Healthcare for all, not Trump or Obama care

SpaceNut · 2017-08-20 19:45:04

Much of the time for the Trump Presidency has been wasted on repeal of Obamacare rather than fixing what is wrong with it and not trying to ram down the throat of the people Trumpcare....I am sure we have a few post in the political topic that apply.

2 Maps Show The Big Obamacare Crisis Republicans Keep Citing Isn’t Actually That Big It’s a real issue for some parts of the country. But it’s not so hard to fix.

Current state maps of insurance:
5995ce871400001f002c3491.jpeg?ops=scalefit_720_noupscale

One must remember that this is for the exchnage and not what is available by private curriers in the state to which each state says whom can operate within there borders to provide insurance.

All I did was google for a list of NH healthcare insurance companies

Hoops for private
http://www.nh.gov/insurance/consumers/healthinscos.htm

exchange
https://www.healthinsurance.org/new-hampshire/

So a state that only has 1 exchange insurer means they are greedy for profits and not being there as a provider.

From the only posted comment on the exchange page:

Gerald Demers
im in very good health. and ill take the credit for that. im looking for a health care plan that will keep the goverment off my back, and thats putting it up too high. show me the cheepist policy there is. its all i need to waste my money on.

This was due to the penaly for not having insurance but the exchange is offering complete all in insurance and not Catastrophic Health Insurance Plans. Even thou the insurers are playing games with what is covered for the whole body such as dental and vision care which are seperate policies.....

SpaceNut · 2017-08-21 16:26:14

For those that are not on an employer insurance plan you would start your look at sites like this one: http://www.governmenthealthinsurance.co … bw_mobile=

entering the zipcode forwards to state issuers of which when you go to that page starts to put you into risk management groups for pricing....

Do you have any of the following health conditions?
AIDS/HIV
Bipolar Disorder
Cancer
Cirrhosis
Depression Requiring
Hospitalization
Diabetes Type I
Erythematous
Heart Disease
Kidney/Renal Failure
Muscular Dystrophy
Schizophrenia
Systemic Lupus
Transplant History

$$$ for the policy....

SpaceNut · 2017-08-21 17:32:44

McConnell: Next Steps on Obamacare are ‘Somewhat Murky’

Well, Senate Majority Leader Mitch McConnell the next steps for Congress on health care reform will require more than just talks with Democrats to see what sort of measures the two parties might be able to agree on as its got to do no harm to the people which are counting on its benefits to be there.

RobertDyck · 2017-08-21 21:53:48

If you Google, you can find other websites that find health insurance. I tried the one you provided. It popped-up a window, which gets stuck on "We are collecting your search results." and "- Loading -".

SpaceNut · 2017-08-22 17:06:46

Only one county in (Ohio) US remains without an Obamacare insurer for 2018

That's a big change from earlier this summer when at different times a total of 82 counties lacked commitments from insurers who sell individual health plans for 2018.
And the continued decline in "bare counties" provides more ammunition for Obamacare advocates arguing against Trump administration claims that the health-care program is failing and needs to be replaced immediately.
The latest potential bare area to get coverage offered for next year was Menominee County in Wisconsin, where just 47 people buy Obamacare plans on the federal marketplace HealthCare.gov.

What was there only 48 in the state that needed it?

Insurance is still to costly for the benefits recieved when you need to use it and the rules from one to the next plus for the place of service all need to astrologically align for you to get the most out of it.

RobertDyck · 2017-08-23 13:18:30

In the Politics thread, I suggested America adopt Canadian Healthcare. Again, it's not free, there's a premium. But it's a lot less expensive.

SpaceNut · 2017-08-23 16:10:05

A little further back in the topic I meantioned how the low income afforded there healthcare by going to the mobile units:
http://newmars.com/forums/viewtopic.php … 65#p139865

GW Johnson wrote:

What do you expect from for-profit operators who DID NOT sign the Hippocratic Oath?
Between that and duplicated overhead, our insurance-mediated health care delivery system is the least cost-effective in the entire civilized world. And for no reason except to toe the line on ideology.
GW

Yes I remember GW...

The same is true for the drugs that can be gotten just north of the border in canada as well.

Having a lower cost would mean that more would be willing to go an get the insurance in the first place.

In fact supplemental insurance would be affordable as well for the excessive costs sometimes incurred....

kbd512 · 2017-08-24 11:03:00

SpaceNut,

Politics

You know as well as anybody that liberals will oppose anything President Trump says or does, no matter how practical, economical, logical, or moral. If anybody had a solution that was politically tenable, it would've materialized by now. Socialists think that if only the government program is "too big to fail", then somehow it won't. Conservatives rightly point out that pretty much every large or poorly defined government-run program has been a failure, if results achieved in terms of dollars spent is in anyway involved in the calculus of a determination of success.

