ACA: Repeal and Delay?

[BlueGin]

If you are going to require everyone to have health insurance then you need some sort of penalty for those that don't.

Or, you could remove the government from the decision process altogether.

If you don't want the government telling a woman what to do about having an abortion, please, don't sit there and advocate for government forcing people to have healthcare insurance.

And people with pre-existing conditions can continue to be unable to get insurance.

Yanno, I'm sick and tired of people playing the pity card when it comes to Obamacare when they have no sufficient counterpoints to make.

Instead of the government forcing anyone to have health insurance, just tailor the law to regulate the existing healthcare industry. Make it easier for insurance companies to insure more people without hemorrhaging money. It never needed to become as complicated as it is now.

For example, the pre-existing conditions. Trump said he wanted to keep that part of Obamacare. Yet here you are seemingly making the implication that Republicans don't care about those with "pre-existing" conditions. Weren't you paying any attention?

Except it's not so simple. If it was, would they have bothered with a mandate? I doubt it - it's clearly the least popular part of the plan.

How will you force insurance companies to take pre-existing conditions? Who will pay for it? If insurance companies don't have enough healthy people in the pool to make up for the costs of the sick people, then rates will sky rocket if you force them to take people with pre-existing conditions. Trump doesn't have a clue how he's going to do that but it sounds good say we'll get rid of the unpopular stuff and keep the popular stuff. Nevermind that the umpopular stuff in some cases is what keeps it "budget neutral" or is the carrot for the insurance companies to take sicker people.

Too many sick people with pre existing conditions and not enough healthy people signing up to pay the bills is what is forcing providers out of the current exchanges.

Oops

 

[TemplarKormac]

If you don't have a replacement plan in place, that has been explained to the public it will create havoc for both people with insurance and for the insurance industry itself.

Read the proposal put forth by Tom Price.

Ya....it's not that great....Tom Price's Health Plan Doesn't Let Insurers Impose Pre-Existing Condition Exclusions - Sort Of

But that counters any liberal notion that Republicans don't have a plan in place to replace it.

 

[Borillar]

If the establishment would just deregulate the medical market, lot of poor folk could afford medical care.

The rich could use "licensed practitioners" and the poor could use those who are alternatively trained.

This is the damned information age. However, government regulation make the market artificially rigid in price structure, both in those who deliver services, for extending the patent on drugs, devices and procedure unnecessarily. If they loosened up the free market, these things would take care of themselves.


But the medical establishment, the schools, education, the professional class, etc. have such a vested interested in making health prohibitively expensive, that folks pay way more to stay healthy, and heal than is necessary.

"Alternatively trained"? What's that? Faith healers and witch doctors? Barbers allowed to do bloodletting?

 

[rightwinger]

More than enough ways to fix it

None require scrapping the whole thing and starting over

Where's the Dem "good will" and competence? And what's taking so fucking long for them to ACKNOWLEDGE it's been blowing up since it was launched? They too busy blocking appointments and stuff?

Nothing that can't be fixed

You want expanded HSAs? Do it
Full tax deductions? Do it
More interstate sales? Do it

Keep the exchanges and make them more efficient

Want to REALLY fix things?
Single payer

I think the Schumer gang spent all their time coming up with the catchy poster slogan for the big Press event today. "Make America Sick Again". Most of the creative energy seems to be slogans and strategery. (Bless GW Bush for that word)..

You should tweet them.. You're further along than they are.

I like that.......almost as good as let em die

Republicans want to scrap Obamacare....show us something better first
It can't be that hard

It's REALLY REALLY hard when you have lawyers and career poly sci students and politicians PRETENDING they can fix it. Nothing's gonna happen until they step aside and bring in some folks that UNDERSTAND medical services and underwriting.

Not even your fantasy "single payer".. Which is the coward's way out of actually UNDERSTANDING how to deliver healthcare efficiently and accurately.

Lets start with getting employers out of the insurance business, eliminating insurance companies as a middle man, ending monopolies from big Pharm, openly advertising rates and fees

 

[rightwinger]

If you don't have a replacement plan in place, that has been explained to the public it will create havoc for both people with insurance and for the insurance industry itself.

Read the proposal put forth by Tom Price.

Ya....it's not that great....Tom Price's Health Plan Doesn't Let Insurers Impose Pre-Existing Condition Exclusions - Sort Of

But that counters any liberal notion that Republicans don't have a plan in place to replace it.

