GOP may "leverage" debt ceiling against de-funding Obamacare

[OohPooPahDoo]

So we should regulate doctors and hospitals?

Yes.

ACA does some things along this line, for example, the Readmissions Reduction Program, which penalizes medicare hospitals with excess readmissions.


I am not saying the insurance companies are FAULTLESS here - but I think they receive too much of the blame. When I see a bill for $1000 for a catscan my doc just felt like I should get that turned up nothing, I think its great I don't have to pay it personally - but then I realize my insurance company does and ultimately that means I have to pay more.

 

[Vandalshandle]

The insurance industry is getting ripped off like the rest of us. When the Doc sends me to get a CAT Scan I don't need - he makes money, and between me and my insurance company - we lose money.

In the health insurance industry, there is always a department, within the Provider Relations division, that monitors for over utilization. They rely on statistics put together by the computer system, comparing our contracted docs with industry norms, for the same specialties. Mostly, we find a certain amount of overutilization, based on docs practicing defensive medicine. We tolerate that, to a reasonable extent. However, it is also not uncommon to find that (for example) an orthopedic specialist to be sending every single patient to his own imaging company, of which he has a major finacial interest, for MRI's, X-rays, Pet scans, etc., even when they are not needed, for example, AFTER surgery, even though there were no complications. These docs get their contracts canceled pronto.

There is no way you will catch all the waste. You're only going to get the obvious cases that stand out from the crowd.

The system itself is flawed. Medical billing is so complicated they have college degrees on the subject. The few times I've had to pay out of pocket at the doctor's office no one ever has any idea how much it will cost me.

This is true...especially the rehab issue. I have been through physical therapy 4 times in my life for my back, but my company will only pay for one series per year, so my therapist always pronouces me "cured" on my 12th visit....until the next calandar year.

 

[Wyatt earp]

Sure alot of sick posters on here so remind me again why a healthy 47 year old like myself is forced to buy health insurance to pay for everyones unhealthy life styles?? I never been to the quack in 30 years except for company paid for physicals and drug tests.

 

[OohPooPahDoo]

Sure alot of sick posters on here so remind me again why a healthy 47 year old like myself is forced to buy health insurance to pay for everyones unhealthy life styles?? I never been to the quack in 30 years except for company paid for physicals and drug tests.

Seriously? You're 47 and voluntarily don't have health insurance?

Morons like you are the reason the ACA is needed. You're proof that a substantial portion of America will time and time again make retarded decisions that wind up costing us all.

When your waning youth finally runs out and you wind up having to go to the doctor for a $150,000 medical procedure - which will be paid for thanks to you being "forced" to buy health insurance - I expect you to come back to this very thread and pen a letter of thanks to Mitt Romney and Barrack Obama for coming up with "ObamaCare"

 

[Vandalshandle]

Sure alot of sick posters on here so remind me again why a healthy 47 year old like myself is forced to buy health insurance to pay for everyones unhealthy life styles?? I never been to the quack in 30 years except for company paid for physicals and drug tests.

Niether did my wife's first husband, until he came down with the 'flu" at age 54. Unfortunately for him, it turned out to be luekemia. He lived for another 18 months, and she stopped opening the hospital bills after they reached $1,000,000. His employee group health insurance maxed out at that amount, and the hospital ended up writting off over $100,000. As a side note, his employer was able to continue his employee health insurance by lying to the insurance company. It contained a clause that made any employee lose his eligibility after he had been unable to work, at least 30 hours per week, for 6 months. In those days, there was a guaranteed conversion to an individual policy privilege (at prohibitive rates), but no COBRA.

 

[ilia25]

No, he isn't sick. Where did I say he was? What I said was he can buy affordable health insurance now (without the ACA). The left pushed the idea that people could not do this, could not afford this; it was part of the selling people the ACA. You know, the 'Affordable' part?

Oh, I see you were specifically speaking about sick people. I missed that earlier.

Well that is the problem ACA is trying to solve -- make health insurance affordable to sick people. And the only way it can be done is by requiring that everyone has an insurance.

And if you have to ask -- no, the government can't simply order the insurance companies to accept people with pre-existing conditions. Been there, done that -- it won't work.

wtf? They just did when they mandated that everyone buy insurance.

People with pre-existing conditions certainly should be able to buy health insurance. And they should pay more for it because they have a pre-exsiting condition.

How much more? If they are required to pay enough to cover their medical expenses, then their premiums would be astronomical. They may just as well forget it and pay for the treatment out of the pocket. Or die.

