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Author Topic:   Republican Healthcare Plan
Taq
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Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


Message 1 of 187 (794151)
11-10-2016 4:35 PM


The future of healthcare in the US has always fascinated me, and it appears that be heading for yet another big shakeup. I would like to start a discussion on what people think of the Republican plan, what they are getting right, and what they should do differently.
The first basic question the Republican party has to answer is if their plan will guarantee insurance for all Americans, or if they will allow insurance companies to deny coverage to sick people in order to lower premiums for healthy people. How they answer that question will greatly affect how they construct their healthcare strategy.
**preferred placement in Coffee House**
Edited by Taq, : No reason given.

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Taq
Member
Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


(2)
Message 21 of 187 (794469)
11-16-2016 11:37 AM
Reply to: Message 14 by petrophysics1
11-11-2016 12:30 PM


Re: Try reading what Trump said it has been on his website since March
petrophysics1 writes:
As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.
One of the biggest hurdles is getting everyone into the healthcare system, including healthy people. By eliminating the mandate to buy health insurance this discourages young healthy people from buying insurance which increases the prices for everyone as a disproportionate number of sick people enter the system. That's just one problem.
The other problem is a lot of "hows". For example:
"As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it." (from the Trump plan that you quoted earlier)
Many state governments have already refused to increase Medicaid coverage for lower income people when it was a part of Obamacare. Trump also does not outline how people will afford insurance if they don't qualify for Medicaid. Paying for unaffordable insurance and then also saving money on the side for an HSA is simply not a viable plan.
On top of that, there is nothing in the plan about guaranteed coverage, at least not that I can see. If you repeal the ACA, you are also repealing the requirement that insurance companies insure everyone. Before the ACA, insurance companies only competed with each other to get healthy people into their plans while denying coverage to sick people. It appears that if we enact the Trump plan, that is what we will return to.

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Replies to this message:
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Taq
Member
Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


Message 22 of 187 (794470)
11-16-2016 11:45 AM
Reply to: Message 6 by jar
11-11-2016 7:59 AM


Re: Eye Of Newt
jar writes:
The US has one of the highest per person health care costs in the developed world and one of the lowest health care ratings in the developed world. No one in civilized countries ever goes bankrupt paying medical bills.
While the quality of US healthcare can be debated back and forth (e.g., shorter life expectancy because people are not receiving healthcare), there is nothing to debate when it comes to the high cost of US healthcare. We pay more than twice what other countries pay.

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Taq
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Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


(2)
Message 24 of 187 (794476)
11-16-2016 1:07 PM
Reply to: Message 23 by New Cat's Eye
11-16-2016 12:29 PM


Re: Try reading what Trump said it has been on his website since March
Cat Sci writes:
That's only half of it, though. Just because an insurance company is required to insure you doesn't mean that a healthcare provider is required to accept it. And that's exactly the problem that friends of mine who utilized Obamacare are complaining about: They have insurance now but they're having problems finding people who take it.
Half is better than none.
The plan is to have the insurance premiums be deducted from your taxes and the contributions to the HSA be tax-free. That should alleviate some of the cost burden.
Many (most?) lower income families are already taking the standard deduction, so I don't know if they could even take advantage of an itemized deduction. I guess it depends on how they write it into the tax code. Will it be in addition to the standard deduction, or would you have to qualify for an itemized deduction?
Even with the deduction, how much will that actually save the consumer? Let's say that premiums are $500/month (6k/year) and their taxable income is 25k a year with a 15% tax rate. 25k would be 3.7k in taxes while taxes on 19k would be 2.85. How much of a difference would an HSA with $800-$900 in it make? Probably not much. In fact, if the deductible is 2.5k they probably can't even afford to save that 1k with the tax deduction if they had any doctor visits during that year.
Does anyone expect someone making 25k a year to put their tax refund check into an HSA? The reason that Social Security works is that we have to put that money into the system. If Social Security were optional, would it still work? Probably not.
I really don't see how HSAs can solve anything. It certainly doesn't address the reason healthcare costs are so high to begin with.
The plan is to block-grant Medicaid to the states. Then they can utilize the money however it best fits their citizens.
We have already seen what Republicans think will best fit their citizens. That would be no social programs whatsoever.
Also, the plan for price transparency of procedures and the cross-state insurance options would allow individuals to shop around for the best prices for both insurance and procedures.
It allows companies to use the worst regulations from the worst state across the entire country, and there has already been competition for decades. Neither is going to lower prices.
All in all, it doesn't sound like a bad plan for allowing individuals to have more control over what they're spending on healthcare, by having the power to decide what they spend on coverage and procedures.
It takes control out of their hands by removing regulations that previously protected them. It also puts no control on prices. The Trump plan looks like it puts all of the control back in the hands of the insurance companies and healthcare providers. Without regulations to limit prices and subsidies for lower income people, there is no getting out of this problem.
Edited by Taq, : No reason given.