Until the Republican Party can come forward and say....This is our plan
They do not have a plan

Looks like Republicans have to pass it before they know what is in it

 

[basquebromance]

 

[flacaltenn]

Where's the Dem "good will" and competence? And what's taking so fucking long for them to ACKNOWLEDGE it's been blowing up since it was launched? They too busy blocking appointments and stuff?

Nothing that can't be fixed

You want expanded HSAs? Do it
Full tax deductions? Do it
More interstate sales? Do it

Keep the exchanges and make them more efficient

Want to REALLY fix things?
Single payer

I think the Schumer gang spent all their time coming up with the catchy poster slogan for the big Press event today. "Make America Sick Again". Most of the creative energy seems to be slogans and strategery. (Bless GW Bush for that word)..

You should tweet them.. You're further along than they are.

I like that.......almost as good as let em die

Republicans want to scrap Obamacare....show us something better first
It can't be that hard

It's REALLY REALLY hard when you have lawyers and career poly sci students and politicians PRETENDING they can fix it. Nothing's gonna happen until they step aside and bring in some folks that UNDERSTAND medical services and underwriting.

Not even your fantasy "single payer".. Which is the coward's way out of actually UNDERSTANDING how to deliver healthcare efficiently and accurately.

Lets start with getting employers out of the insurance business, eliminating insurance companies as a middle man, ending monopolies from big Pharm, openly advertising rates and fees

Why don't you and I and the other 5 rational people start an interest group and discuss this away from all the venom and hijinks and slogans. Seriously -- It's time to ditch the bovine manure.

One thing I've NEVER HEARD and don't understand is why we would EVER be "subsidizing insurance" if the problem is truly working poor and the chronically ill. The idea of pushing folks into high deductible policies as a "fix" for all that is brainless and inhumane.

Seems to ME -- you should be subsidizing DEDUCTIBLES and total OutOfPocket costs when services are DELIVERED instead.

Under THAT paradigm, you allow folks to cover what they can -- even if it's just CATASTROPHIC coverage.. And help them if shit happens. You could even MANDATE minimum coverage if you wanted to (based on income or paycheck to keep them from sandbagging. Make the minimum plan an automatic FICA deduction if you wanted to.

No more govt designed plans that cover EVERYTHING, including stuff you don't need. But provide no help when you NEED medical services with their high deductibles.

Subsidizing insurance premiums that get nibbled and inflated by Insurance carriers is stone stupid. The goal is to CUT the power of the Insurers and their enslavement of medical providers.

Have you ever even HEARD this paradigm discussed? No. I haven't..

 

[TemplarKormac]

They do not have a plan

Despite the fact that I just showed you a plan. Your ignorance seems willful, RW.

 

[rightwinger]

They do not have a plan

Despite the fact that I just showed you a plan. Your ignorance seems willful, RW.

A box of Band-Aids is not a healthcare plan

Show me one thing....How are Republicans going to cover pre-existing conditions without requiring mandatory coverage?

 

[WillReadmore]

They do not have a plan

Despite the fact that I just showed you a plan. Your ignorance seems willful, RW.

No, you're just wrong about that.

Even Ryan stated on the record to reporters that what they have is "ideas".

And, it's widely stated that there is significant disagreement within the GOP as to what direction a plan should take.

 

[WillReadmore]

Nothing that can't be fixed

You want expanded HSAs? Do it
Full tax deductions? Do it
More interstate sales? Do it

Keep the exchanges and make them more efficient

Want to REALLY fix things?
Single payer

I think the Schumer gang spent all their time coming up with the catchy poster slogan for the big Press event today. "Make America Sick Again". Most of the creative energy seems to be slogans and strategery. (Bless GW Bush for that word)..

You should tweet them.. You're further along than they are.

I like that.......almost as good as let em die

Republicans want to scrap Obamacare....show us something better first
It can't be that hard

It's REALLY REALLY hard when you have lawyers and career poly sci students and politicians PRETENDING they can fix it. Nothing's gonna happen until they step aside and bring in some folks that UNDERSTAND medical services and underwriting.

Not even your fantasy "single payer".. Which is the coward's way out of actually UNDERSTANDING how to deliver healthcare efficiently and accurately.

