Concerns over dumping Obamacare growing among GOP lawmakers

[Freewill]

For the last few years I've been saying the GOP was partially to blame for the pig of a law that is the ACA, because they never provided America with a clear & specific alternative.

That's when they would jump and in say "of COURSE we've provided a clear & specific alternative, YOU just don't know what it IS".

And now that the ball is in their court they're starting to poop themselves.

Maybe I haven't been wrong AFTER all, huh?
.

So what you are saying is that the democrats couldn't craft a law that made sense without the Republicans. It does appear that by the results you are right. Maybe there isn't anything better, or even doing nothing would have been better.

 

[Mac1958]

For the last few years I've been saying the GOP was partially to blame for the pig of a law that is the ACA, because they never provided America with a clear & specific alternative.

That's when they would jump and in say "of COURSE we've provided a clear & specific alternative, YOU just don't know what it IS".

And now that the ball is in their court they're starting to poop themselves.

Maybe I haven't been wrong AFTER all, huh?
.

So what you are saying is that the democrats couldn't craft a law that made sense without the Republicans. It does appear that by the results you are right. Maybe there isn't anything better, or even doing nothing would have been better.

My wish is just expanding the current Medicare/Medicare Supplement/Medicare Advantage system to all.

• Efficient mix of public foundation, preventive/diagnostic coverage, free market competition and innovation
• Opens up massive new insurance & delivery markets
  
• Perfectly scalable, already works well, all admin systems are in place
  
• Totally individual & portable
• Takes a huge cost monkey off the backs of employers
• Flushes our stupid 7-headed delivery/payment system right down the toilet

All they have to do is DO it, but that would require a little humility, bravery and cooperation.

Can't have that!
.

 

[thereisnospoon]

For the last few years I've been saying the GOP was partially to blame for the pig of a law that is the ACA, because they never provided America with a clear & specific alternative.
.

And because they did everything they could to sabotage and cripple the law so that it could never work the way it was supposed to.

How did they "sabotage and cripple the law?" The Dims didn't need a single Republican vote to pass it. They had free reign to do whatever they wanted.

First Democrats compromised a lot in the original law, a mistake that has come back to bite them in the has. Republicans have filed lawsuit after lawsuit, blocked funding for higher risk customers (the biggest reason premiums are up), and States have punished their citizens by refusing federal funding for the law and refusing to participate.

I wouldn't be surprised if Trump kept almost all of the ACA, forced republicans and republican run states to cooperate, and then brags about Trumpcare in a few years.

How could democrats have compromised on something the GOP never had a say?

Because we don't have single payer genius

We don't have single payer because even the most far left wing democrat know damned well it cannot work here.
I'll ask you again,. How is it the dems compromised on something they discussed only among themselves?
BTW, if you expect the federal government to become the ONLY health insurance carrier in the US, the best advice is 'expect something else'.
Otherwise, you'll finish your time here as disappointed as on day one of ACA

 

[MACAULAY]

For the last few years I've been saying the GOP was partially to blame for the pig of a law that is the ACA, because they never provided America with a clear & specific alternative.
.

And because they did everything they could to sabotage and cripple the law so that it could never work the way it was supposed to.

___________________

All this is because there is no answer that is satisfactory.

You can't keep heaping burdens on those who take care of themselves...in order to care care of those who can't, or don't, take care of themselves.

We were once a rich society, and we expanded what we could pay to those who can't, or don't, take care of themselves...we now owe 20 trill...and we are going to have to get the people who could take care of themselves, but don't, to do a better job...to get off the Front Porch of the Federal Plantation and deal with the hassle and stress of a job and a boss.

If the healthy people who work are going to pay a share of the premiums for people with pre-existing conditions, we are going to have to get the healthy people who don't work to do their part.

Democrats represent the healthy people who don't work, and Republicans are suppose to represent the healthy people who do work, but the Republican Caucas in Congress is so filled with Pussies that the issue remains in doubt.

 

[thereisnospoon]

For the last few years I've been saying the GOP was partially to blame for the pig of a law that is the ACA, because they never provided America with a clear & specific alternative.
.

And because they did everything they could to sabotage and cripple the law so that it could never work the way it was supposed to.

How did they "sabotage and cripple the law?" The Dims didn't need a single Republican vote to pass it. They had free reign to do whatever they wanted.

First Democrats compromised a lot in the original law, a mistake that has come back to bite them in the has. Republicans have filed lawsuit after lawsuit, blocked funding for higher risk customers (the biggest reason premiums are up), and States have punished their citizens by refusing federal funding for the law and refusing to participate.

