Trump issues EO on Obamacare

[This_person]

This disproportionally will effect the poor and middle class.

So, here's the deal....the payments were illegal in the first place. This is not an overstatement. It was well-known and understood these payments were never legal. The Democrats were so intent on approving a bill - any bill - that they passed a really bad one. So, being a proper executive, Trump is saying, "I am not allowed to do what you want me to do, so fix it" to Congress.

Unless people were dropping dead in the streets prior to the ACA being deemed to pass in the House and then signed by a piss-poor executive, people are not going to die as a result of this.

 

[GURPS]

...... going to harm a Lot of people not only financially but possibly result in deaths.

POSSIBLY



OMG Possibly, Maybe, Could Result In .......... nice talking out your ass as usual fact is YOU Don't know, but you want to throw some shade on anything Trump does

people are ready dying because of Obamacare ....
they can barely AFFORD the payments, and cannot then afford Co-pays or meet the 12,000 deductible

so the go without care

 

[This_person]

If this is the case, maybe we should address why the hell medical care costs so much to begin with?

That's pretty easy - too many people use too much.

There's only a few reasons it could cost so much.

We know that one of the major reasons was that any hospital that takes Medicare/Medicaid must, by law, provide services to people without pay if those people are not insured and unable to pay. Now, unless we mandate slavery, someone has to pay for those people's services. Medicare does, Medicaid does, and the insured do by having hospitals overcharge for things, thus driving up the costs. That was fairly sustainable, and not too much of a problem for anybody.

Another major factor is regulation. The reason our pills are so much more expensive than other nations is that we are the nation that does all of the research to prove the pills are safe. It can take decades of studies before a pill is authorized, and someone has to pay for all of that. We do. Same with equipment.

Another major factor (and in my opinion THE major factor) is that we go to the doctor for EVERYTHING. Have the sniffles? Go to the doctor. Think your kid is too active? Not active enough? Hair is too blond in the summer? Toes are a funny shape? Go to the doctor and get a pill. Feeling blue after Christmas? Go to the doctor and get a pill. Great-grandma had a heart attack? You better get nuclear stress-tested annually. It's insane. And, someone has to pay for all of that. You pay your $15 or $20 co-pay, but everything else is covered by insurance. Well, the more you use medical care, the more your insurance pays, and the more the insurance costs.

In my humble opinion, this is why it costs so much. That's why they wanted to get the young and healthy forced to buy insurance - more people to share the costs, and they're less likely to actually use the service, so it shifted the costs of the middle-aged and their kids, as well as the cost of the elderly, onto the young. Note, that under the ACA if you were too poor you STILL were not required to purchase insurance. The whole of the people for whom this law was touted to help it did not help one little bit. That was salesmanship of the previous administration.

 

[SamSpade]

In my humble opinion, this is why it costs so much.

I agree - that is a LOT of it.

But BECAUSE of that - doctors and hospitals are complicit in it too. How much will insurance cover? What's the maximum they will pay? Amazing - that EXACTLY matches how much I charge my patients. Until next year when you cover more - then it will be exactly the same then, as well.

You go to your doctor - and he's - not so sure - better order a test. Or three. Or ten. They're all covered by insurance so everyone's happy. You look at the EOB and see, wow, I didn't pay for any of these tests. But if I didn't have "insurance", I'd have paid 5000 bucks.

Doctor is worried about you - so he says, come back in, in two weeks, and then a month, for follow-up. Follow up.
See, if he were a tech company, "follow up" means it's on HIS dime; it's part of the process. Not here - insurance covers most and you STILL pay the co-pay.

What you alluded to also - pills cost a lot to research and test, and Americans foot the bill for the world.
Worse, they cost a lot for a lot of reasons, not the least of which is - they lose money on stuff that doesn't pass. And a lot doesn't.

Then, there's the entire insurance health care industry that has made it necessary to hire whole legions of medical professionals to figure out billing.
Used to be, you went to the doctor and he billed you. Hell no. He now has several staff to process insurance, because they're all different and heck, they're different even from state to state.

