Trump and his GOP allies are out to kill the ACA by malignant neglect. They will do everything they can to undermine it and make their mantra of "Obamacare is imploding" a self-fulfilling prophecy.
17
75% of health care spending is on degenerative diseases that are preventable or reversible by diet - see the China Study (2017 edition). Realizing that can solve most of the healthcare problem, health care should not be sick care, but prevention in the first place, give people an $5000 deductible, with some cushioning for the poor and catastrophic health insurance, and teach them how to keep their health care costs down by adopting a whole foods plant based diet, which is well supported by evidence as preventing all the most common degenerative diseases. If they would rather be sick, let them pay the bills.
4
The Democrats created Obamacare unilaterally when they had control of government, excluding Republicans from the process, creating deep and intractable resentment. The GOP is now in control and has failed, in effect, to scuttle the whole thing. Mr. Trump is thinking in terms of the "death by a thousand cuts approach," or at least benign neglect. Whatever his great plan was, it never saw the light of day.
Would it be now so awful if they all sat down and knocked heads to get something workable? Obamacare, flaws and all, has provided coverage for enough people to give it at least honorary third rail political status. The insurers should be part of this process, as well as providers, as well as the insured. It's doubtful that Mr. Trump will be participate. Remember his tenacity insisting that President Obama was born in Africa? However there should be enough people of reason in the other camps to get something done. They would likely have to override Mr. Trump's veto, however.
Mr. Trump paraded a number of citizens in front of the cameras to say how awful Obamacare had treated (or not treated) them. He'd do them and the country a lot of good finding workable remedies and getting them passed. Maybe for once he can set his ego aside and work for the common good.
Would it be now so awful if they all sat down and knocked heads to get something workable? Obamacare, flaws and all, has provided coverage for enough people to give it at least honorary third rail political status. The insurers should be part of this process, as well as providers, as well as the insured. It's doubtful that Mr. Trump will be participate. Remember his tenacity insisting that President Obama was born in Africa? However there should be enough people of reason in the other camps to get something done. They would likely have to override Mr. Trump's veto, however.
Mr. Trump paraded a number of citizens in front of the cameras to say how awful Obamacare had treated (or not treated) them. He'd do them and the country a lot of good finding workable remedies and getting them passed. Maybe for once he can set his ego aside and work for the common good.
5
The guy in the article pays over $1500 a month for a family of 4. This means he has a platinum plan, the highest of the 4 tiers. A bronze plan would cost him under $900 month, a silver plan around $1000. People like him would not even benefit from "Trumpcare", which merely allows providers to offer shoddier plans at lower prices. He has chosen a plan that would be expensive under any circumstances.
8
McCain is my hero and may be provide the watershed vote in the Romney-care or Obama-care argument. I hope so as I am tired of carrying the uninsured through cost shifting. Since hospitals are required to take all patients, they overcharge the insured and thus the insurance companies to make up the shortage over the minimal state funding.
7
No one doubts that the ACA is in need of repair but the Republicans and Trump missed the boat on two points:
1) Once an entitlement program is enacted, history all but tells you that it is not going to be reversed to any significant degree.
2) If they had embraced this point, then they would have understood this was the perfect opportunity for a bipartisan agreement.
And, bipartisan collaboration on anything, is something this country sorely needs.
1) Once an entitlement program is enacted, history all but tells you that it is not going to be reversed to any significant degree.
2) If they had embraced this point, then they would have understood this was the perfect opportunity for a bipartisan agreement.
And, bipartisan collaboration on anything, is something this country sorely needs.
10
Reality check afc is all about profits at expense of american people. Use to be land of free now its free for all at expense of us
5
Like it or not, Trump and the Republicans now own health care. If they choose to work with Democrats to fix and improve the ACA, they will, rightfully, get some credit for doing so (credit which will be shared by, gasp, Democrats!). If they choose to actively or passively let the ACA implode, leaving millions of Americans without healthcare or with higher premiums, then they will pay the price at the ballot box, and Democrats will benefit.
Hopefully republicans now understand that the American people want the government to insure better access to affordable health care for everyone. Efforts to repeal the ACA without a better replacement, like single-payer care (which remains incredibly popular) or Medicare-for all, or Medicaid expansion, will be self defeating.
Hopefully republicans now understand that the American people want the government to insure better access to affordable health care for everyone. Efforts to repeal the ACA without a better replacement, like single-payer care (which remains incredibly popular) or Medicare-for all, or Medicaid expansion, will be self defeating.
21
The GOP owns healthcare? How's that? The current law was enacted by the Democrats. And not one Democrat voted to overturn it. So how is it exactly that the GOP owns the problems wrought by the ill-considered Obamacare?
3
@John: You're not "getting" it John. The Democrats had hearings and added scores of Republicans amendments and even after being treated fairly, Republicans wailed for 8 years about how they were going to purge us of this curse of Obamacare. Then they won the Congress and the Executive and the power was in their hands. They blew it Big Time and now they own it. Cry me a river, brother.
10
Because the GOP now controls the White House, the Senate and the House, and it is their job either to enforce the existing law or to change it.
6
People with employer sponsored coverage should be reminded that they are swimming in the same risk pool, or will be when they get laid off. And they are liable to be laid off before they're eligible for Medicare. There but for the grace of God.....
14
While we consider single payer government run healthcare, let's look at how our government has done with the largest two federal social programs.
Social Security-its going bankrupt, the federal government basically stole $10T from the SS "lockbox" and they have no way to pay it back.
And Medicare? The health program for the elderly cost shifts to the private sector, paying providers less than their cost to care for patients. On top of that, Medicare is still suppose to become insolvent in 2035. And a quick look at true government run healthcare, the VA, shows what an absolute mess the Feds make of running a healthcare system.
So excuse me if I'm not excited about the federal government taking over my healthcare. Washington DC is inept and everything they do, and have been for decades, so it still amazes me that folks look to that city to solve all our ills.
I'd rather have Jeff Bezos and Amazon give it a crack.
Social Security-its going bankrupt, the federal government basically stole $10T from the SS "lockbox" and they have no way to pay it back.
And Medicare? The health program for the elderly cost shifts to the private sector, paying providers less than their cost to care for patients. On top of that, Medicare is still suppose to become insolvent in 2035. And a quick look at true government run healthcare, the VA, shows what an absolute mess the Feds make of running a healthcare system.
So excuse me if I'm not excited about the federal government taking over my healthcare. Washington DC is inept and everything they do, and have been for decades, so it still amazes me that folks look to that city to solve all our ills.
I'd rather have Jeff Bezos and Amazon give it a crack.
9
Repairing the Health Law is not the first order of business. The first task is for Congress -- House and Senate -- members to pause and reflect about the fact that they stand upon a brink. The brink of systemic failure that is one of morals and ethics and politics and science -- sure. But even more, it's a failure to take responsibility for every word and idea they pronounce.
Take away insurance -- and people will die. Ok with that? Sign a document that your children can read and reflect on. Destroy the Earth? Ok. Sign a document and leave for your children to read. Don't believe in science? You will soon enough -- when none of your $$$ antibiotics work. One could go on, but...
Take away insurance -- and people will die. Ok with that? Sign a document that your children can read and reflect on. Destroy the Earth? Ok. Sign a document and leave for your children to read. Don't believe in science? You will soon enough -- when none of your $$$ antibiotics work. One could go on, but...
11
Actually, if you abolished insurance, doctors and hospitals would have to lower their prices to what people can afford, or they wouldn't have any business at all. They charge high prices because they can.
16
Republican voters have priorities. Affordable health care isn’t one of them. It isn’t even one of their basic concerns.
What are Republican voters’ most important concerns?
Protecting their minority ruling status through gerrymandering and the Electoral College.
Repealing Roe v. Wade.
Dismantling K-12 public education.
Putting higher education out of reach for nearly all Americans.
Destroying the separation between church and state.
Gutting civil rights laws that protect ethnic and religious minorities, and the LGBTQ community.
As long as Republican voters win on all these items, they will continue to vote for candidates that support their hateful agenda.
Affordable health care isn’t even on their radar. They would gladly see their own family members suffer serious illnesses with no health care available, as long as their leaders’ actions ensure that this country turns into a white-controlled Republic of Gilead that runs on unrestrained capitalism.
We've deluded ourselves into believing that Republicans vote against their interests. But they’re very clear about their true interests, and they don’t care how they win, as long as they do. The rest of us need to take off our rose-colored glasses and see these Red State voters for who they really are – people who are bigoted, selfish, and willfully ignorant, and see no reason why they shouldn’t rule the rest of us. And that, readers, is why we don’t have affordable health care in this country.
What are Republican voters’ most important concerns?
Protecting their minority ruling status through gerrymandering and the Electoral College.
Repealing Roe v. Wade.
Dismantling K-12 public education.
Putting higher education out of reach for nearly all Americans.
Destroying the separation between church and state.
Gutting civil rights laws that protect ethnic and religious minorities, and the LGBTQ community.
As long as Republican voters win on all these items, they will continue to vote for candidates that support their hateful agenda.
Affordable health care isn’t even on their radar. They would gladly see their own family members suffer serious illnesses with no health care available, as long as their leaders’ actions ensure that this country turns into a white-controlled Republic of Gilead that runs on unrestrained capitalism.
We've deluded ourselves into believing that Republicans vote against their interests. But they’re very clear about their true interests, and they don’t care how they win, as long as they do. The rest of us need to take off our rose-colored glasses and see these Red State voters for who they really are – people who are bigoted, selfish, and willfully ignorant, and see no reason why they shouldn’t rule the rest of us. And that, readers, is why we don’t have affordable health care in this country.
25
Nice summary of their agenda. Now all we need to have them do is to have large business fund the politicians campaigns with Stock Futures.
1
Anything The Supreme Ruler (a.k.a. legend-in-his-own-mind) does to undermine ACA viability, in that moment, makes it Trumpcare.
Lil' Napoleon has stepped in it and has no idea what to do. Guess The Sheep should have elected an adult.
Lil' Napoleon has stepped in it and has no idea what to do. Guess The Sheep should have elected an adult.
6
Obama care will never work unless the Govt. is ready to bail out insurance companies and pay for individuals with huge health bills. It is better to create a pool using incomes of all Americans to pay for them instead of increasing the premium of healthy people insured by individual companies.
3
Lets try the Democrat's approach and start by letting Medicare negotiate drug prices. Next we should allow any citizen to buy into public employee health insurance or after a certain age, Medicare. Why shouldn't a 62 year old be able to buy into Medicare and have a more stable projection of health costs for the duration of retirement.
We also can reduce the cost of health care by improving the physical condition of our population. Weight translates directly into heart conditions and diabetes when it reaches obesity. Overweight Americans cost the system billions of dollars, and we could address that quickly and see savings almost instantly.
We also can reduce the cost of health care by improving the physical condition of our population. Weight translates directly into heart conditions and diabetes when it reaches obesity. Overweight Americans cost the system billions of dollars, and we could address that quickly and see savings almost instantly.
15
We have 'socialized' k-12 education, but no one seems to complain about that. I have no kids but have been subsidizing other families education expense for over 30 years. You can argue that education is for the betterment of society, but so is healthcare for everyone.
21
Yes, but if the public-school teachers were making the salaries that doctors are making, there would be plenty of complaints.
Actually, education is another sector in the US that is grossly overpriced, but at least it is not yet as bad as health care.
Actually, education is another sector in the US that is grossly overpriced, but at least it is not yet as bad as health care.
7
Just state what's going on. It is a proved fact that large modern nations must have single payer government managed health insurance, period. Any other system is just a cash cow for investors. Americans are being bled dry by insurers, period.
The super wealthy & business interests are sucking the life out of this nation, and nobody has the courage to stand up and say so, and if you do while running for President the DNC will make sure you lose, then invent a crisis over some invented bogeyman (Russia) under orders from Wall St.
I'm going on Medicare in a couple years and until then relying on the flaming idiot Trump to make sure I don't pay a fine until then. With that money saved I'll buy a great used car that will last me 20 years ie until I am dead. Good luck suckers, see you at the gym.
The super wealthy & business interests are sucking the life out of this nation, and nobody has the courage to stand up and say so, and if you do while running for President the DNC will make sure you lose, then invent a crisis over some invented bogeyman (Russia) under orders from Wall St.
I'm going on Medicare in a couple years and until then relying on the flaming idiot Trump to make sure I don't pay a fine until then. With that money saved I'll buy a great used car that will last me 20 years ie until I am dead. Good luck suckers, see you at the gym.
8
There are probably a lot of ways to improve the ACA, or to come up with something better and cheaper altogether. But the party currently in power actually wants the ACA to fail disastrously, and Trump himself may have spoken about better and cheaper health care for all, but those were just empty words, he never had a plan, or any real concern - he just likes to say stuff like that sometimes. So, it would be better to say, improving the ACA wouldn't be impossible - if the Republicans had any motivation in that direction. But their motivation is in the opposite direction.
10
A few people commented that obese people should not be entitled to health insurance because they do not take responsibility for their condition. Discounting those whose obesity results from metabolic and other disorders, if we expect obese people to take responsibility for their eating habits, then I suggest we should expect the food industry to take responsibility too.
Maybe it should pay a share of health care costs since it uses chemicals that facilitate health problems: partially hydrogenated oils endanger heart health; sugars are linked to obesity, type II diabetes, learning problems, tooth decay, heart disease; high-fructose corn syrup inhibits leptin, which tells your brain that you’re full,...
Another barrier, healthier foods–fruits, vegetables, fish, and nuts, which are unavailable in many poor neighborhoods, cost much more than processed foods, meats, and refined grains according to a 2013 study by Harvard’s School of Public Health. On top of that, the Trump administration is: delaying the Nutrition Fact labels, which point out “added sugars,” postponing rules for restaurants to list calories on menus, and relaxing school lunch standards that require more whole grains and less salt.
People are responsible for the choices they make–but let’s give them healthy and affordable foods from which to choose and the information about what’s in processed and prepared food so they can choose more wisely. I bet these changes would drive down health care costs. Just saying…
Maybe it should pay a share of health care costs since it uses chemicals that facilitate health problems: partially hydrogenated oils endanger heart health; sugars are linked to obesity, type II diabetes, learning problems, tooth decay, heart disease; high-fructose corn syrup inhibits leptin, which tells your brain that you’re full,...
Another barrier, healthier foods–fruits, vegetables, fish, and nuts, which are unavailable in many poor neighborhoods, cost much more than processed foods, meats, and refined grains according to a 2013 study by Harvard’s School of Public Health. On top of that, the Trump administration is: delaying the Nutrition Fact labels, which point out “added sugars,” postponing rules for restaurants to list calories on menus, and relaxing school lunch standards that require more whole grains and less salt.
People are responsible for the choices they make–but let’s give them healthy and affordable foods from which to choose and the information about what’s in processed and prepared food so they can choose more wisely. I bet these changes would drive down health care costs. Just saying…
14
I understand that obesity is the result of metabolic issues. I get that. But still - Europeans are slimmer than Americans across the board per age bracket, not even considering the obese people. So what gives? At some point, it must be about choice and personal responsibility. Many, many overweight Americans are NOT poor, and have plenty of access to inexpensive, healthy whole foods. Ever hear of beans? Rice? Cabbage? Eggs? Ever hear of not eating between meals? When I was a kid, that was like a public service announcement - don't eat between meals. Never hear that any more.
4
Pass a bill - any bill. No - let Obamacare implode. No wait - pass a bill. No - I've been saying all along, let Obamacare die. Get back in there and pass a bill. I have whiplash - can you imagine how Congress feels? And add to the confusion the threats, public shaming and delay of summer recess - I'd be fuming and not particularly inclined to pass a bill. What happened to the great deal making we were supposed to witness? All we've seen is bullying from a "president" who hasn't taken the time to understand what's in any of the proposed bills, how health insurance works, or how our government works.
11
Congress feels fine, this is business as usual under orders from Wall St. They don't want to act, they want to blame and not act. Wake up. You gotta blame Trump, the joke is on you.
3
How about actually trying to control costs?
7
What a great idea! But it does require data and actual work. Where are the congressional volunteers?
2
It's time to attack actual costs. The reason insurance premiums are high is that medical care is much too expensive. As long as sit around arguing about ways to pay, rather than cutting costs, we won't get anywhere.
Single payer? At the current rate of spending, we'd have to tax everyone an additional 22% of their salary, assuming we could cut administrative costs to $0. I can guarantee you that the voters wouldn't like that, either.
Single payer? At the current rate of spending, we'd have to tax everyone an additional 22% of their salary, assuming we could cut administrative costs to $0. I can guarantee you that the voters wouldn't like that, either.
4
The American health care debate from a Canadian perspective is unbelievable. Every other country in the developped world has managed to provide health care for 100% of their citizens and costs far lower than in the USA. We in Canada dealt with this issue over 50 years ago. Our singe-payer system is far from perfect, yet we live longer, have better health outcomes all at a lower cost than our southern neighbours. From my perspective, the problem in the USA begins with viewing health care as a business instead of a human right.
33
Just got the bill from my wife's last neuro oncologist routine follow up visit. 5 minutes with the doctor and vitals by the nurse. Billed at $850. 5 minutes and $850. Yes this person saved her life, so far. Insurance paid $450. We paid $90. 5 minutes.
Just got the bill from the quarterly MRI too. $5500. Insurance will pay $4500. We've been billed $1300. That machine sees about 10 patients a day, 6 days a week. $55,000 per day.
We keep talking about insurance premiums. We should be talking about healthcare costs. Lower costs, premiums go down. Now who wants to tell the doctor who saved their life to make less money. See the problem?
Just got the bill from the quarterly MRI too. $5500. Insurance will pay $4500. We've been billed $1300. That machine sees about 10 patients a day, 6 days a week. $55,000 per day.
We keep talking about insurance premiums. We should be talking about healthcare costs. Lower costs, premiums go down. Now who wants to tell the doctor who saved their life to make less money. See the problem?
18
Yes, but that's what we have to do. Costs have to come down, and everybody in the medical system has to receive less revenue. Some of them may have to find another job in another sector of the economy.
It's either that, or the country will end up paying 100% of GDP for medical care, leaving nothing for food, shelter, and clothing.
It's either that, or the country will end up paying 100% of GDP for medical care, leaving nothing for food, shelter, and clothing.
3
This article simply regurgitates the same garbage that Dems have been handing out for the past weeks. The problem won't be solved until the law is destroyed and people with good jobs stop being required to send a THIRD of our paychecks to poor, disadvantaged losers that made poor decisions and don't want to pay for their stupidity. Lowering drug costs will never happen because derivatives will always keep the costs high. The NYT continues to amaze with its stupidity.
5
Maybe those poor losers can be forced to sell their organs to the people with good jobs? That would truly make America great.
Are you tired of winning yet?
Are you tired of winning yet?
8
First, even people with good jobs may one day lose those jobs and need health care. Today you are fortunate to be up, tomorrow you may be out of luck and down, and thus need someone else's help. So, your self-congratulatory confidence may be shortsighted. Second, your assertion displays a callousness and lack of empathy that is truly appalling. And you probably call yourself a "Christian" too.