Fiscal Reality

If anyone here can name off a large government program that is successful in terms of results achieved per dollars spent, I'd love to read about it. Pretty much everyone here thinks we spend too much money and the only real disagreement is over what it's spent on. In terms of budget, only the defense budget is comparable to what the US spends on entitlement programs and there are no shortage of critics of our defense spending, even within DoD. My critiques of questionable DoD spending are pretty well known to people who have read what I've written.

Actual Results

In any event, our insurance premiums have just about tripled under the Affordable Care Act (aka ObamaCare), but quality of service has not tripled, access has not tripled, and services covered have not tripled. If anything, our deductibles are higher, coverage is less than what it was prior to implementation of the ACA, and access has most assuredly not improved. Our experience is not in any way unique. I haven't conversed with any Texans who actually use require health care services who also noted an improvement in any of the named areas, apart from people who had never paid into health care insurance to begin with.

Intractable Problems

All those medical conditions you named off are what I categorize as intractable problems because little to no real effort is being made to cure or otherwise create permanent solutions to correct those medical conditions. A decade ago, I honestly believed we were well on our way to curing and vaccinating against HIV/AIDS, but such was and is not the case. Apart from rare forms of cancer, prototypical cancers should've been something we cured decades ago, too. Excepting certain forms of treatment that can be effective when the cancer is detected at an early stage, no real progress has been seen in this critical area of medical capability in decades.

In certain areas, we're clearly much further along than we were even a decade ago. However, there's a one to two decade lag between the time a cure (chemical compound, gene therapy, radiation therapy) is discovered and the time it's implemented on a mass scale. Laser vision correction surgery has only recently become available and affordable to the common person and results are more or less guaranteed.

We now have designer drugs that can completely reverse brain damage, DNA degeneration, and muscular degeneration, but those drugs have literally become available in the past year or two and it'll be another decade before science admits that they work in a general sense and then makes them widely available.

Questions

Does anyone here have any solutions they'd like to try that have been determined through actual implementation elsewhere to improve outcomes, reduce costs, and generally improve upon the feasibility of the system currently in place? If so, then please share. It's fairly evident that nobody in our government (and I include both Democrats and Republicans here) has any realistic solutions.

louis · 2017-08-24 16:23:06

In answer to your last question, I have heard that Belgium is generally held to have the best system in terms of health outcomes and fiscal efficiency. It's quite complex, surprisingly:

https://en.wikipedia.org/wiki/Healthcar … l_security

It is a kind of compulsory contribution system but with competition between insurance providers as far as I understand it.

The problem with the NHS in the UK, is that it is basically the sole provider.

Personally I would like the UK to move to a health voucher system - where every citizen's health voucher allows them to "buy" their health care from a provider, who would have to meet minimal contract standards (but could offer more). The health voucher system also allows you to incentivise healthy behaviour through rebates.

Our health systems reflect our cultural values. American culture is far more individualistic than all European societies - but there is a lot of variation within Europe as well.

kbd512 wrote:

SpaceNut,
Politics
You know as well as anybody that liberals will oppose anything President Trump says or does, no matter how practical, economical, logical, or moral. If anybody had a solution that was politically tenable, it would've materialized by now. Socialists think that if only the government program is "too big to fail", then somehow it won't. Conservatives rightly point out that pretty much every large or poorly defined government-run program has been a failure, if results achieved in terms of dollars spent is in anyway involved in the calculus of a determination of success.
Fiscal Reality
If anyone here can name off a large government program that is successful in terms of results achieved per dollars spent, I'd love to read about it. Pretty much everyone here thinks we spend too much money and the only real disagreement is over what it's spent on. In terms of budget, only the defense budget is comparable to what the US spends on entitlement programs and there are no shortage of critics of our defense spending, even within DoD. My critiques of questionable DoD spending are pretty well known to people who have read what I've written.
Actual Results
In any event, our insurance premiums have just about tripled under the Affordable Care Act (aka ObamaCare), but quality of service has not tripled, access has not tripled, and services covered have not tripled. If anything, our deductibles are higher, coverage is less than what it was prior to implementation of the ACA, and access has most assuredly not improved. Our experience is not in any way unique. I haven't conversed with any Texans who actually use require health care services who also noted an improvement in any of the named areas, apart from people who had never paid into health care insurance to begin with.
Intractable Problems
All those medical conditions you named off are what I categorize as intractable problems because little to no real effort is being made to cure or otherwise create permanent solutions to correct those medical conditions. A decade ago, I honestly believed we were well on our way to curing and vaccinating against HIV/AIDS, but such was and is not the case. Apart from rare forms of cancer, prototypical cancers should've been something we cured decades ago, too. Excepting certain forms of treatment that can be effective when the cancer is detected at an early stage, no real progress has been seen in this critical area of medical capability in decades.
In certain areas, we're clearly much further along than we were even a decade ago. However, there's a one to two decade lag between the time a cure (chemical compound, gene therapy, radiation therapy) is discovered and the time it's implemented on a mass scale. Laser vision correction surgery has only recently become available and affordable to the common person and results are more or less guaranteed.
We now have designer drugs that can completely reverse brain damage, DNA degeneration, and muscular degeneration, but those drugs have literally become available in the past year or two and it'll be another decade before science admits that they work in a general sense and then makes them widely available.
Questions
Does anyone here have any solutions they'd like to try that have been determined through actual implementation elsewhere to improve outcomes, reduce costs, and generally improve upon the feasibility of the system currently in place? If so, then please share. It's fairly evident that nobody in our government (and I include both Democrats and Republicans here) has any realistic solutions.