On and on and on. The whole health care/"insurance" idea has seeped into everything. It's not "insurance" really, because most insurance models balance their costs against risk.
The riskier you are, the more you pay. Show less risk - by having a clean driving record, for example - and you pay LESS. Life insurance? If you're older, you pay MORE.
That's the way it works.

Since we are all appalled at the idea of sicker people having to pay more - we don't do that as much anymore. But every finger the government sticks in drives it up further and we NOW have a situation where health care costs SO MUCH that it is utterly unaffordable by almost EVERYONE unless you DO have insurance. But the richest don't need to buy it at all - they can afford health care at any price. The poorest can't afford any of it - so they get it for free, albeit at a lower quality.

 

[This_person]

I agree - that is a LOT of it.

But BECAUSE of that - doctors and hospitals are complicit in it too. How much will insurance cover? What's the maximum they will pay? Amazing - that EXACTLY matches how much I charge my patients. Until next year when you cover more - then it will be exactly the same then, as well.

You go to your doctor - and he's - not so sure - better order a test. Or three. Or ten. They're all covered by insurance so everyone's happy. You look at the EOB and see, wow, I didn't pay for any of these tests. But if I didn't have "insurance", I'd have paid 5000 bucks.

Doctor is worried about you - so he says, come back in, in two weeks, and then a month, for follow-up. Follow up.
See, if he were a tech company, "follow up" means it's on HIS dime; it's part of the process. Not here - insurance covers most and you STILL pay the co-pay.

What you alluded to also - pills cost a lot to research and test, and Americans foot the bill for the world.
Worse, they cost a lot for a lot of reasons, not the least of which is - they lose money on stuff that doesn't pass. And a lot doesn't.

Then, there's the entire insurance health care industry that has made it necessary to hire whole legions of medical professionals to figure out billing.
Used to be, you went to the doctor and he billed you. Hell no. He now has several staff to process insurance, because they're all different and heck, they're different even from state to state.

On and on and on. The whole health care/"insurance" idea has seeped into everything. It's not "insurance" really, because most insurance models balance their costs against risk.
The riskier you are, the more you pay. Show less risk - by having a clean driving record, for example - and you pay LESS. Life insurance? If you're older, you pay MORE.
That's the way it works.

Since we are all appalled at the idea of sicker people having to pay more - we don't do that as much anymore. But every finger the government sticks in drives it up further and we NOW have a situation where health care costs SO MUCH that it is utterly unaffordable by almost EVERYONE unless you DO have insurance. But the richest don't need to buy it at all - they can afford health care at any price. The poorest can't afford any of it - so they get it for free, albeit at a lower quality.

Agree with all you wrote - and, those extra tests you called out? Well, they're driven both by the doctor/health agency as well as the insurance, too. Someone above said lawsuits, and those lawsuits do drive doctors to do more tests than really required.

Everyone wants to blame insurance companies, and their average profit (for the few who are for-profit agencies) is around 3%. That's a drop in the bucket.

 

[SamSpade]

Agree with all you wrote - and, those extra tests you called out? Well, they're driven both by the doctor/health agency as well as the insurance, too. Someone above said lawsuits, and those lawsuits do drive doctors to do more tests than really required.

I do think a LOT of it is doctors thinking, oh insurance should cover it. Because I've dealt a LOT with Johns Hopkins billing for things insurance does NOT cover, and the doctors answer incredulously - because in truth, they really just have no idea most of the time. That's for staff to figure out. They DO however know if blood tests done right in their office is covered - it just amazes me that the same nurse who hands me my bill does a blood test that takes all of 15 seconds - and the "cost" is hundreds. MUCH more than the billing of the office visit.

 

[itsbob]

Just wait and see how much more expensive it will be if this is all0wed to become law

Wow, this sounds eerily familiar...where were you 7 years ago when we were saying the EXACT same thing?

Only difference, we no know we were right.

 

[Hijinx]

Wow, this sounds eerily familiar...where were you 7 years ago when we were saying the EXACT same thing?

Only difference, we no know we were right.

Everybody seems to feel bad for those with a pre-existing condition, but I don't hear anyone crying for the poor guy who's insurance rates went up so high they had to drop out
because Obamacare drove everyones rates up.

 

[Chris0nllyn]

This disproportionally will effect the poor and middle class.

