Concerns over dumping Obamacare growing among GOP lawmakers

[Freewill]

So what you are saying is that the democrats couldn't craft a law that made sense without the Republicans. It does appear that by the results you are right. Maybe there isn't anything better, or even doing nothing would have been better.

My wish is just expanding the current Medicare/Medicare Supplement/Medicare Advantage system to all.

• Efficient mix of public foundation, preventive/diagnostic coverage, free market competition and innovation
• Opens up massive new insurance & delivery markets
  
• Perfectly scalable, already works well, all admin systems are in place
  
• Totally individual & portable
• Takes a huge cost monkey off the backs of employers
• Flushes our stupid 7-headed delivery/payment system right down the toilet

All they have to do is DO it, but that would require a little humility, bravery and cooperation.

Can't have that!
.

Here is a very simple explanation of why the US costs are almost twice other countries, such as Japan and Britan.

The sources of difference:

1. U.S. spending annual on physicians per capita is about five times higher than peer countries: $1,600 versus $310 in a sample of peer countries, a difference of $1,290 per capita or $390 billion nationally, 37% of the health care spending gap.

2. The high level of per capita income in the U.S. is a major factor driving U.S. health care spending. The U.S. has higher per capita income than any other large country, and higher income is closely associated with higher health care spending.

3. Dartmouth University has analyzed differences in health care costs between U.S. regions, comparing the highest-cost quintile of U.S. regions to the lowest-cost. Its research shows a spending variation of $2,300 per capita after taking account of differences in health status, income, and ethnicity (source). And health outcomes are no better in the high spending regions than in the low spending regions. Dartmouth attributes the gap to regional differences in discretionary medical decisions driving higher patient referral rates for high-cost advanced care (specialists, hospitalization, CAT and MRI scans, etc.). If the entire country were brought to the spending level of the lowest quintile, the savings would be about $750 per capita: $225 billion or 21% of the gap.

Why Are U.S. Health Care Costs So High?

I would question how any of your suggestions solves any of those problems. Eliminate all administrative costs that that only lowers the cost about 5 percent, and you know that can't happen.

Do you think that those who pay less for their health care in other countries probably spend less for their cars and houses? Because they have less income as the article states.

So it would seem that because we have more money we spend more money.

How to you propose lowering doctor salary? Or how do you propose lowing US income?

I'm afraid I don't see what that data has to do with my points. Trying to dig down here - are you saying that people who can't afford health insurance would be able to do so if they were more careful with their spending habits? And if so, how in the world would lowering US incomes help that?

I'm talking about efficiencies, ease of use and competition. Examples:

• Having basic access to preventive & diagnostic services would catch small health issues before they became big health issues.
• The vastly expanded preventive/diagnostic market would create a huge new health market in itself, for more competition & innovation.
  
• Having a market of 330+ million customers would massively increase competition & innovation among the insurance companies.
• The Medicare Supplement/Medicare Advantage program is consistent and far easier for consumers to understand and utilize.
  
• Getting rid of the insane 7-headed monster that is currently our health "system" (ha) would create significant new efficiencies.

Regarding doctors, there would be two contracts, as it is with the current Medicare/Medicare Advantage/Medicare Supplement system: One with the government, one with the insurance companies. Providers and provider groups would be able to negotiate for the best deals, given the makeup of their practices. We could take some of the cost of doing business down by changing tort law and allowing them to decrease and minimize defensive medicine practices. Once we've done this, we look at what the plan would cost overall. And yes, for all the benefits described above, there may (or may not) be more taxes required.

If the GOP has a plan that could do all of that, I'd freakin' love to see it. Do they?

And one more question: Do you know how the Medicare/Medicare Advantage/Medicare Supplement system works?
.

The Forbes' article points out that the gap between the US and other countries was simplified to three componets.

1. doctor salaries being twice what they are in other countries. No amount of competition can bring that gap down without dropping what doctors earn.

2. America on a whole are paid more than other countries, thus there is logically a gap. Kinda like we all use gasoline but the price varies country to country for the same exact thing.

3. One issue the Forbes article points out is there is a difference in cost dependent on area of the country. It appears that if a area has an MRI they they are going to use that MRI which costs money but does not necessarily aid to producing good results. Again, how is that changed? By refusing to pay for the MRI?

As for your last question. As I see Medicare working they have established what they will pay to providers. The providers then can either accept or reject that payment and thus reject the patient. By buying an advantage plan the provider still dictates what they are going to pay for services. So as I understand it the government gives the provider a chunk of money and from that chunk they pay for care. What I heard was it is 800/month, I am not sure if that number is correct, see below. If it is then that is approximately a 1/3 higher than what I bought on ACA. The premium for medicare is based on income. It varies from 108 to 150 or there abouts. Once signed on with an advantage plan medicare is out of the picture and the person is covered under the advantage plan provider.

I do see competition in the medicare system. Apparently because the government actually pays so much per person. When I signed up for my advantage plan I was not asked one question about my health.

Here are some eye popping information concerning health care expenditures. There is no way that my provider spends near that amount of money for my health care.