Lets start with getting employers out of the insurance business, eliminating insurance companies as a middle man, ending monopolies from big Pharm, openly advertising rates and fees

Why don't you and I and the other 5 rational people start an interest group and discuss this away from all the venom and hijinks and slogans. Seriously -- It's time to ditch the bovine manure.

One thing I've NEVER HEARD and don't understand is why we would EVER be "subsidizing insurance" if the problem is truly working poor and the chronically ill. The idea of pushing folks into high deductible policies as a "fix" for all that is brainless and inhumane.

Seems to ME -- you should be subsidizing DEDUCTIBLES and total OutOfPocket costs when services are DELIVERED instead.

Under THAT paradigm, you allow folks to cover what they can -- even if it's just CATASTROPHIC coverage.. And help them if shit happens. You could even MANDATE minimum coverage if you wanted to (based on income or paycheck to keep them from sandbagging. Make the minimum plan an automatic FICA deduction if you wanted to.

No more govt designed plans that cover EVERYTHING, including stuff you don't need. But provide no help when you NEED medical services with their high deductibles.

Subsidizing insurance premiums that get nibbled and inflated by Insurance carriers is stone stupid. The goal is to CUT the power of the Insurers and their enslavement of medical providers.

Have you ever even HEARD this paradigm discussed? No. I haven't..

I think your idea requires that government administer the program, examining care, doing means verification, and cutting subsidy checks that would arrive ... sometime, leaving providers and pharmacies in the lurch until money comes in, (or failing to provide needed care and meds until the government forwards the money first??).

Insurance companies are set manage health care.

Medicare is also set up to do that.

I think you have to base your proposal off of one of those two models.

 

[flacaltenn]

Let's look at an back of the envelope calculation on the O-Care insurance subsidy model and the "current wisdom" of building insurance pools for the benefit of insurance company underwriting --- versus providing "deductible and OOPocket relief" instead.

Every month O-Care writes very expensive checks that subsidize and inflate prices and insurance company profits.
But every month -- only likely 5% or less of those people have substantial CLAIMS on medical services. So if you're subsidizing $1000 each per month, $1M dollars covers 1000 insured. If 5% of those folks had claims over say $200, what kind of monthly ACTUAL services could be rendered? Well that's 50 people. $1Mill/50 = $20,000 each.

Chances of all them having $20,000/month? Slim. And if they had $10,000 OOPocket coverage? Even less subsidy required. And if the rate of Deductible and OOP subsidy is adjusted to NEED? Even less. You gotta conclude that DECREASING reliance on insurance coverage and pools would be a HUGE savings.

Now I know this SOUNDS a bit like "single payer", but it aint. Very far from it. Because 80% of America would be EXEMPT from receiving direct subsidies at all. But IT IS (kinda) a single payer plan that covers the initial problem that O-Care tried to address. Which was the UNINSURED and those mistreated and misclassified by the insurance companies. It also ain't "single payer" because it still puts the CONSUMER in charge of finding cost effective services. As the subsidy level would be such that the doctors and patients would have to understand the costs and budgets and be "market driven"...

 

[flacaltenn]

I think the Schumer gang spent all their time coming up with the catchy poster slogan for the big Press event today. "Make America Sick Again". Most of the creative energy seems to be slogans and strategery. (Bless GW Bush for that word)..

You should tweet them.. You're further along than they are.

I like that.......almost as good as let em die

Republicans want to scrap Obamacare....show us something better first
It can't be that hard

It's REALLY REALLY hard when you have lawyers and career poly sci students and politicians PRETENDING they can fix it. Nothing's gonna happen until they step aside and bring in some folks that UNDERSTAND medical services and underwriting.

Not even your fantasy "single payer".. Which is the coward's way out of actually UNDERSTANDING how to deliver healthcare efficiently and accurately.

Lets start with getting employers out of the insurance business, eliminating insurance companies as a middle man, ending monopolies from big Pharm, openly advertising rates and fees

Why don't you and I and the other 5 rational people start an interest group and discuss this away from all the venom and hijinks and slogans. Seriously -- It's time to ditch the bovine manure.

One thing I've NEVER HEARD and don't understand is why we would EVER be "subsidizing insurance" if the problem is truly working poor and the chronically ill. The idea of pushing folks into high deductible policies as a "fix" for all that is brainless and inhumane.

Seems to ME -- you should be subsidizing DEDUCTIBLES and total OutOfPocket costs when services are DELIVERED instead.

