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CWSmith
09-17-2017, 07:27 PM
MoveOn has sent out an alarm. Word on The Hill is that Congress is very close to having the votes to repeal Obamacare.

I know what our Trumpsters will say about this, but what the GOP will give us will only be of use to those who can afford it.

Watch to see if the pre-existing conditions clause survives the coming GOP view of healthcare. It won't.

CWSmith
09-17-2017, 08:11 PM
Yep, it looks real.



Obamacare repeal is on the brink of coming back from the dead.

Senate Majority Leader Mitch McConnell (R-Ky.) and his leadership team are seriously considering voting on a bill that would scale back the federal government’s role in the health care system and instead provide block grants to states, congressional and Trump administration sources said.

It would be a last-ditch attempt to repeal Obamacare before the GOP’s power to pass health care legislation through a party-line vote in the Senate expires on Sept. 30.

No final decision has been made, but the GOP leader has told his caucus that if the bill written by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) has the support of at least 50 of the 52 GOP senators, he will bring it to the floor, Graham and Cassidy say. That would give Republicans one more crack at repealing the Affordable Care Act, a longtime party pledge.

Right now, support for the bill — which would replace Obamacare’s tax subsidies with block grants, end the law’s individual insurance mandate and scale back its Medicaid expansion — among Republican senators is short of 50 votes. But McConnell and his lieutenants will gauge support this week in private party meetings with help from President Donald Trump, administration and Capitol Hill sources said.


http://www.politico.com/story/2017/09/17/obamacare-senate-republicans-repeal-242821

Arizona Bay
09-17-2017, 10:35 PM
It's a particularly nasty version as well as political. It takes funding money from Dem. states and shifts it to Rep. states.

https://i.imgur.com/sbVpZqL.jpg
And underhanded...


DANGER: CBO normally gives score for COST ($) and for COVERAGE (# ppl who lose insurance). But *only $ req'd for Senate vote.*

CBO scores showing tens of millions of Americans will lose insurance coverage has helped derail past repeal votes. R solution: vote w/o #s

GOP hopes to ram through repeal vote before CBO figures out how many people will lose their insurance. Immoralóbut also malevolently clever.

Ds pushing CBO to not release fiscal impact without also showing coverage impact. Unclear who'll prevail. Anyway: CBO score week of 25th.

Two more notes about timing. 1st: McCain has said no vote w/o hearings. So Johnson (R-WI) saying he'll hold a farcical "hearing" before 30th

Johnson hearing would be joke: not in relevant committee, not regular process. We'll see if McCain says it's enough.

If GOP believes they have the votes, hearing done, fiscal CBO score in hand, they move to vote sometime 9/27-29... with ZERO hours of debate

ZERO hours of debate? Yes. Budget reconciliation votes require 20h of debateóbut technically those hours already happened, back in July.

Explanation. The Senate is officially considering the bill the House passed, the AHCA. Each Trumpcare bill is just an "amendment" to AHCA.

The big votes that failed in July were votes to substitute new repeal bills in place of AHCA. Graham-Cassidy is just another amendment.

AlanMc
09-18-2017, 10:51 AM
MoveOn has sent out an alarm. Word on The Hill is that Congress is very close to having the votes to repeal Obamacare.

I know what our Trumpsters will say about this, but what the GOP will give us will only be of use to those who can afford it.

Watch to see if the pre-existing conditions clause survives the coming GOP view of healthcare. It won't.


well, i can't "afford" what i have now.

John Smith
09-18-2017, 11:00 AM
I've got mixed emotions. A lot of people who voted for Republicans will be hurt if this passes. Maybe that would be a good thing, long term.

If nothing passes, nothing changes, and people will vote in'18 pretty much how they voted n '16. If this passes and people actually lose benefits, it may change their votes in '18, and that may bring good things.

Too Little Time
09-18-2017, 11:08 AM
what the GOP will give us will only be of use to those who can afford it.
That seems to be what those below the median have now.

If I saw that the poor had good food and good schools, I might be sympathetic, but health care seems to be of interest mainly to the rich passing as middle class - those who think others should pay for their expenses.

