The Health Care Debate

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shinatoo
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Re: The Health Care Debate

Postby shinatoo » Fri Aug 26, 2016 8:06 am

Start with Medicare for everyone under 18, or 26. It's the cheapest group to insure and it's a political fail to be opposed to giving children healthcare. Then keep expanding by a year every year until everyone is clamoring to have it become universal.
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grovester
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Re: The Health Care Debate

Postby grovester » Fri Aug 26, 2016 9:05 am

aknowledgeableperson wrote:The ACA was a political hack job from the beginning. Even within the Dem ranks there were too many compromises made to get the votes that in the end all that can be said is "We got something accomplished." And that accomplishment was getting a bill passed. That bill didn't come close to fixing the problem and in some cases made the problem worse.

I don't know what the overall solution would be. Right now I am not completely sold on the idea of Medicare-for-all but I am close to saying that is a major part of the solution. Private insurance companies could still be involved in tie-in programs and such, much like they are now. One major problem that needs to be fixed are drug costs. If other countries can have them and the drug companies comply then why not here.


The ACA got us off zero. It has set up an infrastructure for future needs and proved that universal healthcare would not lead to godless communism or financial collapse.

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grovester
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Re: The Health Care Debate

Postby grovester » Fri Aug 26, 2016 9:06 am

shinatoo wrote:Start with Medicare for everyone under 18, or 26. It's the cheapest group to insure and it's a political fail to be opposed to giving children healthcare. Then keep expanding by a year every year until everyone is clamoring to have it become universal.


^this.

Single payer>ACA>no ACA

aknowledgeableperson
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Re: The Health Care Debate

Postby aknowledgeableperson » Fri Aug 26, 2016 1:10 pm

"The ACA got us off zero. It has set up an infrastructure for future needs and proved that universal healthcare would not lead to godless communism or financial collapse."

Got us off zero but in the wrong direction. As for the infrastructure it will have to be dismantled and replaced. ACA just continues what is wrong with our current health care system.
Right now public health insurance is a state based product. Yes companies have a national presence but because of state regulation it's almost like having 50 individual companies. Medicare is countrywide. If I am a national employer I can have my coverage for employees with one company but that coverage and costs will vary from state to state.

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Re: The Health Care Debate

Postby shinatoo » Fri Aug 26, 2016 1:24 pm

Sorry AKP but I have to disagree. The main issue was "how do we get people on insurance that have preexisting conditions". Only ways that was going to happen way either universal coverage or required coverage. UC was never going to pass eight years ago, or any time since then. Required coverage demands subsidized coverage for low income earners. The only way to manage those subsidies is through the marketplace.

We are moving in the right direction because we are making insurance available to everyone. We have a long way to go, but at least we have taken care of the "basic human rights" portion of the problem.
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Re: The Health Care Debate

Postby aknowledgeableperson » Fri Aug 26, 2016 3:40 pm

Yes, in some areas the move was positive but in many others it was negative.
Eliminating lifetime maximums and pre-existing conditions could have been done without the rest of ACA. Intentions were good, the execution was lacking.
Anyway, preexisting conditions was not the main issue. On that we will just have to disagree.

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Re: The Health Care Debate

Postby grovester » Sun Aug 28, 2016 10:21 am

Latest results of the ACO programs previously mentioned.

http://www.cnbc.com/2016/08/25/obamacar ... -year.html

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Re: The Health Care Debate

Postby aknowledgeableperson » Wed Sep 07, 2016 1:49 pm

Here is a problem the ACA doesn't address, maybe a single payer system like Medicare would. The problem is much like drug costs. And the problem is how much the different insurance companies and the ACA co-ops, actually pay for the services received by their enrollees.
For example I was hospitalized and had surgery back in February this year. My hospital bill totaled almost $116,000. My insurance company arranged savings/discounts of approx. $79,000 meaning the hospital received from my insurance company and me only about $37,000. The surgeon's bill was over $6,500 but it was settled for $1,900. I am not complaining about the amounts, especially since I had emergency room, ICU, operating room, almost 7 days of a hospital stay along with a difficult surgery. In fact given what was actually paid it might be a bargain.
Now I have a rather large insurance carrier and it can negotiate large discounts. But smaller carriers and the small ACA co-ops may not be able to negotiate similar savings for the patient and themselves.
Reminds me of the hospital stay my mother-in-law had over 7 years ago before passing. Her hospital bill was over $44,000 but Medicare and the estate share of payment was under $10,000.

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Re: The Health Care Debate

Postby flyingember » Wed Sep 07, 2016 3:52 pm

I dislike the whole thing where the hospital is in network, the surgeon is, but the anthologist is on contract and isn't.

Even for transparency a single bill with single payment source would help a lot. Why do I get one for the hospital and one for people who I saw at the hospital? Basically the facility/business should be associated with insurance, not the person

I've seen insurance submissions where there was 10-15 different submissions for a three day stay. The bills rarely matched the name submitted under, the insurance company had different numbers than the bill showed, and so on. A single unified bill would help everyone around medicine. I knew what I was looking at and it got confusing for me.

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Re: The Health Care Debate

Postby aknowledgeableperson » Wed Sep 07, 2016 4:25 pm

Oh, I had many, many bills. A big majority from the many doctor's who looked at my case (I was admitted under one condition but that was incorrect and I had a far worse condition). Doctor's work independently of the hospital. Fortunately I was in a health care system that had all health care providers covered by my insurance company.

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grovester
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Re: The Health Care Debate

Postby grovester » Wed Sep 07, 2016 5:06 pm

The numbers they bill before discounts are completely imaginary and only apply to the poor souls who don't have insurance.

https://en.wikipedia.org/wiki/Chargemaster

aknowledgeableperson wrote:Here is a problem the ACA doesn't address, maybe a single payer system like Medicare would. The problem is much like drug costs. And the problem is how much the different insurance companies and the ACA co-ops, actually pay for the services received by their enrollees.
For example I was hospitalized and had surgery back in February this year. My hospital bill totaled almost $116,000. My insurance company arranged savings/discounts of approx. $79,000 meaning the hospital received from my insurance company and me only about $37,000. The surgeon's bill was over $6,500 but it was settled for $1,900. I am not complaining about the amounts, especially since I had emergency room, ICU, operating room, almost 7 days of a hospital stay along with a difficult surgery. In fact given what was actually paid it might be a bargain.
Now I have a rather large insurance carrier and it can negotiate large discounts. But smaller carriers and the small ACA co-ops may not be able to negotiate similar savings for the patient and themselves.
Reminds me of the hospital stay my mother-in-law had over 7 years ago before passing. Her hospital bill was over $44,000 but Medicare and the estate share of payment was under $10,000.

aknowledgeableperson
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Re: The Health Care Debate

Postby aknowledgeableperson » Wed Sep 07, 2016 9:54 pm

I know about those non-discounted charges. What I was hoping to point out is those discounts I received are high and it is quite possible that others may not get the amount of discount I and those on Medicare are able to receive.


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