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House Republicans preparing health care bill
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Owl 69/70/75 Offline
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Post: #21
RE: House Republicans preparing health care bill
Folks, Bismarck solves the universal health care problem, including pre-existing conditions, while preserving the doctor-patient relationship. So why does nobody propose it?
03-25-2020 12:59 PM
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Hambone10 Offline
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Post: #22
RE: House Republicans preparing health care bill
(03-25-2020 12:06 PM)b0ndsj0ns Wrote:  Yes with the current marketplace. Do you think the GOP is gonna keep the marketplace and the subsidies?

(03-25-2020 12:25 PM)b0ndsj0ns Wrote:  Of course it is, COBRA has existed for a long time, but is completely un-affordable for anyone that lost a job. Are you saying you support keeping the subsidies around?

Jons.... you keep saying this but it misrepresents the facts.
You are not required to use COBRA and COBRA is merely the actual cost of your previous policy. You have the ability to go buy a new policy and a marketplace for that, subsidized or not, has always existed. It's just that previously it was an individual policy and now you are in a government created 'group' policy. While you can argue about that the GOP will or will not do, to think that they have or would have the 60% necessary to ram through 'whatever they want' (which means, whatever you assign to them) is silly. Not even all Republicans would support eliminating the turning of the individual marketplace into a 'group' marketplace.... and large portions of the 'subsidy' for policies now comes from the states. Individual states could still keep this sort of practice even if the feds eliminated it, and you can buy across state lines. The 'hole' would now be for the 'expanded' Medicaid

As for Bismarck... even if we did that, I seriously doubt any current politician would call it that. Bernie calls what he offers M4E, and it's quite different from Medicare.... in fact, it would be a MASSIVE expansion of Medicare for current participants... OR... it more likely (in order to control costs) would be a massive expansion of 'Medicare Advantage' plans and they would be put under the government... which makes no sense, taking away from private business something they were doing better than the government before, so that's why I know it would happen.

If Republicans offered well checks, preventative and catastrophic insurance with no deductibles or copays (which are really pretty immaterial if you have a $100,000+ bill), it would essentially be Bismarck.

Option 1, offer preventative, wellness and catastrophic coverage with no deductibles or copays to everyone.... Bismarck.
Option 2, offer the above with deductibles and copays and let the states cover that portion for 'those it decides can't afford it', including potentially even more coverage... Bismarck that retains state control and the taxing mechanisms there.... IMO, most likely...
Option 3, same as 2, but then decide that at some level, you (or your employer) MUST opt out/pay for the basic coverage.... highly probably only to prevent it from being described as a gift to the wealthy

That's the other thing... People who have company policies are sometimes still better off with Medicaid, especially single moms with kids. This is money that a company WOULD pay, that would save the state money, but because there is no option, the state burns money.

The biggest/only reason I'm against 'straight' Bismarck is that it removes 'responsibility' from the equation... and that is precisely what is kicking our butts right now. I most want people to pay for illnesses/diseases of choice. lick a toilet seat and get sick from that or go bungee jumping, pay the consequences. Buy supplemental insurance for that.
(This post was last modified: 03-25-2020 01:15 PM by Hambone10.)
03-25-2020 01:09 PM
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Redwingtom Offline
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Post: #23
RE: House Republicans preparing health care bill
(03-25-2020 10:40 AM)Eldonabe Wrote:  
(03-25-2020 10:15 AM)Redwingtom Wrote:  What is it, year 10 of their "plan" creation? 03-rotfl

[Image: images?q=tbn%3AANd9GcRrcIwn1RSUfvzXrjBhw...LUbo9m2NS_]

For someone who claims no specific political affiliation, your "balance" of political criticism is roughly 15 Republican hits for every 1 Democrat hit.........

Ridiculous. I've only explained this like 50 times now.

