CDZ OK, I'll Try Again, How Can We Save Obamacare and Make it Actually Work for ALL of Us?

[Mac1958]

The ACA is flabby crap, and we have to stop putting band aids on everything.

Expand the current and popular Medicare / Medicare Advantage / Medicare Supplement system to all, with some tweaks. An excellent blend of a public foundation and free market choice, competition & innovation, and individual/portable so that we take a massive cost monkey off the backs of American employers.

Sadly, this solution is too obvious and would require collaboration from both whacked-out sides, something of which we are no longer capable.
.

All that would achieve is to destroy Medicare.

Why not reform MedicAID into a government run insurance and pro-rate the premiums based on income?

I don't think it would destroy Medicare. I was neck-deep in the mechanics of that system for years. That's what I would do.
.

 

[JimBowie1958]

All that would achieve is to destroy Medicare.
Why not reform MedicAID into a government run insurance and pro-rate the premiums based on income?

I don't think it would destroy Medicare. I was neck-deep in the mechanics of that system for years. That's what I would do.
.

You wouldnt call making Medicare run as un-good as the Post Office, the VA, or just about any other government bureaucracy, to be destroying it?

I sure do.

 

[Anathema]

With all due respect and seriousness, you CANT make it work for everyone because there will always be people like me who will never accept Government run or controlled healthcare.

 

[Mac1958]

All that would achieve is to destroy Medicare.
Why not reform MedicAID into a government run insurance and pro-rate the premiums based on income?

I don't think it would destroy Medicare. I was neck-deep in the mechanics of that system for years. That's what I would do.
.

You wouldnt call making Medicare run as un-good as the Post Office, the VA, or just about any other government bureaucracy, to be destroying it?

I sure do.

That's just an incorrect comparison.

Learn more about the system. As I said, there is a strong free market component to it. One of the tweaks could be to reduce public coverage on a sliding age scale, particularly for younger people when they're much cheaper to cover in the free market (that's my original idea, by the way). Poof, easy.

Go to YouTube and search "Medicare Advantage Supplements". There's a ton of info there that goes into enough detail.
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[candycorn]

We need to incentivize more physicians, stat

Having more doctors should lower the costs of medical procedures.

 

[Grumblenuts]

a strong free market component

..equals deliberately injecting tons of ppw and waste for continued billionaire profits at everyone's expense. Medicare A remains pristine. B is perhaps still tolerable. C, wtf is C? D has always been complete garbage, designed to rob the elderly while destroying Medicare. There is no fucking "free market." Right wingers are actually the ones always looking for "free" shit, especially from government. There exists public vs private insurance. Both pay for goods and services provided by private entities. No one has seriously proposed a VA For All plan. Soldiers and veterans have earned that. No one else. Medicare For All compromises more than enough already. Get a job. Pay your taxes. Help everyone stay healthy so they can maximally do the same.

 

[Mac1958]

a strong free market component

..equals deliberately injecting tons of ppw and waste for continued billionaire profits at everyone's expense. Medicare A remains pristine. B is perhaps still tolerable. C, wtf is C? D has always been complete garbage, designed to rob the elderly while destroying Medicare. There is no fucking "free market." Right wingers are actually the ones always looking for free shit, especially from government. There exists public vs private insurance. Both pay for goods and services provided by private entities. No one has seriously proposed a VA For All plan. Soldiers and veterans have earned that. No one else. Medicare For All compromises more than enough already. Get a job. Pay your taxes. Help everyone stay healthy so they can maximally do the same.

Right now, we have seven (7) different health care delivery/payment systems in this country, none of which communicates directly with the other:

1. Individual/ACA
2. Group, at a high cost to our employers
3. VA
4. Medicare
5. Medicaid
   
6. Worker's Compensation
7. Indigent

-7-

Does that sound like the foundation of a smart, efficient health care system to you?
.

 

[Grumblenuts]

Did I stutter? Fuck no. Medicare A was great. Then the billionaires went to work slicing and dicing.

 

[Mac1958]

Did I stutter? Fuck no. Medicare A was great. Then the billionaires went to work slicing and dicing.

Is this some kind of answer to my question?
.

 

[Grumblenuts]

Does that sound like the foundation of a smart, efficient health care system to you?
.

Answer, "Fuck no."
Want more?

 

[Mac1958]

Does that sound like the foundation of a smart, efficient health care system to you?

Answer, "Fuck no." Want more?

