[Winstonm]

 jogs, on 2017-March-08, 08:43, said:

Repeal of Obamacare.

GOP plan.

DOA.

All politicians seem to think those without health insurance from their employer are wealthy independent contractors.
No, they are mostly poor people with no money. Tax credits won't help them.
There needs to be a non insurance model.

Temp solution. Allow all uninsured to sign up with medicaid with a $10K deductible. Poor people would at least have access to a healthcare network.

What you want is from the progressive agenda, not from Donald Trump. Why continue to support a con man? I mean, it's O.K. to be conned. We are all susceptible. It is not O.K. to stay conned.

[Winstonm]

I believe this report addresses in an evenhanded manner one of the most critical preservation-of-democracy problems of our modern times:

http://www.cjr.org/a...rvard-study.php

(emphasis added)

Quote

Use of disinformation by partisan media sources is neither new nor limited to the right wing, but the insulation of the partisan right-wing media from traditional journalistic media sources, and the vehemence of its attacks on journalism in common cause with a similarly outspoken president, is new and distinctive.

Rebuilding a basis on which Americans can form a shared belief about what is going on is a precondition of democracy, and the most important task confronting the press going forward. Our data strongly suggest that most Americans, including those who access news through social networks, continue to pay attention to traditional media, following professional journalistic practices, and cross-reference what they read on partisan sites with what they read on mass media sites.

When you fail to cross check information and rely instead on single sources, you open yourself up to the prospect of being propagandized. This is a bipartisan concern.

[cherdano]

None of my news sources have been able to help me out on this - how is the Republican healthcare plan (endorsed by Trump) going to help the middle class? I am sure ldrews can explain.

[helene_t]

 cherdano, on 2017-March-08, 08:58, said:

None of my news sources have been able to help me out on this - how is the Republican healthcare plan (endorsed by Trump) going to help the middle class? I am sure ldrews can explain.

By removing the mandate. People who'd rather gamble that they don't need health care are free to do so.

[Winstonm]

 cherdano, on 2017-March-08, 08:58, said:

None of my news sources have been able to help me out on this - how is the Republican healthcare plan (endorsed by Trump) going to help the middle class? I am sure ldrews can explain.

Quote

The average compensation for top health insurance executives is in the millions. In 2014 the left-leaning Institute for Policy Studies found that this cap generated $72 million in additional tax revenue. But that cap is being eliminated in the new American Healthcare Act unveiled Monday by Republicans. That means the more health insurance companies pay their executives the less they will pay in taxes.

The extra money will allow them to hire more Mexican American cabana boys.

[kenberg]

Health care? What, me worry? Trump has assured us that it will be terrific. They have been working on this and it is ready to go, we can expect the ACA to be abolished and the new plan put in place all within a week or so, perhaps the same day. It will make health care great again.

"Buyer's remorse" will soon be seen as a serious understatement of the situation.

Here's the plan: We wait another six months or so. Then we poll the public on whether they did or did not vote for Trump. Nobody will admit to having done so. Then we say that indeed Trump was right, there must have been massive voter fraud since according to the polls, nobody actually voted for him.

[billw55]

 kenberg, on 2017-March-08, 09:37, said:

Here's the plan: We wait another six months or so. Then we poll the public on whether they did or did not vote for Trump. Nobody will admit to having done so. Then we say that indeed Trump was right, there must have been massive voter fraud since according to the polls, nobody actually voted for him.

Cute, but unlikely. Most Trump voters will go to the grave still believing he is their savior.

[PassedOut]

 helene_t, on 2017-March-08, 09:05, said:

By removing the mandate. People who'd rather gamble that they don't need health care are free to do so.

As we had before, so that those who lost their gamble had their health care paid by those of us who did have health insurance. A big step backward...

[ldrews]

 PassedOut, on 2017-March-08, 11:19, said:

As we had before, so that those who lost their gamble had their health care paid by those of us who did have health insurance. A big step backward...

So, the consensus is that the Trump health plan is nonsense, unworkable, etc. The current ACA is imploding, premiums are soaring, deductables are soaring, insurance companies are abandoning, etc.

So what is your solution? Or are we to just sit on the sidelines and complain?

[Winstonm]

 ldrews, on 2017-March-08, 11:53, said:

So, the consensus is that the Trump health plan is nonsense, unworkable, etc. The current ACA is imploding, premiums are soaring, deductables are soaring, insurance companies are abandoning, etc.

So what is your solution? Or are we to just sit on the sidelines and complain?

A solution cannot be found in partisan rancor and grandstanding. Why not use the ACA backbone and work to make it better? The polls have shown the American people to like the ACA but to not like Obamacare, which would be funny if not such a serious issue about the power of propaganda to misinform and lead astray. If the Republicans in Congress keep calling for repeal of Obamacare - not the ACA - then they are being disingenuous and relying on inaccurate poll answers to justify their actions.