SpaceNut · 2017-08-24 16:42:05

Questions asked for the insurance:

http://www.kff.org/interactive/subsidy-calculator/
Enter Information About Your Household
1. Select a State
2. Enter income as 2017 yearly or as a % of poverty
3. Enter your yearly household income (dollars)
4. Is coverage available from your or your spouse’s job?
5. Number of people in family
6. Number of adults (21 to 64) enrolling in Marketplace coverage
7. Number of children (20 and younger) enrolling in Marketplace coverage

1 state regulated providers and type of policies not being provided nation wide
2 subsidized levels not equal from one state to the next as table for povery is used are different for each state
3 Income to high will not allow for you to get insurance that might be lower in cost
4 another means to screen out lower costing policies for those that want too
5 a way to inflate risk costs for them but not to give benefits
6 risk pool level, I am surprised that they did not ask how many are over that age of 64 but then again that for medicare and medicade enrollments.
7 coverage type pool for risk

This is just the insurance company side of this complex problem...

Are we the united states or not as we should be able to get any provider in any state and have the same policies in all.....

RobertDyck · 2017-08-24 23:04:28

Text of the Canada Health Act. Could I suggest starting with this for a new American healthcare bill?

In Canada, healthcare started with Canadian equivalent of HMOs. Then provinces created a province-wide system, first one province then others. In 1966 the federal government passed a national healthcare act. It has evolved, the current system is based on a bill passed in 1984.

Key features

Public administration
Comprehensiveness
Universality
Portability
Accessibility
Additional conditions
- federal Minister of Health is entitled to specific information
- the province must "give recognition" to the federal government "in any public documents, or in any advertising or promotional material, relating to insured health services and extended health care services in the province"

Terraformer · 2017-08-25 04:20:11

louis wrote:

Personally I would like the UK to move to a health voucher system - where every citizen's health voucher allows them to "buy" their health care from a provider, who would have to meet minimal contract standards (but could offer more). The health voucher system also allows you to incentivise healthy behaviour through rebates.

I'd prefer if they'd use the system already used for GP surgeries for hospitals. Privately operated (but probably non-profit) hospitals under contract to take NHS patients. There would be a list of how much the government is willing to spend for each treatment... which we already have, but it's done in a very haphazard manner between NICE (National Institute for Care Excellence) and individual NHS trusts. People would be free to top up their healthcare with their own money (so if the government will spend £20k/month on a treatment, and they want to use one which costs £30k/month, they would only have to find the extra £10k/month - at the moment they would have to find the full amount and go private). Prescription charges would be done away with (either completely, or have people paying cost with a price cap - my inhalers cost a lot less than the NHS charge me for them), and instead there would be an appointment copay (no more than £5), applicable when making a new appointment (so if the doctor tells you to come in a month, you wouldn't have to pay), which can be reclaimed by those on low incomes. The idea would be to encourage people to only come in if they're actually sick, which is a major problem GP surgeries face.

Accident and Emergency, though, should probably be treated as one of the emergency services, separate from primary healthcare and treatment of chronic illnesses.

GW Johnson · 2017-08-25 11:32:24

Louis mentioned the Belgian system, and made it sound like a sort of blend of public and private stuff. That blended approach is what the Australians use, and to the best of my knowledge, may be just about the best there is so far. You can't fix or replace anything successfully if you don't go look at examples that offer better outcomes. Then, you "adopt, adapt, and improve", as the old Round Table motto has it. But nothing happens if you value ideology over fact. Which is where we are.