NHE by Age Group and Gender, Selected Years 2002, 2004, 2006, 2008, 2010, and 2012:

• Per person personal health care spending for the 65 and older population was $18,988 in 2012, over 5 times higher than spending per child ($3,552) and approximately 3 times the spending per working-age person ($6,632).
• In 2012, children accounted for approximately 25 percent of the population and slightly less than 12 percent of all PHC spending.
• The working-age group comprised the majority of spending and population in 2012, almost 54 percent and over 61 percent respectively.
• The elderly were the smallest population group, nearly 14 percent of the population, and accounted for approximately 34 percent of all spending in 2012.
• Per person spending for females ($8,315) was 22 percent more than males ($6,788) in 2012.
• In 2012, per person spending for male children (0-18) was 9 percent more than females. However, for the working age and elderly groups, per person spending for females was 28 and 7 percent more than for males.

NHE Fact Sheet - Centers for Medicare & Medicaid Services

Too much.

I've provided my specific proposal with specific rationales, what's yours?
.

• Having basic access to preventive & diagnostic services would catch small health issues before they became big health issues.

Already done in Obamacare, so this would have little effect on the cost.

• The vastly expanded preventive/diagnostic market would create a huge new health market in itself, for more competition & innovation.

How so? Who now does not have healthcare insurance that doesn't already cover basic preventative/diagnostic care? It is part of the ACA all medical plans provide for it.

Having 1 doctor for 10 patients cost X, having 1 doctor for 100 patients cost many times X. Since the vast majority of Americans have healthcare insurance adding millions more that will not be paying a dime into the system is not going to lower prices, it simple can not.

• Having a market of 330+ million customers would massively increase competition & innovation among the insurance companies.

That is already the market size and there is competition between insurance companies. There are more then a few so obviously they are already competing for the same people.

• The Medicare Supplement/Medicare Advantage program is consistent and far easier for consumers to understand and utilize.

Easier then what? ACA? I have done both, neither are hard. The hard part is finding the best price in both systems. ACA was actually easier in that regard because a person had to pick a plan out of three that paid different amounts. With medicare only the company and their benefits needed determined. And neither were as easy as company sponsored health care insurance.

• Getting rid of the insane 7-headed monster that is currently our health "system" (ha) would create significant new efficiencies.

Again, I don't see how since the ACA was suppose to make medical records "travel" with a person.

Here are a few of my proposals.

1. Open the VA to all military veterans, even if it required those making money to pay a premium.

2. If a person is on Medicare or VA then they can opt out of company sponsored healthcare and get at least part of the premium paid to employees paid to them. Not using the company insurance is actually a windfall for the company.

3. Do what the VA is doing now, share specialists via video chat.

As to the real cost of healthcare I defer to the Forbes article.

 

[Vandalshandle]

I would question how any of your suggestions solves any of those problems. Eliminate all administrative costs that that only lowers the cost about 5 percent, and you know that can't happen.

Do you think that those who pay less for their health care in other countries probably spend less for their cars and houses? Because they have less income as the article states.

So it would seem that because we have more money we spend more money.

How to you propose lowering doctor salary? Or how do you propose lowing US income?

Back in the early 80's I was working for a medical company. They decided to use part of the building as a pharmacy so they could mix medications for our customers.

One day after our weekly Monday morning meeting, we started a discussion by the coffee pot of the UPS strike that was going on at the time. As we talked, our newest coworker (the pharmacist) just listened in. She didn't say a word, but her face turned red with anger and she abruptly walked away. We kind of looked at each other like WTF?????

As usual, I was the last person standing by the coffee pot, and she returned. In her hand was a pharmacy magazine she subscribed to. The magazine was opened to an article they had about the UPS strike. She highlighted the section stating that a UPS driver made between 50K and 55K a year. A pharmacist made on average 60K a year.

In rage she said "Do you believe THESE people are going on strike? Do you know what my parents went through to put me through college to be a pharmacists? Do you know what I went through? For what, to make a crummy five or ten grand a year than a UPS driver, and that's not enough for them? I should be the one on strike!!!"

It wasn't long before our country started to run short on pharmacists, nurses, and other medical professionals. Why should they spend money for all that education if they are only going to make the wages of a UPS driver, auto plant worker, or a steel plant worker?

The only way to lure these people into such careers is to pay them much better than a floor sweeper at Ford. And of course, that's one of the reasons medical costs are what they are today.

My X-wife is a pharmacist, and makes $105,000 per year. For that, she takes pills out of a big bottle and puts them in a small bottle. A pharmacist in Mexico makes about $16,000 per year. That is because pills in Mexico come prepackaged like the way our aspirin does. So why does this situation exist? Because the pharmacy lobby put into law in every state that nobody other than a licensed pharmacist may touch a controlled substance and that they can not be prepackaged, except for certain exceptions, like birth control pills. In short, We could cut pharmacist pay to about $35,000, per year, if they did not have such powerful lobbies in Washington. Not that I am complaining. We lived quite well with her paycheck, even though her job bored her to tears.

 

[Freewill]

I would question how any of your suggestions solves any of those problems. Eliminate all administrative costs that that only lowers the cost about 5 percent, and you know that can't happen.

Do you think that those who pay less for their health care in other countries probably spend less for their cars and houses? Because they have less income as the article states.

So it would seem that because we have more money we spend more money.

