Repealing the ACA begins...

[who?]

If the insurance co.s have to cover pre-existing conditions where is the money going to come from? They use the money from premiums to cover existing claims and administrative costs. If they have to cover anything that new enrollees have they'll need a lot more money as no-one will bother to get coverage until they have something that needs to be paid for.
Once Trump has his staff set up to run things day to day he'll spend most of his time playing golf.

 

[Darwin333]

Allow me to clarify as far as my ignorance of the industry will allow me to, seeing as if I assume you're asking for more detail in my post.

The "profit" I refer to is what investors (gamblers) get out of the industry and the pressure they put on the industry in their demands for an ever increasing return on their investments. Correct me if I'm wrong, as I'd like to be as well informed as anyone else about why healthcare costs and the rate of increases in that cost are far and away above those nations that provide decent health care at far less expense.

That's about as concise as I can get.

I think you need to look at the profit made in the US versus the profit made in other countries.

Life saving drugs that you don't have an option of negotiating when you actually need them cost $14,000 in one place but a few hundred miles away they cost a few hundred dollars, same manufacturer and everything. Granted that few hundred miles crosses a border but it's still the same exact drug. Why are healthcare providers (not insurers) allowed to make those kinds of insane profits, that would be Congress. MRIs cost thousands of dollars here but you can get one for under $100 cash in Japan.

 

[Arachnotronic]

I think you need to look at the profit made in the US versus the profit made in other countries.

Life saving drugs that you don't have an option of negotiating when you actually need them cost $14,000 in one place but a few hundred miles away they cost a few hundred dollars, same manufacturer and everything. Granted that few hundred miles crosses a border but it's still the same exact drug. Why are healthcare providers (not insurers) allowed to make those kinds of insane profits, that would be Congress. MRIs cost thousands of dollars here but you can get one for under $100 cash in Japan.

Seems to me that the way to bring down the cost of healthcare is to more tightly regulate what drug companies can charge for their products and what doctors can charge for their services.

Unfortunately, with less of a profit incentive, the pace of innovation in medicine could slow. Why would drug companies want to invest more in R&D if they can't get paid for it? Why would kids want to risk significant debt and the grueling reality of medical school if they're not going to get paid for their blood, sweat, and tears?

There are no free lunches, no magic bullets that only Trump has knowledge of and can apply. I look forward to seeing Trump's approval ratings near the end of his first term in office when the world realizes that not even he could "fix" all that ails the US.

 

[HamburgerBoy]

Employers.

So in other words, employees.

 

[Geekbabe]

I believe the ACA needs overhauling but as a stage IV cancer patient who is still employed I am deeply worried. My insurance already costs close to 20k per year & I pay a fairly hefty premium,

I drag myself to work because COBRA will cost me 2K per month, about $200 a month more than my short term disability policy will pay me. I fear insurance caps, lifetime limits & policy termination.

If I have to leave work, I will get short & long term disability till my SSDI kicks in ( a five month wait after approval) because I am not yet 60 there will be no health insurance attached to that SSDI.

Keeping coverage for pre-existing conditions will do me no good as I won't be able to afford the premiums.

Honestly, I am scared, actually scared doesn't cover it really.

 

[trenchfoot]

I believe the ACA needs overhauling but as a stage IV cancer patient who is still employed I am deeply worried. My insurance already costs close to 20k per year & I pay a fairly hefty premium,

I drag myself to work because COBRA will cost me 2K per month, about $200 a month more than my short term disability policy will pay me. I fear insurance caps, lifetime limits & policy termination.

If I have to leave work, I will get short & long term disability till my SSDI kicks in ( a five month wait after approval) because I am not yet 60 there will be no health insurance attached to that SSDI.

Keeping coverage for pre-existing conditions will do me no good as I won't be able to afford the premiums.

Honestly, I am scared, actually scared doesn't cover it really.

First, let me say that I applaud you for your courage and your grit for hanging in there. I wish for you only the best possible outcome.

That being said, I and many others know that there must be untold thousands of other folks facing the same fears as you, and that we stand with all of you always.

And for those who wish to repeal the ACA sight unseen, please keep in mind there will be a cost in human lives and that should matter so much more than a petty hatred of Obama.

Here's hoping that Trump will realize this and that he does what he promised he would do: to fix the system so as to take care of ALL Americans.