Yes please, perhaps you can describe how "then the billionaires went to work slicing and dicing" Medicare A.

And maybe remember that we're in the Clean Debate Zone.
.

 

[Grumblenuts]

Oh please. Google ACA headquarters for images.

 

[Mac1958]

Oh please. Google ACA headquarters for images.

Well, as I alluded to earlier, I was involved in the construction of Medicare Advantage plans in my state for several years.

So I had to be pretty immersed in the Medicare system and its various mechanics.

That's why I'm curious. Maybe just give me a few hints.
.

 

[Grumblenuts]

Our crappy system is a product of compromise between two political entities, the majority of whom are beholden to the ever greedy billionaires ultimately responsible (for its crappiness). Therefore,..

Compromise is what we're stuck with as always. Medicare For All does so sufficiently to pass through the political gauntlet. It ain't perfect by any stretch. It's a huge improvement though and possible (given enough pot banging in the streets).. That's all I'm saying.

 

[Mac1958]

Our crappy system is a product of compromise between two political entities, the majority of whom are beholden to the ever greedy billionaires ultimately responsible (for its crappiness). Therefore,..

Compromise is what we're stuck with as always. Medicare For All does so sufficiently to pass through the political gauntlet. It ain't perfect by any stretch. It's a huge improvement though and possible (given enough pot banging in the streets).. That's all I'm saying.

Jibberish. Talking points.

I've provided a clear idea. Something is going to happen, so it would be smarter if we stuck with reality, if we stuck with what is possible.
.

 

[Grumblenuts]

none of which communicates directly with the other

Actually, the "Health Insurance Marketplace" or "healthcare.gov" (a 100% private insurance cabal posing as a government entity) is quickly inserting itself into everything healthcare related. Goddamn creepy is what that is.

 

[Grumblenuts]

Our crappy system is a product of compromise between two political entities, the majority of whom are beholden to the ever greedy billionaires ultimately responsible (for its crappiness). Therefore,..

Compromise is what we're stuck with as always. Medicare For All does so sufficiently to pass through the political gauntlet. It ain't perfect by any stretch. It's a huge improvement though and possible (given enough pot banging in the streets).. That's all I'm saying.

Jibberish. Talking points.

I've provided a clear idea. Something is going to happen, so it would be smarter if we stuck with reality, if we stuck with what is possible.
.

Oh, you're welcome! And so sorry for trying to inject some common sense and decency into the discussion. Please, continue with whatever you imagine you're accomplishing here..

 

[rightwinger]

OK, Trump could take the wind out of a lot of Democrat sails if whe would do two things:
1) Adopt this Personalized Health Care proposal; Personalized Healthcare - Healthcare for You

Putting patients in charge by removing barriers that separate them from their doctors.

• We must remove unnecessary red tape that separates doctors and patients. Under Obamacare’s electronic health record (EHR) regulation, doctors are required to spend about half of their time on paperwork and data entry instead of patient care. Regulations like that have put a literal and figurative screen between doctors and patients.
• Red tape and regulations are driving physicians out of private practice; we need more independent doctors, not fewer. 53 percent of doctors are now payroll physicians employed by hospitals. Those doctors are beholden to the hospital and not their patients.
• The doctor-patient relationship is intimate and personal; no one knows better what kind of treatment a patient needs than that patient’s doctor.

Reform: Eliminate unnecessary government red tape that create hours of unnecessary paperwork and strangle the patient-doctor relationship.

Personal Health Management Accounts to give patients more control over their healthcare dollars.

• Personal Health Management accounts allow patients to purchase insurance plans that are customized to their needs and portable—similar to life and auto insurance—so individuals can take it with them from job to job. This eliminates the fear of losing health insurance when you change jobs or move.
• Employers can opt to contribute directly to these accounts, getting them out of the insurance business which puts healthcare decisions in the hands of their employees, not employers and their third-party administrators.
• This allows employees to use pre-tax dollars to pay for healthcare and gives them the same tax benefits enjoyed by employers.
• Allows patients to only pay for what they need, not a one size fits all government plan like Medicare For All.

Reform: Change current rules around Health Savings Accounts by a) increasing the maximum HSA contribution, b) allowing people to pay for insurance premiums from an HSA account so individuals have the same tax advantage currently enjoyed by corporate employees, c) repeal the requirement that exclusively links HSAs to certain high deductible plans and d) allow people to contribute to an HSA and use it to fund a Medical Cost Sharing plan or a Direct Medical Care arrangement.