How to you propose lowering doctor salary? Or how do you propose lowing US income?

Back in the early 80's I was working for a medical company. They decided to use part of the building as a pharmacy so they could mix medications for our customers.

One day after our weekly Monday morning meeting, we started a discussion by the coffee pot of the UPS strike that was going on at the time. As we talked, our newest coworker (the pharmacist) just listened in. She didn't say a word, but her face turned red with anger and she abruptly walked away. We kind of looked at each other like WTF?????

As usual, I was the last person standing by the coffee pot, and she returned. In her hand was a pharmacy magazine she subscribed to. The magazine was opened to an article they had about the UPS strike. She highlighted the section stating that a UPS driver made between 50K and 55K a year. A pharmacist made on average 60K a year.

In rage she said "Do you believe THESE people are going on strike? Do you know what my parents went through to put me through college to be a pharmacists? Do you know what I went through? For what, to make a crummy five or ten grand a year than a UPS driver, and that's not enough for them? I should be the one on strike!!!"

It wasn't long before our country started to run short on pharmacists, nurses, and other medical professionals. Why should they spend money for all that education if they are only going to make the wages of a UPS driver, auto plant worker, or a steel plant worker?

The only way to lure these people into such careers is to pay them much better than a floor sweeper at Ford. And of course, that's one of the reasons medical costs are what they are today.

My X-wife is a pharmacist, and makes $105,000 per year. For that, she takes pills out of a big bottle and puts them in a small bottle. A pharmacist in Mexico makes about $16,000 per year. That is because pills in Mexico come prepackaged like the way our aspirin does. So why does this situation exist? Because the pharmacy lobby put into law in every state that nobody other than a licensed pharmacist may touch a controlled substance and that they can not be prepackaged, except for certain exceptions, like birth control pills. In short, We could cut pharmacist pay to about $35,000, per year, if they did not have such powerful lobbies in Washington. Not that I am complaining. We lived quite well with her paycheck, even though her job bored her to tears.

Some times I will pick up a prescription and they are in a sealed container. I am thinking that the pharmacist is just too busy or lazy to open the container and put it into their containers. So it makes me wonder, why can't this just be mail order?

 

[Ray From Cleveland]

I would question how any of your suggestions solves any of those problems. Eliminate all administrative costs that that only lowers the cost about 5 percent, and you know that can't happen.

Do you think that those who pay less for their health care in other countries probably spend less for their cars and houses? Because they have less income as the article states.

So it would seem that because we have more money we spend more money.

How to you propose lowering doctor salary? Or how do you propose lowing US income?

Back in the early 80's I was working for a medical company. They decided to use part of the building as a pharmacy so they could mix medications for our customers.

One day after our weekly Monday morning meeting, we started a discussion by the coffee pot of the UPS strike that was going on at the time. As we talked, our newest coworker (the pharmacist) just listened in. She didn't say a word, but her face turned red with anger and she abruptly walked away. We kind of looked at each other like WTF?????

As usual, I was the last person standing by the coffee pot, and she returned. In her hand was a pharmacy magazine she subscribed to. The magazine was opened to an article they had about the UPS strike. She highlighted the section stating that a UPS driver made between 50K and 55K a year. A pharmacist made on average 60K a year.

In rage she said "Do you believe THESE people are going on strike? Do you know what my parents went through to put me through college to be a pharmacists? Do you know what I went through? For what, to make a crummy five or ten grand a year than a UPS driver, and that's not enough for them? I should be the one on strike!!!"

It wasn't long before our country started to run short on pharmacists, nurses, and other medical professionals. Why should they spend money for all that education if they are only going to make the wages of a UPS driver, auto plant worker, or a steel plant worker?

The only way to lure these people into such careers is to pay them much better than a floor sweeper at Ford. And of course, that's one of the reasons medical costs are what they are today.

My X-wife is a pharmacist, and makes $105,000 per year. For that, she takes pills out of a big bottle and puts them in a small bottle. A pharmacist in Mexico makes about $16,000 per year. That is because pills in Mexico come prepackaged like the way our aspirin does. So why does this situation exist? Because the pharmacy lobby put into law in every state that nobody other than a licensed pharmacist may touch a controlled substance and that they can not be prepackaged, except for certain exceptions, like birth control pills. In short, We could cut pharmacist pay to about $35,000, per year, if they did not have such powerful lobbies in Washington. Not that I am complaining. We lived quite well with her paycheck, even though her job bored her to tears.

It's not the complexity of the job, but rather the education (and money) it takes to be a pharmacist. A pharmacist is only one step behind from being a medial doctor. That's why they can now prescribe antibiotics, give flu shots, and various other things only doctors were allowed to do in the past.

 

[Ray From Cleveland]

I would question how any of your suggestions solves any of those problems. Eliminate all administrative costs that that only lowers the cost about 5 percent, and you know that can't happen.

Do you think that those who pay less for their health care in other countries probably spend less for their cars and houses? Because they have less income as the article states.

So it would seem that because we have more money we spend more money.

How to you propose lowering doctor salary? Or how do you propose lowing US income?

Back in the early 80's I was working for a medical company. They decided to use part of the building as a pharmacy so they could mix medications for our customers.