6
Allow doctors to certify the chronically or severely ill as qualified for Medicare regardless of age.
6
Euthanasia would be cheaper for these doomed souls, also more in accord with GOP proposals.
3
“…Trump is holding out hope that the Senate will return to health care in September, and bypass parliamentary obstacles to approve it by a simple majority….”
(https://www.nytimes.com/2017/07/29/us/politics/trump-urges-end-of-filibu...
Approve what?
He might as well demand that Congress give everyone in the U.S. good health. It seems like magical thinking by someone who not only doesn’t understand the basics of health care coverage (forget about the complexities) but who won’t accept that there’s anything more to learn beyond a handful of in-vacuo platitudes like “end subsidies to insurance companies” and “don’t require everyone who can buy health insurance to do so.” If you shrink the insurance market to just the high-demand subpopulation but don’t shore up the insurance companies, don't you squeeze them out of existence? And then isn’t somebody else going to have to step up when it’s time to write a $10,000 check for an individual’s unexpected hospital stay? I’ve heard that this Congress isn’t inclined to replace the ACA with single-payer. In fact, even suggesting it publicly probably would get a person barraged with denigrating tweets about their appearance.
Trump, fixated on erasing the term “Obamacare,” would blow up health care coverage. Let’s hope the Republicans finally will sit down with the Democrats and do the hard work of ironing out the practical shortcomings in the ACA. They could read this article as a start.
(https://www.nytimes.com/2017/07/29/us/politics/trump-urges-end-of-filibu...
Approve what?
He might as well demand that Congress give everyone in the U.S. good health. It seems like magical thinking by someone who not only doesn’t understand the basics of health care coverage (forget about the complexities) but who won’t accept that there’s anything more to learn beyond a handful of in-vacuo platitudes like “end subsidies to insurance companies” and “don’t require everyone who can buy health insurance to do so.” If you shrink the insurance market to just the high-demand subpopulation but don’t shore up the insurance companies, don't you squeeze them out of existence? And then isn’t somebody else going to have to step up when it’s time to write a $10,000 check for an individual’s unexpected hospital stay? I’ve heard that this Congress isn’t inclined to replace the ACA with single-payer. In fact, even suggesting it publicly probably would get a person barraged with denigrating tweets about their appearance.
Trump, fixated on erasing the term “Obamacare,” would blow up health care coverage. Let’s hope the Republicans finally will sit down with the Democrats and do the hard work of ironing out the practical shortcomings in the ACA. They could read this article as a start.
2
Gradually move everyone to Medicare by lowering the qualifying age by 2 years every year. Why should insurance companies be profiting from people's need for health care? They are a useless and money-draining middleman.
14
The biggest single complaint about the ACA, is the mandatory enrollment. Americans have an independent gene that was selected by life in isolated cabins on the lonesome prairie. People had to be self sufficient and be independently capable of taking care of themselves.
That independence has persisted for the last couple of centuries even though very few American individuals are independent like prairie dwellers. It rears its irrelevant head when populist politicians invoke American independence and a highly desirable virtue. Paul Ryan, in particular, touts the idea that the House health care plan allows people the freedom to buy whatever they want. He carefully leaves out the fact that they can't afford decent insurance under his plan.
Strangely, Americans don't say a word when "forced" to buy automobile insurance. Why shouldn't we be able to buy auto insurance just when we need it? Why should there be minimum coverage limits? Definitely an infringement on my personal rights.
Single payer is the right plan for several reasons. It also provides camouflage for the fact that everyone is forced to get insurance and pay for it.
That independence has persisted for the last couple of centuries even though very few American individuals are independent like prairie dwellers. It rears its irrelevant head when populist politicians invoke American independence and a highly desirable virtue. Paul Ryan, in particular, touts the idea that the House health care plan allows people the freedom to buy whatever they want. He carefully leaves out the fact that they can't afford decent insurance under his plan.
Strangely, Americans don't say a word when "forced" to buy automobile insurance. Why shouldn't we be able to buy auto insurance just when we need it? Why should there be minimum coverage limits? Definitely an infringement on my personal rights.
Single payer is the right plan for several reasons. It also provides camouflage for the fact that everyone is forced to get insurance and pay for it.
20
Why do we need insurance companies in the health industry in the first place? Get rid of the vultures. Now!
21
As usual, the NY Times takes the Lincolnesque way to fix our de facto (pre ACA) criminal health policy in America.
Progressives scream single payer or something akin to it! Radical republicans circa 1865 screamed total equality between the races or nothing at all.
The authors of this article took the Lincoln path, slow but steady progress to what the rest of the civilized world has re health care policy...
Progressives scream single payer or something akin to it! Radical republicans circa 1865 screamed total equality between the races or nothing at all.
The authors of this article took the Lincoln path, slow but steady progress to what the rest of the civilized world has re health care policy...
1
When it comes to Pharmaceutical drugs both parties are frauds in their approach. Both parties agree we are a capitalist society but neither is prepared to sponsor legislation and vote for it that would negotiate drug prices across the board for government care. Every private insurer does it.
For an individual or a family the way it works in the policy is as follows. The policy includes a formulary. It is list of drugs ususally by tier starting w/ genereics, then working its way up to better generics-will address this below and finally name brand drugs. Most have a specialty tier for those of us w/ outlier situations and where dreck like Shkreli operate.
Games are played here. The first is insurers charge each policy class a seperate price for a drug even though they buy the drug in bulk at one price. The other horse manure is the FDA maintains a list of chemical compounds that go into a drug. Each compound has a purity rating depending on the manufacturer. Each genereic drug manufacturer makes an "equivalent drug" but the compounds are not for arguments sake "90%" equivalents across the board. This allows for multiple generic drugs but all have different efficacy based on the purity of the compounds. It is why you hear your parents complaining about the medication doesn't seem as good when they changed plan so this too has to stop. Set a generic at say 85% across the board. It shouldn't be the equivalent of buying different regular gasoline.
For an individual or a family the way it works in the policy is as follows. The policy includes a formulary. It is list of drugs ususally by tier starting w/ genereics, then working its way up to better generics-will address this below and finally name brand drugs. Most have a specialty tier for those of us w/ outlier situations and where dreck like Shkreli operate.
Games are played here. The first is insurers charge each policy class a seperate price for a drug even though they buy the drug in bulk at one price. The other horse manure is the FDA maintains a list of chemical compounds that go into a drug. Each compound has a purity rating depending on the manufacturer. Each genereic drug manufacturer makes an "equivalent drug" but the compounds are not for arguments sake "90%" equivalents across the board. This allows for multiple generic drugs but all have different efficacy based on the purity of the compounds. It is why you hear your parents complaining about the medication doesn't seem as good when they changed plan so this too has to stop. Set a generic at say 85% across the board. It shouldn't be the equivalent of buying different regular gasoline.
2
Thank goodness a few republicans value America/Americans over rich donners.
3
We have no problem with socialized education, military or roads, why are we hung up on health care ?
12
Unfortunately, we see creeping privatization of the military (what does Blackwater call itself now?), rampant privatization of education (Gee, Betsy Devoss is Eric Prince's sister!), and Trump is planning to start selling off our infrastructure to private investors. So we're moving in the wrong direction here.
8
The Affordable Care Act aka "Obamacare" is largely a single-payer plan when you break down the numbers. While there are about 12 million people enrolled through the for-profit health insurance exchanges, there are currently almost 70 million receiving Medicaid. That is one reason why the Republican Congress focused its major attack on gutting Medicaid. When you add the 44 million Americans now on Medicare, you have one-third of the U.S. population on a single-payer plan. And with Medicare expected to nearly double as the baby boomers retire, we should embrace "Medicare for All" to end the petty politics and the expensive for-profit health insurance industry and also enforce the generic drug market prices to cut costs even further. This is the real way to "repair the health law" (only the politics are "tricky"), especially as more and more insurance companies abandon more and more markets.
5
The ACA limits what insurers can make. For small health plans, they can keep up to 20 cents of every premium dollar to cover some costs and profit. For large health plans, it's only 15 cents of every premium dollar. Even with subsidies and better reinsurance, insurers are limited in what they can do to make premiums more affordable. The ACA is only one leg of the Health Care Reform table. A great deal of work has been done in the provider or healthcare deliverer space to drive a focus on the outcome of care, not just each visit, and quality. Large Health systems have greatly benefited from being forced to be more astute in how they run their businesses. 20 % of healthcare consumption (delivered by highly paid specialists and these large hospitals) accounts for almost 80% of the spend. This, coupled with specialty prescription drugs, account for upwards of 60 cents of every premium dollar. Remember, your health insurance pays a big portion of these healthcare services and drugs. If you want to make healthcare insurance more affordable, then Congress needs to enhance Healthcare Reform to hold the large health systems and prescription drug companies accountable for what they charge. Large Health systems covered the uninsured before ACA through higher charges to the insured, they didn't eat those costs. In spite of now receiving payment for the ex-uninsured, their charges still increase. They're making money hand over fist, they need to be held accountable.
3
Don't think that margins of 15-20% for insurance companies aren't plenty big. They ate far greater than the margins in a lot of other industries.
The overhead for Medicare is a fraction of what it is in for profit insurance, and the national infrastructure for it already exists, making implemntation cheaper. The insurance companies will simply have to make do with selling Medigap coverage policies.
Further, freedom from having to pay for mass employee coverage would be a yuge windfall for companies. Sharing that windfall with employees to make basic Medicare premiums is the tricky part, but should be feasible.
The overhead for Medicare is a fraction of what it is in for profit insurance, and the national infrastructure for it already exists, making implemntation cheaper. The insurance companies will simply have to make do with selling Medigap coverage policies.
Further, freedom from having to pay for mass employee coverage would be a yuge windfall for companies. Sharing that windfall with employees to make basic Medicare premiums is the tricky part, but should be feasible.
7
Next up in the Republican health care follies: the Ryan Eugenics Health Care Act. Like Obamacare, the Ryan Eugenics Health Care Act also has Gold, Siver, and Bronze plans. In addition, however, there is the Master Plan, in which members receive huge discounts on their health care premiums every month if they can prove that they have superior genetics. Also, there are steep discounts on health care premiums for all members who can run a mile in seven minutes or less.
2
Ok Michael Lawson, everyone should be insured. You then pay what we have to pay for two: now probably $2,000/month and a $10.000 deductible. Are you prepared to pay this?
1
Impeach Trump. That is health care for the USA, for the world, and for the Constitution and rule of Law.
5
There is collusion between drug companies and insurance companies, to blackmail consumers to pay high insurance premiums.
Many drugs now are so high priced they burn through a person's deductible withinn weeks.
Either way, patients are literally scared to death about losing their coverage.
They take high deductible policies to try to save money , but as soon as they get even a minor illness they have spent through their deductible and are worse off than if they had taken the lower deductible, higher premium plan..
Meanwhile, only consumers pay retail for drugs , once the deductible is passed and the insurance company starts to pay, the insurance company negotiates a near wholesale price for itself, and pockets the profit.
Collusion.
Many drugs now are so high priced they burn through a person's deductible withinn weeks.
Either way, patients are literally scared to death about losing their coverage.
They take high deductible policies to try to save money , but as soon as they get even a minor illness they have spent through their deductible and are worse off than if they had taken the lower deductible, higher premium plan..
Meanwhile, only consumers pay retail for drugs , once the deductible is passed and the insurance company starts to pay, the insurance company negotiates a near wholesale price for itself, and pockets the profit.
Collusion.
5
The answer is simple, Universal Health care. Everyone gets the same insurance, the rich, the poor, AND all elected officials. Write your representative!
19
In most of the world healthcare does not equal health insurance. Health insurance is a commercial product.
30% of the cost of that product goes straight to administrative bureaucracy and corporate profits!
30% of the cost of that product goes straight to administrative bureaucracy and corporate profits!
19
All these comments about single payer and how great it would be- yet never a word mentioned by our two most Senior members! Pelosi and Schumer avoid talking about the single payer option as if it were the plague. Why are they so afraid of helping people? The only one out there pushing single payer is Bernie- but Hillary and her lynch mob at the DNC made short work of him. Pelosi and Schumer are the key people to pass this thing - Both have served over 20 years in office. Since neither of them have any plans to leave- I imagine it will be another 20 years before they get the courage [or come to their senses] to do what's right for the country.
3
It's not that they don't want to help people. Part of the problem is a long term attitude in America toward "socialized medicine." For decades, it's been political poison to be associated with that. It was just on step from Communism. It's made Dems very leery of being too aggressive about single payer, but times have changed and I hope the Dems take up the banner of single payer. Right now we have a probably unworkable mix of the free market and government.
Because big business -- insurance, AMA, etc. -- do not want it. These folks are beholden to them. So, you won't see single payer, not even from a Democrat. All in Congress are up for sale. But let's not forget, Congress has Cadillac insurance paid by the tax payer while the regular guy can't afford the monthly (exorbitant) premium the Democrats gave us under ACA and passed in order to see what it was all about. They could have read the darn thing but the outcome would have been the same. They do not serve the taxpayers but insurance companies, doctors, hospitals, the AMA, et al. Everyone but the people they lied to in order to be elected/re-elected again.
Bums in Congress. What else is new?
Bums in Congress. What else is new?
1
Trump would have made short of Bernie too.
Trump had Putin on his side
Trump had Putin on his side
Nothing is impossible. But first we have to get a lot of republicans the hell out of the government.
5
Unfortunately, it's almost most Democrats. They too are beholden to the drug companies, the AMA, hospitals, etc. They could have given us single payer when they had the votes but they gave us the inferior ACA.
3
Yakity, yakity, yakity, yak! Here's the two-word solution: single payer. Or, if you prefer the three-word solution, Medicare for all.
9
"It's tricky but not impossible."
Actually, it is impossible until costs are controlled. ACA doesn't do that. Medicare does. This continued toe-stubbing by the GOP is a blessing in disguise, because it is keeping the issue of affordable health care for everyone on the front burner. The D's need to go on the offensive now and push hard for universal coverage, aka Medicare for everyone. It is easier to make that case now than it ever was, and it grows easier with each passing day.
Actually, it is impossible until costs are controlled. ACA doesn't do that. Medicare does. This continued toe-stubbing by the GOP is a blessing in disguise, because it is keeping the issue of affordable health care for everyone on the front burner. The D's need to go on the offensive now and push hard for universal coverage, aka Medicare for everyone. It is easier to make that case now than it ever was, and it grows easier with each passing day.
8
Do you really understand what this would entail? Doctors are willing to take a few Medicare patients because they mostly get much higher rates from everyone else. If all patients paid at the Medicare rate, doctors' incomes would be cut in half.
Now what would you do if someone tried to cut your income in half? I can well believe that the doctors would be highly effective at coming up with a counterattack.
Now what would you do if someone tried to cut your income in half? I can well believe that the doctors would be highly effective at coming up with a counterattack.
2
Like what?
In the US:
Fluticasone/salmeterol (Advair) USD $292/month
In New Zealand:
Fluticasone/salmeterol (Seretide) USD $25.36/month
Americans are being ripped off by insurers and pharmaceutical companies. The US is a health (insurance) failure, caused by profit making entities, naive 'consumers' and a failure of political oversight.
Fluticasone/salmeterol (Advair) USD $292/month
In New Zealand:
Fluticasone/salmeterol (Seretide) USD $25.36/month
Americans are being ripped off by insurers and pharmaceutical companies. The US is a health (insurance) failure, caused by profit making entities, naive 'consumers' and a failure of political oversight.
26
Why does Trump hate Obama?
7
I think this is a Republican thing, going back to the Tea Party. Trump just jumped on for the ride, he doesn't care.
2
Because Obama is everything Trump can never be.
3
One reason for these problems with the ACA is the refusal of Red States to allow Medicaid expansion. The miserable people in those States need to understand this. They need to understand that their own legislators have done this to them, and get rid of them--if they don't die first!
8
Medicare expansion is just one problem. Single Payer would take care of everything. You cannot expect people who do not get government health subsidies to subsidize others. How would you like paying $2,000/month for health insurance and on top of that a $10,000 deductible? Be fair. Most in the middle class who are expected to pay for the health-are of the lower class are NOT money-bags. Why not ask the one percent to pay for health-care? Not going to happen!
2
Funding for three years... Obama declared victory with the time bomb he planted. Good luck.
3
Perhaps I missed it- but I do not see any mention of House v. Price and the 90- day ruling delay requested by Trump (May 2017). What will Trump do? What will this GOP Congress do?
If anyone were serious about a fix for ACA they would simply add a Medicare option to the healthcare exchanges. Of course even though it would provide better options at a lower cost we can't do that because Republicans are opposed to a role of the Federal Government for healthcare. Instead they want to return it to the individual states. Now that may solve a role for the Federal Government, but with regards to improving healthcare - that's just plain stupid.
9
Naive in the extreme. Republicans are not interested in repair. They have used healthcare law as a racket to extract campaign donations fron conflicted insurance companies and providers, and votes from a base that wants to prevent Democrats from holding office. They will keep stringing the nation and fools like Trump alog as long as it is profitable to do so.
13
In this state I can't get healthcare no job no money take care of my mom I live on $ 194.00 in food stamps that's all I get I have had breast cancer still told no health care for you!! The only one who can get Ten Care are voted in to the government in Nashville they make more then most people in this state! Some parts were need but when you look at the big pictures we have a lot of people not getting the help they need for anything there is away to fix this but everyone needs to set down and just talk out there difference in Washington make the one with money take care of the people in the USA not over seas we spend more money in country's that don't want our help!! So lets take care of us first then them next
2
How do you pay for internet and subscription to NYT?
6
As an indigent you should be able to get free health-care.
2
Countries with universal health care include:
Austria, Australia, Belarus, Canada, Costa Rica, Croatia, Czech Republic, Denmark, Finland, France, Georgia, Germany, Greece, Hong Kong, Iceland, Ireland, Israel, Isle of Man, Italy, Luxembourg, Malta, Moldova, the Netherlands, Norway, Portugal, Romania, Russia, Scotland, Serbia, Spain, Sweden, Switzerland, Singapore, Ukraine, Wales, and the United Kingdom.
For god sakes... Botswana, Burkina Faso, Bhutan, Ghana, Morocco, Rwanda, South Africa, Tunisia, and many many more
So, why is the U.S. so afraid of it?
Austria, Australia, Belarus, Canada, Costa Rica, Croatia, Czech Republic, Denmark, Finland, France, Georgia, Germany, Greece, Hong Kong, Iceland, Ireland, Israel, Isle of Man, Italy, Luxembourg, Malta, Moldova, the Netherlands, Norway, Portugal, Romania, Russia, Scotland, Serbia, Spain, Sweden, Switzerland, Singapore, Ukraine, Wales, and the United Kingdom.
For god sakes... Botswana, Burkina Faso, Bhutan, Ghana, Morocco, Rwanda, South Africa, Tunisia, and many many more
So, why is the U.S. so afraid of it?