Under THAT paradigm, you allow folks to cover what they can -- even if it's just CATASTROPHIC coverage.. And help them if shit happens. You could even MANDATE minimum coverage if you wanted to (based on income or paycheck to keep them from sandbagging. Make the minimum plan an automatic FICA deduction if you wanted to.

No more govt designed plans that cover EVERYTHING, including stuff you don't need. But provide no help when you NEED medical services with their high deductibles.

Subsidizing insurance premiums that get nibbled and inflated by Insurance carriers is stone stupid. The goal is to CUT the power of the Insurers and their enslavement of medical providers.

Have you ever even HEARD this paradigm discussed? No. I haven't..

I think your idea requires that government administer the program, examining care, doing means verification, and cutting subsidy checks that would arrive ... sometime, leaving providers and pharmacies in the lurch until money comes in, (or failing to provide needed care and meds until the government forwards the money first??).

Insurance companies are set manage health care.

Medicare is also set up to do that.

I think you have to base your proposal off of one of those two models.

Time for the model to change. Patients are NOT the only victims. Doctors and service providers are being tortured with uncertainty on reimbursements. That's why the "rack rate" on drugs and services is a price that hardly ANYONE pays -- except the truly needy.

If you define a LEVEL of OOPocket subsidy that can be SPENT by a consumer with some type of catastrophic policy it can include approx the same "negotiated discounts" that insurance company "management" provides. Those negotiated prices are the REAL prices anyways. Otherwise medical services would be going bankrupt. Having the insurance companies CAPTURE and STRONGARM providers really does not add value.

Let consumers take their dollars right to Walgreens and CVS. Free them from the insurers. I assure you, there would SPECIAL Walmart stores created to handle the long lines. They'd get the message. WITHOUT all the layers of "management"..

 

[WillReadmore]

Let's look at an back of the envelope calculation on the O-Care insurance subsidy model and the "current wisdom" of building insurance pools for the benefit of insurance company underwriting --- versus providing "deductible and OOPocket relief" instead.

Every month O-Care writes very expensive checks that subsidize and inflate prices and insurance company profits.
But every month -- only likely 5% or less of those people have substantial CLAIMS on medical services. So if you're subsidizing $1000 each per month, $1M dollars covers 1000 insured. If 5% of those folks had claims over say $200, what kind of monthly ACTUAL services could be rendered? Well that's 50 people. $1Mill/50 = $20,000 each.

Chances of all them having $20,000/month? Slim. And if they had $10,000 OOPocket coverage? Even less subsidy required. And if the rate of Deductible and OOP subsidy is adjusted to NEED? Even less. You gotta conclude that DECREASING reliance on insurance coverage and pools would be a HUGE savings.

Now I know this SOUNDS a bit like "single payer", but it aint. Very far from it. Because 80% of America would be EXEMPT from receiving direct subsidies at all. But IT IS (kinda) a single payer plan that covers the initial problem that O-Care tried to address. Which was the UNINSURED and those mistreated and misclassified by the insurance companies. It also ain't "single payer" because it still puts the CONSUMER in charge of finding cost effective services. As the subsidy level would be such that the doctors and patients would have to understand the costs and budgets and be "market driven"...

Well, I really like your objective here. Covering all Americans is an important objective as we need people to be healthy as those who aren't healthy are going to get more support than just health care and they aren't going to be moving America forward.

I'm not in favor of having another health care administration system. We already have VA, Medicare/Medicaid and insurance companies.

It's hard to design a system in one or two posts in a thread like this, so while I don't really understand how your idea would work, I'm not interested in knocking you for that. We do need to be thinking about new ideas - if for no other reason than as prep for understanding what congress could propose.

 

[WillReadmore]

I like that.......almost as good as let em die

Republicans want to scrap Obamacare....show us something better first
It can't be that hard

It's REALLY REALLY hard when you have lawyers and career poly sci students and politicians PRETENDING they can fix it. Nothing's gonna happen until they step aside and bring in some folks that UNDERSTAND medical services and underwriting.

Not even your fantasy "single payer".. Which is the coward's way out of actually UNDERSTANDING how to deliver healthcare efficiently and accurately.

Lets start with getting employers out of the insurance business, eliminating insurance companies as a middle man, ending monopolies from big Pharm, openly advertising rates and fees

Why don't you and I and the other 5 rational people start an interest group and discuss this away from all the venom and hijinks and slogans. Seriously -- It's time to ditch the bovine manure.

