Ladies and Gentlemen your American elected senators

[SPK145]

So if that's not it, why did he vote against it?

He previously voted to repeal Obamacare, he ran last year on a platform of repealing Obamacare, Trump is now president, now he votes NOT to repeal Obamacare, then runs around with a thumbs up victory lap on the Senate floor like a child.

Maverick or asshole?

 

[shu09]

He previously voted to repeal Obamacare, he ran last year on a platform of repealing Obamacare, Trump is now president, now he votes NOT to repeal Obamacare, then runs around with a thumbs up victory lap on the Senate floor like a child.

Maverick or asshole?

That's not how I saw it. He came on the floor and gave the thumbs down after his name was called by the clerk. They were already on to the next senator by the time he got back on the floor after talking directly to Trump.

I don't remember what the bill was that he voted for previously, but no two bills are exactly alike. Maybe this one had provisions in it that he couldn't get behind.

 

[knowknow456]

Maverick or asshole?

It is possible to be both I suppose.

Of course, he voted no on a bill that was going to Conference so it could be re-written. No only was this not a repeal of ACA, it wasn't even a bill that was going to be the final bill - unless of course, the House ran with it and passed it as is - which he was expressly concerned about and opposed to.

Some people called him an ass for his speech, followed by the vote to bring the bill to the Senate floor in the first place. Many believe the bill was not crafted via the regular order and McCain was being disingenuous voting yes at that point.

 

[Merge]

I got on line at Toys R Us and two African- American women had their hours reduced from 40 to 29 and they have to go to the marketplace. They blame Obamacare and the government and nobody else..

Anecdotally - Sure those things have probably happened.
If significant, that would show up in the employment statistics right, meaning more people would be working "part time for economic reasons" meaning they have a part time job but want a full time job.

So I took a quick look at the employment statistics from July 2008. Before Obama took office.
146 million employed. 5.7 million part time

Last report from BLS June 2017
159 million employed. 5.3 million part time.

If what you are saying were a significant problem created by the ACA, that number would be much higher than it is now.

The other person I spoke to there has private healthcare offered from Toys and it has become too expensive for his family of 4. He dropped it and now they pay as they go.

That is not a problem created by the ACA. Insurance costs went up almost 10% every year the 8 years before Obama stepped into office.

 

[Merge]

He previously voted to repeal Obamacare, he ran last year on a platform of repealing Obamacare, Trump is now president, now he votes NOT to repeal Obamacare, then runs around with a thumbs up victory lap on the Senate floor like a child.

Maverick or asshole?

They are all assholes.

Repeal will not pass. No one wants it to pass. They only needed 3 people to say no.
If they needed 10, they would have had 10.

I am however glad McCain got to be the one to do it. Trump's comments about him were disgusting. He deserved a little payback.

 

[Hall-line-forever]

Totally agree, Merge. Great call!

 

[SHUHoopsFan]

They are all assholes.

Repeal will not pass. No one wants it to pass. They only needed 3 people to say no.
If they needed 10, they would have had 10.

I am however glad McCain got to be the one to do it. Trump's comments about him were disgusting. He deserved a little payback.

Repeal will pass. It has to. The one good thing the ACA does is give 30 million people health coverage. Everything else about it is terrible. It forces people to have insurance that don't want it. It doubles the insurance costs of people just above the threshold who are busting their asses to make ends meet so that they can help pay for the 30 million others. It causes small business employers to limit workers hours. While this bill helps 30 million Americans it probably has a negative effect on at least 100 million Americans. Eventually repeal will pass or it's going to blow up. Democratic senators will not approve anything that takes those 30 million off insurance because they need those votes. Republicans aren't going to want to answer how come they didn't repeal it when they had the chance next election cycle. They have a few months to get it right as opposed to just putting a plan together that doesn't work.

 

[Merge]

The one good thing the ACA does is give 30 million people health coverage. Everything else about it is terrible. It forces people to have insurance that don't want it.

So how do we pay for the people who need it if every healthy person dropped their coverage? Also, we would be back to a time where insurance companies can deny coverage for pre-existing conditions?

Republicans may repeal something, but it will likely not be a significant part of the plan... and it will not improve anything.

It causes small business employers to limit workers hours.

Again, it is not a significant issue as the number of part time employees is below where it was when Obama took office. It is a theoretical problem which I get, but there hasn't been a large influx of part time workers. It also didn't happen in Massachusetts when they implemented their healthcare law. Also, employers have been offering different benefits for part time employees for decades, no? If it is too expensive for them to offer healthcare benefits, they just hire part time workers, right?