133
Because...
(pearls fully clutched)
Socialism!
(pearls fully clutched)
Socialism!
3
Wales is not part of the game of the United Kingdom?
1
Who says Republicans want to "fix" Obamacare? This has been a great wedge issue for them and "repeal and replace" helped them win this last election. Trust me, they will say "repeal and replace" again the next election cycle and the same people will vote for them...again. Makes no sense? Exactly.
This is the same party that has used the wedge issue of "turn back Roe v. Wade" for the last 40 years. And THAT is the car most of the Republican dogs NEVER want to catch, but they'll say it over and over to win elections.
This is the same party that has used the wedge issue of "turn back Roe v. Wade" for the last 40 years. And THAT is the car most of the Republican dogs NEVER want to catch, but they'll say it over and over to win elections.
8
I think the government needs to get involved in setting drug prices and medical care. And the first step should be requiring hospitals to disclose prices of common procedures. I buy a house and I get a required disclosure form. I get a knee operation and I get surprise bills.
Someone's medical misfortunes shouldn't be an opening for price gouging by healthcare professionals.
Someone's medical misfortunes shouldn't be an opening for price gouging by healthcare professionals.
6
There is something way superior to repairing Obamacare, its called PACA or pre-Affordable care Act)
PACA gave us the best health care in the world. For those Americans who wanted it and were ready to make the effort.
PACA gave us the best health care in the world. For those Americans who wanted it and were ready to make the effort.
2
@Sunil Kololgi:
On what planet did this happen? Those of us who remember pre-ACA remember routine medical bankruptcies, lack of coverage for pre-existing conditions, people afraid to leave jobs for fear of losing insurance, and the self-employed often unable to find insurance at any price.
On what planet did this happen? Those of us who remember pre-ACA remember routine medical bankruptcies, lack of coverage for pre-existing conditions, people afraid to leave jobs for fear of losing insurance, and the self-employed often unable to find insurance at any price.
8
No, the system pre-ACA was terrible. Fifty million people were uninsured, millions of them unable to buy insurance because of preexisting conditions. According to a 2009 Harvard study, about 45,000 Americans died every year because they were uninsured and had no access to healthcare.
The myth that we had the best health care in the world has been debunked many times. We have a lower life-expectancy rate at birth than most Western countries. We have the highest maternal mortality rates in the industrialized world, and an infant mortality rate that is one of the highest. In every area, we lag other Western countries, whose governments pay far less on health care than ours.
It was never a matter of wanting healthcare--everyone wants it. It was never a matter of "making the effort" to get it. For millions of Americans, healthcare was out of reach because of preexisting conditions. For others it was out of reach because of cost. Obviously the ACA is a big step forward. This excellent analysis shows us how to proceed to fixing the law.
The myth that we had the best health care in the world has been debunked many times. We have a lower life-expectancy rate at birth than most Western countries. We have the highest maternal mortality rates in the industrialized world, and an infant mortality rate that is one of the highest. In every area, we lag other Western countries, whose governments pay far less on health care than ours.
It was never a matter of wanting healthcare--everyone wants it. It was never a matter of "making the effort" to get it. For millions of Americans, healthcare was out of reach because of preexisting conditions. For others it was out of reach because of cost. Obviously the ACA is a big step forward. This excellent analysis shows us how to proceed to fixing the law.
11
Yes, like the kid with leukemia in my community that volunteers organized charity drives for at the local supermarket. I haven't seen that anymore since the ACA. It was only the best healthcare in the world for those who could afford it. If you were out of work, had a pre existing condition, or used up your lifetime cap - which goes very fast if you need cancer treatment - you were out if luck and could drop dead for all the insurance companies cared.
3
The great minds who wrote Obamacare where ignorant of economics or most likely shamelessly dishonest or dumb. They totally ignored the fact that somebody had to pay for all the medical care they signed up to provide. It' sounds great to cover existing conditions but to do that providers were suddenly hit by humongous bills with nobody paying for them. The only way out was to reduce the medical care of those who had been paying for insurance all of their life. Obamacare can not be fixed, it is destroying medical insurance for all of us under the guise of providing care for the uninsured.
8
Many people on employer insurance are under the mistaken impression that their premiums are going up because of the ACA, and that they're paying for people on the exchanges. They're also under the mistaken impression that they've been paying for their insurance their entire lives. Neither is true. Our biggest expenditure in federal healthcare dollars are the subsidies we as taxpayers provide employer-based insurance. Simply excluding the value of employer plans from the employees' payroll taxes costs our government $250 billion a year, many times the costs of the exchanges.
6
Sandra H,
Bill T speaks the truth, details be damned. Insurance keeps getting worse and more expensive, and ACA hasn't done a darned thing to fix that, which is the salient point. I expect my government to look out for my best interests, and that hasn't happened. It's disgusting.
Medicare for everyone.
Bill T speaks the truth, details be damned. Insurance keeps getting worse and more expensive, and ACA hasn't done a darned thing to fix that, which is the salient point. I expect my government to look out for my best interests, and that hasn't happened. It's disgusting.
Medicare for everyone.
1
First of all, Obamacare needs improvements, not "fixing." What we had BEFORE Obamacare is what was broken and needed fixing.
Secondly, please stop referring to Trump and cohorts as having a "populist agenda."
In another article (that doesn't allow comments), you wrote about "the fate of the populist, “drain the swamp” agenda he promised to deliver in partnership with a Republican-controlled Congress."
What Trump and the Republicans are doing is anything but "populist." They are hurting the working class, and any notion that their concerted propaganda campaign has been grassroots is absurd. Stop being part of that propaganda by suggesting anything they're doing is "populist."
Secondly, please stop referring to Trump and cohorts as having a "populist agenda."
In another article (that doesn't allow comments), you wrote about "the fate of the populist, “drain the swamp” agenda he promised to deliver in partnership with a Republican-controlled Congress."
What Trump and the Republicans are doing is anything but "populist." They are hurting the working class, and any notion that their concerted propaganda campaign has been grassroots is absurd. Stop being part of that propaganda by suggesting anything they're doing is "populist."
13
Rarely is there ever a silver bullet to a problem. But in this case there is.
Medicare for all.
Medicare for all.
27
MMM
How much is it going to cost and who will pay for it
How much is it going to cost and who will pay for it
3
Sunil - we all pay for Medicare now and a Medicare participant also pays a monthly premium.
However, Medicare does NOT make a profit or pay dividends nor does it fund PACs. Considering the money in politics these days it's no wonder Medicaid isn't getting considered.
However, Medicare does NOT make a profit or pay dividends nor does it fund PACs. Considering the money in politics these days it's no wonder Medicaid isn't getting considered.
7
@Margo - Yes, everyone pays for Medicare now, but only those over 65 get the benefits. That's the secret - 'someone else' is paying.
If we had 'Medicare for all', there'd be no someone else. Your premium would be $1000 a month, because that's what the average Medicare patient costs.
If we had 'Medicare for all', there'd be no someone else. Your premium would be $1000 a month, because that's what the average Medicare patient costs.
2
In the short term, they should move quickly on:
(1) Congress should enact laws that ensure the $8B to $10B for subsidies for the low income people that need help.
(2) Allow people 55 and above plus areas that have no or only 1 insurance provider to enroll in Medicare. Medicare would have to establish the 2018 premiums for these people.
(3) Set prescription drug prices in 2018 at the average for the G7. Since the US is already paying twice the average. This should automatically set the prices in the US slightly higher than the average G7 price.
Longer term, Congress needs to focus on reducing costs.
(1) Single form for all insurance companies
(2) Forcing hospitals and providers to be transparent and publish prices for services.
(3) Move away from fee for service...
(1) Congress should enact laws that ensure the $8B to $10B for subsidies for the low income people that need help.
(2) Allow people 55 and above plus areas that have no or only 1 insurance provider to enroll in Medicare. Medicare would have to establish the 2018 premiums for these people.
(3) Set prescription drug prices in 2018 at the average for the G7. Since the US is already paying twice the average. This should automatically set the prices in the US slightly higher than the average G7 price.
Longer term, Congress needs to focus on reducing costs.
(1) Single form for all insurance companies
(2) Forcing hospitals and providers to be transparent and publish prices for services.
(3) Move away from fee for service...
9
Drug costs are a component of the problem, but in general, costs for services need control. $1600 for an MRI that costs $200 elsewhere in the world tells me that MRI centers are making a killing, not a living. Same for a shoulder surgery at $12,000 here and a fraction overseas. Insurers are capped at 20% overhead, with 80% of premiums going to care by law, so their profit comes from that 20% - as a result, they have no incentive to negotiate prices downwards - in other words, the larger the bill, the bigger their 20% is, the more gross dollar profit they can make. National fee schedules, adjusted for locality, will drive some of the greed out of the system and drive costs down. But good luck with that......
17
Why costs are so high is an interesting question.
At the MRI center, the machines are fancier and more expensive, the technicians more highly skilled, the building more luxurious. When I had my MRI, I went into a place with fresh flowers and designer furniture in the waiting room, free wi-fi, and a gorgeous receptionist. It was like entering a luxury hotel.
It is not so easy to say 'get rid of all this stuff'. They've already borrowed the money to build the building and buy the machines, and now that have to pay the interest on the bonds.
At the MRI center, the machines are fancier and more expensive, the technicians more highly skilled, the building more luxurious. When I had my MRI, I went into a place with fresh flowers and designer furniture in the waiting room, free wi-fi, and a gorgeous receptionist. It was like entering a luxury hotel.
It is not so easy to say 'get rid of all this stuff'. They've already borrowed the money to build the building and buy the machines, and now that have to pay the interest on the bonds.
1
Amazing how many "free market" conservative politicians cease to be "free market" when their campaign coffers are filled with pharmaceutical industry dollars.
Not "amazing", actually. Predictable!
Not "amazing", actually. Predictable!
8
Most of us are already getting as much health care as we need and is good for us. That part of the system should be left alone, except for efforts to reduce drug costs and avoid future premium increases.
It’s the rest of the country that needs help. Disabled people, unemployed people, poor people, veterans and the homeless.
Let’s start with them.
It’s the rest of the country that needs help. Disabled people, unemployed people, poor people, veterans and the homeless.
Let’s start with them.
2
@a. Stanton
I think we already are friend, however forces against ( republicans ) want to single out ( along with insurance companies ) the very groups you point out. They then can siphon off profits and let that pool of people collapse. ( essentially the premiums become too much )
The only way it works ( helping the most and keeping costs low ) is to have everyone included in the same pool.
... or just take profit out of the system altogether.
I think we already are friend, however forces against ( republicans ) want to single out ( along with insurance companies ) the very groups you point out. They then can siphon off profits and let that pool of people collapse. ( essentially the premiums become too much )
The only way it works ( helping the most and keeping costs low ) is to have everyone included in the same pool.
... or just take profit out of the system altogether.
8
If the Republicans believed that people who aren't rich should have health care, the solution is simple. Medicare for all could be phased in by steadily lowering the age of eligibility. While a substantial majority of Americans support Medicare for people who are 65, they don't support the same for younger people. This makes absolutely no sense.
12
Who is going to pay for this? Right now Medicare is funded by every working American who is NOT receiving it.
1
Trump, McConnell, Ryan, and other racists in Congress are not interested in fixing anything, they are interested in erasing Obama`s legacy, nothing else. This utterly obvious fact, for some reason, is never acknowledged, even if it is glaringly clear to anyone with a minimum of objectivity. One doesn`t have to be a professional historian to appreciate how deeply humiliating it must be to many American whites, especially uneducated ones, to have to acknowledge that Obama no only fixed a problem that many powerful white men failed to address, but that in addition, the fix will bear Obama`s name, recorded forever in history books, the same books their white children will study at school. It is because of this astonishingly simple fact that Trump and his lackeys will spare no effort in erasing the ACA, at any cost, no matter how high, in human suffering or in treasury.
12
There are several ''easy'' fixes. ( keeping in mind that republicans have and continue to sabotage the ACA at every turn )
1. Go full Single Payer ( or at least Medicare for all )
2. Enact a Govt- backed public option
3. Expand coverage to every state to expand the pool ( the true fix )
4. Negotiate drug prices
5. Reduce costs overall
The fixes are self evident ( just like truth in the Declaration of Independence, since health care is a human right ) There is just one political party ( republicans ) that is against any pf the above.
The vision offered by republicans is one of access and freedom. You have the access to anything ( so long as you can afford it ) and you have the freedom to pay or to perish.
Democrats want to spread out the cost to everyone so the less well off are covered and have adequate health care as well.
It is just that simple .
1. Go full Single Payer ( or at least Medicare for all )
2. Enact a Govt- backed public option
3. Expand coverage to every state to expand the pool ( the true fix )
4. Negotiate drug prices
5. Reduce costs overall
The fixes are self evident ( just like truth in the Declaration of Independence, since health care is a human right ) There is just one political party ( republicans ) that is against any pf the above.
The vision offered by republicans is one of access and freedom. You have the access to anything ( so long as you can afford it ) and you have the freedom to pay or to perish.
Democrats want to spread out the cost to everyone so the less well off are covered and have adequate health care as well.
It is just that simple .
34
As long as healthcare is based upon FOR-PROFIT health insurance, not it can't be repaired. But the mainstream politicians want that system to remain in place because how much money they get from the insurance, drug, and medical industries.
Anything less than Medicare For All is failure.
Anything less than Medicare For All is failure.
12
Somebody needs to tell Republicans that just yelling, "Socialized medicine! Socialized medicine!" is not going to scare people like it used to. Why? Because they have just proved that the only way to make comprehensive private insurance affordable for sick people and older workers is to pay the insurance companies with our tax dollars. So if we're giving our tax dollars to insurance companies to reduce their "risk," which they turn into obscene salaries for their executives, guaranteed profits, dividends for shareholders, stock buybacks, and buyouts of other insurance companies to reduce competition, how is this better than government doing the same work for less cost to taxpayers and covering everyone? I'm ready to stop paying Aetna, Humana, UnitedHealth, Blue Cross and all the other middlemen for a basically clerical job. Government workers can enroll people, make contracts with providers, collect premiums and pay claims as well as anybody in the private sector.
16
The only thing that would help ObamaCare is giving big medicine a few hundred billion dollars more. No thanks.
Drug prices, 70% of which are generic, have increased 24% while the CPI has increased 10%. Obamacare has allowed additional price gaming and increased opacity, which the drug sellers have capitalized by increasing prices. The FDA has helped by driving smaller generic suppliers out of business, facilitating the growth of big companies and their ability to raise prices. There is no excuse for it to cost $5-25 million plus three to five years for an established drug manufacturer to get approval to market a drug. But the current FDA policy [the Trump administration has ordered the FDA to modernize] does favor companies like Mylan which raised the price of EpiPens from $100 to $600. Nice work for a CEO whose Daddy is a Senator.
No mention is made of the 33% that hospital services have increased while the CPI increased 10%. Big, profitable hospital chains [like the charity hospital that paid Michelle Obama $350,000 per year for a part time gig when her husband became Senator] have less uncompensated care and yet increased the prices they charge to insurers 33%.
The liberal response to the inefficiencies introduced by government is to increase the involvement of government to fix the problems it created.
Why is there no outrage at the extent to which hospital charges have increased? Charity systems should be prohibited from paying administrators more than $25k.
Drug prices, 70% of which are generic, have increased 24% while the CPI has increased 10%. Obamacare has allowed additional price gaming and increased opacity, which the drug sellers have capitalized by increasing prices. The FDA has helped by driving smaller generic suppliers out of business, facilitating the growth of big companies and their ability to raise prices. There is no excuse for it to cost $5-25 million plus three to five years for an established drug manufacturer to get approval to market a drug. But the current FDA policy [the Trump administration has ordered the FDA to modernize] does favor companies like Mylan which raised the price of EpiPens from $100 to $600. Nice work for a CEO whose Daddy is a Senator.
No mention is made of the 33% that hospital services have increased while the CPI increased 10%. Big, profitable hospital chains [like the charity hospital that paid Michelle Obama $350,000 per year for a part time gig when her husband became Senator] have less uncompensated care and yet increased the prices they charge to insurers 33%.
The liberal response to the inefficiencies introduced by government is to increase the involvement of government to fix the problems it created.
Why is there no outrage at the extent to which hospital charges have increased? Charity systems should be prohibited from paying administrators more than $25k.
5
So, who is stopping Medicare price negotiation?
4
The ACA has nothing to do with private drug companies gouging the public (except that it failed to address this problem). You are seeing the "free market" at work, one that is insufficiently regulated by the federal government.
There are ways to fix the problem, as the article enumerates. Let's fix the patent system first. Let Medicare negotiate prices directly with pharmaceuticals. We can also make modest improvements, like requiring drug companies to notify the secretary of HHS in advance that they plan a price increase of over 20%, and require the company to provide its reason.
There are ways to fix the problem, as the article enumerates. Let's fix the patent system first. Let Medicare negotiate prices directly with pharmaceuticals. We can also make modest improvements, like requiring drug companies to notify the secretary of HHS in advance that they plan a price increase of over 20%, and require the company to provide its reason.
4
Many great points made about single player plans, price gouging, etc. But these often simplify the complexity of healthcare costs. One area that is worth mentioning is the imbalance of primary care physicians and specialists. The healthcare market has slowly shifted towards the more costly, less accessible specialists because it helps the individual doctors, the hospitals, the insurers, and even the schools they come from make more money. Residencies for the less glamorous primary care physicians have been reduced in favor of these specialists. If one is looking to substantially reduce healthcare costs, another way to do so is to reinforce ranks and reverse the decline of primary care. It is less expensive for patients, and decreases the likelihood and frequency of ER and other costly hospital visits.
The healthcare debate is complex, but going beyond the talking points really is imperative to developing a system that is cost efficient for all involved.
The healthcare debate is complex, but going beyond the talking points really is imperative to developing a system that is cost efficient for all involved.
7
Single Payer, Medicare for All. It's not rocket science. Get the profiteers out of the way and join together our bargaining power. The insurance companies and the big pharmaceutical and medical companies are the problem. Any solution that leaves them free to continue to gouge us will fail. Single Payer, Medicare for All.
13
Bidding on drugs would save trillions. The money saved could help lower health care cost for all.
Why do the pro life Republicans want to cut babies and kids Medicaid? I think pro life is just a slogan not to be practiced.
Why do the pro life Republicans want to cut babies and kids Medicaid? I think pro life is just a slogan not to be practiced.
15
I think that one step--allowing Medicare to negotiate drug prices directly--would save the program enough money to allow it to expand to cover 60 year olds.
3
Drugs are only 10% of total health care spending according to the CDC. Even if the governments or politicians manage to cut drug expenditures (prices) by 50%, this will impact total expenditures by a meager 5%.
Drugs are VISIBLE expenditures, and price increases are even more visible. This is why it is easy and convenient to attack drug companies. But if you want to cause a real dent in health care costs, you better focus on the other 90%. The one hidden in insurance premiums and deductibles.
