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No Deal on Health Care Bill After Conservative Meeting With Trump[W:400]******

Re: No Deal on Health Care Bill After Conservative Meeting With Trump

Moderate Right said:
According to your post there is already competition and it's obviously not working
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Not very much, no. Three reasons for that jump out:

1. The attempt to treat insurance as a socialized prepayment scheme rather than as insurance makes consumers non-price-sensitive.

2. Regulatory reduction of competition.

3. Lack of price transparency.



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Re: No Deal on Health Care Bill After Conservative Meeting With Trump

cpwill said:
Not very much, no. Three reasons for that jump out:

1. The attempt to treat insurance as a socialized prepayment scheme rather than as insurance makes consumers non-price-sensitive.

2. Regulatory reduction of competition.

3. Lack of price transparency.



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I just don't think it is realistic for us to shop around for individual healthcare needs. Healthcare is already confusing enough as it is. When people are sick and hurting and getting old the last thing they need is to shop around for every kind of healthcare need there is and we certainly can't import many different providers of our choice while we are in the hospital. We have to take what we get so we do need some form of overall continuity of some form where we don't have to shop around.
 
Re: No Deal on Health Care Bill After Conservative Meeting With Trump

Moderate Right said:
I just don't think it is realistic for us to shop around for individual healthcare needs. Healthcare is already confusing enough as it is. When people are sick and hurting and getting old the last thing they need is to shop around for every kind of healthcare need there is and we certainly can't import many different providers of our choice while we are in the hospital. We have to take what we get so we do need some form of overall continuity of some form where we don't have to shop around.
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:shrug: you could make the same argument about cars and houses, both of which are complicated purchases.

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Re: No Deal on Health Care Bill After Conservative Meeting With Trump

cpwill said:
Furthermore, experiments with mass-HSA's in Indiana have shown that to be true. It turns out people are just as capable of checking relative prices for checkups and colonoscopies as they are for cars.

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Per guroo.com's data on actual claims paid, the price of a "colonoscopy - preventive screening" bundle in Indianapolis is 65% higher (more than $1,500 higher) than the national average price.

Given that the vaunted state employee HDHPs have deductibles of $1,500-$2,500 and both the national and Indianapolis average prices for colonoscopies are at or above that, the impact of those relative prices on consumer decision-making is muted. This only works for services priced below the threshold at which consumer cost-sharing shuts off, which is why there are practical limitations on how much can be achieved through direct price exposure.

For services beyond that threshold or otherwise not shoppable (I.e., those responsible for most health spending) we're reliant on payers to negotiate down prices--or otherwise build consumer-facing incentives into their plan designs to mimic what would happen if consumers could be directly exposed to prices.

Which they're only under heavy pressure to do successfully if they're aggressively competing for enrollees on premium.
 
Re: No Deal on Health Care Bill After Conservative Meeting With Trump

cpwill said:
:shrug: you could make the same argument about cars and houses, both of which are complicated purchases.

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Healthcare is multifaceted and is extremely complicated already. Buying houses and cars doesn't have to be. When people shop around for both houses and cars the huge majority of that is not really based on price that much but on which house or car you want. When you are in the hospital you can't shop around for anything. What you get is what you get. Now don't get me wrong, I'm not advocating for totally government controlled healthcare.
 
Re: No Deal on Health Care Bill After Conservative Meeting With Trump

Moderate Right said:
Healthcare is multifaceted and is extremely complicated already. Buying houses and cars doesn't have to be. When people shop around for both houses and cars the huge majority of that is not really based on price that much but on which house or car you want. When you are in the hospital you can't shop around for anything. What you get is what you get. Now don't get me wrong, I'm not advocating for totally government controlled healthcare.
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You can shop for a house without caring about the price, and think there aren't multiple moving pieces?

You Beyonce IRL or something?

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Re: No Deal on Health Care Bill After Conservative Meeting With Trump

cpwill said:
You can shop for a house without caring about the price, and think there aren't multiple moving pieces?

You Beyonce IRL or something?

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Instead of me searching all over the place for your position on healthcare maybe you could explain your position to me. Then I would have a better understanding in talking with you.
 
Re: No Deal on Health Care Bill After Conservative Meeting With Trump

mbig said:
Appproval Rating:
Obamacare 55%
Trump-care 17%.

And Obamacare is NOT in a "Death Spiral", it needs some fixes/tweaks.
The unbelievable GOP lie and attempted sabotage.

https://www.google.com/search?q=cbo obamacare not spiral&rct=j

Obamacare 'death spiral' argument rebutted by CBO report ...
Obamacare 'death spiral' argument rebutted by CBO report - Washington Times
Mar 19, 2017 - CBO report rebuts Obamacare 'death spiral' argument ... Budget Office, in a little-noticed part of its report last week, said that is not the case.

