Another of Obamacare’s Unloved Provisions Is Gone

Unloved? Unloved by whom? Stingy right-wing bigots? People who want community activities only when they are direct beneficiaries? The IPAB would have been a useful tool for controlling health care costs, even if the rest of PPACA died.

In Britain the equivalent of our IPAB has delivered over a hundred thousand people a year to the undertakers, and it should not cause progressives any surprise that it was always fought here. There was that one solid example in Oregon of a woman refused adequate treatment because of costs but I never heard how that turned out. If she did die from that decision, you'll never read of it here.

How can they keep trying to fool us year after year? The cost of healthcare ( Big Insurance) and medications ( Big Pharma ) will continue to rise and only government has the power to control it. 10,000 baby boomers a day are turning 65, ( Medicare age ) and yet Paul Ryan and friends want to cut /reform / privatize Medicare! It may take a million people on the Mall, it may take Bernie at the head of the march but honestly Medicare for All is the only thing that will work long term for healthcare.

As a Type 1 Diabetic, I'm still angry that President Obama's initial proposal for a public option was scuttled. Shame on the Trump and his court jesters for not only adding over 150 GOP amendments to healthcare reform and turning it into Romneycare then screaming bloody murder about it, but for their vandalizing it along with their idiotic wall, their frivolous corporate welfare, their $640 toilet seats and $7,000 coffee makers, each congressional representatives' bloated staff, and ridiculous parade. Shame on them.

Enjoy another example of the US healthcare system run amok. https://www.vox.com/policy-and-politics/2018/2/7/16851134/rabies-treamen...

As a 61 year old woman I've seen my healthcare costs rise from $450.00 per month to $780.00 per month (Bronze PPO) with a $7000.00 deductible over the last 4 years. But how can you control Medicare costs? The older one gets the more medical care they need. At this point I'm glad there is no penalty for cancelling because I'm tempted to drop mine in the 4th quarter. I voted for Obama and think he is a fine person, but somehow the insurance companies are still in control and the ACA didn't think things through.

Here are my thoughts, as the 50 yr spouse of a 40 yr primary care Internal Medicine Genius, watching the yound MDS bail out of medicine, while insurance and gov't replaces skilled geniuses with lower level/practice extender/imported and not analytically skilled persons: Sometimes You Get What You Pay For. No one wants to work 80-100 hour weeks, make diagnoses on patients with multiple co-morbidities, accept responsibility for evaluation and treatment when they are in competition with 40 hour a week above named replacements not on call at 4 AM and not able to tell a distal from a tumor, cheap and dirty, funded by the Community Health Services head RN makes $350K a year for squat - DOES ANYONE WONDER WHY NO ONE IS ENTERING PRIMARY CARE? WE DON'T.

At the fundamental level, we have to come to the understanding that purchasing medical care isn’t the same as purchasing anything else. While choosing a primary care physician can be the product of investigation and research the actual consumption of medical care puts the buyer in a place where there are few, if any, decisions that aren’t best described by the old phrase: “Your money or your life.” More often than not second opinions are not easy to get and very expensive because most insurance plans may cover one visit for a diagnosis but not two. Then there is the “Charge Master” (CM) which the providers use to bill. This is a black-box that you don’t get to see inside and while your insurance company has a set of Reasonable-and-Customary payments along with contracts with medical providers to accept their R&C’s instead of the CM rates. Many medical care consumers know that the CM can be, and often is, up to 10 times what the R&C’s will pay. No, it isn’t simple and it has to be addressed. Unfortunately there are so many lobbyists on all sides that no elected official wants to deal with the issue. There are other solutions that can be considered. Sadly, the medical care industry has managed to wrap the current system in the American Flag and turn it into some kind of test of patriotism.

Ok gang, let's get over it again. The answer is a national, affordable, quality health care system for all that just about all of our peer countries and not so peer countries have. We can argue the details, more like Canada, or more like Germany or more like England but ever other country has figured it out. It is not rocket science. We are in the Middle Ages with our health care. Rwanda, one of the poorest countries on earth has it in theory ie everybody pays $12 a year. It is just that they are so poor they don't have enough doctors, clinics etc but they figured it out in theory.

Private insurance companies have had 'death panels' all along. When a newer treatment became available that would cost them more than the ones being used they would label it experimental no matter how much testing had been done and how good the results had been in other countries. Pre-approvals for other treatments also helped them to reduce costs on arbitrary standards. Minimum age requirements for knee or hip replacements, no matter how much they were needed, is an example. I trust the government (or those appointed by the government) far more than I trust the benevolence of insurance providers.

You either decide that some form of cost control is necessary with cost transparency now or there will be some form of "death panels" in the future. Unfettered growth of costs in an already broken healthcare system with decreasing returns in outcomes and coverage cannot go on indefinitely.