I wouldn't be surprised if Trump kept almost all of the ACA, forced republicans and republican run states to cooperate, and then brags about Trumpcare in a few years.

How could democrats have compromised on something the GOP never had a say?

They had plenty of say, the ACA was built on ideas republicans had put forth at various times and places to deal with our spiraling costs in an effort to get them to support it. In the end they called their own ideas "communism" and voted against it.

That is a 100% inaccuracy. GOP elected officials had NO SAY whatsoever as to the negotiations or the final version of ACA,.
The reason why ACA was written the way it was and took the length of time it did was for one reason only. In case its failure, Obama and the dems wanted political cover. They wanted to be able to blame the GOP. GOP members saw this and took a walk. Failing that, all the dems could to was run to the media with the term "obstructionist".
Of course you useful assholes took that and ran with it.
Your side paid dearly for your mistakes in 2010, 2012 and 2014. You may have kept the White House, but your collective asses got kicked in the House and Senate.
ACA is a loser. It was perhaps the biggest piece of garbage to come out Congress in the history of this country.
So many promises broken. So many lies. So many deceptions.
look at this thing. So good, it had to be rammed down our throats. So wonderful, the least expensive plan has $7k deductibles per year.
Don't even try to explain it away.
Your side owns this horrible thing

 

[thereisnospoon]

They are just going to repeal it and own the aftermath, what else can they do at this point? They have so poisoned the health care debate with their bullshit that now they must repeal and accept the expense, suffering and deaths that will be on their heads.

That's what you'd like to happen. And that is for purely political reasons.
But you won't get that. Before the ACA is repealed, a replacement will be put together.. And WITH democrat input. Washington wants something that all Americans can use and not have to pay higher premiums.
You people hope this fails. You don't give a shit about how this affects the people. You are looking for political advantage. You're not going to get it

 

[thereisnospoon]

For the last few years I've been saying the GOP was partially to blame for the pig of a law that is the ACA, because they never provided America with a clear & specific alternative.
.

And because they did everything they could to sabotage and cripple the law so that it could never work the way it was supposed to.

How did they "sabotage and cripple the law?" The Dims didn't need a single Republican vote to pass it. They had free reign to do whatever they wanted.

Whatever the GOP does, they cannot allow the Dem's to blame the GOP for Obamacare's failure. Dem's OWN 100% of that mess.

Then stop people like Little Marco running around bragging about sabotaging the law

ACA does not need to be sabotaged. That was done the day the final bill was passed.
You don't get it. ACA was set up for failure. ACA is a precursor to single payer.
The dems had this in the bag. The mistake on their part was they never thought to consider they would not hold the majority in the House and Senate The actually had this idea in their heads that once they achieved majority party status, it was theirs in perpetuity. A colossal blunder.

 

[Ray From Cleveland]

They are just going to repeal it and own the aftermath, what else can they do at this point? They have so poisoned the health care debate with their bullshit that now they must repeal and accept the expense, suffering and deaths that will be on their heads.

That's what you'd like to happen. And that is for purely political reasons.
But you won't get that. Before the ACA is repealed, a replacement will be put together.. And WITH democrat input. Washington wants something that all Americans can use and not have to pay higher premiums.
You people hope this fails. You don't give a shit about how this affects the people. You are looking for political advantage. You're not going to get it

Agreed, because the UCA was designed to benefit likely Democrat voters. Now that Democrats are history, we need a plan that benefits all without shifting the burden onto political adversaries.

 

[Freewill]

For the last few years I've been saying the GOP was partially to blame for the pig of a law that is the ACA, because they never provided America with a clear & specific alternative.

That's when they would jump and in say "of COURSE we've provided a clear & specific alternative, YOU just don't know what it IS".

And now that the ball is in their court they're starting to poop themselves.

Maybe I haven't been wrong AFTER all, huh?
.

So what you are saying is that the democrats couldn't craft a law that made sense without the Republicans. It does appear that by the results you are right. Maybe there isn't anything better, or even doing nothing would have been better.

My wish is just expanding the current Medicare/Medicare Supplement/Medicare Advantage system to all.

• Efficient mix of public foundation, preventive/diagnostic coverage, free market competition and innovation
• Opens up massive new insurance & delivery markets
  
• Perfectly scalable, already works well, all admin systems are in place
  
• Totally individual & portable
• Takes a huge cost monkey off the backs of employers
• Flushes our stupid 7-headed delivery/payment system right down the toilet

All they have to do is DO it, but that would require a little humility, bravery and cooperation.

Can't have that!
.

Here is a very simple explanation of why the US costs are almost twice other countries, such as Japan and Britan.