This message is a reply to:
 Message 23 by New Cat's Eye, posted 11-16-2016 12:29 PM New Cat's Eye has replied

Replies to this message:
 Message 26 by New Cat's Eye, posted 11-16-2016 1:36 PM Taq has replied

  
Taq
Member
Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


Message 28 of 187 (794488)
11-16-2016 2:54 PM
Reply to: Message 26 by New Cat's Eye
11-16-2016 1:36 PM


Re: Try reading what Trump said it has been on his website since March
Cat Sci writes:
Is it, though? Being forced to pay for insurance that your provider won't take and then paying out of pocket for a procedure anyways is not better than just paying out of pocket in the first place.
Going to a provider that does take your insurance is obviously better. The next obvious step is to pass regulations that force all providers to accept all insurance.
I don't know what the standard deduction is, but the way I read it we all get to deduct our insurance premiums from our taxes. If your insurance isn't great, then you should put that money into a tax free HSA.
If your itemized deductions are less than the standard deduction, then you take the standard deduction. For people with low incomes that pay rent for housing, chances are their itemized deductions will be less than the standard deduction so they will often take the standard deduction. The standard deduction for a single person is currently $6,300, so if their insurance premiums are less than 6,300 per year then it might not make a difference in the taxes they pay.
However, they could allow tax payers to use the standard deduction and also deduct the cost of their premiums. Again, it depends on how they write the tax code.
I don't doubt that any plan will have cases that can be made that won't work well, but that's still better than being forced to pay for insurance that your provider doesn't accept.
Then find a provider who does take it. Simple fix.
If they care about being prepared for healthcare costs... what, am I to assume that people in general are idiots?
They probably also care about paying rent, power bills, and car payments.
Obamacare was suppposed to reduce the costs, except that it didn't. Let's try something else.
Let's try something that actually works.
Doesn't that depend on the state? And is there really a correlation between red states and no social programs?
My own state is very red, and they didn't expand Medicaid. Yes, there is a strong correlation.
Does it? If state X has more regulations than state Y, then does state Y really have to accept State X's stuff?
Under Trumpcare, yes it does have to accept the crappier regulations from another state. It takes control out of the hands of the people in that state and gives that power to the legislatures of other states.

This message is a reply to:
 Message 26 by New Cat's Eye, posted 11-16-2016 1:36 PM New Cat's Eye has replied

Replies to this message:
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 Message 30 by Diomedes, posted 11-16-2016 3:17 PM Taq has replied

  
Taq
Member
Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


Message 43 of 187 (794505)
11-16-2016 4:09 PM
Reply to: Message 30 by Diomedes
11-16-2016 3:17 PM


Re: Try reading what Trump said it has been on his website since March
Diomedes writes:
What 'works' is a singular system that is either partially or fully run by the government. Every 1st world country on the planet has recognized this except the USA.
There are a mixture of approaches out there. The common thread is that prices are regulated by the government. They pay less because they don't treat peoples' health as something to make a profit off of.
When you have a product that people can literally not live without (notice the proper usage of "literally" ) and you put that into a free market, what happens? Suppliers will increase prices as high as they can. That's what has happened in the US.