TomF
09-18-2017, 12:43 PM
It may be that really big governmental decisions require some measurable number of citizen deaths (of the right class and etc.) before they can occur. Workplace safety regulations. Building codes. Pharmaceutical and food purity standards. Traffic laws, for cripe's sake. Etc.

It may be that the only way that a sufficient number of those presently against Government intervention in health care provision will change their opinions and demand it ... is that a sufficient number of their family and friends die needlessly. This had been happening for decades already before the ACA ever became part of the equation of course, but Americans hadn't really known it. They will know about it - in excruciating detail - as people formerly insured under the ACA die. Or better, as they suffer publicly and loudly, and die.

Especially if a number of these people were up 'till that point, staunch Republicans ... and let that be known.

I am unaware of any OECD country which introduced a broadening of publicly provided health care which has rescinded that policy. The debate very swiftly becomes how Government should be involved (as with building codes etc.) to ensure citizen access and safety, not whether Government should be involved.

Joe (SoCal)
09-18-2017, 12:53 PM
well, i can't "afford" what i have now.

Join Date Jul 2017
Location huntsville, al, usa
Posts595

Nothing further needs to be said ;)

Ted Hoppe
09-18-2017, 01:00 PM
Join Date Jul 2017
Location huntsville, al, usa
Posts595

Nothing further needs to be said ;)

Cold comfort with winter coming.

Tom Wilkinson
09-18-2017, 01:01 PM
well, i can't "afford" what i have now.

So we should make it more expensive and less available?? That certainly will help.

Too Little Time
09-18-2017, 01:06 PM
It may be that really big governmental decisions require some measurable number of citizen deaths (of the right class and etc.) before they can occur.
Somewhere between 20K and 45K deaths are caused by lack of medical care. Few of those are from the top 20% (or even 50%) of the economy.

You may be right about needing more deaths to force a government decision. If so, we have a long way to go before the number of deaths due to lack of health care becomes significant.

TomF
09-18-2017, 01:16 PM
Somewhere between 20K and 45K deaths are caused by lack of medical care. Few of those are from the top 20% (or even 50%) of the economy.

You may be right about needing more deaths to force a government decision. If so, we have a long way to go before the number of deaths due to lack of health care becomes significant.Addiction counselors talk about taking steps to "raise the bottom," so that an addict will "hit bottom" sooner, and realize that they need to take action on what's killing them.

The ACA "raised the bottom" respecting America's tolerance for gaps in the provision of health care. If 20-45K deaths are caused now by the lack of care (as a hypothesis - not checking your sources), those are deaths despite the ACA's broadening of access. When access shrinks, the death numbers will go up - the CBO's done the math.

Every additional death beyond your 20-45K notional baseline will be known to have been preventable. In addition, health analysts track the "productive years of life lost" as the burden of illness too - and that will similarly increase. Every percentage point in the PYLL degradation will be attributable to screwing up the modest progress which the ACA had been able to achieve. Each of those measures is objective, with criteria established internationally and measured the same way the world over.

The ACA was not sufficient; for the richest country which the world has ever known, it was actually only an incremental improvement on the travesty which preceded it. But it very effectively "raised the bottom" of what the majority of Americans were willing to accept. One can hear that in the stories of people who counted on Trump for expansions of opioid treatment, or who believed him that the health care he'd institute would be both better and cheaper. I'd be very surprised if Republican attempts to restore the bottom to its previous depths, throwing those people off the care they have now, didn't result in a huge electoral price

AlanMc
09-18-2017, 01:35 PM
Join Date Jul 2017
Location huntsville, al, usa
Posts595

Nothing further needs to be said ;)


you have a problem with huntsville or are you just being an equine hindquarter?

CWSmith
09-18-2017, 01:55 PM
It may be that really big governmental decisions require some measurable number of citizen deaths (of the right class and etc.) before they can occur.

One of the intents of Obamacare was to mandate that people get insurance. I have found that many people who complain that their insurance premiums went up were forced to move from an inadequate policy to a policy that offered better coverage.

The reason is that those with poor or no coverage wind up getting their health care in emergency rooms where it is tremendously expensive and often they do not pay the bill.

Eliminating Obamacare and trying to reduce the cost of medicine really means telling those people to go outside and die, we can't afford to treat them. I have not seen any willingness in this country to do that.