The only way to provide an affordable insurance for people with pre-existing condition is to make other people sharing the costs.

The ACA isn't trying to solve anything. It's a foot in the door, it will create more problems than it solves, it will be deemed unworkable and the reason for single payer/universal or whatever. It's all a ruse.

OK, let my try and explain it to you. If the government simply orders the insurance companies to provide affordable insurance to people with pre-existing conditions -- w/o also requiring everyone to buy an insurance -- the whole system explodes. Because as the insurance companies start rising premiums for everyone, the young end healthy would simply opt-out, leaving only sick people in the pool and making their insurance unaffordable.

That is why ACA requires everyone to buy insurance -- so the young, health and affluent are paying for the poor and sick. And yes, that is income redistribution and it will work -- and that is why conservatives hate it.

 

[ilia25]

wtf? They just did when the mandated that everyone buy insurance.

People with pre-existing conditions certainly should be able to buy health insurance. And they should pay more for it because they have a pre-exsiting condition. Smokers, obese, etc should also pay more because they cost more to cover.

but but but but but-----------thats not "fair"

Yeah, I was going to put that in there too.

I'm healthy. Guy next door has diabetes. But we should both pay the same amount for health care because it's not fair that he has diabetes, he didn't ask for that? What a load of crap.

If I get cancer I would certainly expect my health premiums to go up. Why? Because now I cost more to insure.

And what if they go up so much that you would not be able to afford them? What is the point of having the insurance in the first place if you will end up paying for your treatment?

 

[dblack]

And what if they go up so much that you would not be able to afford them? What is the point of having the insurance in the first place if you will end up paying for your treatment?

This is a really hilarious comment when you think about it. And utterly revealing. Delusion abounds.

 

[Zoom-boing]

but but but but but-----------thats not "fair"

Yeah, I was going to put that in there too.

I'm healthy. Guy next door has diabetes. But we should both pay the same amount for health care because it's not fair that he has diabetes, he didn't ask for that? What a load of crap.

If I get cancer I would certainly expect my health premiums to go up. Why? Because now I cost more to insure.

And what if they go up so much that you would not be able to afford them? What is the point of having the insurance in the first place if you will end up paying for your treatment?

If you have the money to pay for your treatment then you have the money to cover your premiums. Individual insurance for catastrophic coverage certainly is affordable. My brother has it.

People who are a higher risk to insure should pay more because they are a higher risk to insure.

 

[ilia25]

Yeah, I was going to put that in there too.

I'm healthy. Guy next door has diabetes. But we should both pay the same amount for health care because it's not fair that he has diabetes, he didn't ask for that? What a load of crap.

If I get cancer I would certainly expect my health premiums to go up. Why? Because now I cost more to insure.

And what if they go up so much that you would not be able to afford them? What is the point of having the insurance in the first place if you will end up paying for your treatment?

If you have the money to pay for your treatment then you have the money to cover your premiums. Individual insurance for catastrophic coverage certainly is affordable.

No, it is not -- not for the people with pre-existing conditions. That, as I keep pointing out, is the problem ACA is designed to solve by requiring that everyone buys an insurance and shares the costs. Specifically those who can do w/o it -- the young, healthy and affluent.

 

[bendog]

Well that is the problem ACA is trying to solve -- make health insurance affordable to sick people. And the only way it can be done is by requiring that everyone has an insurance.

And if you have to ask -- no, the government can't simply order the insurance companies to accept people with pre-existing conditions. Been there, done that -- it won't work.

wtf? They just did when they mandated that everyone buy insurance.

People with pre-existing conditions certainly should be able to buy health insurance. And they should pay more for it because they have a pre-exsiting condition.

How much more? If they are required to pay enough to cover their medical expenses, then their premiums would be astronomical. They may just as well forget it and pay for the treatment out of the pocket. Or die.

The only way to provide an affordable insurance for people with pre-existing condition is to make other people sharing the costs.

The ACA isn't trying to solve anything. It's a foot in the door, it will create more problems than it solves, it will be deemed unworkable and the reason for single payer/universal or whatever. It's all a ruse.

OK, let my try and explain it to you. If the government simply orders the insurance companies to provide affordable insurance to people with pre-existing conditions -- w/o also requiring everyone to buy an insurance -- the whole system explodes. Because as the insurance companies start rising premiums for everyone, the young end healthy would simply opt-out, leaving only sick people in the pool and making their insurance unaffordable.