One day after our weekly Monday morning meeting, we started a discussion by the coffee pot of the UPS strike that was going on at the time. As we talked, our newest coworker (the pharmacist) just listened in. She didn't say a word, but her face turned red with anger and she abruptly walked away. We kind of looked at each other like WTF?????

As usual, I was the last person standing by the coffee pot, and she returned. In her hand was a pharmacy magazine she subscribed to. The magazine was opened to an article they had about the UPS strike. She highlighted the section stating that a UPS driver made between 50K and 55K a year. A pharmacist made on average 60K a year.

In rage she said "Do you believe THESE people are going on strike? Do you know what my parents went through to put me through college to be a pharmacists? Do you know what I went through? For what, to make a crummy five or ten grand a year than a UPS driver, and that's not enough for them? I should be the one on strike!!!"

It wasn't long before our country started to run short on pharmacists, nurses, and other medical professionals. Why should they spend money for all that education if they are only going to make the wages of a UPS driver, auto plant worker, or a steel plant worker?

The only way to lure these people into such careers is to pay them much better than a floor sweeper at Ford. And of course, that's one of the reasons medical costs are what they are today.

I guess if a person is going to rate their worth to that of another I understand the woman's concern. I would hope she chose to be a pharmacist because that is what she wanted to do verses delivering packages in the hot and cold.

Don't take this wrongly but I can see by and largely what a pharmacist does that couldn't be done by machine. Basically they count out pills. I know, oversimplification. Drug interactions are flagged by a computer anyway.

Never the less one of the components in the cost of health care is doctor's, nurse's and pharmacist wages. That, as you pointed out, will be very hard to change when a UPS driver is making what a nurse might earn.

Sure, I wouldn't want to spend all that time and money unless I was going to be much further ahead than some parts inspector on an assembly line. Yes, there should be some passion when choosing a career in college, but you have to look at the money as well. Passion doesn't pay the hundred or so thousand you borrowed to go to school.

Yes, these unions were responsible for non-skilled labor to make great money, but it has a ripple effect such as in our healthcare.

My point is that her wages were not dictated by what the UPS guy makes. When she went in she had to know what the payoff would be. What the UPS guy makes has no effect on what she would make. I think what we are discussing is "fairness."

Correct, but the point is why go through six years of college to make nearly the same kind of money that somebody with a no skill job can make?

When our pharmacist went to school, manual labor was paid a much lower rate. Thanks to unions, they crept up to what professional people made.

So a younger person had two choices to make at that time: one is to attend college, not earn an income for those six years, get a degree in something and start making money at the age of 25, or become a UPS driver and make that kind of money right away at the age of 18.

In other words, it would be stupid to pursue a professional career when non-professional careers paid nearly the same. Many professional people (like my nephew) end up paying for their education past the age of 35. Where is the reward for that?

 

[Vandalshandle]

"It's not the complexity of the job, but rather the education (and money) it takes to be a pharmacist. A pharmacist is only one step behind from being a medial doctor. That's why they can now prescribe antibiotics, give flu shots, and various other things only doctors were allowed to do in the past."

reply

I get my flue shot from a phlebotomist who is a pharmacy clerk at Safeway (not a pharmacist). I get my pills after I reach the Medicare donut hole from a Mexican pharmacist who makes less money than the guy who used to mow my lawn. The whole profession is seriously overrated because of their lobby.

 

[Care4all]

Once working in the field, the pharmacist's salary will go up much faster than the UPS guy...

the UPS guy will have to live with back pain and knee pain and arthritis the rest of his life and retire early at 55,

never earning the money the pharmacist was able to earn in their lifetime...

regardless, the only way to live life, is to work in a field you love.....it isn't always about money, but your chances are greater in making good money, if you are working in a field you love.

 

[Vandalshandle]

I would question how any of your suggestions solves any of those problems. Eliminate all administrative costs that that only lowers the cost about 5 percent, and you know that can't happen.

Do you think that those who pay less for their health care in other countries probably spend less for their cars and houses? Because they have less income as the article states.

So it would seem that because we have more money we spend more money.

How to you propose lowering doctor salary? Or how do you propose lowing US income?

Back in the early 80's I was working for a medical company. They decided to use part of the building as a pharmacy so they could mix medications for our customers.

One day after our weekly Monday morning meeting, we started a discussion by the coffee pot of the UPS strike that was going on at the time. As we talked, our newest coworker (the pharmacist) just listened in. She didn't say a word, but her face turned red with anger and she abruptly walked away. We kind of looked at each other like WTF?????

As usual, I was the last person standing by the coffee pot, and she returned. In her hand was a pharmacy magazine she subscribed to. The magazine was opened to an article they had about the UPS strike. She highlighted the section stating that a UPS driver made between 50K and 55K a year. A pharmacist made on average 60K a year.

In rage she said "Do you believe THESE people are going on strike? Do you know what my parents went through to put me through college to be a pharmacists? Do you know what I went through? For what, to make a crummy five or ten grand a year than a UPS driver, and that's not enough for them? I should be the one on strike!!!"

It wasn't long before our country started to run short on pharmacists, nurses, and other medical professionals. Why should they spend money for all that education if they are only going to make the wages of a UPS driver, auto plant worker, or a steel plant worker?