One thing I've NEVER HEARD and don't understand is why we would EVER be "subsidizing insurance" if the problem is truly working poor and the chronically ill. The idea of pushing folks into high deductible policies as a "fix" for all that is brainless and inhumane.

Seems to ME -- you should be subsidizing DEDUCTIBLES and total OutOfPocket costs when services are DELIVERED instead.

Under THAT paradigm, you allow folks to cover what they can -- even if it's just CATASTROPHIC coverage.. And help them if shit happens. You could even MANDATE minimum coverage if you wanted to (based on income or paycheck to keep them from sandbagging. Make the minimum plan an automatic FICA deduction if you wanted to.

No more govt designed plans that cover EVERYTHING, including stuff you don't need. But provide no help when you NEED medical services with their high deductibles.

Subsidizing insurance premiums that get nibbled and inflated by Insurance carriers is stone stupid. The goal is to CUT the power of the Insurers and their enslavement of medical providers.

Have you ever even HEARD this paradigm discussed? No. I haven't..

I think your idea requires that government administer the program, examining care, doing means verification, and cutting subsidy checks that would arrive ... sometime, leaving providers and pharmacies in the lurch until money comes in, (or failing to provide needed care and meds until the government forwards the money first??).

Insurance companies are set manage health care.

Medicare is also set up to do that.

I think you have to base your proposal off of one of those two models.

Time for the model to change. Patients are NOT the only victims. Doctors and service providers are being tortured with uncertainty on reimbursements. That's why the "rack rate" on drugs and services is a price that hardly ANYONE pays -- except the truly needy.

Today it is insurance companies that cause the payment problem, obviously, as they are the ones who pay providers.

No, every other country pays far less in drug prices, because those in America buying drugs (pharmacies, doctors, Medicare, insurance companies, etc.) are not allowed to shop for better prices.

My experience without insurance is that providers will almost always give a price break of between 20% and 30% to cash customers. Pharmacies can't do that, of course.

Insurance companies nail down prices with those who want to be part of their provider networks. If a provider wants too much, insurance companies will drop them from their network in favor of a cheaper provider.

 

[flacaltenn]

Let's look at an back of the envelope calculation on the O-Care insurance subsidy model and the "current wisdom" of building insurance pools for the benefit of insurance company underwriting --- versus providing "deductible and OOPocket relief" instead.

Every month O-Care writes very expensive checks that subsidize and inflate prices and insurance company profits.
But every month -- only likely 5% or less of those people have substantial CLAIMS on medical services. So if you're subsidizing $1000 each per month, $1M dollars covers 1000 insured. If 5% of those folks had claims over say $200, what kind of monthly ACTUAL services could be rendered? Well that's 50 people. $1Mill/50 = $20,000 each.

Chances of all them having $20,000/month? Slim. And if they had $10,000 OOPocket coverage? Even less subsidy required. And if the rate of Deductible and OOP subsidy is adjusted to NEED? Even less. You gotta conclude that DECREASING reliance on insurance coverage and pools would be a HUGE savings.

Now I know this SOUNDS a bit like "single payer", but it aint. Very far from it. Because 80% of America would be EXEMPT from receiving direct subsidies at all. But IT IS (kinda) a single payer plan that covers the initial problem that O-Care tried to address. Which was the UNINSURED and those mistreated and misclassified by the insurance companies. It also ain't "single payer" because it still puts the CONSUMER in charge of finding cost effective services. As the subsidy level would be such that the doctors and patients would have to understand the costs and budgets and be "market driven"...

Well, I really like your objective here. Covering all Americans is an important objective as we need people to be healthy as those who aren't healthy are going to get more support than just health care and they aren't going to be moving America forward.

I'm not in favor of having another health care administration system. We already have VA, Medicare/Medicaid and insurance companies.

It's hard to design a system in one or two posts in a thread like this, so while I don't really understand how your idea would work, I'm not interested in knocking you for that. We do need to be thinking about new ideas - if for no other reason than as prep for understanding what congress could propose.

I've begun to research and fill this out. But OBVIOUSLY, if the PREMIUMS are being subsidized right now (along with the dark money rebates to the insurers for stop loss) -- then the DEDUCTIBLES can be subsidized in the same fashion WITHOUT the natural expectation of inflating PREMIUM costs.