Expanding Direct Medical Care to increase choices and lower costs.

• Putting patients back in charge of their healthcare spending through expanded pre-tax accounts will vastly increase direct medical care, which cuts out middlemen to lower costs and gives patients more choice.
• For family care needs, direct medical care is known as direct primary care, which offers families all their primary medical care needs for one low monthly membership fee – no insurance or middlemen necessary. Patients can get access to their regular doctors at any time through call, text, or telemedicine.
• For other procedures – at surgery centers, for instance – direct medical care means transparent cash prices, which will allow patients to price shop, lowering prices.
• Cash prices are often cheaper than what insurers can offer. According to Vanderbilt economist Larry Van Horn, cash healthcare prices are 40 percent lower than insurers’ negotiated rates.
• Whether it’s a monthly membership fee for Direct Primary Care, posted pricing at a surgical center, or fee for service from a specialist, patients will be able to get healthcare at a lower price and have more choice.

Reform: Eliminate rules that restrict the use of direct medical care and encourage patients to take advantage of alternative avenues to receiving health services.

Lowering insurance premiums through increased choice and price transparency.

• In every industry where we have more choice and price transparency, we see lower prices and more innovation; healthcare is not an exception to this economic fact.
• End inefficient federal rules and requirements on private insurance plans and allow states to expand and regulate their private insurance markets to offer more choice and better options.
• Let patients purchase plans that are customized to their needs like they do with auto and life insurance
• Rather than another centralized federal experiment, we should remove federal regulations on this private market and let the state insurance departments and lawmakers tackle problems or concerns. What works best in New York may not work for Kansas. You should not be required to pay for features that you don’t want.
• End federal restrictions on modern healthcare advances like telemedicine, which allows patients to access their physicians via text, email and SKYPE, decreasing time spent waiting in doctors’ offices to be seen for minor issues.

Reform: End rules that regulate what should be included in a healthcare plan, how you can access it and when you can keep it.

Lowering drug prices.

• Return savings back to the patients instead of medicine middlemen; right now $250 billion per year goes to middlemen.
• Nearly all the recent increases in drug list prices can be chalked up to rising rebates.

Reform: Repeal the legislation that exempts these middlemen from penalty for violating the federal anti-kickback law.

Protecting against pre-existing conditions.

• Patients will be covered even if they have a pre-existing condition.
• Allow employees to use Personal Health Management Accounts to buy their own health insurance which prevents any lapse in coverage when changing jobs. This change helps address some of the problems of pre-existing conditions.

Reform: Give states the autonomy to guarantee a health insurance policy that cannot raise people’s rates or drop them from coverage due to health conditions. Many states have these laws in place, but they are moot under the ACA. Others can amend their laws to include it, or they can set up risk pools.​

And ...
2) Reform MedicAID into a government run health insurance system that is pro-rated for income level and the premium based on national averages - 20%.

I think if you do that, most moderates thinking about a Democrat will jump over to Trump because we get national health care coverage for everyone, and keep our private insurance too.

its amazing how ignorant some people can be even though we have tons of history to prove socialism doesnt work,,,

Providing affordable healthcare for all does work

 

[progressive hunter]

OK, Trump could take the wind out of a lot of Democrat sails if whe would do two things:
1) Adopt this Personalized Health Care proposal; Personalized Healthcare - Healthcare for You

Putting patients in charge by removing barriers that separate them from their doctors.

• We must remove unnecessary red tape that separates doctors and patients. Under Obamacare’s electronic health record (EHR) regulation, doctors are required to spend about half of their time on paperwork and data entry instead of patient care. Regulations like that have put a literal and figurative screen between doctors and patients.
• Red tape and regulations are driving physicians out of private practice; we need more independent doctors, not fewer. 53 percent of doctors are now payroll physicians employed by hospitals. Those doctors are beholden to the hospital and not their patients.
• The doctor-patient relationship is intimate and personal; no one knows better what kind of treatment a patient needs than that patient’s doctor.

Reform: Eliminate unnecessary government red tape that create hours of unnecessary paperwork and strangle the patient-doctor relationship.

Personal Health Management Accounts to give patients more control over their healthcare dollars.