[barmar]

 Winstonm, on 2017-March-08, 12:25, said:

The polls have shown the American people to like the ACA but to not like Obamacare, which would be funny if not such a serious issue about the power of propaganda to misinform and lead astray.

Doesn't this point the way to a reasonable solution? Create a new healthcare system that's 95% the same as ACA, but tell the people that it's a big change from Obamacare. This would be far more truthful than most of Trump's tweets, it will make the public very happy, but will not do much damage to the status quo.

[barmar]

 PassedOut, on 2017-March-07, 16:33, said:

Here's the dumb-ass thing tweeted this morning:


As president of the US, Trump has easy access to any information he wants, and of course only 9 of those 122 were released during Obama's administration, 113 under Bush's administration. And you'd have to be pretty far out of the loop not to realize that the original tweet was way off base. And yet, there it is.

The problem is that many of his misinformed pronouncements sound plausible, and the people who share his worldview aren't going to go looking for confirmation.

Like when he said he got the biggest Electoral College win since Reagan. I consider myself reasonably well informed, but off the top of my head I couldn't have refuted it. Luckily every media outlet immediately checked it, and pointed out that it was smaller than most of the wins since then.

I know that Obama spent his entire tenure talking about closing Guantanamo, but he wasn't successful at that. But I wouldn't consider it unlikely that he managed to get many of the detainees released. So I wouldn't rush to fact-check Trump's statement about it, it seems like the kind of thing that could easily be true.

He's a snake oil salesman. They spout just the BS that their audience wants to believe, so naturally they'll believe it.

[ldrews]

 Winstonm, on 2017-March-08, 12:25, said:

A solution cannot be found in partisan rancor and grandstanding. Why not use the ACA backbone and work to make it better? The polls have shown the American people to like the ACA but to not like Obamacare, which would be funny if not such a serious issue about the power of propaganda to misinform and lead astray. If the Republicans in Congress keep calling for repeal of Obamacare - not the ACA - then they are being disingenuous and relying on inaccurate poll answers to justify their actions.

OK, specifically, how do we make it work better? Let's move away from vacuous generalizations and get real. Given the current political climate (Republicans in control of House and Senate, Republicans fractured, President is a populist), specifically what improvements should we make and how do we get them passed into law? (I am not smart enough to have the answers but you seem to be)

[Winstonm]

 ldrews, on 2017-March-08, 13:07, said:

OK, specifically, how do we make it work better? Let's move away from vacuous generalizations and get real. Given the current political climate (Republicans in control of House and Senate, Republicans fractured, President is a populist), specifically what improvements should we make and how do we get them passed into law? (I am not smart enough to have the answers but you seem to be)

You hit the key point. There won't be a bipartisan bill because the polarization is too great and there is no more statesmanship in Congress - and that is because ideologues have moved the Republican Party too far right, forcing an equalizing response from Democrats. There may be a bill eventually and it may be passed. If so, millions will lose coverage.

[Winstonm]

 barmar, on 2017-March-08, 12:52, said:

Doesn't this point the way to a reasonable solution? Create a new healthcare system that's 95% the same as ACA, but tell the people that it's a big change from Obamacare. This would be far more truthful than most of Trump's tweets, it will make the public very happy, but will not do much damage to the status quo.

It does, but with the Tea Party and libertarians so entrenched now any solution that utilizes the government for support likely has no chance of passing. The Republicans are going to have to live with the mess they created by opposing rather than offering real solutions.

[billw55]

The USA needs to swallow its pride and give up the myth of exceptionalism. We aren't automatically better at everything than every other country just because we are the USA. Universal health care is one thing we are worse at. Many developed nations provide care for everyone - poor, elderly, very sick - at substantially lower cost per capita, and with better health outcomes overall. Let's learn to do it their way.

[jogs]

 billw55, on 2017-March-08, 15:03, said:

The USA needs to swallow its pride and give up the myth of exceptionalism. We aren't automatically better at everything than every other country just because we are the USA. Universal health care is one thing we are worse at. Many developed nations provide care for everyone - poor, elderly, very sick - at substantially lower cost per capita, and with better health outcomes overall. Let's learn to do it their way.

Health insurance is only good when someone else pays the bulk of your monthly premium. That's employer based health insurance. Medicare is subsidized by whose under 65.
The individual health insurance is paid 100% by the individual. Bad for individuals.
For those without health insurance there needs to be a bold new plan not tried by any other country. If the insurance industry hates the plan then it is probably a good plan for individuals.
Freeze out insurance companies. Eliminate redundant paperwork. Medical computer chips. No need to fill out a multi pages of health info every time you see a new provider. Stop the gouging. No mal-practice lawsuits allowed. That just jacks up the cost for everyone else.
Put the uninsured on medicaid while we figure how to solve this. But not free medicaid. Consumers get access to the network. But they have to pay.