GW

SpaceNut · 2017-09-12 20:08:39

Pay attention to the proposal. Pay more attention to what he says about it. “Medicare-for-all” proposal.
Ready Or Not, Here Comes Bernie Sanders And His Single-Payer Plan

The Affordable Care Act has helped millions to get insurance, improving access to care and offering financial security many lacked before. It also created a political consensus behind the essential principle of universal coverage ― that everybody should have insurance, regardless of income or medical condition.
But the law has also fallen short of realizing that goal. Millions of Americans still don’t have insurance. Millions who do are stuck with high premiums or out-of-pocket expenses.

Sounds like a new grouping somewhere in between Medicaid and Medicare ....

Officials say they are collecting general demographic data for research, but the move has alarmed some state officials Federal Requests For Patient Info Raise Red Flags In States That Allow Medical Pot Use “With the anti-marijuana rhetoric coming from the Trump administration’s Department of Justice, you do have to wonder what the true motivation is here.”

“The intent is to provide factual information about the consequences of medical marijuana, “part of our mission to examine the impacts of medical and recreational marijuana.” which 29 states that have legalized marijuana for medical purposes.

SpaceNut · 2017-09-25 19:23:14

Just how many more times will we have a hit on healthcare via the GOP repeal process....

Republicans hold a 52-to-48 advantage in the Senate and can lose only two votes from their party and still pass legislation with the help of a tiebreaking vote from Vice President Pence. Senate GOP effort to unwind the ACA collapses Monday

The bottom line of the bill was to strip the federal controls and turn all insurtance control back to the states but that is why and what was the cause to this issue in the first place. The inequality of policy, to coverage vs premium ect....

SpaceNut · 2017-10-06 16:33:04

The continual process of undermining the process and conditions of getting healthcare as well as weakening the law via abortion removal for religious reasons( ACLU filing suit over easing of birth control mandate ) from the employer is another way that we are going in the wrong way again.
As ACA enrollment nears, administration keeps cutting federal support of the law

GW Johnson · 2017-10-07 09:02:49

This is what you get from a governing party that is now about half extremists of various types (religious and political). Why would you expect any different?

It has grown to half and dominates party agenda because the extremists have learned how to "primary" their not-extremist opponents. Originally these extremists were a minority within the GOP. Not any longer.

Of many things, one thing that helps get them elected generally is a party agenda to dumb-down education with low-bar standardized testing, linked to funding, so that only the low-ball test is taught. After 2 generations, the effective population IQ is now low enough to actually elect these clowns as the entire government.

We might get out from under this at the ballot box, if the opposing party (Dems) can figure out (1) how to select a candidate acceptable to all, and (2) how to address the needs of the mostly-blue collar middle class they have ignored since the 1950's. They did not do that in 2016.

Otherwise, the only solution to this ugly mess is the guns in civilian hands that the Second Amendment is supposed to protect. The threat of that armed rebellion is its purpose.

GW

Last edited by GW Johnson (2017-10-07 09:10:27)

SpaceNut · 2017-10-07 18:34:38

Candidates that declare that they are running as a party ticket are bound to be rejected even if they are speaking what the oposite party is saying once that democrat or republican announcement has occured.
The person that votes needs to vote for what the candidate is saying that they want and not for what the candidate is saying that he thinks that you want to hear....
Healthcare right now is the biggest screw job to the consumer than it was even a decade ago or more....

SpaceNut · 2017-10-07 20:28:47

Bernie Sanders was touting medicade for all as the one payer answer and this is what is coming down to is that Health-Care Standoff in Washington Raises Stakes of State-Level Fights and elsewhere to deal with the perception that its welfare...but there are rules on earning a living and getting the benefits as there are income tables that apply to whether you will get to have it or not.

https://www.medicaid.gov/medicaid/progr … index.html

https://www.dhhs.nh.gov/dfa/documents/incomelimits.pdf

SpaceNut · 2017-10-08 16:51:12

While the Trump administration failed to repeal Obamacare, it’s doing everything it can to whack it administratively —pulling resources, while pursuing strategies that are likely to depress sign-ups for the law’s fifth open enrollment.

With less than a month before sign-up begins, the federal government has gutted outreach and marketing, slashed funding to outside enrollment groups and left state officials in the dark on key details.

The enrollment window is only half as long as in previous years. HealthCare.gov — the main sign-up site for more than half the country — will be shut down for 12 hours nearly every Sunday. Regional health officials have been told not to participate in sign-up events sponsored by outside groups.