Drugs are VISIBLE expenditures, and price increases are even more visible. This is why it is easy and convenient to attack drug companies. But if you want to cause a real dent in health care costs, you better focus on the other 90%. The one hidden in insurance premiums and deductibles.
1
Since the inception of ObamaCare, the CPI has increased 10% and drug prices have increased 24%. As you say, they are visible because a small proportion of the increase is showing up in co-pays and the balance is hidden in increased insurance premiums. It is odd, given that 70% of drug consumption is in generics and the famous new drugs with stiff list prices have only three to five years of patent protection left, so their impact is minor on total costs.
The fabulous untold story is that charges for hospital services have increased 33% during the same period. Big medicine consolidated, drove smaller competitors out of business or bought them up and with their improved negotiating position, increased charges for everyone. The $2500 family savings that was supposed to be realized by the magic of ObamaCare was gamed into a $5,000 per household increase in costs by the magic of big medicine gaming skills.
BTW, Medicare hospital charges increased by the same price inflation, so the progressive dream of Medicare for all will not reduce medical costs for Americans, it will improve the profitability of Kaiser Permanente, the Mayo Clinic, and the charity hospital that employed Michelle Obama at $350,000 per year for a part time gig. Hospitals that serve primarily the poor will continue to go out of business.
The fabulous untold story is that charges for hospital services have increased 33% during the same period. Big medicine consolidated, drove smaller competitors out of business or bought them up and with their improved negotiating position, increased charges for everyone. The $2500 family savings that was supposed to be realized by the magic of ObamaCare was gamed into a $5,000 per household increase in costs by the magic of big medicine gaming skills.
BTW, Medicare hospital charges increased by the same price inflation, so the progressive dream of Medicare for all will not reduce medical costs for Americans, it will improve the profitability of Kaiser Permanente, the Mayo Clinic, and the charity hospital that employed Michelle Obama at $350,000 per year for a part time gig. Hospitals that serve primarily the poor will continue to go out of business.
3
And what have the Republicans in the House, Senate, and White House done to address any of these issues? 0.
4
You're confusing coincidence with causation. Medical inflation has always been much steeper than ordinary inflation. Unless you can show us the mechanism whereby the ACA supposedly eliminates competition, you're just looking at an ordinary trend.
By the way, the ACA only represents one-fifth of the health care market.
By the way, the ACA only represents one-fifth of the health care market.
Republicans cannot complain, criticize or condemn Obamacare for the money it takes to sustain it when they refuse for sheer political reason to allow Medicare and Medicaid to negotiate for prescriptions. They are going against their often invoked principle of the power of free market, which certainly includes the right to bargain for services. How about a pact between Republicans and Democrats to refuse contributions from big Pharma, thus removing their potential impact upon their election.
12
Medicaid, by law, is entitled to 10-25% below the lowest prices paid for drugs. If you follow the news, Mylan is being fined for paying the lower rebates for their EpiPens because they claimed they were generic, rather than the rebates they owed for brand name drugs. The government under Obama was going to let them off the hook for low fines without their having provided documentation, but under Trump they are going to have to pony up the full amount. Since Medicaid pays lower prices for drug than are paid by private insurers with much larger populations, it is silly to suggest that the government could do a better job of negotiating prices.
As far as Medicare is concerned, the prices paid by Medicare part D prescription drugs are lower than anything the government could possibly negotiate. the pharmacy drug companies and insurance companies each have far more than the 55 million covered by Medicare. United Healthcare covers 70 million plus.
What the Democrats wanted in 2003 was for the federal government to impose price controls on Medicare prescription drug coverage. They were acting at the bequest of the drug companies, who wanted a Medicaid-like price control. It would have said that Medicaid got a rebate from the "free market" price paid by consumers and private sector insurers. Which would leave the drug companies free to increase their prices in the private sector to maximize profits.
The drug companies had to wait for OCare for their price increases.
As far as Medicare is concerned, the prices paid by Medicare part D prescription drugs are lower than anything the government could possibly negotiate. the pharmacy drug companies and insurance companies each have far more than the 55 million covered by Medicare. United Healthcare covers 70 million plus.
What the Democrats wanted in 2003 was for the federal government to impose price controls on Medicare prescription drug coverage. They were acting at the bequest of the drug companies, who wanted a Medicaid-like price control. It would have said that Medicaid got a rebate from the "free market" price paid by consumers and private sector insurers. Which would leave the drug companies free to increase their prices in the private sector to maximize profits.
The drug companies had to wait for OCare for their price increases.
2
Private insurance companies participating in Medicare Part D don't negotiate drugs. That's written into the Part D law. They accept whatever the drug manufacturer wants to charge, and those prices are much higher than what the VA or Medicaid negotiate. Seniors are left paying higher prices because of the lack of negotiation.
No drug company wants a Medicaid-like price control system for Medicare. Trust me. That's why the pharmaceutical lobby invested so much money in defeating the measure when it came up during Part D committee hearings.
There's an easy fix for high drug prices for seniors--just let Medicare negotiate prices directly and create a single formulary.
No drug company wants a Medicaid-like price control system for Medicare. Trust me. That's why the pharmaceutical lobby invested so much money in defeating the measure when it came up during Part D committee hearings.
There's an easy fix for high drug prices for seniors--just let Medicare negotiate prices directly and create a single formulary.
1
I keep hearing that ACA is a "disaster" from each and every Republican interviewed as though they were robots or something. I also hear the pundits say that the Republicans were deficient in keeping their promise to voters and that will hurt them in the next election. Trump calls the Republican senators losers, while they got 48-49/51 votes on each vote, while railing on about how the Democrats didn't help. But right now Obamacare is more popular overall than any of the alternatives. This, voting to make the majority of people satisfied is what democracy is. What the heck is wrong with jettisoning a plan which won't work, agreeing to work with the 55% of the total that don't want the stinky plan they don't even want to be law, fixing the plan in a bipartisan civil way and perhaps relearning that that is what the job is. Do the right thing and your constituents should love you.
6
During 2017, before the Republicans had any opportunity to do anything, one third of the counties in the US have a single insurer and another third of the counties have only two insurers participating in the Obamacare marketplaces. it is difficult to comprehend how anyone can claim ObamaCare is anything other than a failure when the residents living in two thirds of the landmass of the country do not have a competitive marketplace.
The Democrat answer is to throw more money at the profitable elements of big medicine in the hopes that people in two thirds of the landmass will get minimally accessible health insurance.
It never made any sense for the federal government to create a one size-fits-all federal solution. Throwing good money after bad is not an improvement, except for the profits of the winners. It's unfortunate that gruberized Democrats are unable to comprehend the complexity of the Democrat plan. It was always designed to enhance profits for the big boys at the expense of middle class premiums and government borrowing.
The Democrat answer is to throw more money at the profitable elements of big medicine in the hopes that people in two thirds of the landmass will get minimally accessible health insurance.
It never made any sense for the federal government to create a one size-fits-all federal solution. Throwing good money after bad is not an improvement, except for the profits of the winners. It's unfortunate that gruberized Democrats are unable to comprehend the complexity of the Democrat plan. It was always designed to enhance profits for the big boys at the expense of middle class premiums and government borrowing.
2
Land mass is not the same as population. The ACA continues to work for most ACA participants. However, as the article makes clear, we need to make some improvements. The GOP wasn't suggesting improvements. On the contrary, their plans would throw tens of millions off insurance and raise deductibles and co-pays while decreasing premium supports.
These GOP efforts weren't serious plans, since they were written behind closed doors, without committee hearings and without allowing Democrats to participate. That's just bad legislating, and it deserves to fail.
The ACA is self-funding, and it was never designed to create monopolies. The entire idea was to provide more choices and more transparency. Middle class premiums were skyrocketing before the ACA, and they'll continue to climb as long as we have a system based on for-profit insurance. However, we can do things to slow the climb, as the author describes.
These GOP efforts weren't serious plans, since they were written behind closed doors, without committee hearings and without allowing Democrats to participate. That's just bad legislating, and it deserves to fail.
The ACA is self-funding, and it was never designed to create monopolies. The entire idea was to provide more choices and more transparency. Middle class premiums were skyrocketing before the ACA, and they'll continue to climb as long as we have a system based on for-profit insurance. However, we can do things to slow the climb, as the author describes.
Hasn't this obsession over passing a reviled healthcare repeal become something resembling the definition of insanity? Doing the same thing over and over while expecting a different outcome?
Republicans should have collaborated on healthcare reform instead of trying to pull the health insurance rug out from under us behind closed doors. Instead, they continue to demonstrate how little they care about Americans who want healthcare that is affordable and comprehensive.
Republicans should have collaborated on healthcare reform instead of trying to pull the health insurance rug out from under us behind closed doors. Instead, they continue to demonstrate how little they care about Americans who want healthcare that is affordable and comprehensive.
64
Democrats imposed ObamaCare with little input and no votes from Republicans. The provision Republicans did get included, that Congress and their staffs would lose their employer provided subsidies and would have to buy insurance in the Obamacare exchanges, Obama decided not to enforce.
Republicans should have repealed ObamaCare promptly, and then engaged the Democrats into a bipartisan, sustainable plan to reform health care.
IMO, if the Republicans do not promptly repeal ObamaCare, trump should declare that he will implement it exactly as the law was written. No more gifts to the insurers for out-of-pocket subsidies for the poor. Most importantly, Congress and their staffs lose the 70% employer subsidy and have to buy policies in the individual, collapsing exchanges.
Republicans should have repealed ObamaCare promptly, and then engaged the Democrats into a bipartisan, sustainable plan to reform health care.
IMO, if the Republicans do not promptly repeal ObamaCare, trump should declare that he will implement it exactly as the law was written. No more gifts to the insurers for out-of-pocket subsidies for the poor. Most importantly, Congress and their staffs lose the 70% employer subsidy and have to buy policies in the individual, collapsing exchanges.
3
Make VA healthcare available to all veterans. That would help but Medicare for all is best.
2
Only 25% of veterans eligible for VA healthcare elect to use it; the others prefer Medicaid, Medicare, employer provided health insurance or other insurance.
1
It can be fixed but Dems and Rep don't want the other to get credit. So we all suffer because of allegiance to party and selfishness. Boy, what a country.
2
Schumer made clear that Democrats want to work with Republicans to improve the ACA. I don't think it's a matter of being territorial.
1
For the umpteenth gazillion time, we should have a national health insurance system and stop trying to cobble together patchwork bandages for a "market" system based on competing insurers and employer-based insurance pools (if you are lucky enough to be employed where it's offered). So obvious, but, oh, that would be "socialized medicine." Wrong. Every advanced democracy in the world has such a system, and they are not "socialists" but in fact market economies, e.g., Canada, Australia, you name it. Wake up, America.
12
Yes, a single payer system would solve the ills! But, heaven forbid, that's too much of a lean toward socialism. (facetiously said) Never mind that people already like both Social Sec. & Medicare.
IMO, there should be bipartisan comprehensive studies done of all of the best national health programs, with what works the best for the various countries' programs being noted. And for what doesn't work so well, make notes of those things, too, & devise ways to improve upon them. Then take the best of the best, along with the improvements, and... hey, presto! What do you know, but a single payer system that, given the opportunity to use it, people - even those initially skepical of - would wind up giving the thumbs up! More streamlined, more equitable, & less pricey!
IMO, there should be bipartisan comprehensive studies done of all of the best national health programs, with what works the best for the various countries' programs being noted. And for what doesn't work so well, make notes of those things, too, & devise ways to improve upon them. Then take the best of the best, along with the improvements, and... hey, presto! What do you know, but a single payer system that, given the opportunity to use it, people - even those initially skepical of - would wind up giving the thumbs up! More streamlined, more equitable, & less pricey!
60
When is the last time an American travelled to Canada to obtain care not available in America. Never. When is the last time a Canadian travelled to America to obtain care not available in Canada? Today.
2
As I understand it, the Netherlands has universal care under a system like the ACA, built on private insurance markets. Also Switzerland. The problem with the ACA is the very, very bad faith of Republicans, and Republican state governors who refused to expand Medicaid. And now Trump who will blow up the world unless every one obeys his order to kill Obamacare.
1
The problem was never ACA. Because people with pre-existing conditions were either denied coverage or priced out of the market before ACA. Premium hikes were the norm before ACA. "Consumer Driven" jargon was the excuse for Yuge Insurance Executive Compensation supported by declining expenditures for actual care before ACA. For Profit Commercial Insurance was the Problem before ACA. And it still is. When one man/woman needs to siphon off two hundred million in one year from one company, and share-holders demand profit for their stakes, health care will always require more income than actually required to pay providers and administer a simple, single payer claims system. GOP aren't interested in solving this at all. Trump doesn't give a fiddler's fart either. He wants the Obama legacy replaced with a Trump branded anything. He wants it now. He wants you to say you love him, too. He wants adulation, and, yeah, probably something else. Is there a volunteer? Someone who'll take one for the team? Please?
7
There were fewer than 10 million individuals who were either uninsurable or priced out of the market for health insurance in 2010. Not all of them have health insurance today, despite the availability of subsidized health insurance. Everyone who has health insurance is paying a combination of higher premiums, higher co-pays and higher deductibles. The government is adding $1.3 trillion to the deficit to cover the price increases imposed by drug companies and hospitals. And there are in excess of 30 million uninsured, which includes some of the original 10 million.
Insurance for all is a silly objective. Health care for all is a higher level objective. However, available affordable healthcare for all does not guarantee maximum profits for charity hospitals like the one that hired the politically well connected Michelle Obama for $350,000 for a part time gig and does not allow Mylan to increase the price of EpiPens from $100 to $600, enhancing the compensation for its CEO [daughter of a Democrat Senator].
Democrats created a narrative that they were interested in the needs of their constituents. They concealed that Obamacare was designed to benefit their big medicine cronies, the true beneficiaries. The three Republican RINOs who voted against repeal last week have a greater interest in supporting big medicine cronies than they have for doing what is right.
More than half of the insurance providers in ObamaCare markets are non-profits.
Insurance for all is a silly objective. Health care for all is a higher level objective. However, available affordable healthcare for all does not guarantee maximum profits for charity hospitals like the one that hired the politically well connected Michelle Obama for $350,000 for a part time gig and does not allow Mylan to increase the price of EpiPens from $100 to $600, enhancing the compensation for its CEO [daughter of a Democrat Senator].
Democrats created a narrative that they were interested in the needs of their constituents. They concealed that Obamacare was designed to benefit their big medicine cronies, the true beneficiaries. The three Republican RINOs who voted against repeal last week have a greater interest in supporting big medicine cronies than they have for doing what is right.
More than half of the insurance providers in ObamaCare markets are non-profits.
2
I personally believe that being able to pay for needed medical care is a necessity and should not be a luxury. One need only use Google to see what the CEO's of major medical insurance companies make each year. $10Million a year and more in most cases. They are a profit driven businesses NOT healthcare based businesses.
Let's also talk personal responsibility. The folks who live in states where President Trump won are folks with the worst health and citizens who have chosen poor lifestyle behaviors that cost a LOT to treat. Obesity, Type 2 adult onset diabetes, high cholesterol and blood pressure issues relate to high fat foods, fast food, junk food, as well as smoking, drug and alcohol use ALL have a domino effect that causes other health issues. Insist on making person changes and medical costs go down.
If we could change the laws so we had more competition amongst insurance companies across state lines, along with changing the bankruptcy laws so one couldn't file bankruptcy if they ran up medical bills we might be able to have actual affordable medical coverage.
The Amish and Mennonites and various other religious groups self insure. Why couldn't other groups of folks do the same? Or do a single payer like for Medicare where basic care is covered yet for $50-100 a month a person could buy a supplemental policy to cover what Medicare doesn't cover.
Let's also talk personal responsibility. The folks who live in states where President Trump won are folks with the worst health and citizens who have chosen poor lifestyle behaviors that cost a LOT to treat. Obesity, Type 2 adult onset diabetes, high cholesterol and blood pressure issues relate to high fat foods, fast food, junk food, as well as smoking, drug and alcohol use ALL have a domino effect that causes other health issues. Insist on making person changes and medical costs go down.
If we could change the laws so we had more competition amongst insurance companies across state lines, along with changing the bankruptcy laws so one couldn't file bankruptcy if they ran up medical bills we might be able to have actual affordable medical coverage.
The Amish and Mennonites and various other religious groups self insure. Why couldn't other groups of folks do the same? Or do a single payer like for Medicare where basic care is covered yet for $50-100 a month a person could buy a supplemental policy to cover what Medicare doesn't cover.
1
Google the non profit medical organizations like Kaiser Permanente, the Mayo Clinic, the hospital system that employed Michelle Obama, etc. Check out the executive salaries of these charities [through in the Kaiser Foundation, founded by the same big medicine oligarchs as Kaiser Permanente]. Then convince yourself that charities are not being operated for the express benefit of their executives. You could knock 20% out of hospital costs by demanding that charities limit the compensation of their executive staffs.
Medical cost for Medicare's current population is paid for 20% out-of-pocket no annual maximum copays, 40% from the premiums paid by beneficiaries plus transfers from the Medicare payroll tax, and 40% from general federal revenues.
To extend Medicare, with its 20% co-pay and no out of pocket maximum to the rest of the population would cost $1.7 trillion per year. Which would take a 20% payroll tax to fund. How many of the 40% of the population currently covered by their employers would be happy if they relinquished their tax free comprehensive coverage for a 20% payroll tax and 20% co-pays without any annual out-of pocket maximum. The wealthy elite would buy supplemental policies. The rest would just go bankrupt in the event of catastrophic medical costs.
Medical cost for Medicare's current population is paid for 20% out-of-pocket no annual maximum copays, 40% from the premiums paid by beneficiaries plus transfers from the Medicare payroll tax, and 40% from general federal revenues.
To extend Medicare, with its 20% co-pay and no out of pocket maximum to the rest of the population would cost $1.7 trillion per year. Which would take a 20% payroll tax to fund. How many of the 40% of the population currently covered by their employers would be happy if they relinquished their tax free comprehensive coverage for a 20% payroll tax and 20% co-pays without any annual out-of pocket maximum. The wealthy elite would buy supplemental policies. The rest would just go bankrupt in the event of catastrophic medical costs.
1
It's contradictory to approve taxpayer subsidies for 40% of the population getting insurance through their employers, but complain about taxpayer subsidies for those who buy on the individual market. We lose $250 billion each year simply because we don't tax employees for the value of their insurance. That's many, many times what we spend on exchange subsidies.
However, I think even those on employer plans would welcome earlier eligibility for Medicare. Employers are passing along the costs of health care to their employees, a trend that will continue. I've talked to many people unhappy with their employer coverage. I have yet to find anyone who doesn't like Medicare.
However, I think even those on employer plans would welcome earlier eligibility for Medicare. Employers are passing along the costs of health care to their employees, a trend that will continue. I've talked to many people unhappy with their employer coverage. I have yet to find anyone who doesn't like Medicare.