I'm a liberal. So naturally I will side more on the democratic side of policies and priorities. But I don't have an affiliation with the DNC because I feel the two-party system is what's destroying this country. Additionally, the democrats are a bunch of spineless wimps these days. I do not blindly vote for them. And no, I don't want Biden elected president either.

And I'm an Independent because I don't belong to a political party. Is that really that hard to understand?

Many folks on here have views like many in the KKK, but I don't call them a member of the KKK! 01-wingedeagle
(This post was last modified: 03-25-2020 01:25 PM by Redwingtom.)
03-25-2020 01:22 PM
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Owl 69/70/75 Offline
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Post: #24
RE: House Republicans preparing health care bill
(03-25-2020 01:09 PM)Hambone10 Wrote:  The biggest/only reason I'm against 'straight' Bismarck is that it removes 'responsibility' from the equation... and that is precisely what is kicking our butts right now. I most want people to pay for illnesses/diseases of choice. lick a toilet seat and get sick from that or go bungee jumping, pay the consequences. Buy supplemental insurance for that.

But Bismarck doesn't remove responsibility. It precisely uses supplemental insurance to cover the situations you described.
03-25-2020 01:26 PM
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Redwingtom Offline
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Post: #25
RE: House Republicans preparing health care bill
(03-25-2020 11:05 AM)Owl 69/70/75 Wrote:  
(03-25-2020 10:40 AM)Eldonabe Wrote:  
(03-25-2020 10:15 AM)Redwingtom Wrote:  What is it, year 10 of their "plan" creation? 03-rotfl
[Image: images?q=tbn%3AANd9GcRrcIwn1RSUfvzXrjBhw...LUbo9m2NS_]
For someone who claims no specific political affiliation, your "balance" of political criticism is roughly 15 Republican hits for every 1 Democrat hit.........

Tom is basically left of the democrats, except I think he is pro-life and he may also be pro-2nd-Amendment. But I haven't seen him criticize democrats on those things. Where I've seen him criticize democrats, it's because they didn't go far enough left to suit him.

He's a pretty hard-core leftist. He calls himself and independent. Humor him. He's a hell of a lot more sensible than a lot of lefties on here.

Yes, in many instances, the democrats do not go far left for my needs.

Additionally, I'm not really pro-life as that movement is full of hypocrites. My position is that I would never counsel anyone to have an abortion but would rather steer them to adoption. I do allow for rape, incest and health of the mother exceptions. I also want a medically agreed upon term where no abortions are allowed after...excepting rape/incest/health of mother again. I also would like to see way more education on preventing pregnancies to begin with, including way more emphasis on contraception.

As far as the 2A, I'm in no way in favor of repealing it, but I do support common sense legislation to limit things when there's a consensus among lawmakers...you know...like we do with all sorts of rights.

And as I said in my prior post...I'm an independent because I don't belong to any political party as I loathe them all.
03-25-2020 01:31 PM
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b0ndsj0ns Offline
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Post: #26
RE: House Republicans preparing health care bill
(03-25-2020 01:26 PM)Owl 69/70/75 Wrote:  
(03-25-2020 01:09 PM)Hambone10 Wrote:  The biggest/only reason I'm against 'straight' Bismarck is that it removes 'responsibility' from the equation... and that is precisely what is kicking our butts right now. I most want people to pay for illnesses/diseases of choice. lick a toilet seat and get sick from that or go bungee jumping, pay the consequences. Buy supplemental insurance for that.

But Bismarck doesn't remove responsibility. It precisely uses supplemental insurance to cover the situations you described.

04-cheers
03-25-2020 02:02 PM
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Hambone10 Offline
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Post: #27
RE: House Republicans preparing health care bill
(03-25-2020 01:22 PM)Redwingtom Wrote:  Ridiculous. I've only explained this like 50 times now.

A distinction without a difference. Your chastisement of 'the left' versus 'the right' is about 1000:1. Trump initially supported single payer, and you were against it when he was for it with zero specifics, but somehow find a way to be 'okay' with the left's versions of it.

