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Old 11-24-2016, 02:48 PM
 
Location: Living rent free in your head
31,065 posts, read 13,591,379 times
Reputation: 22129

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Quote:
Originally Posted by pilotpair View Post
The best thing about these posts is how many people recognized the falsity of the initial post and urged common sense: the guy isn't President yet, and no one knows yet what he will do, if anything, with social security; therefore, don't go off half-cocked. Trump's campaign platform was that he wouldn't touch social security. This is unlike President Obama who tried to reduce social security benefits. Democrats plead with Obama to abandon Social Security cut | TheHill.
People can decide for themselves if Paul Ryan's voucher plan for Medicare makes sense.
Keep in mind that Obamacare has a drastic impact on Medicare in Section 3403 of the legislation. That created an independent board that MUST cut reimbursement rates for Medicare services if the Medicare budget exceeds targets set the Treasury.
This procedure for the board is not affected by which party is in power. It's an automatic process. Most seniors don't understand how bad this COULD be because the targets haven't been exceeded yet. Nothing has happened YET. When it does, the myth that Democrats care about seniors will blow away.
It's my understanding that cuts made under 3403 were to Medicare Advantage plans and all guaranteed benefits were preserved, what was changed was that insurance companies were held to answer for many of their risk scoring decisions and insurers were no longer reimbursed for 'extras' offered such as eyeglass or dental care unless those were paid for from the insurers profit. Feel free to correct me if I'm wrong on that, but I remember researching it when those cuts were first announced and that is what I found

 
Old 11-24-2016, 03:02 PM
 
Location: Chesapeake Bay
6,048 posts, read 3,872,076 times
Reputation: 3502
Quote:
Originally Posted by pilotpair View Post

People can decide for themselves if Paul Ryan's voucher plan for Medicare makes sense.
It isn't the case of deciding.

All they have to do is look at the prices for ACA for 2017 for age 60 and KNOW that his voucher plan makes no sense. Especially since the age 60 prices will be vastly increased for ages 65, 70, 80+. And not forgetting the huge deductibles the ACA have that most current Medicare plans do NOT have.

Most on social security will simply opt out as they wont have the money to pay for this type of insurance and will go to ER until all the ERs fold. And then...

Last edited by Weichert; 11-24-2016 at 03:40 PM..
 
Old 11-24-2016, 03:33 PM
 
Location: Myrtle Creek, Oregon
12,255 posts, read 12,503,351 times
Reputation: 19413
Quote:
Originally Posted by SportyandMisty View Post
How about investing in R&D and production and the multi-million dollar process to gain approval by the FDA and distribution and physician education and patient education, employing thousands of people directly and indirectly, all so you can heal sick people? Is that morally wrong in your opinion? Just curious.
Just have the FDA approve anybody under the same standards. I paid for a hip replacement for one of my dogs. It's the same technology and the same fabrication techniques they use for human hips. The Hip cost me $3k, the surgery cost $3k and the dog used it for years. In the US, a human hip replacement would cost several times that, because it is illegal to use imported medical devices. It's illegal to go across the border and fill your prescriptions in Canada. Americans who need dental work go to Mexico to have it done for 10% of the US cost.

Is the fact that Americans are getting skinned morally wrong, in your opinion?
 
Old 11-24-2016, 03:59 PM
 
Location: Central IL
15,238 posts, read 8,527,906 times
Reputation: 35667
Quote:
Originally Posted by TuborgP View Post
There are those who say Trump is not a ideologist and thus can't be pigeon holed. They would say he is a pragmatist who adjusts as he gathers information and things play out. Sorta like most deal makers which Washington has a serious lack of. Not sure how many in congress have the national Twitter following he has and as we have seen Twitter is powerful and can bring other elected officials down. Trump can sit in Trump Tower and launch a localized Twitter assault deep into Red States and districts.
Hahah - that's a great way to spin it - "adjusts as he gathers information"...he's the type that the last person he CHOOSES to listen to is the one he believes...until he talks to the next person. He's always amazed when someone he talks to seems intelligent yet he's no brainiac.
 
Old 11-24-2016, 04:02 PM
 
Location: Living rent free in your head
31,065 posts, read 13,591,379 times
Reputation: 22129
Quote:
Originally Posted by Weichert View Post
It isn't the case of deciding.

All they have to do is look at the prices for ACA for 2017 for age 60 and KNOW that his voucher plan makes no sense. Especially since the age 60 prices will be vastly increased for ages 65, 70, 80+. And not forgetting the huge deductibles the ACA have that most current Medicare plans do NOT have.

Most on social security will simply opt out as they wont have the money to pay for this type of insurance and will go to ER until all the ERs fold. And then...
Exactly! and since the grand plan also seems to be to kill expanded medicaid the ER will provide medical care for them as well. Gonna be interesting to watch, that's for sure
 
Old 11-24-2016, 04:03 PM
 
Location: Living rent free in your head
31,065 posts, read 13,591,379 times
Reputation: 22129
Quote:
Originally Posted by reneeh63 View Post
Hahah - that's a great way to spin it - "adjusts as he gathers information"...he's the type that the last person he CHOOSES to listen to is the one he believes...until he talks to the next person. He's always amazed when someone he talks to seems intelligent yet he's no brainiac.
no kidding he seems to change his mind every other day..makes you wonder if he actually believes in anything he has ever said
 
Old 11-25-2016, 03:56 AM
 
Location: R.I.
978 posts, read 605,665 times
Reputation: 4242
Quote:
Originally Posted by NYgal1542 View Post
Thank you for posting this. I guess I have always thought of doctors as being top earners.