The sources of difference:

1. U.S. spending annual on physicians per capita is about five times higher than peer countries: $1,600 versus $310 in a sample of peer countries, a difference of $1,290 per capita or $390 billion nationally, 37% of the health care spending gap.

2. The high level of per capita income in the U.S. is a major factor driving U.S. health care spending. The U.S. has higher per capita income than any other large country, and higher income is closely associated with higher health care spending.

3. Dartmouth University has analyzed differences in health care costs between U.S. regions, comparing the highest-cost quintile of U.S. regions to the lowest-cost. Its research shows a spending variation of $2,300 per capita after taking account of differences in health status, income, and ethnicity (source). And health outcomes are no better in the high spending regions than in the low spending regions. Dartmouth attributes the gap to regional differences in discretionary medical decisions driving higher patient referral rates for high-cost advanced care (specialists, hospitalization, CAT and MRI scans, etc.). If the entire country were brought to the spending level of the lowest quintile, the savings would be about $750 per capita: $225 billion or 21% of the gap.

Why Are U.S. Health Care Costs So High?

I would question how any of your suggestions solves any of those problems. Eliminate all administrative costs that that only lowers the cost about 5 percent, and you know that can't happen.

Do you think that those who pay less for their health care in other countries probably spend less for their cars and houses? Because they have less income as the article states.

So it would seem that because we have more money we spend more money.

How to you propose lowering doctor salary? Or how do you propose lowing US income?

 

[Mac1958]

For the last few years I've been saying the GOP was partially to blame for the pig of a law that is the ACA, because they never provided America with a clear & specific alternative.

That's when they would jump and in say "of COURSE we've provided a clear & specific alternative, YOU just don't know what it IS".

And now that the ball is in their court they're starting to poop themselves.

Maybe I haven't been wrong AFTER all, huh?
.

So what you are saying is that the democrats couldn't craft a law that made sense without the Republicans. It does appear that by the results you are right. Maybe there isn't anything better, or even doing nothing would have been better.

My wish is just expanding the current Medicare/Medicare Supplement/Medicare Advantage system to all.

• Efficient mix of public foundation, preventive/diagnostic coverage, free market competition and innovation
• Opens up massive new insurance & delivery markets
  
• Perfectly scalable, already works well, all admin systems are in place
  
• Totally individual & portable
• Takes a huge cost monkey off the backs of employers
• Flushes our stupid 7-headed delivery/payment system right down the toilet

All they have to do is DO it, but that would require a little humility, bravery and cooperation.

Can't have that!
.

Here is a very simple explanation of why the US costs are almost twice other countries, such as Japan and Britan.

The sources of difference:

1. U.S. spending annual on physicians per capita is about five times higher than peer countries: $1,600 versus $310 in a sample of peer countries, a difference of $1,290 per capita or $390 billion nationally, 37% of the health care spending gap.

2. The high level of per capita income in the U.S. is a major factor driving U.S. health care spending. The U.S. has higher per capita income than any other large country, and higher income is closely associated with higher health care spending.

3. Dartmouth University has analyzed differences in health care costs between U.S. regions, comparing the highest-cost quintile of U.S. regions to the lowest-cost. Its research shows a spending variation of $2,300 per capita after taking account of differences in health status, income, and ethnicity (source). And health outcomes are no better in the high spending regions than in the low spending regions. Dartmouth attributes the gap to regional differences in discretionary medical decisions driving higher patient referral rates for high-cost advanced care (specialists, hospitalization, CAT and MRI scans, etc.). If the entire country were brought to the spending level of the lowest quintile, the savings would be about $750 per capita: $225 billion or 21% of the gap.

Why Are U.S. Health Care Costs So High?

I would question how any of your suggestions solves any of those problems. Eliminate all administrative costs that that only lowers the cost about 5 percent, and you know that can't happen.

Do you think that those who pay less for their health care in other countries probably spend less for their cars and houses? Because they have less income as the article states.

So it would seem that because we have more money we spend more money.

How to you propose lowering doctor salary? Or how do you propose lowing US income?

I'm afraid I don't see what that data has to do with my points. Trying to dig down here - are you saying that people who can't afford health insurance would be able to do so if they were more careful with their spending habits? And if so, how in the world would lowering US incomes help that?

I'm talking about efficiencies, ease of use and competition. Examples:

• Having basic access to preventive & diagnostic services would catch small health issues before they became big health issues.
• The vastly expanded preventive/diagnostic market would create a huge new cottage industry in itself, for more competition & innovation.
  
• Having a market of 330+ million customers would massively increase competition & innovation among the insurance companies.
• The Medicare Supplement/Medicare Advantage program is clear, consistent and far easier for consumers to understand and utilize.
  