The only way to lure these people into such careers is to pay them much better than a floor sweeper at Ford. And of course, that's one of the reasons medical costs are what they are today.

My X-wife is a pharmacist, and makes $105,000 per year. For that, she takes pills out of a big bottle and puts them in a small bottle. A pharmacist in Mexico makes about $16,000 per year. That is because pills in Mexico come prepackaged like the way our aspirin does. So why does this situation exist? Because the pharmacy lobby put into law in every state that nobody other than a licensed pharmacist may touch a controlled substance and that they can not be prepackaged, except for certain exceptions, like birth control pills. In short, We could cut pharmacist pay to about $35,000, per year, if they did not have such powerful lobbies in Washington. Not that I am complaining. We lived quite well with her paycheck, even though her job bored her to tears.

Some times I will pick up a prescription and they are in a sealed container. I am thinking that the pharmacist is just too busy or lazy to open the container and put it into their containers. So it makes me wonder, why can't this just be mail order?

Mail order pharmacies have been around for about 10 years, and are contracting with HMO's. My x-wife has been terrorized that she will lose her job to that competition, because they just stand in a warehouse doing pharmacy assembly line style. I am convinced that eventually, there will be few neighborhood pharmacies left. I remember when chain pharmacies drove all independents out of business, about 20 years ago.

BTW, as for a pharmacist's education is concerned, over 90% of the drugs she dispenses did not even exist when she graduated from pharmacy school in 1975

 

[Care4all]

There is nothing left but the ACA, regarding the 'free market economy'. The liberals destroyed the existing health care system when they passed the ACA. It can not simply be repealed without something being created.

Sure it can. The insurance companies still exist. They can simply go back to providing insurance the way they did before the ACA.

no, they can't,

not if the pre existing conditions being covered stays, as trump wants.

THAT is why all health insurance policies have gone up so much.... if that measure stays then insurance companies can not go back to what it was like... and near everyone wants that part to stay/be kept.

 

[Vandalshandle]

Having spent over 50 years as a health insurance and HMO executive, and can assure everyone that it is actuarially impossible to cover pre-existing conditions unless everyone is forced to sign up, or the government subsidizes the insurance companies.

 

[Mac1958]

My wish is just expanding the current Medicare/Medicare Supplement/Medicare Advantage system to all.

• Efficient mix of public foundation, preventive/diagnostic coverage, free market competition and innovation
• Opens up massive new insurance & delivery markets
  
• Perfectly scalable, already works well, all admin systems are in place
  
• Totally individual & portable
• Takes a huge cost monkey off the backs of employers
• Flushes our stupid 7-headed delivery/payment system right down the toilet

All they have to do is DO it, but that would require a little humility, bravery and cooperation.

Can't have that!
.

Here is a very simple explanation of why the US costs are almost twice other countries, such as Japan and Britan.

The sources of difference:

1. U.S. spending annual on physicians per capita is about five times higher than peer countries: $1,600 versus $310 in a sample of peer countries, a difference of $1,290 per capita or $390 billion nationally, 37% of the health care spending gap.

2. The high level of per capita income in the U.S. is a major factor driving U.S. health care spending. The U.S. has higher per capita income than any other large country, and higher income is closely associated with higher health care spending.

3. Dartmouth University has analyzed differences in health care costs between U.S. regions, comparing the highest-cost quintile of U.S. regions to the lowest-cost. Its research shows a spending variation of $2,300 per capita after taking account of differences in health status, income, and ethnicity (source). And health outcomes are no better in the high spending regions than in the low spending regions. Dartmouth attributes the gap to regional differences in discretionary medical decisions driving higher patient referral rates for high-cost advanced care (specialists, hospitalization, CAT and MRI scans, etc.). If the entire country were brought to the spending level of the lowest quintile, the savings would be about $750 per capita: $225 billion or 21% of the gap.

Why Are U.S. Health Care Costs So High?

I would question how any of your suggestions solves any of those problems. Eliminate all administrative costs that that only lowers the cost about 5 percent, and you know that can't happen.

Do you think that those who pay less for their health care in other countries probably spend less for their cars and houses? Because they have less income as the article states.

So it would seem that because we have more money we spend more money.

How to you propose lowering doctor salary? Or how do you propose lowing US income?

I'm afraid I don't see what that data has to do with my points. Trying to dig down here - are you saying that people who can't afford health insurance would be able to do so if they were more careful with their spending habits? And if so, how in the world would lowering US incomes help that?

I'm talking about efficiencies, ease of use and competition. Examples:

• Having basic access to preventive & diagnostic services would catch small health issues before they became big health issues.
• The vastly expanded preventive/diagnostic market would create a huge new health market in itself, for more competition & innovation.
  
• Having a market of 330+ million customers would massively increase competition & innovation among the insurance companies.
• The Medicare Supplement/Medicare Advantage program is consistent and far easier for consumers to understand and utilize.
  
• Getting rid of the insane 7-headed monster that is currently our health "system" (ha) would create significant new efficiencies.

Regarding doctors, there would be two contracts, as it is with the current Medicare/Medicare Advantage/Medicare Supplement system: One with the government, one with the insurance companies. Providers and provider groups would be able to negotiate for the best deals, given the makeup of their practices. We could take some of the cost of doing business down by changing tort law and allowing them to decrease and minimize defensive medicine practices. Once we've done this, we look at what the plan would cost overall. And yes, for all the benefits described above, there may (or may not) be more taxes required.