Somewhere between 20K and 45K deaths are caused by lack of medical care. Few of those are from the top 20% (or even 50%) of the economy.

Of course not! This is not a reason to do away with Obamacare or to oppose universal health care.



You may be right about needing more deaths to force a government decision. If so, we have a long way to go before the number of deaths due to lack of health care becomes significant.

BS! It is significant at the rates you give. There is no reason for this country to have its citizens die for lack of health care.

Ted Hoppe
09-18-2017, 01:59 PM
you have a problem with huntsville or are you just being an equine hindquarter?

You are aware that your state representatives are undermining your healthcare aren't you?

Alabama premiums increased more, on average, than any of the 39 states that rely on the federal exchange. The increase of 223 percent between 2013 and 2017 was more than twice the national average of 105 percent, according to the study. "The numbers are staggering. Insurance premiums and deductibles have skyrocketed due to the regulations and mandates imposed by Obamacare," U.S. Rep. Martha Roby (R-Ala.) said in a statement. "Providers have been forced out of the market, and Alabama consumers now only have one option for health insurance [Blue Cross Blue Shield of Alabama.]"

U.S. Rep. Mo Brooks (R-Ala.) also released a statement. "Obamacare damaged Alabama more than any other state in America," he said. "In Alabama, health insurance cost increased a staggering and obscene 223%. That is not a 'first' Alabama citizens want or can afford. Alabama's skyrocketing health insurance cost increases severely undermine the ability of Alabama citizens to access healthcare and take care of their own families."

John Smith
09-18-2017, 02:02 PM
Somewhere between 20K and 45K deaths are caused by lack of medical care. Few of those are from the top 20% (or even 50%) of the economy.

You may be right about needing more deaths to force a government decision. If so, we have a long way to go before the number of deaths due to lack of health care becomes significant.

Americans don't care about death, as long at it's someone they don't know. If we did, we'd be upset with all the people exercising 2nd Amendment rights.

Healthcare belongs under the umbrella of infrastructure.

John Smith
09-18-2017, 02:03 PM
One of the intents of Obamacare was to mandate that people get insurance. I have found that many people who complain that their insurance premiums went up were forced to move from an inadequate policy to a policy that offered better coverage.

The reason is that those with poor or no coverage wind up getting their health care in emergency rooms where it is tremendously expensive and often they do not pay the bill.

Eliminating Obamacare and trying to reduce the cost of medicine really means telling those people to go outside and die, we can't afford to treat them. I have not seen any willingness in this country to do that.



Of course not! This is not a reason to do away with Obamacare or to oppose universal health care.



BS! It is significant at the rates you give. There is no reason for this country to have its citizens die for lack of health care.

Let us remember we live in a country where people are concerned about our debt, but everyone wants tax cuts.

AlanMc
09-18-2017, 02:07 PM
You are aware that your state representatives are undermining your healthcare aren't you?

Alabama premiums increased more, on average, than any of the 39 states that rely on the federal exchange. The increase of 223 percent between 2013 and 2017 was more than twice the national average of 105 percent, according to the study. "The numbers are staggering. Insurance premiums and deductibles have skyrocketed due to the regulations and mandates imposed by Obamacare," U.S. Rep. Martha Roby (R-Ala.) said in a statement. "Providers have been forced out of the market, and Alabama consumers now only have one option for health insurance [Blue Cross Blue Shield of Alabama.]"

U.S. Rep. Mo Brooks (R-Ala.) also released a statement. "Obamacare damaged Alabama more than any other state in America," he said. "In Alabama, health insurance cost increased a staggering and obscene 223%. That is not a 'first' Alabama citizens want or can afford. Alabama's skyrocketing health insurance cost increases severely undermine the ability of Alabama citizens to access healthcare and take care of their own families."



it's not going to get any better with the 2 buffoons running for office right now. it's a lose lose scenario.

bailfaster
09-18-2017, 02:10 PM
You are aware that your state representatives are undermining your healthcare aren't you?