(03-25-2020 01:26 PM)Owl 69/70/75 Wrote:  But Bismarck doesn't remove responsibility. It precisely uses supplemental insurance to cover the situations you described.

Not sure I see it this way.
I haven't seen anyone (outside of you) describe it this way. Supplements add 'more' which is what I've described as likely for the right, but it doesn't specifically opt out illnesses or diseases of choice.... a selective donut.

Even if 'it' does, I stand by my comment that we can put that in place without anyone calling it Bismarck. It will be called TrumpCare or GOPCare or AmeriCare or TRIUMPH (The Real Initial Underlying Medical Provisional Healthcare or something like that... made that up on the fly)
(This post was last modified: 03-25-2020 02:15 PM by Hambone10.)
03-25-2020 02:15 PM
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b0ndsj0ns Offline
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Post: #28
RE: House Republicans preparing health care bill
Aside from your "licking a toilet seat" or bungee jumping examples what real world things would you consider illnesses/diseases of choice?
03-25-2020 02:39 PM
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Owl 69/70/75 Offline
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Post: #29
RE: House Republicans preparing health care bill
(03-25-2020 02:15 PM)Hambone10 Wrote:  
(03-25-2020 01:26 PM)Owl 69/70/75 Wrote:  But Bismarck doesn't remove responsibility. It precisely uses supplemental insurance to cover the situations you described.
Not sure I see it this way.
I haven't seen anyone (outside of you) describe it this way. Supplements add 'more' which is what I've described as likely for the right, but it doesn't specifically opt out illnesses or diseases of choice.... a selective donut.
Even if 'it' does, I stand by my comment that we can put that in place without anyone calling it Bismarck. It will be called TrumpCare or GOPCare or AmeriCare or TRIUMPH (The Real Initial Underlying Medical Provisional Healthcare or something like that... made that up on the fly)

What Bismarck does is basically provide some basic level of care. It can be like single-payer or single-provider, where government provides a basic plan directly, or it can be like Heritage, where you pay and government reimburses up to the cost of a basic plan. Either way, you can supplement op to whatever level you want. I would allow the option of substituting a high deductible with a HSA for the basic plan. All that could be worked out actuarially.

The difference between Bismarck and single-payer/single-provider is that Bismarck assumes that queues and shortages will occur in the basic "free" system, and the private "pay" side is intentionally structured to provide relief in those cases. It counts on the "pay" side as an ally to fill in the inevitable gaps, instead of viewing it as an enemy. So health care ends up being about 70% "free" side and 30% "pay" side.
(This post was last modified: 03-25-2020 02:57 PM by Owl 69/70/75.)
03-25-2020 02:56 PM
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Post: #30
RE: House Republicans preparing health care bill
You can't have no pre-existing conditions and a viable health insurance market. The two cannot coexist at the same time by definition. Unless the Republican redefinition of no P.E.C. is "you may not make a claim for x period of time after enrolling in insurance after being without coverage."
03-25-2020 02:57 PM
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Post: #31
RE: House Republicans preparing health care bill
(03-25-2020 02:56 PM)Owl 69/70/75 Wrote:  I would allow the option of substituting a high deductible with a HSA for the basic plan. All that could be worked out actuarially.

This is what health insurance should have always been.... like your car insurance: It doesn't cover oil changes, tires, brake pads, windshield wipers, or any other basic good. But it does present you with a tiny bill when something major happens. How tiny depends upon how much you are willing to pay per month.

The problem with high deductible + HSA is it now flies in the face of the mountain of lies we have erected in the healthcare industry. It will act like a beacon sucking away all the healthy people who will leave the government run pools in increasingly sicker and sicker condition leading to a death spiral in the insurance market. This has been going on since the beginning of Obamacare and that's why in like 1/3 to 1/4 of the country there's only one insurer to choose from on the Obamacare exchange. This is why with the sole exception of temporary insurance high deductible plans have been outlawed since Obamacare's passage.