You can't really "inflate" the Deductibles if you covering folks who can only afford a catastrophic plan anyways. Can you??

 

[WillReadmore]

I like that.......almost as good as let em die

Republicans want to scrap Obamacare....show us something better first
It can't be that hard

It's REALLY REALLY hard when you have lawyers and career poly sci students and politicians PRETENDING they can fix it. Nothing's gonna happen until they step aside and bring in some folks that UNDERSTAND medical services and underwriting.

Not even your fantasy "single payer".. Which is the coward's way out of actually UNDERSTANDING how to deliver healthcare efficiently and accurately.

Lets start with getting employers out of the insurance business, eliminating insurance companies as a middle man, ending monopolies from big Pharm, openly advertising rates and fees

Why don't you and I and the other 5 rational people start an interest group and discuss this away from all the venom and hijinks and slogans. Seriously -- It's time to ditch the bovine manure.

One thing I've NEVER HEARD and don't understand is why we would EVER be "subsidizing insurance" if the problem is truly working poor and the chronically ill. The idea of pushing folks into high deductible policies as a "fix" for all that is brainless and inhumane.

Seems to ME -- you should be subsidizing DEDUCTIBLES and total OutOfPocket costs when services are DELIVERED instead.

Under THAT paradigm, you allow folks to cover what they can -- even if it's just CATASTROPHIC coverage.. And help them if shit happens. You could even MANDATE minimum coverage if you wanted to (based on income or paycheck to keep them from sandbagging. Make the minimum plan an automatic FICA deduction if you wanted to.

No more govt designed plans that cover EVERYTHING, including stuff you don't need. But provide no help when you NEED medical services with their high deductibles.

Subsidizing insurance premiums that get nibbled and inflated by Insurance carriers is stone stupid. The goal is to CUT the power of the Insurers and their enslavement of medical providers.

Have you ever even HEARD this paradigm discussed? No. I haven't..

I think your idea requires that government administer the program, examining care, doing means verification, and cutting subsidy checks that would arrive ... sometime, leaving providers and pharmacies in the lurch until money comes in, (or failing to provide needed care and meds until the government forwards the money first??).

Insurance companies are set manage health care.

Medicare is also set up to do that.

I think you have to base your proposal off of one of those two models.

Time for the model to change. Patients are NOT the only victims. Doctors and service providers are being tortured with uncertainty on reimbursements. That's why the "rack rate" on drugs and services is a price that hardly ANYONE pays -- except the truly needy.

If you define a LEVEL of OOPocket subsidy that can be SPENT by a consumer with some type of catastrophic policy it can include approx the same "negotiated discounts" that insurance company "management" provides. Those negotiated prices are the REAL prices anyways. Otherwise medical services would be going bankrupt. Having the insurance companies CAPTURE and STRONGARM providers really does not add value.

Let consumers take their dollars right to Walgreens and CVS. Free them from the insurers. I assure you, there would SPECIAL Walmart stores created to handle the long lines. They'd get the message. WITHOUT all the layers of "management"..

You haven't explained what agency would be administering this idea of yours, or how a patient would get the money they need for their meds before walking into the pharmacy - or getting wheeled in for heart surgery.

I'm not in favor of another federal administration branch. We already have two, plus we have insurance companies.

My preference remains Medicare for all, with the VA being more of a specialty service available more broadly, as I don't know why segregating vets makes care any better.

Belgium and others have insurance companies that offer coverage for stuff the state solution doesn't cover. That's fine with me, as it means the state solution doesn't have to pay for everything you could ever want.

If every American had Medicare, we would improve it.

 

[WillReadmore]

Let's look at an back of the envelope calculation on the O-Care insurance subsidy model and the "current wisdom" of building insurance pools for the benefit of insurance company underwriting --- versus providing "deductible and OOPocket relief" instead.

Every month O-Care writes very expensive checks that subsidize and inflate prices and insurance company profits.
But every month -- only likely 5% or less of those people have substantial CLAIMS on medical services. So if you're subsidizing $1000 each per month, $1M dollars covers 1000 insured. If 5% of those folks had claims over say $200, what kind of monthly ACTUAL services could be rendered? Well that's 50 people. $1Mill/50 = $20,000 each.