While this bill helps 30 million Americans it probably has a negative effect on at least 100 million Americans.

Probably? Kids up to 26 can now stay on their parents plan. No one can be denied coverage for a preexisting condition (which only works with a mandate btw) No one can be kicked off their individual plan for being too sick. The bill has flaws but it added protections for everyone.

Eventually repeal will pass or it's going to blow up.

What does blow up mean to you? The only part that is at risk of blowing up are the individual plans because insurance companies are waiting for a bailout from the government which may eventually come. We could fix the individual marketplace tomorrow by allowing anyone in the individual marketplace to buy into Medicare... of course that won't happen though.

Bernie is saying he will start to push a single payer bill. If dems are smart they will get behind his bill, build public support into the midterms and negotiate from there.

 

[donnie_baseball]

Here's an interesting debate between a Bernie sycophant and someone with a brain:

 

[Merge]

Ben Shapiro is an excellent debater and incredibly persuasive. If you have an understanding of what he is talking about though, he is full of shit. Cenk is not nearly as polished.
Also worth noting though that Cenk is promoting what SPK (resident leader of the right leaning folk here) was talking about in this thread. Let Medicare be our safety-net and if people want to buy more (free market) they can.

I haven't watched the whole thing, but Shapiro starts it off by saying he is wildly disappointed because the republicans did not pursue a full repeal of Obamacare. Obviously they didn't because they is not an option. They would need 60 votes for full repeal which they do not have.

Then says he thinks the "social fabric" should fill the gap for preexisting conditions.... Really? We should just hope that churches will take care of everyone? His criticism of government healthcare is that it would be bad because they shouldn't be able to tell a doctor what procedures they can perform and what prices they will pay... and what exactly are private insurance companies doing? It is the same exact principle but he has no problem with it?

Also says Medicare for all would not be affordable? I would pay less under the plan Bernie proposed than I am currently paying for my health insurance. Far majority of the country would as well.

I stopped shortly after that.

 

[SPK145]

Also worth noting though that Cenk is promoting what SPK (resident leader of the right leaning folk here) was talking about in this thread. Let Medicare be our safety-net and if people want to buy more (free market) they can.

When did I ever say that???

 

[Merge]

When did I ever say that???

Sorry if I misunderstood you. Medicare for all with optional insurance on top would allow for a safety net with free market approach above the safety net.

 

[HALL85]

Sorry if I misunderstood you. Medicare for all with optional insurance on top would allow for a safety net with free market approach above the safety net.

It's not a safety net if the net is the first level of coverage....kind of like having a tight rope walker, walk across a net with the rope beneath it...

 

[Merge]

It's not a safety net if the net is the first level of coverage....kind of like having a tight rope walker, walk across a net with the rope beneath it...

If that were the case, there would be no market for plans to buy beyond typical Medicare coverage.

This could be a fairly reasonable solution. Medicare for all with bronze level type of plan paid for through a payroll tax. If people want additional coverage - free market plans could be available that meet conservative metrics. Any benefits received through employment would be fully taxable.

 

[Pirata]

The one good thing the ACA does is give 30 million people health coverage.

"Heath coverage" does not equate to "Health Care"

We should not equate having someone pay $3-12K for a insurance policy with a $12K deductible that will not pay a dime for their actual health treatments as increasing their access to health care.

You went on to say:

It forces people to have insurance that don't want it. It doubles the insurance costs of people just above the threshold who are busting their asses to make ends meet so that they can help pay for the 30 million others. It causes small business employers to limit workers hours. While this bill helps 30 million Americans it probably has a negative effect on at least 100 million Americans. Eventually repeal will pass or it's going to blow up.

True dat!

 

[knowknow456]

"Heath coverage" does not equate to "Health Care"

We should not equate having someone pay $3-12K for a insurance policy with a $12K deductible that will not pay a dime for their actual health treatments as increasing their access to health care.

It is an interesting dilemma. Suppose I offered you a policy that was out of pocket for the first $10,000 in medical bills but 100% coverage after that. How much would you pay for that policy?

 

[NYShoreGuy]

It is an interesting dilemma. Suppose I offered you a policy that was out of pocket for the first $10,000 in medical bills but 100% coverage after that. How much would you pay for that policy?

dr. price visits, prescribed medicine will never go down in cost

 

[knowknow456]

dr. price visits, prescribed medicine will never go down in cost

That isn't entirely true. At first it was hard to afford my Viagara pills but since it went generic, the price has softened quite a bit.

Either way, at what price would you buy a policy like the one I described above?