• Personal Health Management accounts allow patients to purchase insurance plans that are customized to their needs and portable—similar to life and auto insurance—so individuals can take it with them from job to job. This eliminates the fear of losing health insurance when you change jobs or move.
• Employers can opt to contribute directly to these accounts, getting them out of the insurance business which puts healthcare decisions in the hands of their employees, not employers and their third-party administrators.
• This allows employees to use pre-tax dollars to pay for healthcare and gives them the same tax benefits enjoyed by employers.
• Allows patients to only pay for what they need, not a one size fits all government plan like Medicare For All.

Reform: Change current rules around Health Savings Accounts by a) increasing the maximum HSA contribution, b) allowing people to pay for insurance premiums from an HSA account so individuals have the same tax advantage currently enjoyed by corporate employees, c) repeal the requirement that exclusively links HSAs to certain high deductible plans and d) allow people to contribute to an HSA and use it to fund a Medical Cost Sharing plan or a Direct Medical Care arrangement.

Expanding Direct Medical Care to increase choices and lower costs.

• Putting patients back in charge of their healthcare spending through expanded pre-tax accounts will vastly increase direct medical care, which cuts out middlemen to lower costs and gives patients more choice.
• For family care needs, direct medical care is known as direct primary care, which offers families all their primary medical care needs for one low monthly membership fee – no insurance or middlemen necessary. Patients can get access to their regular doctors at any time through call, text, or telemedicine.
• For other procedures – at surgery centers, for instance – direct medical care means transparent cash prices, which will allow patients to price shop, lowering prices.
• Cash prices are often cheaper than what insurers can offer. According to Vanderbilt economist Larry Van Horn, cash healthcare prices are 40 percent lower than insurers’ negotiated rates.
• Whether it’s a monthly membership fee for Direct Primary Care, posted pricing at a surgical center, or fee for service from a specialist, patients will be able to get healthcare at a lower price and have more choice.

Reform: Eliminate rules that restrict the use of direct medical care and encourage patients to take advantage of alternative avenues to receiving health services.

Lowering insurance premiums through increased choice and price transparency.

• In every industry where we have more choice and price transparency, we see lower prices and more innovation; healthcare is not an exception to this economic fact.
• End inefficient federal rules and requirements on private insurance plans and allow states to expand and regulate their private insurance markets to offer more choice and better options.
• Let patients purchase plans that are customized to their needs like they do with auto and life insurance
• Rather than another centralized federal experiment, we should remove federal regulations on this private market and let the state insurance departments and lawmakers tackle problems or concerns. What works best in New York may not work for Kansas. You should not be required to pay for features that you don’t want.
• End federal restrictions on modern healthcare advances like telemedicine, which allows patients to access their physicians via text, email and SKYPE, decreasing time spent waiting in doctors’ offices to be seen for minor issues.

Reform: End rules that regulate what should be included in a healthcare plan, how you can access it and when you can keep it.

Lowering drug prices.

• Return savings back to the patients instead of medicine middlemen; right now $250 billion per year goes to middlemen.
• Nearly all the recent increases in drug list prices can be chalked up to rising rebates.

Reform: Repeal the legislation that exempts these middlemen from penalty for violating the federal anti-kickback law.

Protecting against pre-existing conditions.

• Patients will be covered even if they have a pre-existing condition.
• Allow employees to use Personal Health Management Accounts to buy their own health insurance which prevents any lapse in coverage when changing jobs. This change helps address some of the problems of pre-existing conditions.

Reform: Give states the autonomy to guarantee a health insurance policy that cannot raise people’s rates or drop them from coverage due to health conditions. Many states have these laws in place, but they are moot under the ACA. Others can amend their laws to include it, or they can set up risk pools.​

And ...
2) Reform MedicAID into a government run health insurance system that is pro-rated for income level and the premium based on national averages - 20%.

I think if you do that, most moderates thinking about a Democrat will jump over to Trump because we get national health care coverage for everyone, and keep our private insurance too.

its amazing how ignorant some people can be even though we have tons of history to prove socialism doesnt work,,,

Providing affordable healthcare for all does work

youre dodging,,,
it isnt sustainable now and will be worse if its increased,,,

and all that put together causes more suffering,,,

 

[dblack]

Actually, the "Health Insurance Marketplace" or "healthcare.gov" (a 100% private insurance cabal posing as a government entity) is quickly inserting itself into everything healthcare related. Goddamn creepy is what that is.

Just what do you think Medicare is?? You realize it's farmed out to private insurance companies, right?