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Taq
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Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


(3)
Message 67 of 187 (794532)
11-16-2016 6:39 PM
Reply to: Message 50 by JonF
11-16-2016 4:17 PM


Re: Try reading what Trump said it has been on his website since March
JonF writes:
Ok, what laws inhibit sale of insurance across state lines and what side effects will getting rid of them have?
Each state has their own regulations, and an insurance company has to abide by those regulations. I know of no state with just one company offering health insurance, so there is already competition in each state. The only side effect I see of getting rid of this system is to allow companies to use use the most corporate friendly regulations in one state to sell insurance in another state. I believe the same thing has happened with banking rules in the past.
Will anyone do anything to make the economics more favorable?
If the country would pull its collective head out of its ass, the Democrats would. The really sad part is that there is very little public support for a single payer system which is the only viable solution for decreasing the price of healthcare. Propaganda has convinced US citizens that socialism is bad, so they are against it. At the same time, they think their socialist schools, roads, fire departments, and other socialist programs are just great.

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Taq
Member
Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


(3)
Message 68 of 187 (794533)
11-16-2016 6:42 PM
Reply to: Message 39 by New Cat's Eye
11-16-2016 3:58 PM


Re: Try reading what Trump said it has been on his website since March
Cat Sci writes:
Having the government in charge of something makes it cost more money and take longer. Plus they're notoriously incompetent and careless.
Other countries have government run healthcare that people really, really like. On top of that, they pay half of what we do in the US. How do you explain that? The NHS is a government agency that runs the healthcare system in the UK. They pay less than half of what we do for healthcare. How do you explain that?

This message is a reply to:
 Message 39 by New Cat's Eye, posted 11-16-2016 3:58 PM New Cat's Eye has replied

Replies to this message:
 Message 73 by New Cat's Eye, posted 11-16-2016 7:21 PM Taq has replied

  
Taq
Member
Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


Message 69 of 187 (794534)
11-16-2016 6:44 PM
Reply to: Message 53 by New Cat's Eye
11-16-2016 4:35 PM


Re: Try reading what Trump said it has been on his website since March
Cat Sci writes:
I dunno, maybe the UK government is better than ours.
Have you ever worked with the US government?
If the UK can do it, why can't the US?
All of the socialist programs out there cost less than our US for-profit system. How do you explain that?

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Taq
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Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


(7)
Message 71 of 187 (794536)
11-16-2016 7:12 PM


Myths Americans Believe About Healthcare
One of the enduring myths so many Americans believe about socialist healthcare is that it costs too much. We have seen Cat Sci repeat that myth in this very thread. I have heard this same myth repeated ad nauseum by many, many of my fellow citizens. Here are the facts:
See all those countries paying much less than the US? Those are socialist healthcare systems. Unless someone can show how these numbers are incorrect, lets just accept the fact that the the US for-profit system costs too much, not socialist healthcare. If someone can't accept these plain facts, then their opinions on this topic are simply not legitimate.
With that said, the US healthcare system is a 500 billion dollar industry that takes up 16% of our GDP. It is a massive behemoth that employs hundreds of thousands, if not millions of people. Its not as if we can flip a switch and suddenly have our own NHS tomorrow. The industry has massive momentum and it can't be changed overnight.
The ACA was a first step, however flawed. It attempted to get everyone into the healthcare system, something that has to happen if we are going to move healthcare in the right direction. We can't leave out sick people who can't get insurance through an employer. In fact, we shouldn't be tying access to healthcare to employment at all.
So what we are really talking about is something that pushes the massive ship of US healthcare a few degrees towards a better harbor, and a set of future steps to keep pushing the system.
Edited by Taq, : No reason given.

