Healthcare... America and the rest

[rainbow]

Now for:
Oh! Bummer! Care?
http://www.msn.com/en-us/news/politics/ ... id=ieslice

[Forty Two]

"Obamacare forced providers to limit the plan options they offered to patients and caused them to drive prices way up," Trump said. "Now a third of U.S. counties are down to one insurer, and the insurers are fleeing. You people know that better than anybody."

Of course it did, as those other plans were no good for anyone!

LOL -- "of course it did..." -- that's what I and most others against Obamacare were saying in 2010 and such when the monstrosity was passed. It'll limit choice, people will lose their plans, people will lose their doctors, it will drive up costs and prices.... and all you guys said was "oh, no! that's just republican fearmongering -- Obamacare will be all unicorn farts and rainbow blowjobs for everyone...." And, now when it's been shown that Obamacare tripled and quadrupled premiums, fucked everyone out of affordable policies, and caused millions to lose their doctors, etc., and nobody was allowed "if you like your plan, you can keep it." it was all a fucking lie. But, now you folks say "of course it did..." as if it was a no brainer the entire time that it would happen that way, and was actually part of the plan....

In remarks to the National Governors Association before the meeting with insurers, Trump said that the plan to repeal and replace the Affordable Care Act would give states the flexibility they need to make health care work. He also said the politically wise thing for Republicans would be to let the law "implode" so that its failure can be blamed on the Democrats.

And, it should be blamed on the Democrats. They did it. They demanded it. They rammed it through with no debate, and said they had to pass the law before we could find out what was in it. They screwed us with Obamacare, so god damn right -- it's their fucking fault. Own it.

"Let it be a disaster,

It is a disaster already.

because we can blame that on the Dems that are in our room -- and we can blame that on the Democrats and President Obama," Trump said. "But we have to do what's right, because Obamacare is a failed disaster."

He is quite right. They have to try to fix the mess Obama and the Democrats left us with.

[Brian Peacock]

Yeah, because 50 million American's effectively left without access to basic healthcare before the ACA wasn't a mess already.

[Forty Two]

Yeah, because 50 million American's effectively left without access to basic healthcare before the ACA wasn't a mess already.

They were not left without basic healthcare.

First off, the 46.5 million uninsured are only counted as uninsured because they were uninsured "at some point" during the year. So, it includes people who were between jobs and went bare for a month or whatever, as well as people who "can't afford" insurance.

17.8 million of the uninsured earned more than $50,000 annually. So, they could afford insurance, but chose not to have it. About 10 million of the uninsured made over $75,000 per year. And of the uninsured, 8 million were supposedly children, almost all of whom qualified -- but were not enrolled - in SCHIP to give them 100% coverage.

About 9.5 million of the "uninisured" were illegal aliens, who are not eligible to work in the United States and entered the US illegally. Like when I travel to the UK or France - they expect me to carry my own coverage. I'm not entitled to freebies from the French and the Brits.

[Brian Peacock]

And that isn't a mess?

Where are those numbers from?



In the UK a visiting US citizen will receive necessary treatment free at the point of delivery. They may be asked for their insurance details. If they are not covered they will still be treated if it's considered a medical necessity. If they are insured their treatment will not be restricted to a limit set by their insurer.

[Tero]

This is going to be fun. Trump and Republicans will not pass much of anything. If you get the Democrats as a majority they don't mess around.

Conservatives lash out at House GOP's Obamacare replacement bill
Washington Post - ‎2 hours ago‎
Influential conservative lawmakers and activist groups panned health-care legislation drafted by House Republican leaders Tuesday, throwing the GOP's plan to undo the Affordable Care Act in serious doubt less than 24 hours after it was released.

[JimC]

Republicans in a race to the bottom...

[Forty Two]

And that isn't a mess?

Not really. When 85 to 90% of the population is fully insured, and of the remainder who is not, 1/2 of them can afford the insurance but choose not to, and 2/5 are illegal aliens and children already eligible for free health care..... there isn't much of a problem left to solve - not one that requires a trillion dollar 10,000 page behemoth, involving enforcement against violators by the Internal Revenue Service, and jacking premiums up by triple and quadruple.

If it was a mess then, it's 10 times the mess now.

Where are those numbers from?

2008 US census figures. See article by Sally Pipes http://www.washingtonexaminer.com/searc ... nce_figure (Ms. Pipes has published extensively on this matter).

In the UK a visiting US citizen will receive necessary treatment free at the point of delivery.

Same here in the US. The US has a law that prohibits denying medical treatment to anyone who needs it. It's been that way for a generation - no Obamacare needed.

They may be asked for their insurance details.