How?

If they are too poor to afford individual or association plans, they still have Obamacare and its subsidies. The poor don't pay full price for their helathcare now, taxpayers pick up the tab and this EO doesn;t get rid of the option for poor people to still get plans under Obamacare.

 

[GURPS]

How?

Because;

OMG THE POOR


it makes a great sound bite, no press will call a progressive on

 

[Sapidus]

Everybody seems to feel bad for those with a pre-existing condition, but I don't hear anyone crying for the poor guy who's insurance rates went up so high they had to drop out
because Obamacare drove everyones rates up.

That's what the subsidies that trump is cutting were for dum dum

 

[Sapidus]

How?

If they are too poor to afford individual or association plans, they still have Obamacare and its subsidies. The poor don't pay full price for their helathcare now, taxpayers pick up the tab and this EO doesn;t get rid of the option for poor people to still get plans under Obamacare.

No they won't. This gets rid of the subsidies.

 

[Chris0nllyn]

No they won't. This gets rid of the subsidies.

Where in the EO does it state that?

https://www.whitehouse.gov/the-pres...r-promoting-healthcare-choice-and-competition

 

[Hijinx]

That's what the subsidies that trump is cutting were for dum dum

There is a dum dum here but it isn't me.

 

[Sapidus]

There is a dum dum here but it isn't me.

Educate yourself fool

http://www.cnn.com/2017/10/12/politics/obamacare-subsidies/index.html

 

[Gilligan]

No they won't. This gets rid of the subsidies.

It gets rid of the illegal subsidies Barry started paying to the insurance companies.

Different than the subsidies poorer folks receive for insurance.

 

[Chris0nllyn]

Educate yourself fool

http://www.cnn.com/2017/10/12/politics/obamacare-subsidies/index.html

Those subsidies were for insurance companies, not the poor people, but I could see how one could be confused with CNN's horrible coverage of what he was talking about.

The cost-sharing reduction (CSR) subsidies Trump was talking about are in addition to the subsidies available for people up to 400% of the poverty line. The CSR payments pay those evil insurance companies billions of dollars a year ($7 bil in 2016, $10 bil this year, and by 2026, $130 bil), but are unconstitutional. Congress must appropriate funds, not the Executive Branch (President).

U.S. District Judge Rosemary Collyer ruled that way in May of last year. While it may be okay in your eyes for the Obama administration to illegally pay insurance companies billions of dollars per year, I don't think it's okay for taxpayer money to be illegally spent propping up a doomed industry. Of course, it's easier said than done because Judge Collyer issued a stay to help the Obama administration get their #### together (or appeal). Trump won the election and has since asked for delay after delay (along with the House) even making mention of resolving the issue out of court.

During this time, many Congressmen and women and others (such as HHS Secretary Tom Price) have asked to keep those CSR payments going in order to keep the Obamacare exchanges stable. Mitch McConnell, Lamar Alexander, Susan Collins, etc. have all said they should continue. The Trump administration, while Trump himself continues to babble on about the possibility of these payments ending, has continued to make those payments leading some to (wrongly) believe these payments are an executive desicion. They aren't. They're unconstitutional to begin with and Trump is playing games with these payments, holding them for political leverage, undermining the seperation of powers this country is supposed to have.

 

[GURPS]

Those subsidies were for insurance companies, not the poor people, but I could see how one could be confused with CNN's horrible coverage of what he was talking about.

Poor Old Sappy is ONLY Parroting what she was told

 

[SamSpade]

Poor Old Sappy is ONLY Parroting what she was told

Well that's my thought - if all you ever heard or read was leftie news, that's what you'd get.

The people MOST likely to be screwed are actually the middle class in the form of higher premiums, at least, if they have plans from companies that HAD NOT foreseen this development -
one being threatened for months and a known problem.

 

[Sapidus]

Well that's my thought - if all you ever heard or read was leftie news, that's what you'd get.

The people MOST likely to be screwed are actually the middle class in the form of higher premiums, at least, if they have plans from companies that HAD NOT foreseen this development -
one being threatened for months and a known problem.

And why exactly were those subsidies being given to the big bad insurance companies?