Replies to this message:
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Taq
Member
Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


(6)
Message 72 of 187 (794537)
11-16-2016 7:17 PM
Reply to: Message 70 by jar
11-16-2016 7:02 PM


Re: The real obscenity.
jar writes:
The real obscenity and the one not being addressed or even questioned is the idea that health care, education, public utilities, roads and protection should ever be profit centers or for profit enterprises.
Precisely. In my state, and I assume in many or all other states, the price for utilities is controlled by the state. Companies aren't allowed to jack up the price for electrical power or gas when there is a cold snap in the winter. If we treated utilities like we treat healthcare, that is exactly what would happen.
What if we treated education the same way? What if kids born to poor families weren't able to attend elementary school. What if fire departments would just watch houses burn to the ground because they hadn't paid their fire department insurance? What if all roads were toll roads so poor workers couldn't even afford to get to work?
Why should healthcare be any different than utilities, education, roads, and the fire department? It is absolutely obscene that people treat healthcare differently than these other institutions.

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Taq
Member
Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


Message 75 of 187 (794540)
11-16-2016 7:24 PM
Reply to: Message 73 by New Cat's Eye
11-16-2016 7:21 PM


Re: Try reading what Trump said it has been on his website since March
Cat Sci writes:
A damn 40% tax rate. Fuck that.
So you don't want to spend less than 50% of what we are currently spending on healthcare if it means that the government is involved? If so, why?

This message is a reply to:
 Message 73 by New Cat's Eye, posted 11-16-2016 7:21 PM New Cat's Eye has replied

Replies to this message:
 Message 77 by New Cat's Eye, posted 11-16-2016 7:30 PM Taq has replied

  
Taq
Member
Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


Message 76 of 187 (794541)
11-16-2016 7:26 PM
Reply to: Message 74 by New Cat's Eye
11-16-2016 7:23 PM


Re: Myths Americans Believe About Healthcare
Cat Sci writes:
Where did I say that?
"Having the government in charge of something makes it cost more money and take longer. "--Cat Sci, message 39

This message is a reply to:
 Message 74 by New Cat's Eye, posted 11-16-2016 7:23 PM New Cat's Eye has replied

Replies to this message:
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Taq
Member
Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


(3)
Message 91 of 187 (794568)
11-17-2016 10:42 AM
Reply to: Message 77 by New Cat's Eye
11-16-2016 7:30 PM


Re: Try reading what Trump said it has been on his website since March
Cat Sci writes:
I've seen the government fuck up enough shit that the last thing that I want them in charge of is my healthcare. But I don't care if they are in charge of your healthcare.
In your own posts you are describing how the current corporate run system is fucked up, yet you want to stick with it. You want to stick with a system that is messed up AND pay twice as much for it.
I also don't want to pay more in taxes. And I'd like to keep my healthcare costs reasonable.
So now what?
Now you work on realizing how those two wishes are in complete contradiction to each other.
Edited by Taq, : No reason given.

This message is a reply to:
 Message 77 by New Cat's Eye, posted 11-16-2016 7:30 PM New Cat's Eye has replied

Replies to this message:
 Message 94 by New Cat's Eye, posted 11-17-2016 10:54 AM Taq has replied

  
Taq
Member
Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


(4)
Message 93 of 187 (794570)
11-17-2016 10:50 AM
Reply to: Message 87 by New Cat's Eye
11-17-2016 9:39 AM


Re: Try reading what Trump said it has been on his website since March
Cat Sci writes:
My employer pays me a salary and on top of that they pay for my health insurance as a benefit. If I opt out of the benefit, then that money does *not* go on top of my salary.
This is why we need better unions in the US. Workers need to band together and negotiate better deals for their compensation. If we do shift from private insurance to single payer, employers absolutely should give you that money as salary.
Medicare also requires supplemental insurance.
Now you are complaining that people don't have enough socialist healthcare.
So why would you want them in charge of your healthcare?
In a single-payer system, your doctor is in charge of your healthcare just as your doctor is now. The government's role is to figure out how to pay for the treatments that your doctor prescribes.
I'd expect it to be worse with the government...
And yet this system works in every other first world nation.

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