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Healthcare Proposals to "replace" ACA in usa

 
 
 
Rhea

Rhea

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I'd really like to hear detailed discussion of the pros and cons of the various "replace" plans from the Republicans. Has anyone studied these in depth yet? Do you know of blogs that analyze them:

First, the Collings - Cassidy plan
https://www.collins.senate.gov/news...duce-comprehensive-obamacare-replacement-plan

Repeals: This proposal repeals burdensome federal mandates imposed by the Affordable Care Act, such as the individual mandate, the employer mandate, the actuarial value requirements that force plans to fit into one of four categories, the age band requirements that drive up costs for young people, and the benefit mandates that often force Americans to pay for coverage they don’t need and can’t afford.

Keeps: This proposal keeps essential consumer protections, including prohibitions on annual and lifetime limits, prohibition of pre-existing condition exclusions, and prohibitions on discrimination. It also preserves guaranteed issue and guaranteed renewability and allows young adults to stay on their parents’ plan until age 26, as well as preserving coverage for mental health and substance use disorders.
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So far what I see is that it is a terrific program for freeloaders who can refuse all insurance payments and just go to the ER when they are sick where the hospital will be required to treat them and then pass on the costs to the rest of us. And we expect that to "save us money".
 
In other words, do what's popular without regard for what will actually work.
 
I agree Obamacare is an absurd, (originally) Republican compromise designed to satisfy all the special interests and keep everyone's finger in the pie. The ACA is an insurance reform policy, not comprehensive healthcare reform.

I'd like to scrap the whole thing. There are successful, working models of Beveridge, Bismark and NSI models from all over the world, with costs a quarter to a half what we're paying in the US -- and with better outcomes -- but no-one's talking about them because they'd exclude the expensive, parasitic special interests currently driving health care costs through the ceiling.
https://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/models.html

The US already has a successful, socialized (Beveridge) system in the Veterans Administration, and a single payer (NSI) system in the Social Security Administration, yet the US continues to support an outrageously expensive, for-profit, out-of-pocket business model for most citizens.
 
The Republicans have no plan.

They are the dog that caught the car and don't have a clue what to do.

They cried for eight years about Obama's plan and never developed one of their own.

They have nothing but politics, ugly politics, no plans.

They are a disgrace.
 
untermensche said:
The Republicans have no plan.

They are the dog that caught the car and don't have a clue what to do.

They cried for eight years about Obama's plan and never developed one of their own.

They have nothing but politics, ugly politics, no plans.

They are a disgrace.
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Who's the greater disgrace? The disgrace or the guys who lost to them?
 
Tom Sawyer said:
untermensche said:
The Republicans have no plan.

They are the dog that caught the car and don't have a clue what to do.

They cried for eight years about Obama's plan and never developed one of their own.

They have nothing but politics, ugly politics, no plans.

They are a disgrace.
Click to expand...

Who's the greater disgrace? The disgrace or the guys who lost to them?
Click to expand...

It's more disgraceful to win with no plan than to lose with one.

If Hillary had come out loudly and strongly for universal one payer healthcare then her losing would be disgraceful to that position.

She didn't.
 
Rhea said:
So far what I see is that it is a terrific program for freeloaders who can refuse all insurance payments and just go to the ER when they are sick where the hospital will be required to treat them and then pass on the costs to the rest of us. And we expect that to "save us money".
Click to expand...


Exactly. Here in Houston, we have the Harris County Health system that is actually pretty good. Low income people get pretty good health care based on ability to pay, free for those in need. But thanks to our GOP state government, support for health care is lacking. So no Medicare expansion here. And that has affected Harris Health whose budget cuts now mean an $85 million budget shortfall thanks to our GOP state government. The Feds won't pull the budget fat out of the fire for Texas.

So there are several layers to the health care puzzle and any number of places to create roadblocks for the GOP. I do not see the GOP now running Washington to care any more than the state GOP government of Texas now does. The excuse for this in Texas was that doing the right thing involved taxes.

I have seen a number of proposals from individuals in Congress and various committees and it seems there is no plan, but a lot of opposition to things as they are based on dislike of the system by conservative voters. Where all of this will end up is a total unknown, but it won't be good whatever it is. The Texas model to date shows that we can expect nothing good from Congress.
 