If the GOP has a plan that could do all of that, I'd freakin' love to see it. Do they?

And one more question: Do you know how the Medicare/Medicare Advantage/Medicare Supplement system works?
.

The Forbes' article points out that the gap between the US and other countries was simplified to three componets.

1. doctor salaries being twice what they are in other countries. No amount of competition can bring that gap down without dropping what doctors earn.

2. America on a whole are paid more than other countries, thus there is logically a gap. Kinda like we all use gasoline but the price varies country to country for the same exact thing.

3. One issue the Forbes article points out is there is a difference in cost dependent on area of the country. It appears that if a area has an MRI they they are going to use that MRI which costs money but does not necessarily aid to producing good results. Again, how is that changed? By refusing to pay for the MRI?

As for your last question. As I see Medicare working they have established what they will pay to providers. The providers then can either accept or reject that payment and thus reject the patient. By buying an advantage plan the provider still dictates what they are going to pay for services. So as I understand it the government gives the provider a chunk of money and from that chunk they pay for care. What I heard was it is 800/month, I am not sure if that number is correct, see below. If it is then that is approximately a 1/3 higher than what I bought on ACA. The premium for medicare is based on income. It varies from 108 to 150 or there abouts. Once signed on with an advantage plan medicare is out of the picture and the person is covered under the advantage plan provider.

I do see competition in the medicare system. Apparently because the government actually pays so much per person. When I signed up for my advantage plan I was not asked one question about my health.

Here are some eye popping information concerning health care expenditures. There is no way that my provider spends near that amount of money for my health care.

NHE by Age Group and Gender, Selected Years 2002, 2004, 2006, 2008, 2010, and 2012:

• Per person personal health care spending for the 65 and older population was $18,988 in 2012, over 5 times higher than spending per child ($3,552) and approximately 3 times the spending per working-age person ($6,632).
• In 2012, children accounted for approximately 25 percent of the population and slightly less than 12 percent of all PHC spending.
• The working-age group comprised the majority of spending and population in 2012, almost 54 percent and over 61 percent respectively.
• The elderly were the smallest population group, nearly 14 percent of the population, and accounted for approximately 34 percent of all spending in 2012.
• Per person spending for females ($8,315) was 22 percent more than males ($6,788) in 2012.
• In 2012, per person spending for male children (0-18) was 9 percent more than females. However, for the working age and elderly groups, per person spending for females was 28 and 7 percent more than for males.

NHE Fact Sheet - Centers for Medicare & Medicaid Services

Too much.

I've provided my specific proposal with specific rationales, what's yours?
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• Having basic access to preventive & diagnostic services would catch small health issues before they became big health issues.

Already done in Obamacare, so this would have little effect on the cost.

• The vastly expanded preventive/diagnostic market would create a huge new health market in itself, for more competition & innovation.

How so? Who now does not have healthcare insurance that doesn't already cover basic preventative/diagnostic care? It is part of the ACA all medical plans provide for it.

Having 1 doctor for 10 patients cost X, having 1 doctor for 100 patients cost many times X. Since the vast majority of Americans have healthcare insurance adding millions more that will not be paying a dime into the system is not going to lower prices, it simple can not.

• Having a market of 330+ million customers would massively increase competition & innovation among the insurance companies.

That is already the market size and there is competition between insurance companies. There are more then a few so obviously they are already competing for the same people.

• The Medicare Supplement/Medicare Advantage program is consistent and far easier for consumers to understand and utilize.

Easier then what? ACA? I have done both, neither are hard. The hard part is finding the best price in both systems. ACA was actually easier in that regard because a person had to pick a plan out of three that paid different amounts. With medicare only the company and their benefits needed determined. And neither were as easy as company sponsored health care insurance.

• Getting rid of the insane 7-headed monster that is currently our health "system" (ha) would create significant new efficiencies.

Again, I don't see how since the ACA was suppose to make medical records "travel" with a person.

Here are a few of my proposals.

1. Open the VA to all military veterans, even if it required those making money to pay a premium.

2. If a person is on Medicare or VA then they can opt out of company sponsored healthcare and get at least part of the premium paid to employees paid to them. Not using the company insurance is actually a windfall for the company.

3. Do what the VA is doing now, share specialists via video chat.

As to the real cost of healthcare I defer to the Forbes article.

You're comparing my plan to the ACA, almost as if you're defending the ACA. My plan would replace the ACA, if that wasn't clear.

My specifics weren't addressed specifically. You defended the stupid 7-headed beast of a system by discussing portability? Huh?

And I looked at the Forbes article. It's not a plan. Presenting a plan in detail would not have been difficult. I did it.

Never mind.
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[Ray From Cleveland]

Having spent over 50 years as a health insurance and HMO executive, and can assure everyone that it is actuarially impossible to cover pre-existing conditions unless everyone is forced to sign up, or the government subsidizes the insurance companies.

Or (what should have been done in the first place) is those who absolutely could not get insurance because of preexisting conditions be allowed to go on Medicare. I don't understand that of course because I've had preexisting conditions since 1985, and until Commie Care came along, I always had coverage.