 

[senseamp]

I think at this point, it's pretty clear that we are eventually going to end up doing Medicare/Medicaid for all, and all these patchwork complicated ideas are stopgaps. This is why Medicaid expansion is working with no complaints, and exchanges are in trouble. Only single payer has the leverage and bargaining power to deal with the real problem of cost.
Right now, Trump's big decision, which I think he is blowing, is to decide if he wants to be a great president, or just push Republican trickle down dogma that has failed America for 35 years. Does he want to be a Bush substitute, or do what he believes.
If Trump gets Medicare for all passed and fixes this mess once and for all, he will unite this country and go down as the greatest president since FDR.

 

[trenchfoot]

I think at this point, it's pretty clear that we are eventually going to end up doing Medicare/Medicaid for all, and all these patchwork complicated ideas are stopgaps. This is why Medicaid expansion is working with no complaints, and exchanges are in trouble. Only single payer has the leverage and bargaining power to deal with the real problem of cost.
Right now, Trump's big decision, which I think he is blowing, is to decide if he wants to be a great president, or just push Republican trickle down dogma that has failed America for 35 years. Does he want to be a Bush substitute, or do what he believes.
If Trump gets Medicare for all passed and fixes this mess once and for all, he will unite this country and go down as the greatest president since FDR.

Trump is going to have to withstand the incessant assault the establishment Repubs are going to unleash on him if he is seriously wanting to unite the nation. He is going to have to make decisions that will piss off the very folks that elected him into office by reneging on a bevy of promises he made to them if he wants to gain the trust and support of those that voted against him.

He cannot rely on words to gain their support, as his words have zero credibility, even with many of those who voted for him.

He'll have to lead by example and prove his worth by deeds, deeds that show he cares for the working class more than he does the privileged few of which he is a member of.

He branded himself as the outsider with no ties of which gives him the ability to overcome the hard wired establishment ways that have been in place for decades on end.

Let's hope that brand he gave himself is worth more than the outlandish rhetoric he tossed around the airwaves to get himself elected.

 

[senseamp]

I doubt many Trump's working class supporters would complain if he passed Medicare for all of them. If they cared about Republican dogma, he would not have been the nominee. They want their specific economic needs and struggles addressed, and health care is near the top of the list.

 

[trenchfoot]

I doubt many Trump's working class supporters would complain if he passed Medicare for all of them. If they cared about Republican dogma, he would not have been the nominee. They want their specific economic needs and struggles addressed, and health care is near the top of the list.

Agreed. The needs of the working class encompasses ALL of the working class, Repubs, Dems, Independents, Libertarians, you name it. That's something I've always felt and frequently expressed in this forum, this war the very wealthy have been waging against the middle class and the poor for nigh on decades now. It really doesn't matter to me who unites the working class against the rigged system that Trump has been railing on about. Hey, if Trump can do it, more power to him.

Yet, the very wealthy, in their efforts to dictate terms to the nation so as to keep on hoarding the portion of ill-begotten wealth they corrupted their way into possessing, have very effectively split the working class into opposing camps to keep them (us) suppressed and properly "managed" by using race, gender, religion, homophobia and all of those other single issues that they keep right on inflaming the populace with.

If Trump wants to do any kind of uniting, I'd sure like for him start with uniting the middle class and the poor first and foremost. And he can do just that by demanding tax cuts for the middle class and the poor while raising taxes on himself and his ilk.

 

[agent00f]

So in other words, employees.

Employers already pay. Nationalized care is just a bigger risk pool plus cost control minus overhead/profits.

 

[agent00f]

I doubt many Trump's working class supporters would complain if he passed Medicare for all of them. If they cared about Republican dogma, he would not have been the nominee. They want their specific economic needs and struggles addressed, and health care is near the top of the list.

The likelihood of republicans supporting/passing nationalized healthcare is zero.

 

[fskimospy]

I believe the ACA needs overhauling but as a stage IV cancer patient who is still employed I am deeply worried. My insurance already costs close to 20k per year & I pay a fairly hefty premium,

I drag myself to work because COBRA will cost me 2K per month, about $200 a month more than my short term disability policy will pay me. I fear insurance caps, lifetime limits & policy termination.

If I have to leave work, I will get short & long term disability till my SSDI kicks in ( a five month wait after approval) because I am not yet 60 there will be no health insurance attached to that SSDI.