I'm not a great fan of this Republican proposal from what I've read. But I far more hate those who champion Obamacare while standing atop the ashes of what use to be the health insurance industry.
03-25-2020 03:04 PM
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Hambone10 Offline
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Post: #32
RE: House Republicans preparing health care bill
(03-25-2020 02:56 PM)Owl 69/70/75 Wrote:  What Bismarck does is basically provide some basic level of care. It can be like single-payer or single-provider, where government provides a basic plan directly, or it can be like Heritage, where you pay and government reimburses up to the cost of a basic plan. Either way, you can supplement op to whatever level you want. I would allow the option of substituting a high deductible with a HSA for the basic plan. All that could be worked out actuarially.

The difference between Bismarck and single-payer/single-provider is that Bismarck assumes that queues and shortages will occur in the basic "free" system, and the private "pay" side is intentionally structured to provide relief in those cases. It counts on the "pay" side as an ally to fill in the inevitable gaps, instead of viewing it as an enemy. So health care ends up being about 70% "free" side and 30% "pay" side.

And I support that, but that isn't what I was describing. You can have that (and I did allude to that which you noted) but it isn't the 'responsibility' aspect I speak of.

In every nation where this even arguably 'works', they have engaged in some form of healthcare rationing for decades... hence they are more aware of their impact on 'the system' and the cost of poor choices than we are. We all want a 5 minute wait time, a 30 second diagnosis and then a magic pill.

(03-25-2020 02:57 PM)georgia_tech_swagger Wrote:  You can't have no pre-existing conditions and a viable health insurance market. The two cannot coexist at the same time by definition. Unless the Republican redefinition of no P.E.C. is "you may not make a claim for x period of time after enrolling in insurance after being without coverage."

Except because of the ACA, this isn't an issue for anyone (who didn't choose to be so).... or isn't an issue for enough people anymore to be a hindrance, so I agree 100%
03-25-2020 03:17 PM
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Post: #33
RE: House Republicans preparing health care bill
(03-25-2020 02:57 PM)georgia_tech_swagger Wrote:  You can't have no pre-existing conditions and a viable health insurance market. The two cannot coexist at the same time by definition. Unless the Republican redefinition of no P.E.C. is "you may not make a claim for x period of time after enrolling in insurance after being without coverage."

I disagree totally.

Anyone who already has health insurance is covered for those "pre-existing conditions."

So all we are talking about for most people is portability. There is ZERO extra cost to the system for anyone already covered.

The people not covered are generally young and healthy or poor and already subsidized. So you have a relatively small group that adds to the system costs.
03-25-2020 03:23 PM
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b0ndsj0ns Offline
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Post: #34
RE: House Republicans preparing health care bill
(03-25-2020 03:04 PM)georgia_tech_swagger Wrote:  
(03-25-2020 02:56 PM)Owl 69/70/75 Wrote:  I would allow the option of substituting a high deductible with a HSA for the basic plan. All that could be worked out actuarially.

This is what health insurance should have always been.... like your car insurance: It doesn't cover oil changes, tires, brake pads, windshield wipers, or any other basic good. But it does present you with a tiny bill when something major happens. How tiny depends upon how much you are willing to pay per month.

The problem with high deductible + HSA is it now flies in the face of the mountain of lies we have erected in the healthcare industry. It will act like a beacon sucking away all the healthy people who will leave the government run pools in increasingly sicker and sicker condition leading to a death spiral in the insurance market. This has been going on since the beginning of Obamacare and that's why in like 1/3 to 1/4 of the country there's only one insurer to choose from on the Obamacare exchange. This is why with the sole exception of temporary insurance high deductible plans have been outlawed since Obamacare's passage.

I'm not a great fan of this Republican proposal from what I've read. But I far more hate those who champion Obamacare while standing atop the ashes of what use to be the health insurance industry.