• Getting rid of the insane 7-headed monster that is currently our health "system" (ha) would create significant new efficiencies.

If the GOP has a plan that could do all of that, I'd freakin' love to see it. Do they?

Regarding doctors, there would be two sets of contracts, as it is with the current Medicare/Medicare Advantage/Medicare Supplement system: One with the government, one with the insurance companies. Providers and provider groups would be able to negotiate for the best deals, given the makeup of their practices. We could take some of the cost of doing business down by changing tort law and allowing them to decrease and minimize defensive medicine practices. Once we've done this, we look at what the plan would cost overall. And yes, for all the benefits described above, there may (or may not) be more taxes required, depending on how the contracts shake out.

And one more question: Do you know how the Medicare/Medicare Advantage/Medicare Supplement system works? Seriously, I would be surprised if 20% of the population did. If I didn't have to train on that stuff every year, I wouldn't either.
.

 

[Ray From Cleveland]

I would question how any of your suggestions solves any of those problems. Eliminate all administrative costs that that only lowers the cost about 5 percent, and you know that can't happen.

Do you think that those who pay less for their health care in other countries probably spend less for their cars and houses? Because they have less income as the article states.

So it would seem that because we have more money we spend more money.

How to you propose lowering doctor salary? Or how do you propose lowing US income?

Back in the early 80's I was working for a medical company. They decided to use part of the building as a pharmacy so they could mix medications for our customers.

One day after our weekly Monday morning meeting, we started a discussion by the coffee pot of the UPS strike that was going on at the time. As we talked, our newest coworker (the pharmacist) just listened in. She didn't say a word, but her face turned red with anger and she abruptly walked away. We kind of looked at each other like WTF?????

As usual, I was the last person standing by the coffee pot, and she returned. In her hand was a pharmacy magazine she subscribed to. The magazine was opened to an article they had about the UPS strike. She highlighted the section stating that a UPS driver made between 50K and 55K a year. A pharmacist made on average 60K a year.

In rage she said "Do you believe THESE people are going on strike? Do you know what my parents went through to put me through college to be a pharmacists? Do you know what I went through? For what, to make a crummy five or ten grand a year than a UPS driver, and that's not enough for them? I should be the one on strike!!!"

It wasn't long before our country started to run short on pharmacists, nurses, and other medical professionals. Why should they spend money for all that education if they are only going to make the wages of a UPS driver, auto plant worker, or a steel plant worker?

The only way to lure these people into such careers is to pay them much better than a floor sweeper at Ford. And of course, that's one of the reasons medical costs are what they are today.

 

[Freewill]

For the last few years I've been saying the GOP was partially to blame for the pig of a law that is the ACA, because they never provided America with a clear & specific alternative.

That's when they would jump and in say "of COURSE we've provided a clear & specific alternative, YOU just don't know what it IS".

And now that the ball is in their court they're starting to poop themselves.

Maybe I haven't been wrong AFTER all, huh?
.

So what you are saying is that the democrats couldn't craft a law that made sense without the Republicans. It does appear that by the results you are right. Maybe there isn't anything better, or even doing nothing would have been better.

My wish is just expanding the current Medicare/Medicare Supplement/Medicare Advantage system to all.

• Efficient mix of public foundation, preventive/diagnostic coverage, free market competition and innovation
• Opens up massive new insurance & delivery markets
  
• Perfectly scalable, already works well, all admin systems are in place
  
• Totally individual & portable
• Takes a huge cost monkey off the backs of employers
• Flushes our stupid 7-headed delivery/payment system right down the toilet

All they have to do is DO it, but that would require a little humility, bravery and cooperation.

Can't have that!
.

Here is a very simple explanation of why the US costs are almost twice other countries, such as Japan and Britan.

The sources of difference:

1. U.S. spending annual on physicians per capita is about five times higher than peer countries: $1,600 versus $310 in a sample of peer countries, a difference of $1,290 per capita or $390 billion nationally, 37% of the health care spending gap.

2. The high level of per capita income in the U.S. is a major factor driving U.S. health care spending. The U.S. has higher per capita income than any other large country, and higher income is closely associated with higher health care spending.

3. Dartmouth University has analyzed differences in health care costs between U.S. regions, comparing the highest-cost quintile of U.S. regions to the lowest-cost. Its research shows a spending variation of $2,300 per capita after taking account of differences in health status, income, and ethnicity (source). And health outcomes are no better in the high spending regions than in the low spending regions. Dartmouth attributes the gap to regional differences in discretionary medical decisions driving higher patient referral rates for high-cost advanced care (specialists, hospitalization, CAT and MRI scans, etc.). If the entire country were brought to the spending level of the lowest quintile, the savings would be about $750 per capita: $225 billion or 21% of the gap.