It very much looks like President Trump and Health and Human Services Secretary Tom Price are determined to prove that the Affordable Care Act is in a "death spiral" by stopping subsidy payments to insurers, as a ploy to get congressional Democrats to somehow cooperate in the Act's legislative evisceration.
I wish my senator, Bill Nelson, the best in efforts with Sen. Susan Collins of Maine in finding bipartisan ways to improve the national health care system, but I fear their efforts will not even get off to a decent start.
I wish my senator, Bill Nelson, the best in efforts with Sen. Susan Collins of Maine in finding bipartisan ways to improve the national health care system, but I fear their efforts will not even get off to a decent start.
3
Why should taxpayer dollars go to pay subsidies for insurance companies? That's crony capitalism.
This should never have been part of any plan.
This should never have been part of any plan.
2
It is not legal for the federal government to be making those gifts to the insurers, and it was not legal for Obama to have done so. In addition to that aspect of enforcing the law, Trump and Price should also reverse the Obama policy of providing employer subsidies to Congress and their staffs. Had Obama enforced the law as written, including the provision that Congress had to follow the law, it would have been repealed long before now.
The Democrat narrative has been that repealing it would cause people to suffer. They never acknowledged that the law was causing suffering, which they would have been aware of if they were compelled to use it.
The Democrat narrative has been that repealing it would cause people to suffer. They never acknowledged that the law was causing suffering, which they would have been aware of if they were compelled to use it.
2
Cost-sharing subsidies are subsidies to low-income Americans, not insurance companies. The companies are required by law to reduce deductibles and co-pays for those making less than 250% of the federal poverty limit. The federal government is paying for these reductions. It's the only way insurance markets work if you want to provide access to the poor. We need to pass legislation guaranteeing these payments, as the author suggests. That's how we reduce uncertainty and stabilize the markets.
Crony capitalism would be paying the subsidies to one company but not another.
Crony capitalism would be paying the subsidies to one company but not another.
1
Several things need to be done. (1) Allow aggressive negotiation of drug prices. We should not be paying more than Canadians for our drugs. (2) Make Medicaid a federal program. This would mean that all citizens would get the expanded coverage, regardless of in which state they reside. (3) Increase the mandate. No one is exempt from ever needing medical care. (4) Offer a public option, such as the ability to enroll in Medicare. This would ensure that regardless of where people lived they could get affordable coverage. If insurance companies could compete, so much the better. These changes, in all likelihood would inevitably lead to single payer, and so much the better.
2
How does any one of your demands decrease the amount of money Americans are paying for medical care? If government programs set price controls (as is the case with Medicaid already) drug sellers will increase prices to those outside of government programs to make up the lost revenue (something that accelerated under ObamaCare)
Medicaid is currently paid by the states and the federal government in a cost sharing program. If you replace the state portion with a federal portion, costs per capita will increase in the low cost states as additional benefits are authorized, which will increase total sending. All of the current state contribution, along with the growth in costs, will be added to the federal deficit.
If you increase the mandate, more people will plan their taxes to avoid having a refund, and even less of the mandate will ever be collected.
Medicare currently pays 30% more than necessary for unneeded costs, costs upcoded, or services unnecessary or not rendered. Do you really want to increase those excess payments to providers?
Your scheme increases the flow of cash to big medicine.
Medicaid is currently paid by the states and the federal government in a cost sharing program. If you replace the state portion with a federal portion, costs per capita will increase in the low cost states as additional benefits are authorized, which will increase total sending. All of the current state contribution, along with the growth in costs, will be added to the federal deficit.
If you increase the mandate, more people will plan their taxes to avoid having a refund, and even less of the mandate will ever be collected.
Medicare currently pays 30% more than necessary for unneeded costs, costs upcoded, or services unnecessary or not rendered. Do you really want to increase those excess payments to providers?
Your scheme increases the flow of cash to big medicine.
1
Can someone address why we have our healthcare discussion beholden to the Freedom Caucus, a group of 30 white guys??
One of them- Ken Buck- is from Colorado and he thinks Climate Change is a hoax even though he went to Princeton. I guess he thought it was cute to bring his ignorance out West. He got beat in a race for Senate when he said we should make him a senator "because I don't wear heels".
Why exactly are we distorting the fact that Americans want healthcare to somehow please this bunch of losers? What makes them special? Most Americans certainly never "promised" them to get rid of the ACA- maybe they "promised" each other. At any rate they are a pack of liars about healthcare.
One of them- Ken Buck- is from Colorado and he thinks Climate Change is a hoax even though he went to Princeton. I guess he thought it was cute to bring his ignorance out West. He got beat in a race for Senate when he said we should make him a senator "because I don't wear heels".
Why exactly are we distorting the fact that Americans want healthcare to somehow please this bunch of losers? What makes them special? Most Americans certainly never "promised" them to get rid of the ACA- maybe they "promised" each other. At any rate they are a pack of liars about healthcare.
16
You'd figure that Princeton and the rest of the Ivy League would do a review of its Alumni, and if they weren't meeting standards then their Graduation Degree Status would be taken away. Right now, Scaramucci from Harvard Law would be an example of a person with a high probability of "cancellation".
6
Enough with these Rube Goldberg devices. Make it universal. The healthcare in Spain, is better- it's so plain.
6
Americans are increasingly demanding single-payer insurance via Medicare. Forget "fixing" ACA, Democrats in Congress need to start talking loudly about putting everyone on Medicare. Premiums compared to the health insurance scam will be drastically reduced. Congress should investigate the numbers and make them public.
6
The issues here are greater than attributing problems in the malfunctioning expensive health care system to insurance companies who treat their customers like cash cows.
The problem with health care in the US is that the US is the only country in the civilized world that still uses the insurance company based system for health care which is REGRESSIVE to the insured. In contrast, Canada, Japan and Western Europe use the single-payer health care system which is PROGRESSIVE to the insured.
Notwithstanding the positive developments of more affordable health care being offered to Americans under the ACA, the central issue on explaining the high costs for health care that has NOT been debated is that the U.S. insurance system of health coverage is REGRESSIVE. It is regressive in that a given policy with identified benefits will have a set price and this price is to be paid by all persons whether they are rich or poor. As a result, the rich buy the Cadillac versions and the poor the Skateboard versions.
In contrast the public single payer system of payments through taxes is PROGRESSIVE. In Canada, the government established that everyone has the right to have free access to health care. But the fact is that all health care expenses are paid by taxes and these payments of income taxes are progressive in that the more one makes in income the more one pays in taxes.
The universal health care system in Canada is not perfect, but it works. Also administration costs are much lower.
The problem with health care in the US is that the US is the only country in the civilized world that still uses the insurance company based system for health care which is REGRESSIVE to the insured. In contrast, Canada, Japan and Western Europe use the single-payer health care system which is PROGRESSIVE to the insured.
Notwithstanding the positive developments of more affordable health care being offered to Americans under the ACA, the central issue on explaining the high costs for health care that has NOT been debated is that the U.S. insurance system of health coverage is REGRESSIVE. It is regressive in that a given policy with identified benefits will have a set price and this price is to be paid by all persons whether they are rich or poor. As a result, the rich buy the Cadillac versions and the poor the Skateboard versions.
In contrast the public single payer system of payments through taxes is PROGRESSIVE. In Canada, the government established that everyone has the right to have free access to health care. But the fact is that all health care expenses are paid by taxes and these payments of income taxes are progressive in that the more one makes in income the more one pays in taxes.
The universal health care system in Canada is not perfect, but it works. Also administration costs are much lower.
6
I'm convinced that the historic animus for the ACA on the part of Trump and the Republicans has two sources only: First, the fact that it's known as "Obamacare." They simply want to wipe out something that might go down in history as Obama's legacy. And second, it's despised by the super-rich who have been empowered to bribe elected officials by Citizens United, and want to pay lower taxes. Everything else (millions of people losing coverage, premiums skyrocketing, uninsurability of those with pre-existing conditions, throwing seniors off Medicaid and into the gutter) is purely secondary. The rest of us are just dust under their shoes.
67
I believe Obamacare was the derogatory name assigned by people who originally opposed it?
3
You want things fixed? So simple. VOTE!
And don't pout when your 100% personally loved primary candidate is not the general election choice. Making the perfect the enemy of the good will destroy the nation (See Donald Trump, 2016).
VOTE. Because complaining and letter writing and marching is completely useless if you don't follow through on what really matters: VOTING.
2018 - Vote for Democratic candidates across the board.
And don't pout when your 100% personally loved primary candidate is not the general election choice. Making the perfect the enemy of the good will destroy the nation (See Donald Trump, 2016).
VOTE. Because complaining and letter writing and marching is completely useless if you don't follow through on what really matters: VOTING.
2018 - Vote for Democratic candidates across the board.
11
The GOP had no intention of doing that as we know. Killing OBAMAcare was their goal no matter the consequences to us all. After all they, were taken care of so nothing to worry about. Had these ravenous and dangerous insects been less intent on destruction for seven years, they might've come up with ways to improve Obamacare rather than totally destroying it. It's easier to build on a base than build a new one. Time for the exterminator. But we all know that...I hope!
2
The major health insurance carriers have been making money hand over fist ever since (and before) the ACA went into effect. Check out the share price increases below.
Since March 23, 2010 (the day the ACA started) –
United Health Group – up 439%
Cigna – up 395%
Humana – up 388%
Aetna – up 345%
Anthem – up 202%
For reference, the S&P 500 is up 112%.
Talk of "stabilizing" the insurance markets is a lot of hot air. The insurance companies are in the business of making as much money as possible for their shareholders. That's their job. They have figured out that if they cry about doom and gloom, and make ridiculous claims about how they are at risk of failing, they can get yet more subsidies, raise rates even more, and cover even less.
Since March 23, 2010 (the day the ACA started) –
United Health Group – up 439%
Cigna – up 395%
Humana – up 388%
Aetna – up 345%
Anthem – up 202%
For reference, the S&P 500 is up 112%.
Talk of "stabilizing" the insurance markets is a lot of hot air. The insurance companies are in the business of making as much money as possible for their shareholders. That's their job. They have figured out that if they cry about doom and gloom, and make ridiculous claims about how they are at risk of failing, they can get yet more subsidies, raise rates even more, and cover even less.
14
Republicans need to understand that a majority of Americans want good, accessible healthcare. That is their simple bottom line. Nothing special, just good healthcare at a fair price delivered by healthcare professionals who they can trust to make good decisions.
The Federal government enacted the A.C.A. to help do the job Americans want. It is a very awkward, backhanded device, but it could work if the Republican Party had not spent the last 7 years trying to sink it by underfunding it, and refusing to allow the citizens of many states to participate in the Medicaid expansion.
Now our President tells us that he will defund the insurance program put in place by the A.C.A., and further destabilize the health insurance market place. Our Republican Congress continues to whimper and whine about repealing Obamacare. Our President is simply heartless and wrong minded. When are the Republicans going to get serious about fixing the law we have, and giving Americans the healthcare programs they deserve.
The Federal government enacted the A.C.A. to help do the job Americans want. It is a very awkward, backhanded device, but it could work if the Republican Party had not spent the last 7 years trying to sink it by underfunding it, and refusing to allow the citizens of many states to participate in the Medicaid expansion.
Now our President tells us that he will defund the insurance program put in place by the A.C.A., and further destabilize the health insurance market place. Our Republican Congress continues to whimper and whine about repealing Obamacare. Our President is simply heartless and wrong minded. When are the Republicans going to get serious about fixing the law we have, and giving Americans the healthcare programs they deserve.
7
The majority of Americans had good, stable healthcare before ACA. ACA was devised to provide healthcare to the poor who were not covered under Medicaid.
1
ACA is also about the ability of obtaining insurance independent of employment. And bo, I don't receive subsidies, but was able to retire early and purchase insurance on my own, which was previously not possible.
Don't believe the Trump mantra that ACA is only for freeloaders. ..
Don't believe the Trump mantra that ACA is only for freeloaders. ..
I want the same government healthcare plan for my family that the Donald and all the Senators and Representatives have for theirs. If it's good enough for our royals, it should be good enough for the rest of us peasants.
36
The whole premise of this article is misguided: The Republicans never intended to fix whatever weak points exist in the ACA, they only want to destroy it. The vote to bring it back to the floor had the unfortunate effect of establishing that the ACA has to be changed, and this article gives the Republicans undue credit. So far, the insurance companies are not complaining, and millions more have insurance, albeit often with high deductibles. The coverage could be better, but that is not what the GOP has in mind.
Another thought: Looking at the Anti-ACA comments here: Car insurance is also mandatory, and there is no uproar, why with health insurance? Why do people have such a hard time to accept the idea of insuring health for everybody to have some security? Everybody can have the misfortune to have a costly illness that could bankrupt them.
Another thought: Looking at the Anti-ACA comments here: Car insurance is also mandatory, and there is no uproar, why with health insurance? Why do people have such a hard time to accept the idea of insuring health for everybody to have some security? Everybody can have the misfortune to have a costly illness that could bankrupt them.
11
The fundamental question that must first be resolved is: Medical care is either a human-right or only a business transaction.
EMTALA (1986) seems to say that Medical Care is a human-right because it sets up a system that demands care be given to anyone who presents himself to a medical care provider. However, there is no provision in the law about the cost or payment.
The problem is that you don't need insurance but if you do get sick or injured the chances are that getting the necessary medical treatment can render you bankrupt if you don't have a third party to negotiate and pay your expenses.
We forget that a large part of the mortgage crisis of 2008 was driven by people mortgaging their homes to pay medical bills. Not all mortgages but a significant portion of them were paying off medical bills.
In addition, the "charity care" gets rolled into the overall cost of operations and is passed along to paying patients and their insurance companies. Some states have programs to compensate providers and that money comes from taxpayers.
In the end we are paying for providing a human-right, but in the most costly way possible because the pre-ACA system pushes people to delay care till it is a crisis where the costs are the highest and the outcomes the worst.
Yet, the posturing goes on ignoring the simple facts that the ACA is the first step towards fixing the root cause problems.
EMTALA (1986) seems to say that Medical Care is a human-right because it sets up a system that demands care be given to anyone who presents himself to a medical care provider. However, there is no provision in the law about the cost or payment.
The problem is that you don't need insurance but if you do get sick or injured the chances are that getting the necessary medical treatment can render you bankrupt if you don't have a third party to negotiate and pay your expenses.
We forget that a large part of the mortgage crisis of 2008 was driven by people mortgaging their homes to pay medical bills. Not all mortgages but a significant portion of them were paying off medical bills.
In addition, the "charity care" gets rolled into the overall cost of operations and is passed along to paying patients and their insurance companies. Some states have programs to compensate providers and that money comes from taxpayers.
In the end we are paying for providing a human-right, but in the most costly way possible because the pre-ACA system pushes people to delay care till it is a crisis where the costs are the highest and the outcomes the worst.
Yet, the posturing goes on ignoring the simple facts that the ACA is the first step towards fixing the root cause problems.
3
While the piece points to the 3 main fixes. I would add another. Preventitive care has to be made a priority option. Americans need to be covered, in full for those services that help us prevent bigger health issues. Fully covered testing, on a regular schedule has to become part of the coverage. Gyno, prostate, colon, blood tests, along with structural (muscular, skeletal) tests/screening - all fully covered. Period. Fully covered testing should be the foundation of all the policies offered. Without it, most people wait till they are sick, or nearly immobile to seek help.
We cannot cover the overweight and obese. Universal Medicare for non-obese and overweight people may be viable. Otherwise we will be bankrupt.
Or the smokers, or the drinkers, or the fast drivers, or the elderly, or the genetic inheritors?????? Get over your biases.
11
Interestingly, the countries that do have Universal Medical Coverage like Denmark, Norway, Sweden, France, Switzerland, Canada, etc., actually have many fewer obese and overweight people than the U.S. Getting healthcare is one way they are helped to maintain healthy weight. Some medications actually increase weight gain as a side effect. When people do not have access to health care, their overall physical health and ability to exercise decreases. One of the best ways to promote good health, exercise, healthy diet and lower stress is to provide accessible health care.
4
So anorexics get health care but obese people do not. Anorexics suffer from the side effects of that condition in the same way as the obese. Cardiac faliure is one problem. Athletes have lots of problems. Torn knees, concussions, and sudden death syndrome to name just three things that are in the stable. Are you going to hang out and monitor people having unprotected sex? That's another high risk group.
6
It sounds like it is impossible since you have a President Trump who is trying to undermine it in anyway possible.
You listen to Tom Price who thinks he's cute by referring to it only as Obama-care, and not as the Affordable Healthcare law, and to me is the biggest problem with the Republican's in general.
It seems like the Republicans can't get over the ACA as being a law that was implemented by President Obama, and will not quit until they get their way of extinguishing it from the books, which has nothing to do with the need of the people using and needing the healthcare.
When I listen to Tom Price continually ignore the questions posed to him this morning, not answering any questions, but continually parrot the party line of repeal like trained bird, it tells me the only way to fix it is to get rid of this Do Nothing Dysfunctional Obstructionist Republican logjam of Republican's in the congress and the Whitehouse.
Tom Price is nothing but a gas bag.
You listen to Tom Price who thinks he's cute by referring to it only as Obama-care, and not as the Affordable Healthcare law, and to me is the biggest problem with the Republican's in general.
It seems like the Republicans can't get over the ACA as being a law that was implemented by President Obama, and will not quit until they get their way of extinguishing it from the books, which has nothing to do with the need of the people using and needing the healthcare.
When I listen to Tom Price continually ignore the questions posed to him this morning, not answering any questions, but continually parrot the party line of repeal like trained bird, it tells me the only way to fix it is to get rid of this Do Nothing Dysfunctional Obstructionist Republican logjam of Republican's in the congress and the Whitehouse.
Tom Price is nothing but a gas bag.
6
Many Repubs believe that capitalism is the answer to all problems.
But, apparently, in many situations, not much profit can be had from healthcare insurance, unless the pool is large or sky-high premiums are charged.
Maybe we need one large insurance company? But that's not free enterprise. In short, capitalism may be intrinsically incapable of fixing this widespread problem. Until we agree on a solution, poor people will continue to suffer. If only we were a compassionate nation that understood the limitations of capitalism!
But, apparently, in many situations, not much profit can be had from healthcare insurance, unless the pool is large or sky-high premiums are charged.
Maybe we need one large insurance company? But that's not free enterprise. In short, capitalism may be intrinsically incapable of fixing this widespread problem. Until we agree on a solution, poor people will continue to suffer. If only we were a compassionate nation that understood the limitations of capitalism!
2
I just had cataract surgery done on both eyes. A very common procedure. I went with mono-focal implantable lenses, as they were covered by insurance. My employer provides what some would call platinum insurance. Something like cover 90%, deductible is like $2500 a year.
Now, that all the claims have come in, I have a final total price.
The before insurance costs, was $16000. When all said and done, it cost out of pocket about $3100. If I were a Canadian citizen, the procedure would have been about $7000 and out of pocket $0. I checked with with British Columbia Health care.