Alabama premiums increased more, on average, than any of the 39 states that rely on the federal exchange. The increase of 223 percent between 2013 and 2017 was more than twice the national average of 105 percent, according to the study. "The numbers are staggering. Insurance premiums and deductibles have skyrocketed due to the regulations and mandates imposed by Obamacare," U.S. Rep. Martha Roby (R-Ala.) said in a statement. "Providers have been forced out of the market, and Alabama consumers now only have one option for health insurance [Blue Cross Blue Shield of Alabama.]"



U.S. Rep. Mo Brooks (R-Ala.) also released a statement. "Obamacare damaged Alabama more than any other state in America," he said. "In Alabama, health insurance cost increased a staggering and obscene 223%. That is not a 'first' Alabama citizens want or can afford. Alabama's skyrocketing health insurance cost increases severely undermine the ability of Alabama citizens to access healthcare and take care of their own families."

Begs a question...Why is it that insurance is the only product I can think of that I cannot buy across state lines? I really don't understand this one.

John Smith
09-18-2017, 02:15 PM
Begs a question...Why is it that insurance is the only product I can think of that I cannot buy across state lines? I really don't understand this one.

YOU CAN buy insurance across state lines. HOWEVER, don't think it saves money. I can buy auto insurance from a Pa. company, but I will pay NJ rates.

I have FEDERAL BLUE CROSS health insurance. It is administered by Blue Cross of NJ. No matter where the company is that sells you insurance, your premiums and benefits will be based on the state you live in.

If you bought health insurance from a company in SC, you wold not get SC premiums. You'd get NJ premiums.

As a federal employee, I had a number of plans available in all states, but the premiums depended on the state you live in.

AlanMc
09-18-2017, 02:16 PM
Begs a question...Why is it that insurance is the only product I can think of that I cannot buy across state lines? I really don't understand this one.



and why does my ins not work "outside of network"? so if i have a heart attack and i'm in chicago (random example) now i'm paying uninsured rates?

stromborg
09-18-2017, 02:20 PM
This is a pretty good explanation of the pitfalls involved in selling health insurance across state lines:
http://www.factcheck.org/2017/07/selling-insurance-across-state-lines/

For those unwilling to do the reading my summary of the article is that it comes down to "states rights". Here in the US the insurance companies are regulated at the state level, the ACA set a floor but it is up to the individual state to decide how far above the floor they want to be.

Joe (SoCal)
09-18-2017, 02:21 PM
you have a problem with huntsville or are you just being an equine hindquarter?

both ;)

Also I think Ted spelled it out best ;)

Tom Wilkinson
09-18-2017, 02:21 PM
YOU CAN buy insurance across state lines. HOWEVER, don't think it saves money. I can buy auto insurance from a Pa. company, but I will pay NJ rates.

I have FEDERAL BLUE CROSS health insurance. It is administered by Blue Cross of NJ. No matter where the company is that sells you insurance, your premiums and benefits will be based on the state you live in.

If you bought health insurance from a company in SC, you wold not get SC premiums. You'd get NJ premiums.

As a federal employee, I had a number of plans available in all states, but the premiums depended on the state you live in.

I'm not so sure you can do that. I know for a fact I cannot buy home insurance across state lines. I have to buy it in the state I am insuring the home. My Allstate agent in Georgia cannot insure my home in NH or vise versa. I have to have to separate agencies due to being in different states. I'm doubtful that health insurance is different.

Keith Wilson
09-18-2017, 02:30 PM
There are plenty of problems with both care and health medical insurance in the US, but nothing that won't be made worse by every plan the Republicans have proposed. An angry toddler with a hammer would be less destructive.

George Jung
09-18-2017, 02:41 PM
I 'had the opportunity' to 'engage' an old pt from SD - wealthy rancher, 70 years old - who railed against 'socialized medicine' on FB. Lot's of wrong statements, of course, saying how 'bad' it is, in other countries. I asked 'do you have Medicare'? (she does).

So far... only crickets. She may be wackadoodle, but she knows a trap when she sees one. Another deplorable - 'I got mine, screw the rest of ya'.

Had the same conversation with our noon drug reps - one identifies as a Libertarian. I quoted the above - he didn't deny it, but wouldn't engage. Wonderful citizenry we have here.