Why Are U.S. Health Care Costs So High?

I would question how any of your suggestions solves any of those problems. Eliminate all administrative costs that that only lowers the cost about 5 percent, and you know that can't happen.

Do you think that those who pay less for their health care in other countries probably spend less for their cars and houses? Because they have less income as the article states.

So it would seem that because we have more money we spend more money.

How to you propose lowering doctor salary? Or how do you propose lowing US income?

I'm afraid I don't see what that data has to do with my points. Trying to dig down here - are you saying that people who can't afford health insurance would be able to do so if they were more careful with their spending habits? And if so, how in the world would lowering US incomes help that?

I'm talking about efficiencies, ease of use and competition. Examples:

• Having basic access to preventive & diagnostic services would catch small health issues before they became big health issues.
• The vastly expanded preventive/diagnostic market would create a huge new health market in itself, for more competition & innovation.
  
• Having a market of 330+ million customers would massively increase competition & innovation among the insurance companies.
• The Medicare Supplement/Medicare Advantage program is consistent and far easier for consumers to understand and utilize.
  
• Getting rid of the insane 7-headed monster that is currently our health "system" (ha) would create significant new efficiencies.

Regarding doctors, there would be two contracts, as it is with the current Medicare/Medicare Advantage/Medicare Supplement system: One with the government, one with the insurance companies. Providers and provider groups would be able to negotiate for the best deals, given the makeup of their practices. We could take some of the cost of doing business down by changing tort law and allowing them to decrease and minimize defensive medicine practices. Once we've done this, we look at what the plan would cost overall. And yes, for all the benefits described above, there may (or may not) be more taxes required.

If the GOP has a plan that could do all of that, I'd freakin' love to see it. Do they?

And one more question: Do you know how the Medicare/Medicare Advantage/Medicare Supplement system works?
.

The Forbes' article points out that the gap between the US and other countries was simplified to three componets.

1. doctor salaries being twice what they are in other countries. No amount of competition can bring that gap down without dropping what doctors earn.

2. America on a whole are paid more than other countries, thus there is logically a gap. Kinda like we all use gasoline but the price varies country to country for the same exact thing.

3. One issue the Forbes article points out is there is a difference in cost dependent on area of the country. It appears that if a area has an MRI they they are going to use that MRI which costs money but does not necessarily aid to producing good results. Again, how is that changed? By refusing to pay for the MRI?

As for your last question. As I see Medicare working they have established what they will pay to providers. The providers then can either accept or reject that payment and thus reject the patient. By buying an advantage plan the provider still dictates what they are going to pay for services. So as I understand it the government gives the provider a chunk of money and from that chunk they pay for care. What I heard was it is 800/month, I am not sure if that number is correct, see below. If it is then that is approximately a 1/3 higher than what I bought on ACA. The premium for medicare is based on income. It varies from 108 to 150 or there abouts. Once signed on with an advantage plan medicare is out of the picture and the person is covered under the advantage plan provider.

I do see competition in the medicare system. Apparently because the government actually pays so much per person. When I signed up for my advantage plan I was not asked one question about my health.

Here are some eye popping information concerning health care expenditures. There is no way that my provider spends near that amount of money for my health care.

NHE by Age Group and Gender, Selected Years 2002, 2004, 2006, 2008, 2010, and 2012:

• Per person personal health care spending for the 65 and older population was $18,988 in 2012, over 5 times higher than spending per child ($3,552) and approximately 3 times the spending per working-age person ($6,632).
• In 2012, children accounted for approximately 25 percent of the population and slightly less than 12 percent of all PHC spending.
• The working-age group comprised the majority of spending and population in 2012, almost 54 percent and over 61 percent respectively.
• The elderly were the smallest population group, nearly 14 percent of the population, and accounted for approximately 34 percent of all spending in 2012.
• Per person spending for females ($8,315) was 22 percent more than males ($6,788) in 2012.
• In 2012, per person spending for male children (0-18) was 9 percent more than females. However, for the working age and elderly groups, per person spending for females was 28 and 7 percent more than for males.

NHE Fact Sheet - Centers for Medicare & Medicaid Services

 

[Seawytch]

For the last few years I've been saying the GOP was partially to blame for the pig of a law that is the ACA, because they never provided America with a clear & specific alternative.

That's when they would jump and in say "of COURSE we've provided a clear & specific alternative, YOU just don't know what it IS".