So, what was the out of pocket:
$1250 fro use of the surgery center. ($5200 the "starting" price).
$1250 fro the surgery itself ($000 is the "starting" price)
$0 fro an Anesthesiologist ($1600 is the "starting" price).
$500 for to meet various deductibles and co pays
$400 ((instead d of $800) fro very low power glasses and frames).
FYI, the implantable lenses are priced at $1450 each.
The mark ups on some of this was amazing. By the way, the surgery itself, including prep, is about 45 minutes. The surgery is about 15 minutes max.
Now remember cataract surgery is very common, rather benign surgery. Done as out patient and very low risk.
If this doe snot make people think about how over priced and greedy our health care system is; nothing will.
Colorado is below average for care costs.
The worse part about this, I did not know any of the costs, until after the fact. Know one could tell me.
Now, that all the claims have come in, I have a final total price.
The before insurance costs, was $16000. When all said and done, it cost out of pocket about $3100. If I were a Canadian citizen, the procedure would have been about $7000 and out of pocket $0. I checked with with British Columbia Health care.
So, what was the out of pocket:
$1250 fro use of the surgery center. ($5200 the "starting" price).
$1250 fro the surgery itself ($000 is the "starting" price)
$0 fro an Anesthesiologist ($1600 is the "starting" price).
$500 for to meet various deductibles and co pays
$400 ((instead d of $800) fro very low power glasses and frames).
FYI, the implantable lenses are priced at $1450 each.
The mark ups on some of this was amazing. By the way, the surgery itself, including prep, is about 45 minutes. The surgery is about 15 minutes max.
Now remember cataract surgery is very common, rather benign surgery. Done as out patient and very low risk.
If this doe snot make people think about how over priced and greedy our health care system is; nothing will.
Colorado is below average for care costs.
The worse part about this, I did not know any of the costs, until after the fact. Know one could tell me.
42
So you and I get to pay for all those "Don't Tread on Me Folks" whom insist that the government should not mandate insurance coverage. They show up with no coverage and you, I and our employers pay...
6
Nick: in Canada, you would be paying much higher taxes -- income tax, plus taxes on gasoline and other items -- PLUS a 13% VAT on every purchase.
There is also a charge of roughly $100 a month premium for Canadian single payer, unless you are very poor.
So it is grossly unfair to claim "it is free". You simply prepay your expenses, rather than pay on the back end.
More importantly: the Canadian government STRICTLY CONTROLS PRICES. There is no "open market" there, where a hospital can charge anything they want, and a Martin Shkreli can charge $600 for a $5 EpiPen.
There is also a charge of roughly $100 a month premium for Canadian single payer, unless you are very poor.
So it is grossly unfair to claim "it is free". You simply prepay your expenses, rather than pay on the back end.
More importantly: the Canadian government STRICTLY CONTROLS PRICES. There is no "open market" there, where a hospital can charge anything they want, and a Martin Shkreli can charge $600 for a $5 EpiPen.
Concerned Citizen, FYI Canadian taxes per capita are less than they are in the United States, when you add them all up. I would pay less income tax if I lived there, even though they do not have a mortgage interest deduction. I already pay over 9% in sales taxes on pretty much everything. I pay a tax by having lower wages, and lower wage increases, because of employer provided health insurance. Employers get tax breaks for providing insurance.
The problem is with conservatives they do not want t o pay any taxes. But, depend on the government, that they do not want to pay for.
By they way, you can go to any province web site and figure out what your taxes could be, living in Canada. Just like you can go to any province site to see what it costs for health care.
The problem is with conservatives they do not want t o pay any taxes. But, depend on the government, that they do not want to pay for.
By they way, you can go to any province web site and figure out what your taxes could be, living in Canada. Just like you can go to any province site to see what it costs for health care.
2
Instead of raising people's premiums for health insurance, why don't we consider trimming the profits of insurance companies and pharmaceutical companies? The CEOs of many of these companies are paid much, more more than Trump. Tell him that and maybe he will see the merits of renegotiating the deals with these profit sharks who drive up the cost of health insurance for Americans in need of coverage. I'M DEEPLY ASHAMED TO BE A CITIZEN OF THE ONLY INDUSTRIALIZED NATION IN THE WORLD THAT FAILS TO PROVIDE A NATIONAL HEALTH PLAN FOR ITS PEOPLE!
10
Very moved to see John McCain make his speech and give the thumbs down. But then I realized that he probably had no out-of-pocket expenses and no delays in receiving his important surgery & treatment. The obvious conclusion: give ALL Americans the same quality of care that elected officials receive. Oh right, that would be 'socialism'.
6
That is NOT true, assuming Sen. McCain is using his Federal health insurance. It requires a 20% payment the premiums...then 20% of the the bills, after the insurance pays 80%....and there is a $2500 deductible.
It is a good plan, but not FREE by any means.
However, it is very likely at 80 that Sen. McCain is on Medicare -- WHICH IS NOT FREE EITHER.
It is a good plan, but not FREE by any means.
However, it is very likely at 80 that Sen. McCain is on Medicare -- WHICH IS NOT FREE EITHER.
"Trumpcare," (really it should be called McConnell-Ryancare) failed because if was complete junk. Insurance premiums would have continued to escalate even for healthy people. For the sick and elderly, they would have skyrocketed. People with preexisting conditions would have risked being shut out of access to affordable care altogether. It would have been awful for millions of Americans.
.
I sincerely hope that someone, somewhere in the Republican held Congress or Senate reads this article - and takes it to heart. Our Nation deserves a workable, universal health care system that serves us all, and their are great ideas here to make that happen.
.
I have little faith they will, though. We have two parties in Washington DC and neither of them knows what it's like to be a middle class American. The only difference is that Democrats are the kind of people who might care if they knew.
.
I sincerely hope that someone, somewhere in the Republican held Congress or Senate reads this article - and takes it to heart. Our Nation deserves a workable, universal health care system that serves us all, and their are great ideas here to make that happen.
.
I have little faith they will, though. We have two parties in Washington DC and neither of them knows what it's like to be a middle class American. The only difference is that Democrats are the kind of people who might care if they knew.
4
There are some good thoughts here. Positive. Help the current bill to work as it should and maybe some of the heartaches will be eased. There are Republican governors who see the benefits of the A.C.A. They could act to bring the bill more in line with what it was intended to be. Drop the hatred. Help the people. In time, I hope we are then able to move to a single payer program for all. Yes, governments should take care of their people. The rhetoric and feelings of late guarantee we will devolve into a very selfish people. With no health care.
1
Universal Medicare.
9
Any adults left in Congress, should be pushing Single Payer Now. It's the only way forward. We need memes, influencers, and a strategy to get the message out, but now is the time. Actually, a year ago was a good time, too. GET MOVING Y'ALL!
5
Still waiting for the Democrats to step forward with some plans of their own to help improve the system. They knew the GOP would be attacking the ACA. They know the problems with it. They must have had a contingency plan in place, right? RIGHT?
#RepairAndRelax
#RepairAndRelax
2
"....That would involve the government helping insurers pay for the sickest, most expensive people, whose costs can drive up premiums in places where there are not enough healthy customers to balance them out."
That statement right there is the reason OBAMACARE will never work. Have you ever traveled across the country and if so, have you ever noticed that the majority of Americans in are grossly obese? The small minority of healthy, fit individuals cannot, and should not, be responsible for paying the health costs of those who do not take care of themselves. Most of the ailments of which these unhealthy people suffer can be cured by a healthy diet, exercise and a good night's sleep.
Get off of the meds and on the treadmill.
That statement right there is the reason OBAMACARE will never work. Have you ever traveled across the country and if so, have you ever noticed that the majority of Americans in are grossly obese? The small minority of healthy, fit individuals cannot, and should not, be responsible for paying the health costs of those who do not take care of themselves. Most of the ailments of which these unhealthy people suffer can be cured by a healthy diet, exercise and a good night's sleep.
Get off of the meds and on the treadmill.
3
Bingo. And since it costs nothing to lose weight (just eat less!) it is completely fair to deny coverage to the obese and overweight.
Until we address this 'Elephant in the Room' we can't have heath care.
Until we address this 'Elephant in the Room' we can't have heath care.
1
The problem is, no one in health care is going to deny treatment to anyone based on their wt. that's morally repugnant. However, charging more for the already subsidized food that gets you to that point (or switching the subsidies to healthy foods and activities) might go a ways towards paying for people's care.
Let Obamacare die by restricting the subsidies which take tax dollars from financially stressed middle-class families who can't afford their own deductibles in order to subsidize able-bodied individuals on Medicaid. Once everyone pays their fair share and we don't reward freeloaders with generous subsidies perhaps a better healthcare plan will emerge.
3
"And though Mr. Trump has excoriated the [pharma] industry, his administration has not yet put forward a plan to address the [drug price] issue. A draft executive order on drug prices that was obtained by The New York Times in June revealed a far more industry-friendly approach, easing regulations in the hopes the drug companies would lower prices on their own."
Boy is that funny. Why? Well, first, Trump is willing to do money laundering for Russian mobsters (as Mueller will find out). If the pharma industry waves enough cash in his face Trump will do whatever the pharma industry tells him to do.
Secondly, HHS sectretary Tom Price created his entire multi-million dollar fortune by using his position as congressman to loosen regualtions on drug companies he, co-incidently, had previously invested in. You really think he is going to stop now?
Boy is that funny. Why? Well, first, Trump is willing to do money laundering for Russian mobsters (as Mueller will find out). If the pharma industry waves enough cash in his face Trump will do whatever the pharma industry tells him to do.
Secondly, HHS sectretary Tom Price created his entire multi-million dollar fortune by using his position as congressman to loosen regualtions on drug companies he, co-incidently, had previously invested in. You really think he is going to stop now?
4
The Republicans, genius businesspeople that they are, don't think that Medicare should negotiate drug prices. They can't complain about runaway costs without addressing this issue.
Also, does anyone not believe that the obscene amount of drug advertising may have an impact on prices? The evening network news, with its average viewer of Medicare age, is saturated with drug ads....for drugs that will likely be paid by Medicare at full cost!
Also, does anyone not believe that the obscene amount of drug advertising may have an impact on prices? The evening network news, with its average viewer of Medicare age, is saturated with drug ads....for drugs that will likely be paid by Medicare at full cost!
2
From its inception the GOP has been very good at controlling the narrative with the ACA, death panels being an excellent example. When they bother trying to sell trumpcare it is always with an emphasis on freedom of choice. Unfortunately, since it is clear from even the most optimistic reading of the CBO score that there will be millions fewer life preservers in any GOP plan, the choice will be to sink or swim.
3
1. If an insurance company wishes to operate in a state, they should have to offer on the exchanges to all people. If they can't work out rural areas, or poorer areas, then maybe that industry is not right for them.
2. It is time to let the government negotiate on Prices. As the major provider this is what needs to be done. If not, the cost for services should match the average of other first world nations. If the US insurance companies cannot live without crony capitalism to fund record profits, so be it. Many operate in other nations like Germany and do just fine.
It is time to stop mindlessly feeding the pig. Stabilization will not happen without reform. This is an industry dedicated to bleeding America dry while providing substandard care compared to other first world nations. There is a matter of basic fairness, of value at stake here.
The Democrats need to realize that they lost on Obamacare due to lack of options in rural areas, high payments and even higher deductibles that put anything besides extreme care out of the ability of much of the poor or middle class to pay for even if they have insurance.
The Republicans lost, because their reform didn't address the problem. It just tried to make it so that people could legally go without, instead of the sham of insurance many "possess.
If the Democrats go crony capitalist, and the Republicans go screw the poor. The final outcome for anyone outside the top 20percent ends up very similar.
2. It is time to let the government negotiate on Prices. As the major provider this is what needs to be done. If not, the cost for services should match the average of other first world nations. If the US insurance companies cannot live without crony capitalism to fund record profits, so be it. Many operate in other nations like Germany and do just fine.
It is time to stop mindlessly feeding the pig. Stabilization will not happen without reform. This is an industry dedicated to bleeding America dry while providing substandard care compared to other first world nations. There is a matter of basic fairness, of value at stake here.
The Democrats need to realize that they lost on Obamacare due to lack of options in rural areas, high payments and even higher deductibles that put anything besides extreme care out of the ability of much of the poor or middle class to pay for even if they have insurance.
The Republicans lost, because their reform didn't address the problem. It just tried to make it so that people could legally go without, instead of the sham of insurance many "possess.
If the Democrats go crony capitalist, and the Republicans go screw the poor. The final outcome for anyone outside the top 20percent ends up very similar.
2
"Stop feeding the pig!" Now if thats not a rallying cry...! Great!
Insurance companies must do what each state demands, depending upon the state insurance office. They don't have unlimited freedom to do or serve who they want. That's why you are not free to buy insurance from any plan, the control is in the hands of the state. If we allowed people to choose from all the plans offered it would open up a lot of choices for people, but, of course, the states' would have to give up control and the jobs and money that go with it. We could have catastrophic insurance like we do now with Ocare and also other plans tailored to other people's needs. It would be nice to try.
Wake up
The GOP doesn't want to fix it.
The GOP doesn't want to fix it.
6
Exactly, that whole premise is giving them way too much credit!
2
Why should they when the dems did this all in the first place. If it's such a great idea, why does anyone need to fix it? I'm not even a republican.
2
First, you HAVE to have an individual mandate. This isn't a personal freedom issue. If you have a car, you have to have car insurance. If you have a body, it needs to have insurance. If you get sick, you'll get care, even if you can't pay or don't have insurance, the cost will just get passed on to other pts. Second, the "market" is not going to fix health care. This isn't a can of beans situation. We regulate utilities because everybody has to have them. The same principle applies to health care. Third, personal responsibility needs to play a bigger role. If you: smoke, drink, are obese or have a number of other largely personal choice medical issues you need to pay more at the point of purchase ie buying beer tobacco or whatever. Obviously this doesn't apply to conditions like juvenile onset diabetes. Health care IS hard. There are no easy market based or other solutions, but we need to take the parts of the aca that work and modify the parts that need changing, both now and as conditions change. Lastly, there are people, who for a variety of reasons, are never going to be able to pay for their health needs. We going to need to step up and take that on (it's called Medicaid), but that doesn't mean we can't ask them to modify their behavior to help in the cost as appropriate.
4
I agree, that those who are belligerent to their own health need to pay a liitle more, but for insurance, not the products. As a skinny person can be a health disaster but a McDonalds clerk couldnt know that...but then look at a big person, who might be an athlete, and charge them more.
Plus a recent study showed that poor smokers already spend too much of their income on cigarettes. In fact, when the price goes up, they forgo essentials to purchase cigs. So charging people more at the POP isnt the answer.
Plus a recent study showed that poor smokers already spend too much of their income on cigarettes. In fact, when the price goes up, they forgo essentials to purchase cigs. So charging people more at the POP isnt the answer.
2
Addicts of all kinds: food, alcohol, tobacco, heroin etc are going to pay whatever they have to unless they quit. Seems to me we're better off getting the money for their care up front. We ain't getting after they get the fix- they will have spent it. Plus there's a chance the price increases will dampen their ardor. Btw, this line of reasoning applies to activities like seat belts and motorcycle helmets. You can't allow people to make bad decisions that they can then pass off the costs for to others later.
Folks, the answer is staring us in the face-- Medicare for all, an obvious solution to a broken system. The free market works fine in many instances. For example, want to buy a yacht, a new car, organic foods at the grocery store? No problem, the market provides unlimited choice. Health care does not belong in the whipsaw machinations of a free wheeling profit-seeking marketplace, period. Every human being has a right to have their health care needs taken care of, and certainly in the richest country in the world. The provider system (e.g., doctors, hospitals, outpatient clinics) can be composed across a wide range of private non-profit, for-profit, public and non-public entities, but administered through a federal system. In other words, no insurance company middlemen. This is Not, socialized medicine, contrary to the Republican rhetoric. All we need is public demand--let's get started now.
7
Not the obese or overweight. People should be compelled to get to a healthy weight before getting health care. The fat and obese should have to pay their premiums though.
Why does it need to be administered through a federal agency? I've had military healthcare and wouldn't wish that on anyone. If you're healthy or have very limited problems it works great, but if you really need any kind of care outside of that you're screwed. We all know how well the VA system works and my husband has had to deal with them and feels we should force N. Korean to use it and then they will surrender. The insurance companies will work better than any federal office.
3
What possible interest would motivate the Republicans to "stabilize" the ACA? In fact, its in the interest of the Republican Party to "destabilize" the ACA to the greatest extent possible.
3
The passage and implementation of ACA has mostly changed the thinking of Americans in that health care access should be universally guaranteed. The question is now how best to implement this guarantee. ACA attempted to split the responsibility through private insurance markets and a Medicaid expansion to serve different populations. It failed in the private insurance markets because it left too much of that business model intact, which is what has produced the negative experiences of those in the exchanges facing policies that are overpriced, contain overly high deductibles, narrow networks and still feature the insurance bureaucracy interference with health care decision making. Republican plans would have changed none of these features, but simply shifted the costs around to allow some to pay less and others more, much more. Plans to address the problems in a more bipartisan fashion will all involve subsidizing this industry to some degree, either by reinsurance or increasing the subsidy formula to cover more of those currently left out of it. The question is how much can we afford to subsidize this industry when it is clear it is incapable of providing the sort of universal guarantee Americans desire?
Then the alternative is to look outside of the insurance industry to administrate basic health care. Either single payer or through reforming the industry down into a cost distributing utility versus "insurance". Doing either will save Americans lots of $ versus the first.
Then the alternative is to look outside of the insurance industry to administrate basic health care. Either single payer or through reforming the industry down into a cost distributing utility versus "insurance". Doing either will save Americans lots of $ versus the first.
2
Alabama, though, Ms. Thrasher remains pessimistic.
“Alabama sticks to its guns,” she said, “even if it’s shooting itself in the foot.”
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Nationally Assisted Suicide: GOP 2017
“Alabama sticks to its guns,” she said, “even if it’s shooting itself in the foot.”
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Nationally Assisted Suicide: GOP 2017
6
As long as the focus is on the health of the Insurance Companies and not on the health of citizens, not much is going to change.
69
Secretary Price pointed out that we have several health care systems in this country -- Medicare, Medicaid, employer-supplied insurance, the VA, and individual plans. The way to fix this is to have fewer systems, which would make things simpler and get rid of arguments over boundaries and dumping patients from one system to another. Anything else is adding more duck tape to a mess of systems created at different times by different people for different purposes (why do employers provide medical insurance, for example) and held together with massive amounts of duck tape that leave all sorts of gaps where people fall through, sometimes to their death.
If we are going to add or rearrange the duck tape (which is what we are talking about most of the time), we could at least stop pretending that we are trying to move beyond our duck tape solutions and actually fix things.
If we are going to add or rearrange the duck tape (which is what we are talking about most of the time), we could at least stop pretending that we are trying to move beyond our duck tape solutions and actually fix things.