John of Phoenix
09-18-2017, 02:45 PM
There's a part of my that says these morons who consistently vote against their best interests heartily deserve the fate that awaits them (remember, I used to be a republican).

At the same time, I know that they'll Rock the Celebration and blame it all on Obama anyway.

Joe (SoCal)
09-18-2017, 02:52 PM
George - your input and insight on these matters is invaluable and irrefutable. Thank you

George Jung
09-18-2017, 03:48 PM
I have no credibility with those folks - even after treating them for 30 years. True Believers don't have many good options.

CWSmith
09-18-2017, 03:59 PM
I know for a fact I cannot buy home insurance across state lines.

Actually, I bought home insurance across state lines.

John of Phoenix
09-18-2017, 04:04 PM
My company is based in NY with offices in a dozen states. The HR department is in MI. Our insurance was BCBS of MI. It's now Cigna.

My car and homeowners' is with USAA in TX. They insure worldwide.

Who knows?

CWSmith
09-18-2017, 04:09 PM
It's now Cigna.

My employer just moved us to Cigna for health insurance. We do not like it.

John of Phoenix
09-18-2017, 04:15 PM
Same here. Cheaper but miserable service. I've received two late notices from providers because they're so slow paying claims.

Tom Wilkinson
09-18-2017, 04:16 PM
Actually, I bought home insurance across state lines.

I have insurance in both states, but had to buy the policies from local agents. You are saying you could buy a policy from an agent in a different state than the home was located?

CWSmith
09-18-2017, 05:06 PM
I have insurance in both states, but had to buy the policies from local agents. You are saying you could buy a policy from an agent in a different state than the home was located?

I am in New Hampshire. My agent is in Maine. I have no idea where the insurance company is. They have my car insurance, too.

skuthorp
09-18-2017, 05:18 PM
Same here. Cheaper but miserable service. I've received two late notices from providers because they're so slow paying claims.
Late payments often indicates a cash flow problem, or worse.
So what happens if they go broke, or just phenix themselves to walk away from debts?

Too Little Time
09-18-2017, 07:12 PM
Of course not! This is not a reason to do away with Obamacare or to oppose universal health care.
One reason I oppose the ACA is that the poor, healthy, and young are required to pay for the rich, sick and old. Helping the rich is a good enough reason to oppose universal health care.


BS! It is significant at the rates you give. There is no reason for this country to have its citizens die for lack of health care.
20K-45K deaths/year (55-125/day) is noise in the overall death rate - 6775/day.

I am all in favor of providing food, shelter and yes - health care for the bottom 50%. No one else seems to be in favor of that.

Too Little Time
09-18-2017, 07:21 PM
I 'had the opportunity' to 'engage' an old pt from SD - wealthy rancher, 70 years old - who railed against 'socialized medicine' on FB. Lot's of wrong statements, of course, saying how 'bad' it is, in other countries. I asked 'do you have Medicare'? (she does).

So far... only crickets. She may be wackadoodle, but she knows a trap when she sees one. Another deplorable - 'I got mine, screw the rest of ya'.

Had the same conversation with our noon drug reps - one identifies as a Libertarian. I quoted the above - he didn't deny it, but wouldn't engage. Wonderful citizenry we have here.
You should be careful when setting traps. I have Medicare. Look at the costs and plan limits (link below). Pay attention to parts A and B. Then compare the costs and limits to any of the ACA plans. (The average Social Security benefit is $16K. Consider that when you discover how much those on Medicare are expected to pay. And then they go on Medicaid.)

https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

I expect to hear crickets also.

CWSmith
09-18-2017, 08:23 PM
One reason I oppose the ACA is that the poor, healthy, and young are required to pay for the rich, sick and old. Helping the rich is a good enough reason to oppose universal health care.

Go into the emergency room on any Friday or Saturday night and watch the teenagers and young drivers (almost always male, except for their victims) as they roll in on the gurneys. Teenagers think they will live forever, and they have relatively few mild medical problems, but they have a great many of the truly catastrophic life-threatening problems because they are dumb-@ss, drunk driving kids.


20K-45K deaths/year (55-125/day) is noise in the overall death rate - 6775/day.

Maybe, unless you or someone you love is among the 29k to 45k.


