rational debate with the pros and cons of single payer laid out and people need to come together in a calm manner and work it out with a pragmatic compromise that leaves no one truly happy with the outcome but something we can all live with and will help our nation going forward

too bad. this is AMERICA-- go big or go home, none of this small ball malarkey for us
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Re: Healthcare Predictions

Postby ToddStarnes » Fri Sep 22, 2017 9:56 am

The bill would radically alter requirements with respect to insurance provides by insurers so not sure where you came to the conclusion it wouldn't effect insurance coverage?

Link for people not using coverage like I discussed above? I googled briefly but didn't see anything.
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Re: Healthcare Predictions

Postby Kane » Fri Sep 22, 2017 2:33 pm

McCain is a no vote.

http://thehill.com/policy/healthcare/35 ... are-repeal

Suck it GOP. Good on McCain. This bill was a heaping pile of shit.
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Re: Healthcare Predictions

Postby NAB » Fri Sep 22, 2017 2:38 pm

Kane wrote:McCain is a no vote.

http://thehill.com/policy/healthcare/35 ... are-repeal

Suck it GOP. Good on McCain. This bill was a heaping pile of shit.


I'm not sure why the GOP keeps banging it's head against the wall and coming out looking like complete incompetents.. They'll have to wait until McCain dies to get a shitty healthcare bill passed at this point.
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