I would like proof of that. How does a UK doctor bill Florida Blue Cross or Aetna in the US for services provided in the UK? The only insurance they will accept for a visiting foreigner is an EHIC (European Health Insurance Card) and that's only because the UK was part of the EU. Every other visitor has to pay at the "standard NHS rate."

If they are not covered they will still be treated if it's considered a medical necessity. If they are insured their treatment will not be restricted to a limit set by their insurer.

Same was true in the US before Obamacare. If a foreign visitor is here in the US, he would be treated for what was wrong, and billed for the cost JUST LIKE IN THE UK.

Not sure how a foreign insurer is accepted by a British doctor. If they are not in network or have not enrolled with the insurance company to accept that insurance, they aren't allowed to bill. Insurance companies -- the world over - don't just let claims come rolling in from anywhere.

[Forty Two]

This is going to be fun. Trump and Republicans will not pass much of anything. If you get the Democrats as a majority they don't mess around.

Conservatives lash out at House GOP's Obamacare replacement bill
Washington Post - ‎2 hours ago‎
Influential conservative lawmakers and activist groups panned health-care legislation drafted by House Republican leaders Tuesday, throwing the GOP's plan to undo the Affordable Care Act in serious doubt less than 24 hours after it was released.

Good. The replacement bill is horse shit.

Repeal Obamacare, and create a system that makes sense.

[Brian Peacock]

And that isn't a mess?

Not really. When 85 to 90% of the population is fully insured, and of the remainder who is not, 1/2 of them can afford the insurance but choose not to, and 2/5 are illegal aliens and children already eligible for free health care..... there isn't much of a problem left to solve - not one that requires a trillion dollar 10,000 page behemoth, involving enforcement against violators by the Internal Revenue Service, and jacking premiums up by triple and quadruple.

If it was a mess then, it's 10 times the mess now.

Where are those numbers from?

2008 US census figures. See article by Sally Pipes http://www.washingtonexaminer.com/searc ... nce_figure (Ms. Pipes has published extensively on this matter).

In the UK a visiting US citizen will receive necessary treatment free at the point of delivery.

Same here in the US. The US has a law that prohibits denying medical treatment to anyone who needs it. It's been that way for a generation - no Obamacare needed.

They may be asked for their insurance details.

I would like proof of that. How does a UK doctor bill Florida Blue Cross or Aetna in the US for services provided in the UK? The only insurance they will accept for a visiting foreigner is an EHIC (European Health Insurance Card) and that's only because the UK was part of the EU. Every other visitor has to pay at the "standard NHS rate."

Nope. The 'standard NHS rate' is free at the point of delivery and paid for from general taxation. People do have private health insurance here, which does afford them the ability to queue jump, to a certain extent, but mostly it's to cover post-treatment expenses, like additional physio or loss of earnings.

People who live outside the EEA, including former UK residents, should now make sure they are covered by personal health insurance, unless an exemption applies to them. Anyone who does not have insurance will be charged at 150% of the NHS national tariff for any care they receive.

...

Treatment in A&E [ER] departments and at GP surgeries remains free for all.

...

An overseas visitor who has been subjected to certain types of violence must not be charged for treatment or services needed to treat any condition caused by that violence, in recognition of the particularly vulnerable position they may be in. The types of violence are:

• torture
• female genital mutilation
• domestic violence
• sexual violence

The conditions include physical or mental illness, or an acute or chronic condition. The exemption applies wherever the violence has been experienced, provided that the overseas visitor has not travelled to the UK for the purpose of seeking that treatment.
https://www.gov.uk/government/publicati ... pital-care

Health insurance is a common component of travel insurance you know.

If they are not covered they will still be treated if it's considered a medical necessity. If they are insured their treatment will not be restricted to a limit set by their insurer.

Same was true in the US before Obamacare. If a foreign visitor is here in the US, he would be treated for what was wrong, and billed for the cost JUST LIKE IN THE UK.

Nobody is billed by a Dr or a hospital for 'immediate and necessary treatment.' Nobody is billed by a GP (family Dr) or charged for a prescription. Pharmacist prescribers can diagnoses and distribute medicines on the basis of need, which do incur a small cost at point of sale unless you are exempt (a minor, retired, pregnant, in receipt of income-related supplementary benefits), and nurse prescribers can diagnoses, initiate treatments, revue and discharge from GP surgeries and A&E departments. Nobody goes bankrupt in the UK because they are presented with a bill for £1m after emergency surgery and two weeks in ICU. Nobody with a chronic condition has there access to healthcare services restricted by an insurer to a certain level, or is unable to get insurance entirely due to the nature of their chronic illness pricing insurance beyond their means. Nobody loses their house over medical charges, and nobody has their treatment withdrawn when it exceeds a certain cost. Nobody is going to have their wages garnished at source for medical debts, let alone those which have expired the statute of limitations, or result from courts making decisions based on the presentation of inaccurate or false information, nobody will see their employer informed of the state of their medical indebtedness, or have their medical debts sold to a company for cents on the dollar while they retain a right to aggressively pursue the full value of the outstanding sum. No hospital ER refuses treatment and no ambulance crew refuse to take someone to ER based on their income, level of personal insurance, or the credit cards in their possession at the time.