 

[Ray From Cleveland]

Once working in the field, the pharmacist's salary will go up much faster than the UPS guy...

the UPS guy will have to live with back pain and knee pain and arthritis the rest of his life and retire early at 55,

never earning the money the pharmacist was able to earn in their lifetime...

regardless, the only way to live life, is to work in a field you love.....it isn't always about money, but your chances are greater in making good money, if you are working in a field you love.

As I explained in my story, they were pretty close to making what a UPS driver made. That's why they make so much more today. And remember that pharmacists don't get every holiday off. They work nights, weekends and holidays.

 

[Care4all]

Having spent over 50 years as a health insurance and HMO executive, and can assure everyone that it is actuarially impossible to cover pre-existing conditions unless everyone is forced to sign up, or the government subsidizes the insurance companies.

Or (what should have been done in the first place) is those who absolutely could not get insurance because of preexisting conditions be allowed to go on Medicare. I don't understand that of course because I've had preexisting conditions since 1985, and until Commie Care came along, I always had coverage.

Group health insurance policies through your employment, covers pre-existing conditions in their policies....at least with every job I have ever worked at, and same with Matt...

And the problem was not just preexisting conditions, but people who work, whose employer did not offer health care insurance as a benefit. Individual Heath Insurance policies are much more expensive than Group health insurance plans, and coupled with no employer contribution towards the policies made them completely un-affordable.

The only way to get a subsidy on the exchange is if your employer does not offer health insurance or your spouse's employer did not carry health insurance that you can buy in to.... so no group plan at work is the only way to get insurance through the exchange with govt help.

 

[LeftofLeft]

As I have said from the start, no matter how bad is Obamacare it is never ever going away. What program that the government has started has ever gone away? Especially one where the government controls so much of the money. Those who voted for Trump thinking he would repeal Obamacare, sorry you will be disappointed. Those who have acted like they were scared he would, you were just lying.

The Hospitals, doctors, and insurance providers are still becoming rich, so nothing is going to change.

Does anyone know the stat for the difference between treatment at a VA hospital and the treatment at a private hospital?

Concerns over dumping Obamacare growing among GOP lawmakers

I would be fine with a fundamental transformation of the ACA; one that does not result in proponents and supporters getting themselves exempted from the plan. Fundamental Transformation of ACA is definitely in order.

 

[Vandalshandle]

Having spent over 50 years as a health insurance and HMO executive, and can assure everyone that it is actuarially impossible to cover pre-existing conditions unless everyone is forced to sign up, or the government subsidizes the insurance companies.

Or (what should have been done in the first place) is those who absolutely could not get insurance because of preexisting conditions be allowed to go on Medicare. I don't understand that of course because I've had preexisting conditions since 1985, and until Commie Care came along, I always had coverage.

I get it. You suggest that Medicare be bankrupted so that your employer can afford to continue paying for your health insurance. Who would have thought that a Republican would have thought of that? Oh, and BTW, even your employer's group health insurance required satisfactory evidence of good health from any eligible employee or dependent who did not enroll withing 30 days of becoming eligible. AS VP of Underwriting, it was my job to reject their application for insurance when they tried to save money by no enrolling when they were well, only to try to enroll later, when they were sick.

 

[Ray From Cleveland]

Having spent over 50 years as a health insurance and HMO executive, and can assure everyone that it is actuarially impossible to cover pre-existing conditions unless everyone is forced to sign up, or the government subsidizes the insurance companies.

Or (what should have been done in the first place) is those who absolutely could not get insurance because of preexisting conditions be allowed to go on Medicare. I don't understand that of course because I've had preexisting conditions since 1985, and until Commie Care came along, I always had coverage.

I get it. You suggest that Medicare be bankrupted so that your employer can afford to continue paying for your health insurance. Who would have thought that a Republican would have thought of that? Oh, and BTW, even your employer's group health insurance required satisfactory evidence of good health from any eligible employee or dependent who did not enroll withing 30 days of becoming eligible. AS VP of Underwriting, it was my job to reject their application for insurance when they tried to save money by no enrolling when they were well, only to try to enroll later, when they were sick.

Expanding Mediare would have been a hell of a lot better than ruining the entire healthcare industry.

An insurance company will cover you provided you had coverage before you enrolled with them. If there was any time lapse, they will still cover you just not for anything related to the preexisting condition for one year. After that year is up, they will cover you for the preexisting conditions as well.

 

[Ray From Cleveland]

Having spent over 50 years as a health insurance and HMO executive, and can assure everyone that it is actuarially impossible to cover pre-existing conditions unless everyone is forced to sign up, or the government subsidizes the insurance companies.

Or (what should have been done in the first place) is those who absolutely could not get insurance because of preexisting conditions be allowed to go on Medicare. I don't understand that of course because I've had preexisting conditions since 1985, and until Commie Care came along, I always had coverage.

Group health insurance policies through your employment, covers pre-existing conditions in their policies....at least with every job I have ever worked at, and same with Matt...

And the problem was not just preexisting conditions, but people who work, whose employer did not offer health care insurance as a benefit. Individual Heath Insurance policies are much more expensive than Group health insurance plans, and coupled with no employer contribution towards the policies made them completely un-affordable.