The Solution:

1. A public system, tax-paid, free to anyone who wants to use it, no insurance or private companies; and

2. A private system, with little/no regulation, state stays out of it.

The public system is limited to a fixed annual budget. The providers decide what's worth spending on, cut out anything too expensive.
 
ZiprHead said:
Lumpenproletariat said:
2. A private system, with little/no regulation, state stays out of it.
Click to expand...

View attachment 9709
Click to expand...

How about no regulation of the prices or setting the terms of what insurance companies are required to cover. Like forcing all policies to cover mental illness or sex changes or plastic surgery. Let consumers individually decide what they want to be covered for, not the politicians. (For the private system -- totally paid for privately.)

But tax-paid public system: free to patients, for all citizens who want to use it. Low-cost, avoidance of hi-tech exotic treatments, no fee-for-service.

Similar to education: "free" public schools open to all + Private schools for whoever can pay the cost.
 
Lumpenproletariat said:
ZiprHead said:
View attachment 9709
Click to expand...

How about no regulation of the prices or setting the terms of what insurance companies are required to cover. Like forcing all policies to cover mental illness or sex changes or plastic surgery. Let consumers individually decide what they want to be covered for, not the politicians. (For the private system -- totally paid for privately.)

But tax-paid public system: free to patients, for all citizens who want to use it. Low-cost, avoidance of hi-tech exotic treatments, no fee-for-service.
Click to expand...

Frankly I would say mental health is vastly underappreciated as a medical concern. The reason it needs to be included is that mental disorders are often pre-existing conditions, especially when they are chronic and/or diagnosed early. It isn't at all reasonable that someone's ability to afford healthcare should be so negatively impacted by something they can't help.
 
Lumpenproletariat said:
How about no regulation of the prices or setting the terms of what insurance companies are required to cover. Like forcing all policies to cover mental illness or sex changes or plastic surgery. Let consumers individually decide what they want to be covered for, not the politicians. (For the private system -- totally paid for privately.)
Click to expand...

That is called paying cash as you go for only what affects you.
And it's been found to be a resounding disaster. Especially for mental health which often strips a person of their savings before they realize they need a doctor.
 
Rhea said:
I'd really like to hear detailed discussion of the pros and cons of the various "replace" plans from the Republicans. Has anyone studied these in depth yet? Do you know of blogs that analyze them:

First, the Collings - Cassidy plan
https://www.collins.senate.gov/news...duce-comprehensive-obamacare-replacement-plan

Repeals: This proposal repeals burdensome federal mandates imposed by the Affordable Care Act, such as the individual mandate, the employer mandate, the actuarial value requirements that force plans to fit into one of four categories, the age band requirements that drive up costs for young people, and the benefit mandates that often force Americans to pay for coverage they don’t need and can’t afford.

Keeps: This proposal keeps essential consumer protections, including prohibitions on annual and lifetime limits, prohibition of pre-existing condition exclusions, and prohibitions on discrimination. It also preserves guaranteed issue and guaranteed renewability and allows young adults to stay on their parents’ plan until age 26, as well as preserving coverage for mental health and substance use disorders.
Click to expand...
Click to expand...

At first blush, the above plan looks to be a good thing for the public, and bad for the insurance companies because the mandates would be gone, but the things people like about the ACA (pre-existing conditions, lifetime limits, kids on parents insurance until age 26) would be kept. The reality will be that because the mandates are gone, including the coverage mandate, and presumably the mandate that 80% of premiums must go to paying for care, then the individual market will likely only include catastrophic and Cadillac plans. So, the result would be that poor people get screwed again, and the insurance companies get to laugh all the way to the bank.
 
We already have a working, single-payer system with only 3% overhead. Why not just drop the Medicare age from 65 to 0?
 
seyorni said:
We already have a working, single-payer system with only 3% overhead. Why not just drop the Medicare age from 65 to 0?
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It makes too much sense.

The Republican's have a religious belief that government can do no good.

So they seek to make government programs that actually help people well as weak and dysfunctional as possible.
 
Bernie Sanders and Ted Cruz will be having a town hall debate on Medicare tomorrow night on CNN at 9pm eastern.
 
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