Chances of all them having $20,000/month? Slim. And if they had $10,000 OOPocket coverage? Even less subsidy required. And if the rate of Deductible and OOP subsidy is adjusted to NEED? Even less. You gotta conclude that DECREASING reliance on insurance coverage and pools would be a HUGE savings.

Now I know this SOUNDS a bit like "single payer", but it aint. Very far from it. Because 80% of America would be EXEMPT from receiving direct subsidies at all. But IT IS (kinda) a single payer plan that covers the initial problem that O-Care tried to address. Which was the UNINSURED and those mistreated and misclassified by the insurance companies. It also ain't "single payer" because it still puts the CONSUMER in charge of finding cost effective services. As the subsidy level would be such that the doctors and patients would have to understand the costs and budgets and be "market driven"...

Well, I really like your objective here. Covering all Americans is an important objective as we need people to be healthy as those who aren't healthy are going to get more support than just health care and they aren't going to be moving America forward.

I'm not in favor of having another health care administration system. We already have VA, Medicare/Medicaid and insurance companies.

It's hard to design a system in one or two posts in a thread like this, so while I don't really understand how your idea would work, I'm not interested in knocking you for that. We do need to be thinking about new ideas - if for no other reason than as prep for understanding what congress could propose.

I've begun to research and fill this out. But OBVIOUSLY, if the PREMIUMS are being subsidized right now (along with the dark money rebates to the insurers for stop loss) -- then the DEDUCTIBLES can be subsidized in the same fashion WITHOUT the natural expectation of inflating PREMIUM costs.

You can't really "inflate" the Deductibles if you covering folks who can only afford a catastrophic plan anyways. Can you??

Yes, we could subsidize deductibles, but that would require an agency to do that. Someone would need to determine whether each particular deductible qualified. And, there would have to be management for all those doing that job.

I'm not as concerned about the price inflation you mention, as insurance companies have been providing downward pressure on cost of service.

 

[flacaltenn]

Let's look at an back of the envelope calculation on the O-Care insurance subsidy model and the "current wisdom" of building insurance pools for the benefit of insurance company underwriting --- versus providing "deductible and OOPocket relief" instead.

Every month O-Care writes very expensive checks that subsidize and inflate prices and insurance company profits.
But every month -- only likely 5% or less of those people have substantial CLAIMS on medical services. So if you're subsidizing $1000 each per month, $1M dollars covers 1000 insured. If 5% of those folks had claims over say $200, what kind of monthly ACTUAL services could be rendered? Well that's 50 people. $1Mill/50 = $20,000 each.

Chances of all them having $20,000/month? Slim. And if they had $10,000 OOPocket coverage? Even less subsidy required. And if the rate of Deductible and OOP subsidy is adjusted to NEED? Even less. You gotta conclude that DECREASING reliance on insurance coverage and pools would be a HUGE savings.

Now I know this SOUNDS a bit like "single payer", but it aint. Very far from it. Because 80% of America would be EXEMPT from receiving direct subsidies at all. But IT IS (kinda) a single payer plan that covers the initial problem that O-Care tried to address. Which was the UNINSURED and those mistreated and misclassified by the insurance companies. It also ain't "single payer" because it still puts the CONSUMER in charge of finding cost effective services. As the subsidy level would be such that the doctors and patients would have to understand the costs and budgets and be "market driven"...

Well, I really like your objective here. Covering all Americans is an important objective as we need people to be healthy as those who aren't healthy are going to get more support than just health care and they aren't going to be moving America forward.

I'm not in favor of having another health care administration system. We already have VA, Medicare/Medicaid and insurance companies.

It's hard to design a system in one or two posts in a thread like this, so while I don't really understand how your idea would work, I'm not interested in knocking you for that. We do need to be thinking about new ideas - if for no other reason than as prep for understanding what congress could propose.

I've begun to research and fill this out. But OBVIOUSLY, if the PREMIUMS are being subsidized right now (along with the dark money rebates to the insurers for stop loss) -- then the DEDUCTIBLES can be subsidized in the same fashion WITHOUT the natural expectation of inflating PREMIUM costs.

You can't really "inflate" the Deductibles if you covering folks who can only afford a catastrophic plan anyways. Can you??

Yes, we could subsidize deductibles, but that would require an agency to do that. Someone would need to determine whether each particular deductible qualified. And, there would have to be management for all those doing that job.

I'm not as concerned about the price inflation you mention, as insurance companies have been providing downward pressure on cost of service.