Keeping coverage for pre-existing conditions will do me no good as I won't be able to afford the premiums.

Honestly, I am scared, actually scared doesn't cover it really.

First of all I want to say that what you're doing takes incredible will and courage but at the same time sounds heartbreaking. You have all my best wishes.

Second, you should keep telling your story to as many people as possible. It's easy for people who oppose the ACA to get worked up about how terrible they think it is and never take the time to hear from the people who are subject to the worst abuses of our insurance industry that it was designed to prevent.

 

[Darwin333]

Seems to me that the way to bring down the cost of healthcare is to more tightly regulate what drug companies can charge for their products and what doctors can charge for their services.

Unfortunately, with less of a profit incentive, the pace of innovation in medicine could slow. Why would drug companies want to invest more in R&D if they can't get paid for it? Why would kids want to risk significant debt and the grueling reality of medical school if they're not going to get paid for their blood, sweat, and tears?

There are no free lunches, no magic bullets that only Trump has knowledge of and can apply. I look forward to seeing Trump's approval ratings near the end of his first term in office when the world realizes that not even he could "fix" all that ails the US.

Orrrrr...... We could just allow the importation of drugs. Why shouldn't a person be allowed to purchase the same exact safe prescription drug from Canada made by the same manufacturer that costs 1/10th of the price? Since we are talking about the same manufacturers they are obviously able to make money selling the drugs at far lower prices in Canada, if they can't sell them for the absurd markups in the US anymore because anyone, including pharmacies and people themselves, can purchase them at 1/10th the price they will have to lower their prices. That is true free market at work, something we currently don't have with healthcare in the US. You might be wondering why we can't do this already and the answer would be Congress and even the president being bought off by lobbyists. Or I guess we could consider that maybe they thought US citizens paying insanely higher prices for the exact same drugs was a great idea.

As far as doctors, I don't advocate restricting anyone's pay but from what I understand the AMA keeps the supply of doctors artificially low. If that is true, we should change that.

As far as hospitals and doctors offices, they get away with stuff that no other industry in the country does and I think that existing law would be good enough to end a lot of those practices.

 

[senseamp]

The likelihood of republicans supporting/passing nationalized healthcare is zero.

They expanded Medicare under Bush.

 

[Sheik Yerbouti]

I believe the ACA needs overhauling but as a stage IV cancer patient who is still employed I am deeply worried. My insurance already costs close to 20k per year & I pay a fairly hefty premium,

I drag myself to work because COBRA will cost me 2K per month, about $200 a month more than my short term disability policy will pay me. I fear insurance caps, lifetime limits & policy termination.

If I have to leave work, I will get short & long term disability till my SSDI kicks in ( a five month wait after approval) because I am not yet 60 there will be no health insurance attached to that SSDI.

Keeping coverage for pre-existing conditions will do me no good as I won't be able to afford the premiums.

Honestly, I am scared, actually scared doesn't cover it really.

goddammit, I am so, so sorry. you shouldn't have to feel this way. going through what you're going through and then having to worry about the bullshit bills on top of it. and I agree with Eskimo. Get this story out there, to as many folks as possible, make this a tangible, real thing, if you are ok with that.
I know at some point my heart is going to go sideways in a big way, potential for another open heart or transplant, and there's no way in hell I could afford either of those. I wish you the very best with yours. And again, I am so very sorry you have to deal with such mundane bullshit as bills when you're dealing with such a life changing health issue.

 

[agent00f]

They expanded Medicare under Bush.

Buying off their base with some new drug benefits is hardly comparable to wholesale "socialized" healthcare.

 

[Darwin333]

I think at this point, it's pretty clear that we are eventually going to end up doing Medicare/Medicaid for all, and all these patchwork complicated ideas are stopgaps. This is why Medicaid expansion is working with no complaints, and exchanges are in trouble. Only single payer has the leverage and bargaining power to deal with the real problem of cost.
Right now, Trump's big decision, which I think he is blowing, is to decide if he wants to be a great president, or just push Republican trickle down dogma that has failed America for 35 years. Does he want to be a Bush substitute, or do what he believes.
If Trump gets Medicare for all passed and fixes this mess once and for all, he will unite this country and go down as the greatest president since FDR.

