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The solution is too spend most of your non-working and sleeping hours looking for or getting credentials so you can join the majority of Americans who get their insurance thru their employer.
So small businesses that either consist of one FTE, or those that have fewer than 50 FTE's but may not be able to afford insuring people, should just close their doors?
You realize the impact that would have, right?
Last edited by MPowering1; 11-13-2016 at 02:36 PM..
"Aw F.... we will just rename the thing, tweak it a bit and declare victory.... make it look like we had a replacement. How does Trumpcare sound? Always looked great on the side of casinos"
I said this all along. Anyone with a brain could see that the ACA can't be fully repealed. They will just rename it with a tweak or two.
Going to play devil's advocate here: Pre existing conditions are not my concern. I don't have a pre existing condition and no one in my immediate family does, so I don't want to pay into some healthcare plan that includes that. Until that happens then and only then will I pay
That is the devil in HC, compared to other insurance. Because we will about all have a very serious medical condition(s) before we croak. Of course more uncommonly when young. But as we age about all of us will develop significant and serious disease. Thus Medicare, where we about all will eventually partake of the benefits.
For the young and healthy HC should be relatively cheap, as risks are low. IMO OOP costs need to be significantly lower for the young and healthy than with say Obamacare of today. As long as they tow the line...
I get employer provided insurance, but not everyone does
So there will always be uninsured is what you are saying
Part of HC reform should be to get HC costs off the backs of business. IMO of course. As a doc it is of course easier for me and my business. But for most any other it makes little sense for the employer to do the heavy lifting. The employer can provide more in pay, and then let the individuals seek their own care in whatever new system we have.
Thanks. Wow that it took 9 pages for someone to think of this.
This is a huge missing piece in Obamacare.
So many things that could be done to reduce the cost of health care and doesn't appear that anyone is focused on this.
Great point, Blondy. Frankly, it's been too long (and too many battles) since the ACA went through and I may have the details a tad muddied. But I'll weigh in ...
In entering the healthcare arena, the focus of the battle could have been on *costs* or *coverage*. The designers chose coverage but included collecting data on costs and, more important, OUTCOMES. I think this is the "the evidence-based patient care" portion of the Act.
For example, lots of studies show that many back surgeries are not only expensive, lead to all sorts of secondary complications (and even more costs) but also are not more effective over a set of amount of time like 3 months than physical therapy. Orthopedic surgeons tend to recommend surgery and who is to say nay. Certainly not Obama but the evidence-based portion was a start. First the data.
There's a lot more to the ACA than just the mechanisms that result in insurance policy pricing but dealing with costs is if anything more politically sensitive and difficult than coverage has been.
I'm pretty sure I just read somehow that it is this portion of the ACA (collecting data on outcomes) that Republicans are most interested in shutting down. If I'm wrong here anyone is more than free to pounce.
Part of HC reform should be to get HC costs off the backs of business. IMO of course. As a doc it is of course easier for me and my business. But for most any other it makes little sense for the employer to do the heavy lifting. The employer can provide more in pay, and then let the individuals seek their own care in whatever new system we have.
That won't work without price controls.
Health care costs have outpaced inflation by leaps and bounds
because the free market doesn't work, it is piggish and takes
advantage of the desperately ill.
Hey Lilyflower I don't want to jump on you in particular but when looking at candidate promises maybe it helps to imagine ourselves in someone's else's position and wonder whether it could happen to *us.*
The reason that employer-based insurance covers pre-existing conditions is that most actively working folks are not sick. They certainly are not hired sick. So say you have a job and develop a serious life-threatening illness. Maybe cancer that doesn't kill you right away but makes you so ill and weak that you aren't able to do your job effectively and are fired. Your employer feels terrible about it but they are not a charity. There goes your relatively inexpensive or maybe even free medical care.
Now you may have some savings and so can cover COBRA costs but that will only last for 18 months. Now you are out of the less-expensive employer-based pool. Will an insurer be "happy" to cover you? Yes, I suppose but any actuary will of course make your premium the entire cost of your treatment plus overhead and profit. Insurance companies too are not a charity but profit-making centers. Cancer drugs can cost thousands a month. ERs will cover the emergencies but not on-going treatment.
What happens next? Some would try for SSD and Medicaid. But that road isn't a sure thing and in the meantime you will need to scrape together every cent you can to keep yourself alive and a roof over your head. You will need to sell everything, borrow to the hilt, ask friends and family for money.
Cases like this were not at all uncommon and were what the ACA was, in part, intended to prevent. Of course, it does it by spreading the costs (the mandate, higher insurance costs for many). Why costs for insurance under the ACA have risen is another story and certainly needs to be addressed. But nothing Trump has presented so far acknowledges or deals with the complexity of these issues.
In my medical office we excluded my wife from our medical plan. With her disease she would have DOUBLED the premiums of all our 40 or so employees! Her medical bills are up to $170K so far this year. About every 4 years new and expensive medical technologies save her.
That won't work without price controls.
Health care costs have outpaced inflation by leaps and bounds
because the free market doesn't work, it is piggish and takes
advantage of the desperately ill.
For the bulk of our relatively young, healthy and working population free markets can mostly do their thing. Up to a point. The point of serious medical or surgical calamity, and then up to a point in age.
Simply by lowering the age of entry into Medicare, Obamacare could conceivably be saved. Age 50-55 or so. Because that removes most of the medical risks from the private sector. And Medicare not only has huge price controls, it is a relative bargain for the enrollees.
Great point, Blondy. Frankly, it's been too long (and too many battles) since the ACA went through and I may have the details a tad muddied. But I'll weigh in ...
In entering the healthcare arena, the focus of the battle could have been on *costs* or *coverage*. The designers chose coverage but included collecting data on costs and, more important, OUTCOMES. I think this is the "the evidence-based patient care" portion of the Act.
For example, lots of studies show that many back surgeries are not only expensive, lead to all sorts of secondary complications (and even more costs) but also are not more effective over a set of amount of time like 3 months than physical therapy. Orthopedic surgeons tend to recommend surgery and who is to say nay. Certainly not Obama but the evidence-based portion was a start. First the data.
There's a lot more to the ACA than just the mechanisms that result in insurance policy pricing but dealing with costs is if anything more politically sensitive and difficult than coverage has been.
I'm pretty sure I just read somehow that it is this portion of the ACA (collecting data on outcomes) that Republicans are most interested in shutting down. If I'm wrong here anyone is more than free to pounce.
Some goods points there.
Part of HC reforms have been to push, support and financially augment primary care and the medical home. In specific terms as a primary care doc, I would (and should) be the one to send a patient to the surgeon. And typically after cheaper, easier and less painful modalities have failed. Like Chiro, PT, pain management and/or injections. In my practice it is more common sense than evidence based.
As a back patient myself for 25 years, this comes easier for me.
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