The US is the most expensive place in the world to be sick.

Not sure how a foreign insurer is accepted by a British doctor. If they are not in network or have not enrolled with the insurance company to accept that insurance, they aren't allowed to bill. Insurance companies -- the world over - don't just let claims come rolling in from anywhere.

Again, if people have health insurance as a component of their travel insurance they will pay a charge and claim it back from their insurer. The NHS may bill them for treatment but nobody visiting the UK is going to be detained on egress if they don't or can't pay - though I reckon most people are honourable about this kind of thing. It's common for US visitors to the UK to try and pay for emergency and essential treatment - mostly they can't believe that their treatment is decided on the basis of need and without a quibble, and it isn't unknown for visiting USians to try and force cash on nursing staff and doctors (which they are not allowed to take by law). In these circumstances visitors are usually encouraged to donate something to a local charity.

The US healthcare system cost the taxpayer about 17% of GDP and it still, by your own reckoning, leaves up to 48m people without ready access to basic healthcare services such as pregnancy and post-natal monitoring or dental care, let alone chronic disease management. Currently the NHS cost the UK taxpayer around 9% of GDP and most people still get the treatment they need when they need it (rather than the treatment they want or demand).

Unfortunately though, the current health minister is enamoured of the US system, has written two books on how to dismantle the NHS, and is currently starving it of resources while overburdening it under an avalanche of bureaucratic hoops. In the UK the political narratives of the right-leaning commentator and politician seek to blame the NHS and those who are obliged to operate the system for the apparent failings in the system, whereas in the US the right seem more inclined to blame the poor: "If we can legislate away the extra burden of covering the health costs of the low-to-no waged then we can truly Make America Great Again."

[Scot Dutchy]

Our healthcare system does not appear as part of the political arena. That is too mind blowing for Americans.

[Svartalf]

you're lucky, here, it's still a problem, not the principle, but the extent and cost...

[Scot Dutchy]

Health and education are very seldom in the political arena. Both have very strong (very very) inspectorates whose policies are agreed upon by committees made up of all those involved. It is a way of avoiding political turmoil and is part of the 'polder' system which extends into the work place.

[Brian Peacock]

The Republic bill currently progressing is noteworthy for several reasons. It will remove the Medicaid expansion, in states that took advantage of that expansion, in three years time, to be replaced by a yet-to-be-decided fixed-sum state grant not tied to costs. Under the bill as it stands insurance cover and rates for those with pre-existing conditions will now be determined entirely at the discretion of the insurer - at a surcharge of up to 30% - meaning they will be free to price the seriously ill out of the market, thus displacing obligations to pay for the treatment of pre-existing conditions out of profits. The bill also removes the cap on tax deductibility against executive compensation in medical insurers companies (page 37) such that executive remuneration will be fully deductible against a companies corporate income tax liability. The CEO of Aetna health insurance paid it's CEO $17m last year, so the new bill will allow Aetna to offset that full amount against their corporate tax liability, and the same for every other executive - that's right, the insurers tax liability goes down as executive pay goes up. In effect, the big 5 health insurers have demanded that they won't take part in any new scheme unless they see a tangible profit boost. In their hurry to repeal #ACA the Republicans are happy to oblige.

Isn't it time the US took a serious look at a single-payer system? There are number of models out there, all of which give higher levels of care at a lower cost to the tax-payer.

[Tero]

Republicans ramming through Trumpcare without fiscal analysis, which Obamacare had:

Democrats aren’t alone in attacking House leaders for moving forward before the completion of those kinds of impact assessments. Congressional expert Norm Ornstein of the American Enterprise Institute, a center-right think tank, tells Newsweek the urgency to vote on the bill “is made up.” And he notes that for all the criticism Republicans heaped on the way Obamacare was jammed through Congress in 2010, “the architects of that bill kept going back to make changes that fit the CBO scores” and make sure “that this was fiscally sound, trying to make sure that the promises made would largely be kept.”

“That’s the way you’re supposed to be making policy,” Ornstein says. “This is not.”

Roy, meanwhile, wrote in Forbes that “proceeding without a [CBO] score…means that members of the House Energy and Commerce and Ways and Means Committees will not have the information they need to make informed decisions about how best to revise the bill.” Roy predicted the CBO will assess that Republicans’ replacement plan will cover “around 20 million fewer Americans than Obamacare.”

http://www.newsweek.com/obamacare-repeal-cbo-564947