But something you did not mention is what they have to pay for malpractice insurance. And in these days, I believe they can't take the chance of not having it.
The Federal Government pays for their malpractice insurance.
 
Old 11-25-2016, 05:03 AM
 
Location: Central Massachusetts
4,800 posts, read 4,847,776 times
Reputation: 6379
Quote:
Originally Posted by NYgal1542 View Post
Thank you for posting this. I guess I have always thought of doctors as being top earners.

But something you did not mention is what they have to pay for malpractice insurance. And in these days, I believe they can't take the chance of not having it.
They are federal employees. They like the rest of us don't work to get rich. They do it because they love it. They also do it because of the future financial security it provides which by the way will not make them rich either.

Quote:
Originally Posted by Nightengale212 View Post
The Federal Government pays for their malpractice insurance.
Thank goodness for that. The doctors at the VA are under enough pressure as it is.


Oh by the way. It is not the doctors nor the nurses at the VA that are the problem. Most likely it isn't anyone person in the VA. I suspect it is just the system. If I had the ear of the head of the VA I would suggest they look at the Reliant Healthcare system I am in. Although I think it would need something a bit more because Reliant is IT heavy. I email doctors and nurse practitioners with questions and concerns. I get responses back quite quickly. The VA could not depend on that with how many homeless veterans there are.
 
Old 11-25-2016, 07:51 AM
 
Location: R.I.
978 posts, read 605,665 times
Reputation: 4242
Quote:
Originally Posted by Windwalker2 View Post
Thank you for supporting the point I was making. Your docs work for the government, salaried employees. You say they are dedicated and hardworking, in spite of earning less than they would in private practice. This is what could happen if we had single payer national health care, and doctors who cared more about healing and less about money. It works in most other industrialized countries.
I have had a bird's eye view of the evolution of health care in this country over the last 40 years, and not sure if giving the government more control over our health care will be the solution to the problem.

The VA is the closest model of care this country has that would be similar to what is available in Canada and the UK. When the funding pocket book starts to become depleted what happens next is services are reduced or eliminated all together. In my position I am often the one who delivers the bad news of service reduction to the patients in my care. A few years ago the VA had a wonderful program that paid for home health aides that would assist patients with personal care, light house cleaning and meal prep which allowed many patients to stay in their homes instead of having to transition to a long term care facility. The VA was paying Medicare rates for these aides which was $25/hour, and I was able arrange 3 hours a day 5 times a week for these home health aides to provide services which would equal a monthly cost of $1500 per patient. This is a great bargain compared to the monthly cost for inpatient long term care which roughly would cost $10,000 per month. Sadly funding for this program was cut and now I can only arrange 3 hours a week of home health aide services instead of 15. This significant reduction in services resulted in the home health aids making 1 hour visits 3 x a week and with that limited time all they are able to provide is very rushed personal care. With many of my patients having some level of incontinence and mobility deficits where they will sit in the same position for hours at a time, without daily personal hygiene, mobility assistance, and adequate nutrition they now suffer from skin breakdown which leads to pressure ulcers which become infected and require expensive acute hospitalization to treat. More often than not following their hospitalizations they have to be placed in expensive long term care because their care level is now greater than what they can receive in their homes.

I won't bore you with other examples of reduction in services that has produced some significant negative care outcomes but they are many. Myself being a healthcare provider it is a great concern to me if this country goes to a model of care where there is a greater potential for rationing of services than what already exists now that I have witnessed first hand within the VA.

In a nutshell, I honestly don't think there are many people who would truly want the poor and disabled denied needed care. But when those hard working individuals who are paying for that care via their taxes and can't afford to have the same level of care their taxes are paying for another to have that is a serious problem and this is what happened to some extent with Obamacare. President elect Trump certainly has his work cut out for him in putting together a healthcare plan that will work for all across the economic spectrum. I truly hope that he employees people to evolve a healthcare plan who work in ground zero hands on health care and not just pencil pushers that don't know the difference between an asprin and a bandaid.
 
Old 11-25-2016, 10:34 AM
 
358 posts, read 222,731 times
Reputation: 627
2sleepy - I agree and disagree with your comments.

Section 3403 authorizes the board to target the administrative costs and profits under Medicare Advantage Part C plans and Part D (prescription drug plans). You're on target but it wasn't specific to costs of any one item. There's nothing in the law (I found) that says insurance companies have to pay for x items from their profit. Is that wishful thinking?

Section 3403 also authorizes the board to target reimbursement rates to physicians as well as costs of items such as walkers under Part B which is original Medicare. Interestingly, the board has no authority over hospital reimbursements (someone has a good lobby). So it is broader than you stated although the law doesn't 100% take effect until 2020.

As to dental, eyeglasses - are you confusing these with the Cadillac Tax that starts in 2020? That's a 40 percent excise tax on the health benefits companies provide their workers above a certain threshold. Congress has taken steps to remove dental and eye exams from the base so there's no impact to plan that cover those.
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