2
This is a no brainer. Eliminate the middle man. That would be insurance providers. Provide health care for all via Medicare. So, tax is all a bit more. It's been done in other major nations, except the one that likes to call itself the greatest. You can't be the greatest, when you're behind the rest of the world.
37
It's not 'tax a bit more', it's tax a whole lot more. Please!
2
Just like in the debate, about the ACA, this newspaper still thinks the free market works fro health care. It has not worked since insurance companies entered ithe health insurance market in the late 1940s. The AMA, hospitals and drug companies created this mess, with the help of a Democratic elected Congress and president (Truman). At that time they made it impossible to truly have not for profit health care. Medicare, Medicaid and the VA exist, because of the failure of the for profit system. Meanwhile, the United States has slipped to near the bottom of health care outcomes and to the top in costs.
This newspaper then, as now, has failed to have a serious discussion about single payer health care, as seen in much of the industrialized world. Not even going as far as discussing how health care works in Canada.
This newspaper failed to debunk the lies, from powerful lobbyists and the health care industrial complex, which condemn the Canadian system. Never the mind that a vast majority of Canadians would not trade their system for the for profit, US system.
The New York Times needs to put aside corporate loyalties to the health care industrial complex and start writing articles on implementing a Canadian like system in the United States. And while it is at it, put to bed all the deceit and lies.
With price controls on drugs and procedures, the US can implement single payer, at a lower cost, than using for profit insurance. The free market is a failure, because of greed.
This newspaper then, as now, has failed to have a serious discussion about single payer health care, as seen in much of the industrialized world. Not even going as far as discussing how health care works in Canada.
This newspaper failed to debunk the lies, from powerful lobbyists and the health care industrial complex, which condemn the Canadian system. Never the mind that a vast majority of Canadians would not trade their system for the for profit, US system.
The New York Times needs to put aside corporate loyalties to the health care industrial complex and start writing articles on implementing a Canadian like system in the United States. And while it is at it, put to bed all the deceit and lies.
With price controls on drugs and procedures, the US can implement single payer, at a lower cost, than using for profit insurance. The free market is a failure, because of greed.
55
Bravo.
1
There has not been a free market for health insurance since at least WW2. Greed is not the problem and such a simplistic answer adds to the mess instead of helping to clean it up. Price controls? I can't believe you even said that. Price controls are the worst way to go. We need to free up insurance companies from the regulations now and let the people decide what care and at how much cost they want, without the feds and the states adding on to things.
2
It's hard to see how this GOP government can support or repair the ACA.
Given that the best the House could do was a "mean" bill that would leave 23 million uninsured --and they looked to the Senate to save them from themselves.
The Senate was reduced to advocating a vote for a bill they knew would be deadly, raise everyone's premiums and lead to a REAL death spiral for most health plans----and looked to Ryan in the House to save them from themselves. (Exactly why vote for a bill you do NOT under any circumstances want to be enacted? This is not legislation but simple destruction.)
If 22 million lose health care--this essentially means 43,000 deaths per year or 827 deaths/per YES vote/per year/every year.
Given that this the best the GOP could come up with after 8 years of deliberation--these people are simply not to be trusted.
Single payer...as Trump says...just like Australia, Medicare for all....its a better plan than the GOP ideas or even the ACA.
Given that the best the House could do was a "mean" bill that would leave 23 million uninsured --and they looked to the Senate to save them from themselves.
The Senate was reduced to advocating a vote for a bill they knew would be deadly, raise everyone's premiums and lead to a REAL death spiral for most health plans----and looked to Ryan in the House to save them from themselves. (Exactly why vote for a bill you do NOT under any circumstances want to be enacted? This is not legislation but simple destruction.)
If 22 million lose health care--this essentially means 43,000 deaths per year or 827 deaths/per YES vote/per year/every year.
Given that this the best the GOP could come up with after 8 years of deliberation--these people are simply not to be trusted.
Single payer...as Trump says...just like Australia, Medicare for all....its a better plan than the GOP ideas or even the ACA.
7
As this article points out, the first step is to stabilize the markets. The insurance markets have suffered as a result of repeated Republican attempts at sabotage. This article only mentions the most recent Republican sabotage - the refusal to guarantee continued funding for the cost-sharing reductions.
There were two other major acts of Republican sabotage. First, in a 2014 spending bill, Marco Rubio undermined the risk corridor provisions of the ACA. That began the destabilization of the insurance markets, and raised premiums. Second, the ACA originally had provisions for a reinsurance program, to spread the risk of high cases as people with pre-existing conditions began to obtain insurance. Republicans dragged their feet on funding it, and the reinsurance provision expired in 2016. Bring back the portions of the law that Republicans sabotaged, and the ACA will be on much more solid ground.
In addition, Democrats can propose one more small step: allow people ages 60-64 who purchase insurance on the exchanges to opt into Medicare. That age group is paying the highest premiums under the ACA, and costs insurance companies the most. If it works well, the opt-in age could then be reduced to 55. The Medicare actuaries could calculate appropriate rates. We may someday have single payer health insurance, but I think it will likely be a long, slow process, with strong Republican resistance every step of the way. Let's see what small steps we can take now to get started.
There were two other major acts of Republican sabotage. First, in a 2014 spending bill, Marco Rubio undermined the risk corridor provisions of the ACA. That began the destabilization of the insurance markets, and raised premiums. Second, the ACA originally had provisions for a reinsurance program, to spread the risk of high cases as people with pre-existing conditions began to obtain insurance. Republicans dragged their feet on funding it, and the reinsurance provision expired in 2016. Bring back the portions of the law that Republicans sabotaged, and the ACA will be on much more solid ground.
In addition, Democrats can propose one more small step: allow people ages 60-64 who purchase insurance on the exchanges to opt into Medicare. That age group is paying the highest premiums under the ACA, and costs insurance companies the most. If it works well, the opt-in age could then be reduced to 55. The Medicare actuaries could calculate appropriate rates. We may someday have single payer health insurance, but I think it will likely be a long, slow process, with strong Republican resistance every step of the way. Let's see what small steps we can take now to get started.
19
People with practical and sane proposals like this should run for Congress and replace the slackers who are only dedicated to their ideology and to those who fill their campaign coffers instead of being dedicated to serving their actual constituents back home.
1
Republicans can't "fix" health care because they don't see lack of health care as a problem. The massive loss of coverage for the poor and the middle class under Republican "fixes" are features, not bugs. The Republicans' fundamental worldview demands that they punish the poor for being poor, and reward the rich for being rich.
10
It's not impossible if the country wants to take away the health care of the poor in our country; while the elite continues to protect theirs. Try the life of a poor person for just 48 hours and see the many difficulties they all face.
5
one thing that allows for such a lousy health care situation is the degree of ignorance of much more equitable and efficient health systems, whether it is a Swiss, non-profit, regulated market or the English National health care service. People in those societies know that they will be covered for almost everything involving their health. Of course, there are rationing regimes in place, explicitly, while in the US, the rationing is based on employment and wealth, implicitly and far less fairly. Fee for service, certainly doesn't help the situation. The US has a lot of work to do.....
17
The USA public is either extremely ignorant or just plain hypocritical.
The healthcare system-- costs and coverage and service-- will only be "fixed" when the tax subsidy for employer-supplied-insurance is eliminated.
But neither R's nor D's want to deal with this particular elephant in the room.
If you are commenting on healthcare and haven't read this NYT piece...
https://www.nytimes.com/2017/07/07/health/health-insurance-tax-deduction...
... then you are not serious about finding a solution.
Most people in the US already have "government healthcare" in one form or another; ESI is the least efficient of those. It is why the US has so much higher costs than any other country; ESI has distorted the market for decades now.
Look at the numbers-- is it a coincidence that when you have a hidden subsidy of 30-40-50%, the price of the product is at least that much higher than what it is without the subsidy?
The healthcare system-- costs and coverage and service-- will only be "fixed" when the tax subsidy for employer-supplied-insurance is eliminated.
But neither R's nor D's want to deal with this particular elephant in the room.
If you are commenting on healthcare and haven't read this NYT piece...
https://www.nytimes.com/2017/07/07/health/health-insurance-tax-deduction...
... then you are not serious about finding a solution.
Most people in the US already have "government healthcare" in one form or another; ESI is the least efficient of those. It is why the US has so much higher costs than any other country; ESI has distorted the market for decades now.
Look at the numbers-- is it a coincidence that when you have a hidden subsidy of 30-40-50%, the price of the product is at least that much higher than what it is without the subsidy?
4
It's broke, don't fix it, break it. Go to 2008, go directly to 2008, do not pass Replace, do not collect $ubsidie$. Bah.
3
another "christian" comment???? amazing the lack of compassion
2
@Mitzi
So compassion started in 2009 with Obama??? Or was it unlimited drugs with paid addiction treatment, not to mention government-sponsored unlimited irresponsible sex? It was the latter. Now on way out. Broke. Sorry.
So compassion started in 2009 with Obama??? Or was it unlimited drugs with paid addiction treatment, not to mention government-sponsored unlimited irresponsible sex? It was the latter. Now on way out. Broke. Sorry.
2
The issue before ACA was rapidly rising insurance rates...
Trump and Price can fix most of the problems by just obeying the law and doing their jobs. Quit putting Trump's celebrity image ahead of the lives of millions of Americans and stop sabotaging the ACA.
1
Democrats "fixing" health care is like letting the lunatics run the asylum.
4
@bruce:
Tens of millions of people have gained coverage as a result of the ACA. People who couldn't get coverage before, at any price. What's your "fix"?
Tens of millions of people have gained coverage as a result of the ACA. People who couldn't get coverage before, at any price. What's your "fix"?
6
Yes Bruce! We hear you but all we hear is nonsense. IF the Dems couldn't do it, the Republicans just proved they are so far away from offering anything sensible. What did they do during those 7 years they say they were working for a solution to health care? absolutely nothing positive and constructive.
3
What is your plan, Bruce? Uh huh, don't have one? I guess you are just like the Republicans who after 7 long years couldn't come up with a single plan that made sense. But then they never intended to have a healthcare plan only a tax cut.
4
It's a travesty that Republicans wasted 7 years trying to destroy the ACA instead of working with Democrats to fix it. Even if they're ready to now (which is doubtful), President Trump may single-handedly try to make it fail. That has always been his one overriding goal.
But paying $25,000 in premiums and deductibles before insurance kicks in is insane. Who can afford that?
At a minimum, Congress needs to increase subsidies and set reasonable limits on out of pocket costs. The better option is single-payer.
But paying $25,000 in premiums and deductibles before insurance kicks in is insane. Who can afford that?
At a minimum, Congress needs to increase subsidies and set reasonable limits on out of pocket costs. The better option is single-payer.
111
WHY WHY WHY did Obamacare not figure this out, and set a maximum for copays, deductibles and premiums? Like "no more than 10% of your after-tax income"? or deductibles not to exceed $1500 per individual? (or a percentage of your income)? Or "no copays beyond 20%"? Why did Obamacare not have first dollar coverage -- 80%/20%, like all good employer-paid policies have?
I think it’s fair to say, there will be little or no help from this President and Republican Congress in the near future. These are the people who wanted to torpedo the ACA and kill off much of the Medicaid expansion. All so they could provide the wealthy with some tax cuts. So, with no help coming from the Federal Government, it will be up to the States to place Band-Aids and Tourniquets on the ACA and Medicaid. If they don’t their citizens will suffer. And unfortunately, in states like Alabama, many will suffer greatly and some will die.
That’s the reality. We shouldn’t kid ourselves into thinking the Republican Administration or Congress will lift a finger to help. The only hope will be when the Governors of AL, NC, SC, WV, OH, TX, WI, and the other uncaring Republican states start getting thousands of phone calls from their constituents. Then something might happen. During these last heart wrenching months the States have been insulated from the debate, it was all focused on Washington. But not anymore!
That’s the reality. We shouldn’t kid ourselves into thinking the Republican Administration or Congress will lift a finger to help. The only hope will be when the Governors of AL, NC, SC, WV, OH, TX, WI, and the other uncaring Republican states start getting thousands of phone calls from their constituents. Then something might happen. During these last heart wrenching months the States have been insulated from the debate, it was all focused on Washington. But not anymore!
98
As long as healthcare in this country is delivered via a for-profit system, with insurers being a large segment of that system, there will be no chance of reining in costs or providing affordable coverage for everyone. The solution is a dual system where everyone is covered by a single payer ie government run program like Medicare that operates alongside a for-profit program of private insurance and providers who see private patients who are willing to pay more for easier or faster access to care. The Canadian healthcare system, which is administered at the provincial rather than the federal level provides a model, as does their governmental regulation of pharmaceutical prices.
28
If drug costs, hospital fees and surgical fees were in line with other countries, the costs of health care would be half of what they are. For what it's worth, the insurance companies by way of fee schedules and prior authorizations and denials are the main brake on runaway costs. We should ask them what would help to lower costs and still have full insurance coverage for all citizens.
5
Now that empire bcbs has informed it's customers that it is dropping out of the marketplace in Dec 2017, self employed physicians like myself will be unable to get medical care at the Manhattan hospitals like nyph- Columbia/Cornell that we spent three years putting in 36 hour shifts every week. These hospitals refuse to contract with most other aca plans, even though they charge unreasonable facility fees that hike up the cost of care that private practice drs deliver at a fraction of the cost.
9
It seems incurable even though its only been 6 mos.
1
Basically, it’s easier for politicians to tell 30 million Americans they no longer qualify to receive healthcare than it is to tell the Martin Shkrelis and the EpiPens of America that they can’t rake in obscene profits. In the same way, no one, including this article, has mentioned the increase in profits to America’s hospitals and hospital administrators since Obamacare became effective (see Politico’s “How hospitals got richer off Obamacare”) or demanded that hospitals cut the estimated $765 billion healthcare dollars wasted each year (see ProPublica’s “Wasted Medicine”). If government sweetens the pot through involvement in financing healthcare, which they’ve been doing since the advent of Medicare, they should insist on a reasonable rate of return by subsidized institutions, not price gouging. Why, instead of demanding accountability from society’s most affluent, does government instead ask the poor person at the bottom of the heap to sacrifice much-needed care?
10
Single self employed female physician. Just got my letter yesterday from blue cross blue shield leaving the Manhattan market in Dec 2017. My premium went from $500 health republic, to $700 then HR was closed down two years ago. Now I am paying $900 per month thru empire bcbs, what happens in December I don't even want to think about.
9
The joys of the Affordable Care Act! In many cases, it's sham insurance. If you don't get subsidies, the cost is usually prohibitive and the deductibles are in the stratosphere. The networks tend to be very narrow. So much for the promise of being able to keep your doctor and your insurance...
My brother-in-law in Miami suffered a return of an aggressive form of prostate cancer, When he called to make an appointment at the Sylvester Cancer Center (the best place for cancer treatment in Miami), he was asked what kind of insurance he had.
He replied that he had Blue Cross/Blue Shield.
He was then asked, "Is it BC/BS through your employer or is it BC/BS purchased through the Obamacare exchanges?"
When my brother-in-law told them it was through his employer, he was told, "That's good because we don't accept any BC/BS plan purchased on the exchanges."
It's rarely reported in this paper, but unless you are eligible for subsidies, you are paying more for an Obamacare policy than you ever did previously in the individual market. For most middle class families I know, Obamacare has been a disaster.
There is a reason why the passage of the ACA resulted in the Democrats losing the House and later the Senate.
My brother-in-law in Miami suffered a return of an aggressive form of prostate cancer, When he called to make an appointment at the Sylvester Cancer Center (the best place for cancer treatment in Miami), he was asked what kind of insurance he had.
He replied that he had Blue Cross/Blue Shield.
He was then asked, "Is it BC/BS through your employer or is it BC/BS purchased through the Obamacare exchanges?"
When my brother-in-law told them it was through his employer, he was told, "That's good because we don't accept any BC/BS plan purchased on the exchanges."
It's rarely reported in this paper, but unless you are eligible for subsidies, you are paying more for an Obamacare policy than you ever did previously in the individual market. For most middle class families I know, Obamacare has been a disaster.
There is a reason why the passage of the ACA resulted in the Democrats losing the House and later the Senate.
2
.
(1) With the GOP having been vociferously against ObamaCare/RomneyCare/HeritageFoundationCare for the entirety of the Obama's 8-year tenure, and
(2) with the Republican Congress then displaying 6 months of disarray by constantly dissing what we've got - but still being totally unable to enact ANYTHING, and
(3) with trump - even today - gleefully crowing that the program is "imploding" and he expects it to "collapse":
Why would anyone expect ANY insurance company to wade into this SWAMP?
We're about to be sucked into that vacuum of NO HEALTH INSURANCE for millions of our citizens. Heck, you might know (or be) one of them!
Medicare-for-All is the ONLY path to salvation.
(1) With the GOP having been vociferously against ObamaCare/RomneyCare/HeritageFoundationCare for the entirety of the Obama's 8-year tenure, and
(2) with the Republican Congress then displaying 6 months of disarray by constantly dissing what we've got - but still being totally unable to enact ANYTHING, and
(3) with trump - even today - gleefully crowing that the program is "imploding" and he expects it to "collapse":
Why would anyone expect ANY insurance company to wade into this SWAMP?
We're about to be sucked into that vacuum of NO HEALTH INSURANCE for millions of our citizens. Heck, you might know (or be) one of them!
Medicare-for-All is the ONLY path to salvation.
67
It's that free market that the GOP love at work! The free market will NOT reduce health care costs. How do you know what care is going to cost especially when in theER!
Here's two common sense steps to stem the bleeding of the ACA:
1) Establish a public option (or Federal insurance company) as a replacement for the failed co-op experiment implemented in the original law. These co-ops lacked the long-term cash reserves required to compete - and only a public option can realistically replace them.
2) Allow citizens 55 and older to buy into Medicare at cost, thus taking the most risk-laden segment of the current for-profit insurance market off the exchanges and into the existing public system. Given that these Americans are younger than the general Medicare population, and would likely require far fewer services, this move would likely improve the finances of the larger Medicare program as well. The cost of buying into Medicare (at Medicare's cost) would likely be significantly cheaper for the 55-64 year old population than any offering by a for-profit insurance company. Furthermore, it is this segment of the American population than can least afford to pay the exorbitant rates being asked by the for-profit insurance industry (especially under the proposed Republican plans), and yet least able to forgo coverage.
1) Establish a public option (or Federal insurance company) as a replacement for the failed co-op experiment implemented in the original law. These co-ops lacked the long-term cash reserves required to compete - and only a public option can realistically replace them.
2) Allow citizens 55 and older to buy into Medicare at cost, thus taking the most risk-laden segment of the current for-profit insurance market off the exchanges and into the existing public system. Given that these Americans are younger than the general Medicare population, and would likely require far fewer services, this move would likely improve the finances of the larger Medicare program as well. The cost of buying into Medicare (at Medicare's cost) would likely be significantly cheaper for the 55-64 year old population than any offering by a for-profit insurance company. Furthermore, it is this segment of the American population than can least afford to pay the exorbitant rates being asked by the for-profit insurance industry (especially under the proposed Republican plans), and yet least able to forgo coverage.