That is why ACA requires everyone to buy insurance -- so the young, health and affluent are paying for the poor and sick. And yes, that is income redistribution and it will work -- and that is why conservatives hate it.

I agree on a broad scope, but there are few options.

1. It's a fallacy to think that people with pre-existing conditions can find affordable insurane. They can't, and that's why it's a problem. Those arguing otherwise are simply ignoring reality because it's inconvenient for their ideology. We have gop dr/pols pushing for fed subsidies to help fund high risk pools. Coburn and Barrasco are at least attempting to move forward. The money to do this can be found with pretty much the same type of taxes funding obamacare subsidies ... tax the providers and insurors who profit from treating high risk folks.

2. Wealth redistribution or not, it really makes no sense to force an underemployed college grad waiting tables to buy a policy that in all liklihood he'll never need. Catastrophic care policies are probably all they need, and if they fail to buy those and then need to try and buy in when they're sick, they can be punished for their greed by basically levying liens on all their future income ... assuming they get well. That's similar to how medicare works, and just about every oldster signs up for medicare.

 

[ilia25]

wtf? They just did when they mandated that everyone buy insurance.

People with pre-existing conditions certainly should be able to buy health insurance. And they should pay more for it because they have a pre-exsiting condition.

How much more? If they are required to pay enough to cover their medical expenses, then their premiums would be astronomical. They may just as well forget it and pay for the treatment out of the pocket. Or die.

The only way to provide an affordable insurance for people with pre-existing condition is to make other people sharing the costs.

The ACA isn't trying to solve anything. It's a foot in the door, it will create more problems than it solves, it will be deemed unworkable and the reason for single payer/universal or whatever. It's all a ruse.

OK, let my try and explain it to you. If the government simply orders the insurance companies to provide affordable insurance to people with pre-existing conditions -- w/o also requiring everyone to buy an insurance -- the whole system explodes. Because as the insurance companies start rising premiums for everyone, the young end healthy would simply opt-out, leaving only sick people in the pool and making their insurance unaffordable.

That is why ACA requires everyone to buy insurance -- so the young, health and affluent are paying for the poor and sick. And yes, that is income redistribution and it will work -- and that is why conservatives hate it.

I agree on a broad scope, but there are few options.

1. It's a fallacy to think that people with pre-existing conditions can find affordable insurane. They can't, and that's why it's a problem. Those arguing otherwise are simply ignoring reality because it's inconvenient for their ideology. We have gop dr/pols pushing for fed subsidies to help fund high risk pools. Coburn and Barrasco are at least attempting to move forward. The money to do this can be found with pretty much the same type of taxes funding obamacare subsidies ... tax the providers and insurors who profit from treating high risk folks.

2. Wealth redistribution or not, it really makes no sense to force an underemployed college grad waiting tables to buy a policy that in all liklihood he'll never need.

That is why ACA subsidies the insurance to those who cannot afford it. And I don't think it requires people to buy excessive packages. Again the goal is to share the costs, with wealthy people paying more and the poor being subsidized. And yes, it is very similar to Medicare. In fact, the best approach would be extending Medicare to everyone -- but Obama wanted to please conservatives and they are paying him back.

 

[dblack]

That is why ACA subsidies the insurance to those who cannot afford it. And I don't think it requires people to buy excessive packages. Again the goal is to share the costs, with wealthy people paying more and the poor being subsidized. And yes, it is very similar to Medicare. In fact, the best approach would be extending Medicare to everyone -- but Obama wanted to please conservatives and they are paying him back.

ACA makes the unwarranted, and untrue, assumption that insurance is the only way to pay for health care. This is a great call from the point of view of the insurance industry, and given their role in the creation of the law should come as no surprise. But it's slavery for the rest of us - leaving us permanently indebted the same fucking corporations that created this mess in the first place.

 

[ilia25]

That is why ACA subsidies the insurance to those who cannot afford it. And I don't think it requires people to buy excessive packages. Again the goal is to share the costs, with wealthy people paying more and the poor being subsidized. And yes, it is very similar to Medicare. In fact, the best approach would be extending Medicare to everyone -- but Obama wanted to please conservatives and they are paying him back.

ACA makes the unwarranted, and untrue, assumption that insurance is the only way to pay for health care.

Sure, and I have an even better story -- I saw TWO unicorns in my driveway this morning.