 

[Merge]

It is an interesting dilemma. Suppose I offered you a policy that was out of pocket for the first $10,000 in medical bills but 100% coverage after that. How much would you pay for that policy?

For reference, I have around a 7k out of pocket max and 5,800 deductible. Cost is about 3k per year for the family plan.

I do also fund an HSA for expenses.

My wife tells me to look for a new job at least once a month when we have to argue medical bills though.

Amazingly before we hit our deductible last year, everything was covered. After the deductible nothing was covered and we had to fight every bill.

 

[HALL85]

At first it was hard to afford my Viagara pills but since it went generic, the price has softened quite a bit?

Freudian slip? LOL

 

[SHUHoopsFan]

That isn't entirely true. At first it was hard to afford my Viagara pills but since it went generic, the price has softened quite a bit.

Either way, at what price would you buy a policy like the one I described above?

Stop wasting your money on pills. Put some watermelon and lemon in a blender. Mix it up, boil it, let it cool down and no need for either the Viagra or the generic.

 

[HALL85]

Stop wasting your money on pills. Put some watermelon and lemon in a blender. Mix it up, boil it, let it cool down and no need for either the Viagra or the generic.

Put things in perspective. The US represents 5% of the global population but consumes 80% prescription opioids. Houston, we have a problem.

Was that a meeting today an an exec from the AHA gave an update on their advocacy efforts. Two interesting points. Regarding the ACA, there was zero emphasis on reducing the cost of care. Considering hospitals are the most expensive point of care, I found this reprehensible. On slide 45 under "other issues", opioid abuse was just one bullet...no detail. At the end when they took questions, I asked the speaker exactly what is their advocacy position on the epidemic (i.e. surveillance, accountability, treatment, behavioral health, etc). His answer demonstrated that they have put no thought into it at all.

 

[NYShoreGuy]

For reference, I have around a 7k out of pocket max and 5,800 deductible. Cost is about 3k per year for the family plan.

I do also fund an HSA for expenses.

My wife tells me to look for a new job at least once a month when we have to argue medical bills though.

Amazingly before we hit our deductible last year, everything was covered. After the deductible nothing was covered and we had to fight every bill.

you are saying your health coverage failed to cover your account once you hit the deductible? good thing about the hsa is that you can contribute per paycheck or standalone contributions towards the deductible. if you have hsa at my workplace, you get 125 in jan, 125 in july and another 200 if you complete a yearly wellness checkup with blood panel and either an eye exam or a dental exam and then you get another 50 if you participate in blood drive, skin cancer screening, next years health expo/coverage plans or set fitness goals with an online coach, have to do 2 of these; a few yrs ago the company used to just give 500 towards hsa spread out quarterly then they added more staff and now you have to do all this to get the 500

 

[Pirata]

Suppose I offered you a policy that was out of pocket for the first $10,000 in medical bills but 100% coverage after that. How much would you pay for that policy?

Without splitting hairs I interpret your policy as what is commonly referred to as a catastrophic policy.

Average premium on those is south of $200 per month.

 

[knowknow456]

Without splitting hairs I interpret your policy as what is commonly referred to as a catastrophic policy.

Average premium on those is south of $200 per month.

A catastrophic policy is health coverage, not necessarily health care. That isn't a completely terrible thing. Many people don't need health care, especially if they are young and otherwise healthy, but they should have health coverage. As anyone who has seen a hospital bill, it doesn't take much to run up a $10,000 bill.

A catastrophic medical event destroys a person's financial life, and often the fees never get paid. That is not good for the patient or the providers. I think there is a place for catastrophic health coverage.

 

[Merge]

you are saying your health coverage failed to cover your account once you hit the deductible? good thing about the hsa is that you can contribute per paycheck or standalone contributions towards the deductible. if you have hsa at my workplace, you get 125 in jan, 125 in july and another 200 if you complete a yearly wellness checkup with blood panel and either an eye exam or a dental exam and then you get another 50 if you participate in blood drive, skin cancer screening, next years health expo/coverage plans or set fitness goals with an online coach, have to do 2 of these; a few yrs ago the company used to just give 500 towards hsa spread out quarterly then they added more staff and now you have to do all this to get the 500

Yep. Once I hit my deductible the insurance company started saying the services we received were not covered by my plan. So I started getting bills for the full price of the services instead of the 10% coinsurance that I would normally pay after the deductible amount. I argued them all and they were eventually covered, it was just a very frustrating process taking many hours. I hit my deductible with 2 different employers (so 2 different plans) over the last 5 years. Both times that resulted in the insurance company denying claims after I hit.