Don't need a need oversight/mgt agency.. .The SAME agencies that are boosting people's income and personal info for ObamaCare can subsidize ACTUAL COSTS rather than the insurance premium. Whether that service "qualifies" would be spelled out in the "catastrophic" coverage policy. Just like deductibles are qualified for coverage now. If there's a service network specified -- also determines "eligibility" for that payment..

Could be done as 20/80, 50/50, 80/20 or other ratios depending on "need" -- or just as max/month or any other flexible formula. .. Just like "need" is established for Medicare or O-care subsidies.

Actually puts TAXPAYER dollars towards patient/provider interactions. and the closer you GET to that -- the more efficient the spending becomes.

 

[WillReadmore]

Let's look at an back of the envelope calculation on the O-Care insurance subsidy model and the "current wisdom" of building insurance pools for the benefit of insurance company underwriting --- versus providing "deductible and OOPocket relief" instead.

Every month O-Care writes very expensive checks that subsidize and inflate prices and insurance company profits.
But every month -- only likely 5% or less of those people have substantial CLAIMS on medical services. So if you're subsidizing $1000 each per month, $1M dollars covers 1000 insured. If 5% of those folks had claims over say $200, what kind of monthly ACTUAL services could be rendered? Well that's 50 people. $1Mill/50 = $20,000 each.

Chances of all them having $20,000/month? Slim. And if they had $10,000 OOPocket coverage? Even less subsidy required. And if the rate of Deductible and OOP subsidy is adjusted to NEED? Even less. You gotta conclude that DECREASING reliance on insurance coverage and pools would be a HUGE savings.

Now I know this SOUNDS a bit like "single payer", but it aint. Very far from it. Because 80% of America would be EXEMPT from receiving direct subsidies at all. But IT IS (kinda) a single payer plan that covers the initial problem that O-Care tried to address. Which was the UNINSURED and those mistreated and misclassified by the insurance companies. It also ain't "single payer" because it still puts the CONSUMER in charge of finding cost effective services. As the subsidy level would be such that the doctors and patients would have to understand the costs and budgets and be "market driven"...

Well, I really like your objective here. Covering all Americans is an important objective as we need people to be healthy as those who aren't healthy are going to get more support than just health care and they aren't going to be moving America forward.

I'm not in favor of having another health care administration system. We already have VA, Medicare/Medicaid and insurance companies.

It's hard to design a system in one or two posts in a thread like this, so while I don't really understand how your idea would work, I'm not interested in knocking you for that. We do need to be thinking about new ideas - if for no other reason than as prep for understanding what congress could propose.

I've begun to research and fill this out. But OBVIOUSLY, if the PREMIUMS are being subsidized right now (along with the dark money rebates to the insurers for stop loss) -- then the DEDUCTIBLES can be subsidized in the same fashion WITHOUT the natural expectation of inflating PREMIUM costs.

You can't really "inflate" the Deductibles if you covering folks who can only afford a catastrophic plan anyways. Can you??

Yes, we could subsidize deductibles, but that would require an agency to do that. Someone would need to determine whether each particular deductible qualified. And, there would have to be management for all those doing that job.

I'm not as concerned about the price inflation you mention, as insurance companies have been providing downward pressure on cost of service.

Don't need a need oversight/mgt agency.. .The SAME agencies that are boosting people's income and personal info for ObamaCare can subsidize ACTUAL COSTS rather than the insurance premium. Whether that service "qualifies" would be spelled out in the "catastrophic" coverage policy. Just like deductibles are qualified for coverage now. If there's a service network specified -- also determines "eligibility" for that payment..

Could be done as 20/80, 50/50, 80/20 or other ratios depending on "need" -- or just as max/month or any other flexible formula. .. Just like "need" is established for Medicare or O-care subsidies.

Actually puts TAXPAYER dollars towards patient/provider interactions. and the closer you GET to that -- the more efficient the spending becomes.

Administration of your idea would require looking at individual payments to providers. We're not going to give people a percent of whatever they claim they spent without even looking at the bill. Medicare does that. They have lists of qualified providers and policy on various procedures and medications. They don't just pump out checks for whatever people say they paid to whomever they decided to pay money.

But, I don't believe you are suggesting that these people who are only subsidized today would be moved to Medicare.

Today, ACA is limited to screening for subsidizing payments for insurance companies to do that job of administering health care payments.