I am all in favor of providing food, shelter and yes - health care for the bottom 50%. No one else seems to be in favor of that.

I think you will find that many people are. To suggest you are alone is not realistic and that's the kind way of saying it. What many of us want is never spoken about in Washington because it would be a waste of effort. The Republican Party will happily pay too much for a fighter jet, but wants to cheap out on schools. So long as they have a significant number of votes, we will never get what you want.

George Jung
09-18-2017, 08:30 PM
Nailed it, CW. Trump wants to add another $50 billion/year to military expenditures - which the Republicans think is great - but not a dime more for education or infrastructure. Messed up priorities!

Tangential, I ran across this bit comparing healthcare systems. IMO, it gives far too little weight to poor coverage here.

https://www.nytimes.com/interactive/2017/09/18/upshot/best-health-care-system-country-bracket.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region&region=top-news&WT.nav=top-news

John Smith
09-18-2017, 09:38 PM
and why does my ins not work "outside of network"? so if i have a heart attack and i'm in chicago (random example) now i'm paying uninsured rates?

Your insurance likely does work if you are out of state and have an emergency.

John Smith
09-18-2017, 09:41 PM
I'm not so sure you can do that. I know for a fact I cannot buy home insurance across state lines. I have to buy it in the state I am insuring the home. My Allstate agent in Georgia cannot insure my home in NH or vise versa. I have to have to separate agencies due to being in different states. I'm doubtful that health insurance is different.

I don't believe this is a legal problem. It is, I think, a logistics problem. A lot of in state regs would need to be learned, and met, to offer insurance in a state, and a license required, I suspect. You'd have to meet all the rules and regs, etc. of the state the home is in.

John Smith
09-18-2017, 09:43 PM
As I see our dilemma: If the ACA is not repealed, and nothing changes, voting patterns won't change either. If it is repealed, and a lot of people suffer, it MAY change the way they vote.

TomF
09-18-2017, 09:48 PM
Preventable death, particularly death which has recently actually been prevented, is probably as strong a motivator as you are likely to get.

George Jung
09-18-2017, 09:55 PM
Yeah. The alternative loses some of it's 'ooomph'!

Too Little Time
09-19-2017, 12:55 AM
I think you will find that many people are. To suggest you are alone is not realistic and that's the kind way of saying it. What many of us want is never spoken about in Washington because it would be a waste of effort. The Republican Party will happily pay too much for a fighter jet, but wants to cheap out on schools. So long as they have a significant number of votes, we will never get what you want.
I agree it is a waste of waste of effort. But not because of the Republicans. The Democrats thought that giving the poor free health care was too expensive. So to save $100 billion over 10 years, they made the Medicaid expansion optional and they charged the poor premiums and out of pocket amounts. And how did that turn out.

As for the cost of young people and emergency room care, you might look at per capita health care costs by age group rather than picking on a few outliers. (In a nation of 330 million af few is a massive number.) And as I said noise in the numbers. But the ACA could have prevented a lot of those deaths. But the Democrats made a choice to not do so.

David G
09-19-2017, 09:52 PM
https://scontent-sea1-1.xx.fbcdn.net/v/t1.0-9/21686313_1820738437951426_8719805881599784200_n.pn g?oh=8782c1a8efd8b8ebb4c812d7c9c623e0&oe=5A4E95E9

David G
09-19-2017, 09:53 PM
What you need to know --

http://www.politico.com/interactives/2017/graham-cassidy-health-care-bill-what-you-need-to-know/?cmpid=sf

David G
09-30-2017, 01:08 PM
https://static.politico.com/dims4/default/7d01099/2147483647/resize/1160x%3E/quality/90/?url=http%3A%2F%2Fstatic.politico.com%2F7a%2F73%2F 751a87494c8f99039a8baa65e249%2F2-rick-mckee-augusta-chronicle.jpg

David G
09-30-2017, 01:10 PM
https://static.politico.com/dims4/default/2ac0b7b/2147483647/resize/1160x%3E/quality/90/?url=http%3A%2F%2Fstatic.politico.com%2F07%2Fca%2F f7db8f73454787e7a2967bc690c8%2F6-steve-sack-minneapolis-star-tribune.jpg