[Winstonm]

 billw55, on 2017-March-08, 15:03, said:

The USA needs to swallow its pride and give up the myth of exceptionalism. We aren't automatically better at everything than every other country just because we are the USA. Universal health care is one thing we are worse at. Many developed nations provide care for everyone - poor, elderly, very sick - at substantially lower cost per capita, and with better health outcomes overall. Let's learn to do it their way.

Thank you.

[kenberg]

 ldrews, on 2017-March-08, 13:07, said:

OK, specifically, how do we make it work better? Let's move away from vacuous generalizations and get real. Given the current political climate (Republicans in control of House and Senate, Republicans fractured, President is a populist), specifically what improvements should we make and how do we get them passed into law? (I am not smart enough to have the answers but you seem to be)

I happily confess to similar limitations on providing a solution. I will try, and this is tough enough, to look a little at where we are and where we seem to be heading. Nothing I say will be brilliant, probably not even original.

Charles Lane expresses part of this nicely;

Quote

Heretofore, the health-care debate was a contest between Republicans, who were bent on repealing "every word of Obamacare," and Democrats, who defended it. Now it's an argument about whose subsidized-regulated-individual-market-plus-some-Medicaid thingy works better.

Indeed. We seem to have accepted that we are going to do something along the lines of the ACA.

Now let's look at what it is. The injunction to "Read the bill" is fair enough, as long as we are not required to read every word of the damned thing. Here is a "Cliff's notes" version:

summary

Ok, I will try to see how this hits me. Being over 60, I was struck by the fact that I get a 4K tax credit while those in their 20s get only 2K. This seemed inverted from what I would expect. But then I see that insurers ge to charge me five times what they charge younger people for the same plan. So maybe I need the extra tax credit! But wait! Would I ever gt the same plan? For example, I am pretty sure Becky no longer feels the need for maternity care coverage. I haven't asked, but I think that is so. More seriously, I have Medicare. Can I apply this tax credit to my Medicare premiums? I also have a supplement to Medicare from Blue Cross Blue Shield. Someone in their 20s does not have such a supplemental plan to Medicare, since they are not on Medicare.

The above is just a start on trying to figure out what it all means. I would say more but I have to go. I am being fitted for a hearing aid today. Medicare does not cover hearing aids. BCBS gives an allowance of something like $2800. I'll take it. I have no idea if the this new plan would cover it.


Anyway, I think Charles Lane makes a good point (which of course has occurred to others as well). We are going to do something where the gov is heavily involved in our health care. That seems to be a settled matter.

[helene_t]

 billw55, on 2017-March-08, 15:03, said:

The USA needs to swallow its pride and give up the myth of exceptionalism. We aren't automatically better at everything than every other country just because we are the USA. Universal health care is one thing we are worse at. Many developed nations provide care for everyone - poor, elderly, very sick - at substantially lower cost per capita, and with better health outcomes overall. Let's learn to do it their way.

Yes.

However, I warn you. Getting rid of the insurance companies and let the public sector reimburse (or even provide) all essential healthcare would be a step in the right direction, but it would not in itself bring the cost-effectiveness of the US health care system up to international standards. Here are a few other things that have to change:

- Get rid of malpractice lawsuits. If the doctor out of extreme neglect kills someone or causes permanent disability, report it to the police. Otherwise it's just bad luck. You can get his license revoked or maybe even get him in prisson if he's a really bad guy but your personal gain will be small. And if you report him just for failure to administer a treatment or test that in retrospect could have saved you then sorry, you are wasting everybody's time.

- Get rid of doctor-shopping. You have a single GP who knows you and if he's on holidays you just wait till he's back if it's not urgent. And I mean URGENT, not just "urgent".

- Accept substantial waiting lists for non-urgent (and even "somewhat urgent") specialist care.

- 60-70% paycut for doctors. OK, they save on malpractice insurance so they keep a liveable net income.

- Get rid of second opinion except if you are happy to pay for it yourself. Same with all diagnostic tests that don't have a clear indication.

- Every "condition" that was discovered by one of those ridicolous "general health checks" is given very low priority. They are usually false positives. Not much better than "my astrologist told me I might have cancer".

- No antibiotics unless a serious bacterial infection has been diagnosed. This applies to farm animals also.

- Start cycling to work and eat normal size meals. And don't drink stuff that contains fructose syrup. Etc.

- Drug expenses are reimbursed at the price of the cheapest generics unless a patented drug has been scientifically proven not just to be better but to be so much better that it is worth the cost. This means that at current prescription practice, you will often suffer some 90% co-payment so patients will have to put pressure on their doctors to prescribe something that is covered. Obviously guidelines will have to be written for this so patients don't have to ask for it.

- Medical school is free to attend. This actually saves money since doctors won't have justification for demanding ridicolous salaries. More doctors will graduate, creating negative pressure on salaries.

I wish you good luck.