SpaceNut · 2017-10-08 19:31:24

Trump to sign another executive order White House to order expansion of health care options

expand health plans offered by associations to allow individuals to pool together and buy insurance outside their states, President Donald Trump has long asserted that selling insurance across state lines would trigger competition that brings down premiums for people buying their own policies. Experts say that's not guaranteed, partly because health insurance reflects local medical costs, which vary widely around the country.
they wouldn't have to offer the full menu of benefits required under the Affordable Care Act,
under consideration by the White House, to loosen restrictions on "short term" insurance plans, could be a safety valve for some consumers.
Those plans generally have limited benefits and remain in force for less than a year.
iphoning off healthy people to plans with lower premiums and skinnier benefits.

Meaning the places used will inflate costs based on the insurance that they get presented.....as to what they will pay for given service...
a tiered approach to less coverage at a lesser premium is not health insurance, its a rip off....

clark · 2017-10-15 04:05:18

i love these little social dramas.

I'm a reductionist. I take complicated problems and look for a way to grossly simplify and distill their essence. Dealing with complexity hurts the head. And complexity means nuance which means I've lost you due to some obscure factoid you use to completely disregard the rest of the truth. so here it is. ready?

healthcare is broken because people are broken. well, a lot of people are. not their health, just their souls.

The premise, simple. I pay for something I don't use, and ideally, never will, so someone else can use it, just in case someday, when I need it, I'll have it.

That's it. Scream all you want about Canada this, or Norway that. Medicare for all! Medicaid for none! HSA me baby, death council me darling! Doesn't matter. All those systems are broken. All rotten cause we are rotten.

How do I know? One, I have a ring side seat. Two, just look at donor rates for blood and organs. We cannot replicate either. The donor rates for blood are terrible. The premise of donating blood is EXACTLY the premise of of paying for healthcare. Donating organs, especially postmortem, terrible.

Give a penny/take a penny needs to be more mainstream before we will find a workable solution.

SpaceNut · 2017-10-15 06:32:02

Start with healthcare being a tier systems of well care (examines, minor aches & sprains ect, colds, flu), minor surgery (common ailments .. tonsil, apendix removal,...), major surgery as you might die, ect...you pay for the level you should have during you life.....

Terraformer · 2017-10-15 14:00:52

Who pays for emergency healthcare in America? Since the government picks up the tab for other emergency services, perhaps a system where they pay for emergency healthcare would be politically workable?

Combine that with a sliding scale based primary healthcare system to ensure everyone's covered for that. Insurance, savings, and other methods can pay for the rest. Whatever you do, make sure there is some kind of feedback system between people's lifestyle choices and their healthcare, such as copays.

SpaceNut · 2017-10-15 15:53:33

Emergency care happens for a couple of reasons:
1. being hours of operation that your primary care doctor is open
2. due to the lack of a primary care doctor at all

The business of urgent care is a watered down version of the hospitals emergency care system charging emergency care prices as setup by the hospitals.

Stop the garbage of deductibles, copays, care limits and price it for what you get for the service.

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#1 2017-08-20 19:45:04

Healthcare for all, not Trump or Obama care

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Re: Healthcare for all, not Trump or Obama care

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Re: Healthcare for all, not Trump or Obama care

#4 2017-08-21 21:53:48

Re: Healthcare for all, not Trump or Obama care

#5 2017-08-22 17:06:46

Re: Healthcare for all, not Trump or Obama care

#6 2017-08-23 13:18:30

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#7 2017-08-23 16:10:05

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#8 2017-08-24 11:03:00

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Re: Healthcare for all, not Trump or Obama care

#10 2017-08-24 16:42:05

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#11 2017-08-24 23:04:28

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#12 2017-08-25 04:20:11

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#13 2017-08-25 11:32:24

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#14 2017-09-12 20:08:39

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#15 2017-09-25 19:23:14

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#16 2017-10-06 16:33:04

Re: Healthcare for all, not Trump or Obama care

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Re: Healthcare for all, not Trump or Obama care

#18 2017-10-07 18:34:38

Re: Healthcare for all, not Trump or Obama care

#19 2017-10-07 20:28:47

Re: Healthcare for all, not Trump or Obama care

#20 2017-10-08 16:51:12

Re: Healthcare for all, not Trump or Obama care

#21 2017-10-08 19:31:24

Re: Healthcare for all, not Trump or Obama care

#22 2017-10-15 04:05:18

Re: Healthcare for all, not Trump or Obama care

#23 2017-10-15 06:32:02

Re: Healthcare for all, not Trump or Obama care

#24 2017-10-15 14:00:52

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#25 2017-10-15 15:53:33

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