And now that the ball is in their court they're starting to poop themselves.

Maybe I haven't been wrong AFTER all, huh?
.

The GOP is "partially to blame" for the ACA because they crafted it. Remember, it's almost exactly like Romneycare which was a lot like DoleCare which is a lot like Heritagecare...

They have no alternative because the black guy stole their plan...they got him back, they stole his SCOTUS pick.

 

[Mac1958]

For the last few years I've been saying the GOP was partially to blame for the pig of a law that is the ACA, because they never provided America with a clear & specific alternative.

That's when they would jump and in say "of COURSE we've provided a clear & specific alternative, YOU just don't know what it IS".

And now that the ball is in their court they're starting to poop themselves.

Maybe I haven't been wrong AFTER all, huh?
.

So what you are saying is that the democrats couldn't craft a law that made sense without the Republicans. It does appear that by the results you are right. Maybe there isn't anything better, or even doing nothing would have been better.

My wish is just expanding the current Medicare/Medicare Supplement/Medicare Advantage system to all.

• Efficient mix of public foundation, preventive/diagnostic coverage, free market competition and innovation
• Opens up massive new insurance & delivery markets
  
• Perfectly scalable, already works well, all admin systems are in place
  
• Totally individual & portable
• Takes a huge cost monkey off the backs of employers
• Flushes our stupid 7-headed delivery/payment system right down the toilet

All they have to do is DO it, but that would require a little humility, bravery and cooperation.

Can't have that!
.

Here is a very simple explanation of why the US costs are almost twice other countries, such as Japan and Britan.

The sources of difference:

1. U.S. spending annual on physicians per capita is about five times higher than peer countries: $1,600 versus $310 in a sample of peer countries, a difference of $1,290 per capita or $390 billion nationally, 37% of the health care spending gap.

2. The high level of per capita income in the U.S. is a major factor driving U.S. health care spending. The U.S. has higher per capita income than any other large country, and higher income is closely associated with higher health care spending.

3. Dartmouth University has analyzed differences in health care costs between U.S. regions, comparing the highest-cost quintile of U.S. regions to the lowest-cost. Its research shows a spending variation of $2,300 per capita after taking account of differences in health status, income, and ethnicity (source). And health outcomes are no better in the high spending regions than in the low spending regions. Dartmouth attributes the gap to regional differences in discretionary medical decisions driving higher patient referral rates for high-cost advanced care (specialists, hospitalization, CAT and MRI scans, etc.). If the entire country were brought to the spending level of the lowest quintile, the savings would be about $750 per capita: $225 billion or 21% of the gap.

Why Are U.S. Health Care Costs So High?

I would question how any of your suggestions solves any of those problems. Eliminate all administrative costs that that only lowers the cost about 5 percent, and you know that can't happen.

Do you think that those who pay less for their health care in other countries probably spend less for their cars and houses? Because they have less income as the article states.

So it would seem that because we have more money we spend more money.

How to you propose lowering doctor salary? Or how do you propose lowing US income?

I'm afraid I don't see what that data has to do with my points. Trying to dig down here - are you saying that people who can't afford health insurance would be able to do so if they were more careful with their spending habits? And if so, how in the world would lowering US incomes help that?

I'm talking about efficiencies, ease of use and competition. Examples:

• Having basic access to preventive & diagnostic services would catch small health issues before they became big health issues.
• The vastly expanded preventive/diagnostic market would create a huge new health market in itself, for more competition & innovation.
  
• Having a market of 330+ million customers would massively increase competition & innovation among the insurance companies.
• The Medicare Supplement/Medicare Advantage program is consistent and far easier for consumers to understand and utilize.
  
• Getting rid of the insane 7-headed monster that is currently our health "system" (ha) would create significant new efficiencies.

Regarding doctors, there would be two contracts, as it is with the current Medicare/Medicare Advantage/Medicare Supplement system: One with the government, one with the insurance companies. Providers and provider groups would be able to negotiate for the best deals, given the makeup of their practices. We could take some of the cost of doing business down by changing tort law and allowing them to decrease and minimize defensive medicine practices. Once we've done this, we look at what the plan would cost overall. And yes, for all the benefits described above, there may (or may not) be more taxes required.

If the GOP has a plan that could do all of that, I'd freakin' love to see it. Do they?

And one more question: Do you know how the Medicare/Medicare Advantage/Medicare Supplement system works?
.

The Forbes' article points out that the gap between the US and other countries was simplified to three componets.

1. doctor salaries being twice what they are in other countries. No amount of competition can bring that gap down without dropping what doctors earn.