Medicare and Medicaid currently cost $1.5T and the trend has been a roughly 9.3% increase per year. That means at the current rate in 4 years we will be paying a full $2 TRILLION just to insure roughly 1/3 of the population. I don't see how we can afford to pay an additional $600 billion for current Medicare/Medicaid in 4 years, I would love someone to explain how we can afford to triple the amount of people on the program and somehow afford it.

 

[senseamp]

Medicare and Medicaid currently cost $1.5T and the trend has been a roughly 9.3% increase per year. That means at the current rate in 4 years we will be paying a full $2 TRILLION just to insure roughly 1/3 of the population. I don't see how we can afford to pay an additional $600 billion for current Medicare/Medicaid in 4 years, I would love someone to explain how we can afford to triple the amount of people on the program and somehow afford it.

We are spending more than enough money on health care in total to cover everyone. Something like twice as much as other countries spend. Obviously if there is Medicare for all, companies/individuals won't be spending money on private insurance, and instead paying the savings in some form of tax to fund Medicare for all. On top of that, Medicare would actively negotiate lower prices on everything, including prescription drugs, which it's not doing now.

 

[poofyhairguy]

We are spending more than enough money on health care in total to cover everyone. Something like twice as much as other countries spend. Obviously if there is Medicare for all, companies/individuals won't be spending money on private insurance, and instead paying the savings in some form of tax to fund Medicare for all. On top of that, Medicare would actively negotiate lower prices on everything, including prescription drugs, which it's not doing now.

There is no evidence that universal healthcare in America would be cheaper. In fact given the data we have the opposite looks true- the fact that we spend so much on Medicare and it only covers a small part of the population.

The real problem is the American demand for instant gratification and consumption of any product including healthcare

Until we can learn to accept "no grandma can't have that procedure that will only give her an extra week of life at a cost of a half million dollars" or "no you can't see YOUR doctor until the people in line before you see one so here is a nurse instead" we are screwed when it comes to the cost of health care.

 

[Darwin333]

We are spending more than enough money on health care in total to cover everyone. Something like twice as much as other countries spend. Obviously if there is Medicare for all, companies/individuals won't be spending money on private insurance, and instead paying the savings in some form of tax to fund Medicare for all. On top of that, Medicare would actively negotiate lower prices on everything, including prescription drugs, which it's not doing now.

Can you tell me how we are going to pay for the extra $600B for our current system in 4 years? As far as negotiating drug costs, why isn't it doing that now?

 

[Sonikku]

They expanded Medicare under Bush.

Part D actually increased costs, but you never hear about that from the so called liberal mainstream media. All you hear about is when Dems do that stuff.

 

[senseamp]

Can you tell me how we are going to pay for the extra $600B for our current system in 4 years?

We will pay what we can pay, not a penny more. If an extrapolation conflicts with feasible reality, feasible reality will happen, not the extrapolation.

As far as negotiating drug costs, why isn't it doing that now?

Because the law that Republicans passed in the middle of the night explicitly forbade it from doing that.

 

[HamburgerBoy]

We are spending more than enough money on health care in total to cover everyone. Something like twice as much as other countries spend. Obviously if there is Medicare for all, companies/individuals won't be spending money on private insurance, and instead paying the savings in some form of tax to fund Medicare for all. On top of that, Medicare would actively negotiate lower prices on everything, including prescription drugs, which it's not doing now.

How do you "negotiate" a price when only one party owns a gun? Drug companies negotiate with Europe because the cost of getting a drug on the market is mostly government approval, so something is better than nothing. Manufacturing is pennies. Drug design, on the other hand, has been on a long downhill slope in Europe. Maybe if people couldn't file billion dollar law suits when 0.01% of the population suffers an adverse reaction to an otherwise perfectly usable drug, we drug companies wouldn't need to charge obscene prices.

 

[K1052]

Can you tell me how we are going to pay for the extra $600B for our current system in 4 years? As far as negotiating drug costs, why isn't it doing that now?

Last I saw net Medicare outlays were like $550B-ish. Unless Medicaid is transporting everybody in RR Phantoms not sure there the other trillion bucks is going.

Medicare Part D forbid the government from negotiating drug prices in the program. Thanks Bush and Republicans. For reference the prices the VA pays, who can negotiate, can be half or less than Medicare pays.