121
Cost of Medicare is not that cheap at over $10,000 per beneficiary. This is on par with private insurance. We've got to stop thinking that government is cheaper because there is no profit motive. Without a profit motive nobody cares about what anything costs or if money is lost or wasted. Ever watch 60 Minutes? They have a show on every two years about how Medicare loses and wastes over $200b a year. That doesn't happen to private insurers because the money lost would reduce their profits.
People also forget that single payer countries all have a national sales tax of 13% to 20% on everything. Yes put in singler payer but there is no free lunch.
People also forget that single payer countries all have a national sales tax of 13% to 20% on everything. Yes put in singler payer but there is no free lunch.
4
Reducing healthcare expenditures can be tackled piecemeal with some pretty common sense changes.
For example, I worked as a licensed pharmacy assistant for a major retail pharmacy. This time every year, I saw parents repurchasing EpiPens because of the one year expiration date stated by the manufacturer, Mylan.
However, University of California study found EpiPens to still be effective four years past their expiration date.
There is no good excuse for the invalid expiration date pushed by Mylan. It raises Medicaid expenditures, it financially burdens parents, and it jacks up the operating costs for emergency response departments.
Addressing invalid expiration dates on prescription medication could be a simple starting point for reducing wasteful expenditure.
For example, I worked as a licensed pharmacy assistant for a major retail pharmacy. This time every year, I saw parents repurchasing EpiPens because of the one year expiration date stated by the manufacturer, Mylan.
However, University of California study found EpiPens to still be effective four years past their expiration date.
There is no good excuse for the invalid expiration date pushed by Mylan. It raises Medicaid expenditures, it financially burdens parents, and it jacks up the operating costs for emergency response departments.
Addressing invalid expiration dates on prescription medication could be a simple starting point for reducing wasteful expenditure.
42
Instead of putting the burden of health insurance on the average joe, possibly our government should rein in what pharmaceutical companies, hospitals, doctors, insurance companies charge for their services to begin with.
Since our Congressmen, Representatives and Senators are all bought and paid for by 500 fortune companies, our elected government officials vote to keep their wallets full (kickbacks) and their campaigns funded. Corporations using lobbyist to sway a vote should be "illegal".
There is absolutely no way to rein in health care cost, if our government doesn't start at the very top and work their way down to the average joe.
The last hospital stay I had, the hospital charged $12.00 for a 99 cent box of Kleenex. Why are hospitals allowed to gouge customers? Shouldn't their be laws to protect patients from excessive billing practices? Why are hospitals and pharmaceutical companies exempt from rules and regulations that other companies have to abide by?
The health care industry is NOT in the business to make sick people well - they are in the business to "make millions of dollars off sick people", so that CEO's and stockholders go to bed happy at night.
We need to take back our health care system. It is broken and and on life support. What if we all just say "forget it"? What if we all stopped paying insurance premiums? What if we all just showed up at the ER room at 2:00 a.m. to receive health care, that we then refused to pay for?
Since our Congressmen, Representatives and Senators are all bought and paid for by 500 fortune companies, our elected government officials vote to keep their wallets full (kickbacks) and their campaigns funded. Corporations using lobbyist to sway a vote should be "illegal".
There is absolutely no way to rein in health care cost, if our government doesn't start at the very top and work their way down to the average joe.
The last hospital stay I had, the hospital charged $12.00 for a 99 cent box of Kleenex. Why are hospitals allowed to gouge customers? Shouldn't their be laws to protect patients from excessive billing practices? Why are hospitals and pharmaceutical companies exempt from rules and regulations that other companies have to abide by?
The health care industry is NOT in the business to make sick people well - they are in the business to "make millions of dollars off sick people", so that CEO's and stockholders go to bed happy at night.
We need to take back our health care system. It is broken and and on life support. What if we all just say "forget it"? What if we all stopped paying insurance premiums? What if we all just showed up at the ER room at 2:00 a.m. to receive health care, that we then refused to pay for?
8
Prior to ACA, that is what was happening. Uninsured in ER's. It still happens now for those that remain uninsured. Then the costs are passed on to paying patients. I agree a box of kleenex should not cost $12. The problem with your solution is that the ER has to treat you enough to keep you alive, they don't have to treat you well; they don't have to pay for your meds, they don't have to pay for physical or occupational therapy and they don't have to pay for specialty costs. They just have to stabilize you...
And if no one pays, they close down. EMTALA requires ER's to say yes to emergency treatment, but no other doctor would be required to treat you if you just show up and demand treatment without paying them. Some would because they try to do the right thing, but they would quickly be swamped by people looking for help for free.
And if no one pays, they close down. EMTALA requires ER's to say yes to emergency treatment, but no other doctor would be required to treat you if you just show up and demand treatment without paying them. Some would because they try to do the right thing, but they would quickly be swamped by people looking for help for free.
3
you don't have to pay at the ER...and well, we never really were in control of the health care system in the US...
1
Give the GOP plan s chance...it is the ACA. If it can't be fixed move on to single payer.
10
What plan? There is no plan. A plan has an objective, a means to achieve it, and possible glitch fixes. So there is no GOP plan, unless sticking a pin it, is your idea of a plan.
5
Via Canada, generic Advair is $115 for 360 doses -- about $15/month. It is a bit painful to order from Canada, but savings can be incredible. Once you are 'in the system,' it is not much worse than mail order pharmacies in the US.
4
The Obama administration kept insurance providers in the Affordable Care Act market by transferring money from the Treasury to cover their losses. But a federal court has ruled this transfer of funds is unconstitutional. District Court Judge Rosemary Collyer ruled that the Constitution says "No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law.” She said “Paying [those] reimbursements without an appropriation thus violates the Constitution. Congress is the only source for such an appropriation, and no public money can be spent without one." Republicans asked for and were granted an abeyance to give them time to repeal and replace the ACA, but if their efforts prove unsuccessful, Judge Collyer’s ruling will go into effect, and the ACA market will collapse. This will increase pressure on Democrats to work with Republicans on a repeal and replace bill.
1
William,
"This will increase pressure on Democrats to work with Republicans on a repeal and replace bill"
What planet were you residing on for the last 7 years? The Republicans have refused to allow Democrats into any committees, or even to allow them to see the contents of their "bills" until hours before having to vote.
This fiasco is exclusively owned by the Republicans.
"This will increase pressure on Democrats to work with Republicans on a repeal and replace bill"
What planet were you residing on for the last 7 years? The Republicans have refused to allow Democrats into any committees, or even to allow them to see the contents of their "bills" until hours before having to vote.
This fiasco is exclusively owned by the Republicans.
8
Hey Willy, you have it backwards. The impending collapse forces the Repubs to work with the Dems. Which they, Repubs, keep saying is untenable...McConnell, thinks he's the great idea man. Thinks he's the messiah and has all the magic power to himself. (Just like his party leader!)
Repubs OWN this problem. Lock, stock and stinking barrel. But they need help, and they need to ask for it.
Its really simple, the Repubs need to seek the help of the right industry people, and the Dems.
Repubs OWN this problem. Lock, stock and stinking barrel. But they need help, and they need to ask for it.
Its really simple, the Repubs need to seek the help of the right industry people, and the Dems.
5
Who rammed the ACA down our throats without even reading it? Democrats. They are the only ones that 'own' this. No passing this thing off on to anybody else.
2
The 2017/2018 projected premium for my wife and me will be about $1,500 per month, which is in-line with examples cited in the article.
Can we at least start calling it the UCA (Unaffordable Care Act)? It somehow feels better.
Can we at least start calling it the UCA (Unaffordable Care Act)? It somehow feels better.
10
Tell Trump to quit making the markets unstable.
Or better yet, get rid of the republicans in 2018 and let's have healthcare like every other industrialized nation.
Or better yet, get rid of the republicans in 2018 and let's have healthcare like every other industrialized nation.
2
Kay:
My healthcare premiums have risen about 25% annually since losing my insurance policy because of the UCA.
Republicans are the problem? Really?
In between the partisan extremes and bickering, non-subsidized marketplace policy holders are taking the worst beating. Democrats and Republicans alike have health insurance blind spots, sticking solely to their party talking points.
My healthcare premiums have risen about 25% annually since losing my insurance policy because of the UCA.
Republicans are the problem? Really?
In between the partisan extremes and bickering, non-subsidized marketplace policy holders are taking the worst beating. Democrats and Republicans alike have health insurance blind spots, sticking solely to their party talking points.
2
Start talking seriously about single payer.
152
Which we the Employers of our congressional employees need to be more vocal about! We employ them, and they work for us. So far that's the way it still mostly works. But until the greater population comes to its senses, and sees the forest and the trees, and the leaves - our employees will keep acting like they are doing things out of kindness for us.
We Employers have to organize and make it known that enough is enough with the Repubs ideological games and worship of same. And the Dems need to man-up and own things. (and shed Pelosi)
We Employers have to organize and make it known that enough is enough with the Repubs ideological games and worship of same. And the Dems need to man-up and own things. (and shed Pelosi)
4
Math doesn't work, according to "WashPost"
https://www.washingtonpost.com/opinions/single-payer-health-care-would-h...
https://www.washingtonpost.com/opinions/single-payer-health-care-would-h...
1
This column and these comments want a bigger role for government in healthcare. I'm a moderate and believe government can and should solve the issues of uncovered individuals and access to healthcare but, on the other hand, free market innovation will be best for lowering the cost of healthcare and making it efficient. I don't think we really want a socialist healthcare sector. Let government insure access and set the boundaries then let entrepreneurs and for-profits serve the markets.
6
But it never has. The only example you can point to is LASIK.
No country has seen it.
No country has seen it.
2
...I don't think we really want a socialist healthcare sector...
--------- a rose by any other name...
we should just hire canada to extend their health-care system to us. if not canada, then denmark, sweden, finland or norway. or france. or germany. or england . etc.
--------- a rose by any other name...
we should just hire canada to extend their health-care system to us. if not canada, then denmark, sweden, finland or norway. or france. or germany. or england . etc.
5
So whats been stopping them? This notion that the Free-market cures all ills is absurd. It only "cures" what the consumers didnt know they needed, or that which provides them oodles of profits. And as it now stands they make those profits, and see no reason to fix things for consumers benefits.
What we need is Govt to step in and demand lower costs, fair pricing standards, break up monopolistic behaviors, and level the fields across the board. "The un-free Market" will not do anything for altruistic reasons. Never has,never will. It must be made to...always has, always will.
What we need is Govt to step in and demand lower costs, fair pricing standards, break up monopolistic behaviors, and level the fields across the board. "The un-free Market" will not do anything for altruistic reasons. Never has,never will. It must be made to...always has, always will.
4
I never see any recognition in the media that having healthcare insurance is not the same thing as having affordable care.
Our family has Obamacare with a $9,000 deductible. A 5 minute ultrasound this year cost us $900. Not much "affordable" about that.
Our family has Obamacare with a $9,000 deductible. A 5 minute ultrasound this year cost us $900. Not much "affordable" about that.
7
It is imperative that something be done pronto to stabilize the insurance markets.
Too many counties of USA now have zero to one insurer. The effect is going to be catastrophic very quickly if that doesn't get the first short term fix.
Alas, Trump doesn't care if millions of Americans more lose coverage because of this and other problems. He wants to see ACA implode and die--no matter how many citizens get harmed physically and economically.
Serving and protecting the citizens is NOT his highest priority.
Too many counties of USA now have zero to one insurer. The effect is going to be catastrophic very quickly if that doesn't get the first short term fix.
Alas, Trump doesn't care if millions of Americans more lose coverage because of this and other problems. He wants to see ACA implode and die--no matter how many citizens get harmed physically and economically.
Serving and protecting the citizens is NOT his highest priority.
26
The health care system in the USA is working perfectly well and as designed.
It was designed to maximize the profit of health care providers and insurance companies. It is certainly doing that.
If you think that our valiant congressmen and senators will propose a system to reduce/control the profits of
- drug companies
- medical equipment companies
- hospitals
- doctors
- insurance companies
I have a little bridge that I could sell you.
Those dreaming about a single payer system should realize the impossibility of implementing such a system without lowering the huge costs inherent in health care.
It was designed to maximize the profit of health care providers and insurance companies. It is certainly doing that.
If you think that our valiant congressmen and senators will propose a system to reduce/control the profits of
- drug companies
- medical equipment companies
- hospitals
- doctors
- insurance companies
I have a little bridge that I could sell you.
Those dreaming about a single payer system should realize the impossibility of implementing such a system without lowering the huge costs inherent in health care.
17
"mandate" every private insurance that sells insurance to federal employees th to sell insurance on the exchange.
If an insurance company sell policy to postal worker in small town Iowa, that company should be required to sell polices on the exchange in that particular zip code.
If an insurance company sell policy to postal worker in small town Iowa, that company should be required to sell polices on the exchange in that particular zip code.
18
Will the New York Times ever have a frank discussion about profiting off health care delivery?
This seems fundamental to repairing Obamacare or even better choosing a limited profiting with universal Medicare.
The total value of Health on the Market has doubled since Obamacare began, now at $1.5 Trillion. Was protecting this wealth and its wealth holders purposeful?
Is profiting off health care delivery to this extent moral?
This seems fundamental to repairing Obamacare or even better choosing a limited profiting with universal Medicare.
The total value of Health on the Market has doubled since Obamacare began, now at $1.5 Trillion. Was protecting this wealth and its wealth holders purposeful?
Is profiting off health care delivery to this extent moral?
105
This is why we need Medicare for all phased in so as to maintain order. Drug advertising must be stopped (do not want to hear about women's plumbing issues or old man dysfunction anyway). Insurance companies and associated overhead to include CEO compensation needs to either be severely curtailed or eliminated totally.
I'm on Medicare. But for those who are not: How about raising the qualification age for Social Security to 70 and lowering the Medicare age to 50, the difference paid for by Social Security payment savings. That should be revenue neutral. That helps individuals but not families. Reinsurance for companies and a rise in payroll Social Security/Medicare payments, taking monies from all income levels, should greatly increase.tax revenue to cover what's left for families' coverage. I would also suggest a limited Medicare for all, balanced with supplemental coverage policies, just like I pay with my Medicare.
2
Raising the qualification age for Social Security really shafts people who have done physical labor all their lives. And what about people who are laid off when they're over 50 or 55, and are considered "unemployable" in today's market? Age discrimination is a reality. Those people are hanging on by the skin of their teeth until they can collect Social Security and Medicare.
6
I'm a reasonably informed person - I know some of the specifics about ACA and have formed an opinion about why it's not working as intended. However, I fear I am still in the majority of Americans who don't truly understand how one can possibly fix the issues.
This article provided an interesting perspective, and offered some solutions that seemingly will go a long way towards fixing the ACA. However, you have to agree that the rhetoric from mainstream Republicans is a lot easier to digest than the talking points provided here. It's so much easier to say "It's not working, therefore we should remove it" than saying "It's not working, but if we change X, Y, and Z, analysts agree that it should improve the overall costs for end users."
I think that all Democrats will have to agree on one or two specific points worth fighting for (essentially creating a catchy campaign against repealing the ACA). Otherwise, the only headlines that will sink in to American people are going to be the more approachable, Republican headlines against the ACA.
This article provided an interesting perspective, and offered some solutions that seemingly will go a long way towards fixing the ACA. However, you have to agree that the rhetoric from mainstream Republicans is a lot easier to digest than the talking points provided here. It's so much easier to say "It's not working, therefore we should remove it" than saying "It's not working, but if we change X, Y, and Z, analysts agree that it should improve the overall costs for end users."
I think that all Democrats will have to agree on one or two specific points worth fighting for (essentially creating a catchy campaign against repealing the ACA). Otherwise, the only headlines that will sink in to American people are going to be the more approachable, Republican headlines against the ACA.
9
#RepairAndRelax
“Alabama sticks to its guns,” she said, “even if it’s shooting itself in the foot.”
You can say that about the GOP as well. I appreciate this excellent article but the question is, who among the Republican Party faithful are listening?
You can say that about the GOP as well. I appreciate this excellent article but the question is, who among the Republican Party faithful are listening?
34
Here's how: Medicare For ALL.
177
Are you aware that Medicare has no family policies? It is all totally individual. Each person now pays something like $450 or more, for Parts A and B, Part D drug plan and a Medigap policy to cover deductibles and other charges.
So for a family of four....that would be at least $1800 a month or $21,600 a year. The median family income in the US is $49,000, or about $36,000 after taxes.
Do you think families can afford to pay $21,600 out of their $36,000 after-tax income???? leaving them $14,000 to live on all year????
So for a family of four....that would be at least $1800 a month or $21,600 a year. The median family income in the US is $49,000, or about $36,000 after taxes.
Do you think families can afford to pay $21,600 out of their $36,000 after-tax income???? leaving them $14,000 to live on all year????
I believe your math on Medicare is incorrect. I pay aproximately $405 per QUARTER, not per month. My wife pays the same, so for the two of us, Medicare Parts A, B, and a drug plan cost $3,250 a year. Assuming a Medicare for all then, a family of four would pay about $6,500 a year, much less than they are paying now, I'm sure, and only a fraction of the $21,600 annual cost your post suggests.
4
"The Trump administration has threatened to stop making the payments; insurers are now getting them on a month-to-month basis."
we'll see how much hardball the trump administration is willing to play. stopping these cost sharing reductions would probably be enough leverage to produce a new bill because of the ensuing chaos and uncertainty to follow. the morality of doing this is another issue.
we'll see how much hardball the trump administration is willing to play. stopping these cost sharing reductions would probably be enough leverage to produce a new bill because of the ensuing chaos and uncertainty to follow. the morality of doing this is another issue.
5
the first thing is that all discretionary authoriity must be removed from the executive branch.
24
This is essential. Out of sheer malevolence, Trump intends to murder ACA and then declare it a suicide. His ability to do this must be eliminated; otherwise, an apparent reprieve for millions of health care consumers will be short lived.
4
lets be sensible about this issue for a change. Senator McCain was on the ball when he called for the Senate to act like the Senate should perform. Let's get a bi-partisan committee together and work out a plan acceptable to all, given a fe w concessions here and there. The problem the democrats have had is they really never presented a good plan. Their approach was all tricks and procedures and many of them submitted to the White House "Bully."
6
This is ridiculous. This travesty can't be repaired, it's health INSURANCE not health CARE.
Full-featured Single Payer with Dental NOW.
Full-featured Single Payer with Dental NOW.
190
" .. Full-featured Single Payer with Dental NOW .."
WashPost editorial board says that would be financially crippling --
https://www.washingtonpost.com/opinions/single-payer-health-care-would-h...
Sometimes, reality does appear.
WashPost editorial board says that would be financially crippling --
https://www.washingtonpost.com/opinions/single-payer-health-care-would-h...
Sometimes, reality does appear.