 

[bendog]

That is why ACA subsidies the insurance to those who cannot afford it. And I don't think it requires people to buy excessive packages. Again the goal is to share the costs, with wealthy people paying more and the poor being subsidized. And yes, it is very similar to Medicare. In fact, the best approach would be extending Medicare to everyone -- but Obama wanted to please conservatives and they are paying him back.

Sure, but we can subsidize higher risk people in other ways. I just don't see any enthusiasm with younger folks for mandates. There was a less Heavy Hand of Govt to coerce them into getting very low end policies.

Actually, you probably saw one unicorn, but also a reflection. Now Ted Cruz and Mike Lee, they're actually convinced they see mult unicorns.

 

[ilia25]

That is why ACA subsidies the insurance to those who cannot afford it. And I don't think it requires people to buy excessive packages. Again the goal is to share the costs, with wealthy people paying more and the poor being subsidized. And yes, it is very similar to Medicare. In fact, the best approach would be extending Medicare to everyone -- but Obama wanted to please conservatives and they are paying him back.

Sure, but we can subsidize higher risk people in other ways. I just don't see any enthusiasm with younger folks for mandates.

Of course people usually are not enthusiastic about paying more taxes. And for all intents and purposes Obamacare is a new tax to provide health care for the poor and sick. Younger people benefit less, so they may feel that way. But it is really no different form the same younger people paying for social security and Medicare.

All social programs are like that -- those relatively well off are made to pay for a decent living of those less fortunate, or disabled, or old. And that is how it should be in any civilized society.

 

[bendog]

That is why ACA subsidies the insurance to those who cannot afford it. And I don't think it requires people to buy excessive packages. Again the goal is to share the costs, with wealthy people paying more and the poor being subsidized. And yes, it is very similar to Medicare. In fact, the best approach would be extending Medicare to everyone -- but Obama wanted to please conservatives and they are paying him back.

Sure, but we can subsidize higher risk people in other ways. I just don't see any enthusiasm with younger folks for mandates.

Of course people usually are not enthusiastic about paying more taxes. And for all intents and purposes Obamacare is a new tax to provide health care for the poor and sick. Younger people benefit less, so they may feel that way. But it is really no different form the same younger people paying for social security and Medicare.

All social programs are like that -- those relatively well off are made to pay for a decent living of those less fortunate, or disabled, or old. And that is how it should be in any civilized society.

But the goal is to win elections. If we can insure high risk without mandating kids have anything but catastrophic care, it's not rocket science.

The gop knew it had a winning issue when Pelosi sent this thing through and lost the House, but they got derailed on bashing latinos, women, gays and lower income workers.

 

[Zoom-boing]

And what if they go up so much that you would not be able to afford them? What is the point of having the insurance in the first place if you will end up paying for your treatment?

If you have the money to pay for your treatment then you have the money to cover your premiums. Individual insurance for catastrophic coverage certainly is affordable.

No, it is not -- not for the people with pre-existing conditions. That, as I keep pointing out, is the problem ACA is designed to solve by requiring that everyone buys an insurance and shares the costs. Specifically those who can do w/o it -- the young, healthy and affluent.

Then they should have found a way to fix that problem without putting the cost on the rest of us and taking over 1/6 of the economy. Young healthy Joe Taxpayer shouldn't have to cover pre-existing condition Paul's illness.

Bullshit. The ACA is nothing more than a power grab and the foot in the door for more gov't intrusion. And some of you are just find with that.

 

[JakeStarkey]

Zoom, we had from 1994 to 2006.

Talk to the leaders of our party then.

 

[Redfish]

And what if they go up so much that you would not be able to afford them? What is the point of having the insurance in the first place if you will end up paying for your treatment?

If you have the money to pay for your treatment then you have the money to cover your premiums. Individual insurance for catastrophic coverage certainly is affordable.

No, it is not -- not for the people with pre-existing conditions. That, as I keep pointing out, is the problem ACA is designed to solve by requiring that everyone buys an insurance and shares the costs. Specifically those who can do w/o it -- the young, healthy and affluent.

the problem with that is that it will be cheaper to pay the penalty than to buy a policy. That will put the insurance companies out of business and turn medicine over to the government, which, of course was the dem/lib goal all along.

what I find disturbing is that roughly half of ameicans are too ignorant to see through the ruse.

If nothing changes we will have socialized one-payer medicine in the USA very soon.

If you think that will be good, take a trip to the UK or Canada and ask those people about it. Ask them why they come to the US for anything serious.