2. America on a whole are paid more than other countries, thus there is logically a gap. Kinda like we all use gasoline but the price varies country to country for the same exact thing.

3. One issue the Forbes article points out is there is a difference in cost dependent on area of the country. It appears that if a area has an MRI they they are going to use that MRI which costs money but does not necessarily aid to producing good results. Again, how is that changed? By refusing to pay for the MRI?

As for your last question. As I see Medicare working they have established what they will pay to providers. The providers then can either accept or reject that payment and thus reject the patient. By buying an advantage plan the provider still dictates what they are going to pay for services. So as I understand it the government gives the provider a chunk of money and from that chunk they pay for care. What I heard was it is 800/month, I am not sure if that number is correct, see below. If it is then that is approximately a 1/3 higher than what I bought on ACA. The premium for medicare is based on income. It varies from 108 to 150 or there abouts. Once signed on with an advantage plan medicare is out of the picture and the person is covered under the advantage plan provider.

I do see competition in the medicare system. Apparently because the government actually pays so much per person. When I signed up for my advantage plan I was not asked one question about my health.

Here are some eye popping information concerning health care expenditures. There is no way that my provider spends near that amount of money for my health care.

NHE by Age Group and Gender, Selected Years 2002, 2004, 2006, 2008, 2010, and 2012:

• Per person personal health care spending for the 65 and older population was $18,988 in 2012, over 5 times higher than spending per child ($3,552) and approximately 3 times the spending per working-age person ($6,632).
• In 2012, children accounted for approximately 25 percent of the population and slightly less than 12 percent of all PHC spending.
• The working-age group comprised the majority of spending and population in 2012, almost 54 percent and over 61 percent respectively.
• The elderly were the smallest population group, nearly 14 percent of the population, and accounted for approximately 34 percent of all spending in 2012.
• Per person spending for females ($8,315) was 22 percent more than males ($6,788) in 2012.
• In 2012, per person spending for male children (0-18) was 9 percent more than females. However, for the working age and elderly groups, per person spending for females was 28 and 7 percent more than for males.

NHE Fact Sheet - Centers for Medicare & Medicaid Services

Too much.

I've provided my specific proposal with specific rationales, what's yours?
.

 

[Freewill]

I would question how any of your suggestions solves any of those problems. Eliminate all administrative costs that that only lowers the cost about 5 percent, and you know that can't happen.

Do you think that those who pay less for their health care in other countries probably spend less for their cars and houses? Because they have less income as the article states.

So it would seem that because we have more money we spend more money.

How to you propose lowering doctor salary? Or how do you propose lowing US income?

Back in the early 80's I was working for a medical company. They decided to use part of the building as a pharmacy so they could mix medications for our customers.

One day after our weekly Monday morning meeting, we started a discussion by the coffee pot of the UPS strike that was going on at the time. As we talked, our newest coworker (the pharmacist) just listened in. She didn't say a word, but her face turned red with anger and she abruptly walked away. We kind of looked at each other like WTF?????

As usual, I was the last person standing by the coffee pot, and she returned. In her hand was a pharmacy magazine she subscribed to. The magazine was opened to an article they had about the UPS strike. She highlighted the section stating that a UPS driver made between 50K and 55K a year. A pharmacist made on average 60K a year.

In rage she said "Do you believe THESE people are going on strike? Do you know what my parents went through to put me through college to be a pharmacists? Do you know what I went through? For what, to make a crummy five or ten grand a year than a UPS driver, and that's not enough for them? I should be the one on strike!!!"

It wasn't long before our country started to run short on pharmacists, nurses, and other medical professionals. Why should they spend money for all that education if they are only going to make the wages of a UPS driver, auto plant worker, or a steel plant worker?

The only way to lure these people into such careers is to pay them much better than a floor sweeper at Ford. And of course, that's one of the reasons medical costs are what they are today.

I guess if a person is going to rate their worth to that of another I understand the woman's concern. I would hope she chose to be a pharmacist because that is what she wanted to do verses delivering packages in the hot and cold.

Don't take this wrongly but I can see by and largely what a pharmacist does that couldn't be done by machine. Basically they count out pills. I know, oversimplification. Drug interactions are flagged by a computer anyway.

Never the less one of the components in the cost of health care is doctor's, nurse's and pharmacist wages. That, as you pointed out, will be very hard to change when a UPS driver is making what a nurse might earn.

 

[easyt65]

The growing concern among the GOP is that the Liberals will be successful in passing ownership of the worst legislation passed in the history of the US onto them and that they will be blamed for the pain that will come from trying to remove this 'cancer'.

Their fear is not over / of what will happen to the American people but rather what will happen to their jobs and their party.