My current workplace promotes the high deductible plans with a match on the HSA of up to $150 per month on my plan which I do take advantage of.

 

[Pirata]

A catastrophic policy is health coverage, not necessarily health care. That isn't a completely terrible thing. Many people don't need health care, especially if they are young and otherwise healthy, but they should have health coverage. As anyone who has seen a hospital bill, it doesn't take much to run up a $10,000 bill.

A catastrophic medical event destroys a person's financial life, and often the fees never get paid. That is not good for the patient or the providers. I think there is a place for catastrophic health coverage.

I agree.

Offer a catastrophic plan without the added expense of other overage.

 

[SHUHoopsFan]

I agree.

Offer a catastrophic plan without the added expense of other overage.

For now there is a need for catastrophic plans. How about let's do something to clean up the air. Let's do something to prevent people from putting ingredients they can't pronounce in their body. Let's do something to reduce the level of stress in this country. These are the main culprits of why everyone is so sick. These are the things Congress should be focusing on. Instead they focusing on covering up the root of the problem by trying to be able to get more people on dialysis, or more people able to get diabetes medication, or more heart medicine, etc. The human body is an amazing thing. Nobody ever needed a pill to heal a cut. The human body knows how to heal itself. We just have to give it the tools it needs. If we continue to harm it, it cannot heal itself like it was designed to.

 

[Merge]

For now there is a need for catastrophic plans. How about let's do something to clean up the air. Let's do something to prevent people from putting ingredients they can't pronounce in their body. Let's do something to reduce the level of stress in this country. These are the main culprits of why everyone is so sick. These are the things Congress should be focusing on. Instead they focusing on covering up the root of the problem by trying to be able to get more people on dialysis, or more people able to get diabetes medication, or more heart medicine, etc. The human body is an amazing thing. Nobody ever needed a pill to heal a cut. The human body knows how to heal itself. We just have to give it the tools it needs. If we continue to harm it, it cannot heal itself like it was designed to.

So this is politically incorrect, but I believe it is a long term goal of Obamacare. Healthcare utilization is so high in our country because care is cheap. I've said here many times that the consequence for a lifetime of a bad diet, smoking , and heavy drinking should cost a lot more than a copay for a doctor visit and a monthly Rx.

These ACA plans don't really provide that anymore. Treating your body like crap on one of those plans will hurt your wallet. That is a good thing In my opinion. The unfortunate part of that is that is also hurts people who get sick at no fault of their own... but long term people will make healthier choices when they can't afford not to. We need a cultural change and it will take many years to get there.

 

[knowknow456]

I never knew my grandparents.
Mother's Mother - dead at 56, breast cancer
Mother's Father - dead at 39, infection
Father's Father - dead at 50, appendicitis
Father's Mother - dead at 31 childbirth
The human body isn't as good at healing itself as you imply

 

[HALL85]

So this is politically incorrect, but I believe it is a long term goal of Obamacare. Healthcare utilization is so high in our country because care is cheap. I've said here many times that the consequence for a lifetime of a bad diet, smoking , and heavy drinking should cost a lot more than a copay for a doctor visit and a monthly Rx.

These ACA plans don't really provide that anymore. Treating your body like crap on one of those plans will hurt your wallet. That is a good thing In my opinion. The unfortunate part of that is that is also hurts people who get sick at no fault of their own... but long term people will make healthier choices when they can't afford not to. We need a cultural change and it will take many years to get there.

That's really not an accurate statement. Care is NOT cheap, in fact it's more expensive here than pretty much every country. The reason it's high is that we have mis-aligned incentives and the patient has no visibility into pricing like they do for just about everything else they purchase. They also purchase insurance which creates layers upon layers where everyone in the system profits through the confusion. Obamacare is just an extension of that.

There are models that work and they are in existence today. What stops them is the system we have that prevents real competition. As a consumer, if I can comparison shop AND I can modify my behavior to improve my cost position, I will do a pretty damn good job of finding the right care for me and it will be infinitely more affordable.

 

[HALL85]

Let me ask this question. Why do we allow direct-to-consumer advertising that funnels billions of dollars on TV advertising, so we have the consumer begging a doctor for every medication on earth? Can anyone give me a reason why this is a good thing? We consume 35% of the worlds prescription drugs....OTC's are no better....that is not cheap care, and if those drugs were so good, why doesn't it translate into our morbidity stats? If you watched the Super Bowl, there were several ads for a medication that treats opioid constipation!!! How many people are suffering from opioid constipation that it requires Super Bowl ads??? Cause and effect.