I'm not champion of Obamacare, but there's little I'd love more than to be standing atop the ashes of the for profit health insurance industry.
03-25-2020 03:26 PM
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Post: #35
RE: House Republicans preparing health care bill
(03-25-2020 03:26 PM)b0ndsj0ns Wrote:  
(03-25-2020 03:04 PM)georgia_tech_swagger Wrote:  
(03-25-2020 02:56 PM)Owl 69/70/75 Wrote:  I would allow the option of substituting a high deductible with a HSA for the basic plan. All that could be worked out actuarially.

This is what health insurance should have always been.... like your car insurance: It doesn't cover oil changes, tires, brake pads, windshield wipers, or any other basic good. But it does present you with a tiny bill when something major happens. How tiny depends upon how much you are willing to pay per month.

The problem with high deductible + HSA is it now flies in the face of the mountain of lies we have erected in the healthcare industry. It will act like a beacon sucking away all the healthy people who will leave the government run pools in increasingly sicker and sicker condition leading to a death spiral in the insurance market. This has been going on since the beginning of Obamacare and that's why in like 1/3 to 1/4 of the country there's only one insurer to choose from on the Obamacare exchange. This is why with the sole exception of temporary insurance high deductible plans have been outlawed since Obamacare's passage.

I'm not a great fan of this Republican proposal from what I've read. But I far more hate those who champion Obamacare while standing atop the ashes of what use to be the health insurance industry.

I'm not champion of Obamacare, but there's little I'd love more than to be standing atop the ashes of the for profit health insurance industry.

Without foor profit health insurance, you wouldnt be standing on the ashes. You would be the ashes.
03-25-2020 03:29 PM
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Post: #36
RE: House Republicans preparing health care bill
(03-25-2020 03:23 PM)bullet Wrote:  I disagree totally.

Anyone who already has health insurance is covered for those "pre-existing conditions."

So all we are talking about for most people is portability. There is ZERO extra cost to the system for anyone already covered.

The people not covered are generally young and healthy or poor and already subsidized. So you have a relatively small group that adds to the system costs.


If you can not have insurance and then simply pick up coverage when you get sick that's not insurance: that's a bailout. And that is the nature of the health insurance market for at minimum 2 months a year. For anybody with a functioning brain you get a free health insurance bailout 2 months a year every year. I get temporary health insurance for the non-open enrollment period then sit without coverage during open enrollment or get coverage and get all the physicals/exams on planet earth, including a year's supply of generic norvasc (high blood pressure). Yes, they'll write it for a literal year's supply with one visit.

I don't feel bad in the least about this behavior because as somebody who is self-employed and buying for just themselves on the individual market I can say with total confidence that the Democrats ****** and fleeced me on health insurance. I went from a choice of 6 carriers at around $150/mo premium to 1 carrier, $400/mo premium, shittier coverage, and far less doctors to choose from. But in the event I suddenly grow a uterus and give birth I have maternity care, required by law, as part of my Obamacare coverage. You know, we need to be all woke and inclusive and equality minded by asking for men everywhere to subsidize the medical cost of a uterus. *roll eyes*
03-25-2020 03:30 PM
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Post: #37
RE: House Republicans preparing health care bill
(03-25-2020 09:18 AM)bullet Wrote:  https://justthenews.com/politics-policy/...eform-plan

Of course its just a campaign platform since Putin's puppet Pelosi will never let it see the light of day.

"...According to Scalise, key elements of the plan will include:

Protecting patients with pre-existing conditions.
Allowing Americans to shop across state lines for cheaper insurance.
Ending the practice of drug companies paying generic manufacturers to make cheaper versions of popular but expensive medicines
Ending hidden/surprise hospital, testing and doctor charges that arrive later in the mail.
Getting rid of middlemen in the medical supply chain who drive up the costs of drugs, procedures and equipment or interfere in treatment decisions.
Scalise said Republicans are also ready to battle over the issue of pre-existing conditions, which Democrats used effectively in their 2018 election efforts by touting
Obamacare’s protections...."