Whether it's threat by liberals of a shutdown, the idea of Impeaching a President who has deserved such at least 3 times over, or necessarily replacing the ACA, the GOP have proven time and again to be cowards, frozen, un-willing / un-able to act.

They voted close to 100 times to repeal the ACA...until it came time when it really mattered - the opportunity to defund it. They did not do so because they knew the Liberals would blame them for it.

Nothing has changed.

 

[Ray From Cleveland]

I would question how any of your suggestions solves any of those problems. Eliminate all administrative costs that that only lowers the cost about 5 percent, and you know that can't happen.

Do you think that those who pay less for their health care in other countries probably spend less for their cars and houses? Because they have less income as the article states.

So it would seem that because we have more money we spend more money.

How to you propose lowering doctor salary? Or how do you propose lowing US income?

Back in the early 80's I was working for a medical company. They decided to use part of the building as a pharmacy so they could mix medications for our customers.

One day after our weekly Monday morning meeting, we started a discussion by the coffee pot of the UPS strike that was going on at the time. As we talked, our newest coworker (the pharmacist) just listened in. She didn't say a word, but her face turned red with anger and she abruptly walked away. We kind of looked at each other like WTF?????

As usual, I was the last person standing by the coffee pot, and she returned. In her hand was a pharmacy magazine she subscribed to. The magazine was opened to an article they had about the UPS strike. She highlighted the section stating that a UPS driver made between 50K and 55K a year. A pharmacist made on average 60K a year.

In rage she said "Do you believe THESE people are going on strike? Do you know what my parents went through to put me through college to be a pharmacists? Do you know what I went through? For what, to make a crummy five or ten grand a year than a UPS driver, and that's not enough for them? I should be the one on strike!!!"

It wasn't long before our country started to run short on pharmacists, nurses, and other medical professionals. Why should they spend money for all that education if they are only going to make the wages of a UPS driver, auto plant worker, or a steel plant worker?

The only way to lure these people into such careers is to pay them much better than a floor sweeper at Ford. And of course, that's one of the reasons medical costs are what they are today.

I guess if a person is going to rate their worth to that of another I understand the woman's concern. I would hope she chose to be a pharmacist because that is what she wanted to do verses delivering packages in the hot and cold.

Don't take this wrongly but I can see by and largely what a pharmacist does that couldn't be done by machine. Basically they count out pills. I know, oversimplification. Drug interactions are flagged by a computer anyway.

Never the less one of the components in the cost of health care is doctor's, nurse's and pharmacist wages. That, as you pointed out, will be very hard to change when a UPS driver is making what a nurse might earn.

Sure, I wouldn't want to spend all that time and money unless I was going to be much further ahead than some parts inspector on an assembly line. Yes, there should be some passion when choosing a career in college, but you have to look at the money as well. Passion doesn't pay the hundred or so thousand you borrowed to go to school.

Yes, these unions were responsible for non-skilled labor to make great money, but it has a ripple effect such as in our healthcare.

 

[Eloy]

I never heard a Republican politician say a single positive thing about the Affordable Care Act and FOX News is like a broken record about the need to repeal the program. Now the Republican president-elect wants the same. How could any Republican have a concern about getting rid of it, it has to be asked.

 

[Ray From Cleveland]

The growing concern among the GOP is that the Liberals will be successful in passing ownership of the worst legislation passed in the history of the US onto them and that they will be blamed for the pain that will come from trying to remove this 'cancer'.

Their fear is not over / of what will happen to the American people but rather what will happen to their jobs and their party.

Whether it's threat by liberals of a shutdown, the idea of Impeaching a President who has deserved such at least 3 times over, or necessarily replacing the ACA, the GOP have proven time and again to be cowards, frozen, un-willing / un-able to act.

They voted close to 100 times to repeal the ACA...until it came time when it really mattered - the opportunity to defund it. They did not do so because they knew the Liberals would blame them for it.

Nothing has changed.

Too early to tell. My crystal ball is no bette than anybody else's. But I don't think it's possible to just repeal Commie Care on day one and leave it there. It wouldn't affect many people, but other voters would find it in very bad taste--especially when the media would get done with the story.

 

[NYcarbineer]

what are you going to replace obamacare with? youve had 8 years to think of something you still got nothing?....


maybe you should just admit to yourselves that you dont really give a shit about the affordable healthcare act and you were really just pissed obama was black but were too scared and embarrassed to say it...

It's going to be replaced by the free market. The healthcare industry should operate like any other industry in America.

In a free market, people who can't afford a product or service at the market price have little choice but to go without.

Americans will never go for that with healthcare.