 

[Merge]

That's really not an accurate statement. Care is NOT cheap, in fact it's more expensive here than pretty much every country.

I am talking about to the consumer. It is cheap. We get insurance from our employer. We never see that money, and if I didn't opt for the high deductible plan and got diabetes... what is my out of pocket costs? Copays? That's it.

I remember copays of $5 to $30. At $5 I went to the doctor for everything. At $30 I started to wait things out.

 

[Merge]

Let me ask this question. Why do we allow direct-to-consumer advertising that funnels billions of dollars on TV advertising, so we have the consumer begging a doctor for every medication on earth?

Agreed. We shouldn't allow that.
Not sure congress would allow such "burdensome job killing regulation" though.

 

[HALL85]

Agreed. We shouldn't allow that.
Not sure congress would allow such "burdensome job killing regulation" though.

Then we should be more demanding of Congress. Why should we tolerate them not doing their jobs?

 

[HALL85]

I am talking about to the consumer. It is cheap. We get insurance from our employer. We never see that money, and if I didn't opt for the high deductible plan and got diabetes... what is my out of pocket costs? Copays? That's it.

I remember copays of $5 to $30. At $5 I went to the doctor for everything. At $30 I started to wait things out.

Not to sound trite, but if it's that cheap, then why is everyone complaining about the cost of their care?

Insurance masks the real market forces and does not enable the consumer to choose the most cost effective choice. Assuming you only had a catastrophic plan and for basic care you had to shop. You have flu like symptoms. You can choose the following:

* Tele-medicine (physician): $20
* Walgreen's minute clinic (staffed by a PA): $40
* Urgent Care center (physician first-come-first serve): $75
* Your primary care physician: $100
* Emergency room (physician/PA): $400

Treatment and outcomes are identical overall, but individually we know that not all docs and PA's are created equally, but that's where ratings services like Healthgrades come in. What would most people choose? Tele-medicine of course, which is also the most cost effective treatment.

 

[Merge]

Then we should be more demanding of Congress. Why should we tolerate them not doing their jobs?

We shouldn't... but they are really good at convincing everyone that it's the other guy who is the problem.

Needs to start with campaign finance reform.

 

[Merge]

Not to sound trite, but if it's that cheap, then why is everyone complaining about the cost of their care?

Because people mix up what they are taking about. Far majority of the time they are complaining about the costs of the premiums or that they are upset that they actually have to pay a deductible now... again, that is a big change from copay culture but it is a good thing getting cosumers more involved.

You're example is also proving my point. When my insurance was a $30 copay for a doc in the box vs a primary care physician... want to guess where I went for everything?

Now with a high deductible plan, I use less care. If I need a strep test I'll go to cvs. If I need something else, I'll go to my PCP. No one has had to weigh any decisions regarding their health for decades because care was cheap to the consumer.

 

[HALL85]

Because people mix up what they are taking about. Far majority of the time they are complaining about the costs of the premiums or that they are upset that they actually have to pay a deductible now... again, that is a big change from copay culture but it is a good thing getting cosumers more involved.

You're example is also proving my point. When my insurance was a $30 copay for a doc in the box vs a primary care physician... want to guess where I went for everything?

Now with a high deductible plan, I use less care. If I need a strep test I'll go to cvs. If I need something else, I'll go to my PCP. No one has had to weigh any decisions regarding their health for decades because care was cheap to the consumer.

We are talking about two different things. $30 may or may not be the appropriate price to pay for that service. I believe people should have the right to shop there healthcare, know what they are actually paying for and have the ability to compare outcomes of providers.

And having a ridiculously high deductible I don't think is good for the individual. any cases, a consumer may avoid necessary treatment because they cant pay the deductible.

 

[Merge]

We are talking about two different things. $30 may or may not be the appropriate price to pay for that service. I believe people should have the right to shop there healthcare, know what they are actually paying for and have the ability to compare outcomes of providers.

And having a ridiculously high deductible I don't think is good for the individual. any cases, a consumer may avoid necessary treatment because they cant pay the deductible.

This is actually pretty funny. We had almost this same exact conversation almost 3 years ago. I had to look it up because everything sounded so familiar. You even used the same line "not to sound trite" ... haha

https://setonhall.forums.rivals.com/threads/can-i-say-i-told-you-so.1360/#post-19620

In any case, I have also expressed concern over deductibles that are too high that people start avoiding care that they need but I believe (and still believe) that when healthcare is too cheap, the majority of citizens will not care about their health. When it will hurt their wallet to get sick, they will start to think about their lifestyle.