The only way to get a subsidy on the exchange is if your employer does not offer health insurance or your spouse's employer did not carry health insurance that you can buy in to.... so no group plan at work is the only way to get insurance through the exchange with govt help.

The problem is the plans are unaffordable and they don't cover crap.

Commie Care wanted over 20% of my net pay for a plan with a $7,000 deductible that didn't have eye, prescriptions, or dental care. It also had a $50.00 copay for doctors visits.

In other words, it was an expensive garbage plan that I'd probably never use unless I walked in front of a moving bus. Even if I could afford it, I wouldn't be able to pay my medical bills which of course I would get until I hit that $7,000 mark.

Bottom line: Commie Care is great if you don't make very much or no money. It's terrible if you're just a middle-class working guy because we are the ones that have to pay for those getting cheap insurance. But then again, as I said repeatedly, Commie Care was designed to favor likely Democrat voters at the cost of likely Republican voters.

 

[Vandalshandle]

Having spent over 50 years as a health insurance and HMO executive, and can assure everyone that it is actuarially impossible to cover pre-existing conditions unless everyone is forced to sign up, or the government subsidizes the insurance companies.

Or (what should have been done in the first place) is those who absolutely could not get insurance because of preexisting conditions be allowed to go on Medicare. I don't understand that of course because I've had preexisting conditions since 1985, and until Commie Care came along, I always had coverage.

I get it. You suggest that Medicare be bankrupted so that your employer can afford to continue paying for your health insurance. Who would have thought that a Republican would have thought of that? Oh, and BTW, even your employer's group health insurance required satisfactory evidence of good health from any eligible employee or dependent who did not enroll withing 30 days of becoming eligible. AS VP of Underwriting, it was my job to reject their application for insurance when they tried to save money by no enrolling when they were well, only to try to enroll later, when they were sick.

Expanding Mediare would have been a hell of a lot better than ruining the entire healthcare industry.

An insurance company will cover you provided you had coverage before you enrolled with them. If there was any time lapse, they will still cover you just not for anything related to the preexisting condition for one year. After that year is up, they will cover you for the preexisting conditions as well.

Gee, Ray, I learn something new every day. For over 50 years, I declined individuals who could not submit a satisfactory evidence of good health if they failed to submit an application during the 30 day open enrollment period following the date that they became eligible. This included, for example, spouses of employees who had their own insurance through their employer, but then lost their job, and not having elected to be covered by us at the time the employee was hired, had then become a "late enrollee', giving me the right to tell them that they will NEVER be eligible for insurance with our plan, because of their heart disease. This was moderated, somewhat, when HMO statutes went in to effect, which gave all eligibles a 30 day window of guaranteed issue per year, if they lived until that window was open. Who would have guessed that I was violating the law throughout that 50 year period at no less than 12 insurance companies in which I was in charge of medical underwriting?

 

[Ray From Cleveland]

Having spent over 50 years as a health insurance and HMO executive, and can assure everyone that it is actuarially impossible to cover pre-existing conditions unless everyone is forced to sign up, or the government subsidizes the insurance companies.

Or (what should have been done in the first place) is those who absolutely could not get insurance because of preexisting conditions be allowed to go on Medicare. I don't understand that of course because I've had preexisting conditions since 1985, and until Commie Care came along, I always had coverage.

I get it. You suggest that Medicare be bankrupted so that your employer can afford to continue paying for your health insurance. Who would have thought that a Republican would have thought of that? Oh, and BTW, even your employer's group health insurance required satisfactory evidence of good health from any eligible employee or dependent who did not enroll withing 30 days of becoming eligible. AS VP of Underwriting, it was my job to reject their application for insurance when they tried to save money by no enrolling when they were well, only to try to enroll later, when they were sick.

Expanding Mediare would have been a hell of a lot better than ruining the entire healthcare industry.

An insurance company will cover you provided you had coverage before you enrolled with them. If there was any time lapse, they will still cover you just not for anything related to the preexisting condition for one year. After that year is up, they will cover you for the preexisting conditions as well.

Gee, Ray, I learn something new every day. For over 50 years, I declined individuals who could not submit a satisfactory evidence of good health if they failed to submit an application during the 30 day open enrollment period following the date that they became eligible. This included, for example, spouses of employees who had their own insurance through their employer, but then lost their job, and not having elected to be covered by us at the time the employee was hired, had then become a "late enrollee', giving me the right to tell them that they will NEVER be eligible for insurance with our plan, because of their heart disease. This was moderated, somewhat, when HMO statutes went in to effect, which gave all eligibles a 30 day window of guaranteed issue per year, if they lived until that window was open. Who would have guessed that I was violating the law throughout that 50 year period at no less than 12 insurance companies in which I was in charge of medical underwriting?

All I can tell you is what my experiences have been and my dealings with healthcare insurance companies. I've been on this job for a long time, but prior to that, I went from job to job staying with a company anywhere from less than a year to five years. Have things changed? I don't know. They probably have. When I worked in the medical field, our office staff had to have meetings once a week just to keep up with the new changes in Medicare, Medicaid and private insurance. Those meetings were for billing purposes, but I can't imagine that covering people would be any different.