Another words, Republicans are forcing ration cure and death panels.
2.Blue Cross/Blue Shields is becoming a monopoly in the state of Arkansas because clinics, doctors and hospitals are slowly rejecting other insurances because for not paying.
03-25-2020 03:42 PM
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Post: #38
RE: House Republicans preparing health care bill
(03-25-2020 03:26 PM)b0ndsj0ns Wrote:  I'm not champion of Obamacare, but there's little I'd love more than to be standing atop the ashes of the for profit health insurance industry.

Which sounds great and is popular....

but even a worst-case scenario puts the margins for healthcare in the mid single digits....and more importantly, encourages cost-savings through efficiency while the 'nfp' sector does not. Before you say 'they deny care to save costs', that's not generally true since ICD-9 and the advent of EMR and billing codes, where the only things that are denied are codes that are not covered, and all you have to do to fix that is precisely what has happened, where codes and categories of codes are all either covered, or not.

It says something that 'for profit' Medicare Advantage plans can often cover the 20% copay, add dental insurance and often many more things for the SAME money that Medicare allots to them (which is less than what is actually allocated to them through Medicare)... all while generally paying providers more than Medicare does. 20% of inpatient services for the cohort of people 65+ is a whole lot of money. Sure, it doesn't happen everywhere, but why would it happen at all if Medicare were efficient?
(This post was last modified: 03-25-2020 03:48 PM by Hambone10.)
03-25-2020 03:48 PM
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Post: #39
RE: House Republicans preparing health care bill
(03-25-2020 03:42 PM)DavidSt Wrote:  Another words, Republicans are forcing ration cure and death panels.
2.Blue Cross/Blue Shields is becoming a monopoly in the state of Arkansas because clinics, doctors and hospitals are slowly rejecting other insurances because for not paying.

Did you miss the part about buying across state lines?

What you mean is BCBS is paying providers more than others are. Why is the quickest/highest paying service who is obviously price competitive with/cheaper than everyone else (else everyone would buy their policy and doctors would be forced to take it) a 'bad' thing in your world?
(This post was last modified: 03-25-2020 03:52 PM by Hambone10.)
03-25-2020 03:50 PM
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Post: #40
RE: House Republicans preparing health care bill
(03-25-2020 03:29 PM)UofMstateU Wrote:  
(03-25-2020 03:26 PM)b0ndsj0ns Wrote:  
(03-25-2020 03:04 PM)georgia_tech_swagger Wrote:  
(03-25-2020 02:56 PM)Owl 69/70/75 Wrote:  I would allow the option of substituting a high deductible with a HSA for the basic plan. All that could be worked out actuarially.

This is what health insurance should have always been.... like your car insurance: It doesn't cover oil changes, tires, brake pads, windshield wipers, or any other basic good. But it does present you with a tiny bill when something major happens. How tiny depends upon how much you are willing to pay per month.

The problem with high deductible + HSA is it now flies in the face of the mountain of lies we have erected in the healthcare industry. It will act like a beacon sucking away all the healthy people who will leave the government run pools in increasingly sicker and sicker condition leading to a death spiral in the insurance market. This has been going on since the beginning of Obamacare and that's why in like 1/3 to 1/4 of the country there's only one insurer to choose from on the Obamacare exchange. This is why with the sole exception of temporary insurance high deductible plans have been outlawed since Obamacare's passage.

I'm not a great fan of this Republican proposal from what I've read. But I far more hate those who champion Obamacare while standing atop the ashes of what use to be the health insurance industry.

I'm not champion of Obamacare, but there's little I'd love more than to be standing atop the ashes of the for profit health insurance industry.

Without foor profit health insurance, you wouldnt be standing on the ashes. You would be the ashes.

Or we could have non-profit heath insurance industries like Bismarck countries have. There is zero value added by those companies being for profit. They aren't doing research, they aren't developing drugs, they are literally just profiting off of human suffering.
03-25-2020 03:52 PM
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