No, Obamacare Isn't in a 'Death Spiral' - The New York Times
https://www.nytimes.com/.../obamacare-isnt-in-a-death-spiral-its-replacement-probably-...
Mar 15, 2017 - But the new estimates from the Congressional Budget Office ... But those recent woes are not the same as a death spiral, a term used to ...

Is Obamacare in a 'death spiral'? | PunditFact - PolitiFact
Is Obamacare in a 'death spiral'? | PunditFact
Claim: Says the Affordable Care Act “is in a death spiral.”
Claimed by: Hugh Hewitt
Fact check by PolitiFact: False

The CBO's other bombshell: the Affordable Care Act isn't imploding - Vox
The CBO's other bombshell: the Affordable Care Act isn't imploding - Vox
Mar 14, 2017 - Trump can "fix" Obamacare by doing nothing. ... also frequently claims that the Affordable Care Act is currently in a “death spiral.” ... CBO says the Affordable Care Act will stabilize ... But CBO says that's not what's happening:.

Is Obamacare in a 'death spiral' or just in need of important reforms ...
https://www.washingtonpost.com/.../is-obamacare-in-a-death-spiral-or-just-in-need-of-i...
Mar 15, 2017 - Price: CBO report is 'just not believable'. Embed ... have advanced for their health-care bill is that “Obamacare is failing” or is in a “death spiral.

Opinion | The GOP masterminds behind the Obamacare sabotage
https://www.washingtonpost.com/...obamacares...spiral/.../ad798b5a-08ed-11e7-b77c-00...
Mar 14, 2017 - The Affordable Care Act may or may not be in the death spiral ... They're seeking to discredit the CBO, perhaps hoping people won't recall that ...

The CBO delivers a fatal dose to the GOP's Obamacare replacement ...
https://www.bostonglobe.com/opinion/2017/03/14/the-cbo...obamacare.../story.html
Mar 14, 2017 - In fact, as the CBO reminded us — once again — Obamacare is not ... care, is not limiting choice, is not in a death spiral, and is not imploding.
[......]​
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The ACA is not in a "death spiral," but Trumpcare already died en utero. I'm not sure if it was a natural miscarriage, or an induced abortion, but either way, it never got off of the ground.

And the Democrats didn't even have to rant about death panels and offing granny to make it go away.

So, what now? Does the government finally give up trying to find an ideological, partisan solution to the problem of health care costs? Is it finally and at long last ready to start researching a practical, realistic, and workable solution to that issue?

My guess is, it will still go the ideological, partisan route for a while, but it can't go on much longer. Already, people in the upper middle class are finding it difficult to get affordable health care.
 
Re: No Deal on Health Care Bill After Conservative Meeting With Trump

Moderate Right said:
I just don't think it is realistic for us to shop around for individual healthcare needs. Healthcare is already confusing enough as it is. When people are sick and hurting and getting old the last thing they need is to shop around for every kind of healthcare need there is and we certainly can't import many different providers of our choice while we are in the hospital. We have to take what we get so we do need some form of overall continuity of some form where we don't have to shop around.
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It doesn't matter.

Look there are tens of millions of people who can't afford health insurance. Our system needs to be prepared to handle those patients in some, reasonably-fair system. If they can't even shop around for what little care they receive, that's worse for them.

Why are you attacking price transparency? If we're not going to buy these people health insurance, we need to secure price transparency for them. This is not optional in my mind.
 
Re: No Deal on Health Care Bill After Conservative Meeting With Trump

cpwill said:
Furthermore, experiments with mass-HSA's in Indiana have shown that to be true. It turns out people are just as capable of checking relative prices for checkups and colonoscopies as they are for cars.

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I'm not as enthused about HSAs because those may help the people with the highest income taxes the most. If we're going to subsidize healthcare for the goal of helping those who can't afford it, a regressive subsidy is an expensive way to do it.

I wouldn't fight HSA reform, but we can't stop there IMO.
 
Re: No Deal on Health Care Bill After Conservative Meeting With Trump

Absentglare said:
It doesn't matter.

Look there are tens of millions of people who can't afford health insurance. Our system needs to be prepared to handle those patients in some, reasonably-fair system. If they can't even shop around for what little care they receive, that's worse for them.

Why are you attacking price transparency? If we're not going to buy these people health insurance, we need to secure price transparency for them. This is not optional in my mind.
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For the most part, people don't have an option of who or what healthcare they receive so price transparency, while it sounds nice, is rather unrealistic and for the poor it doesn't really matter if X procedure costs $1500 or $2500. If they can't afford it they can't afford it. Obamacare has made healthcare costs astronomical, even for the subsidized who can't afford the deductibles and out of pocket costs.
 
Re: No Deal on Health Care Bill After Conservative Meeting With Trump

Moderate Right said:
For the most part, people don't have an option of who or what healthcare they receive so price transparency, while it sounds nice, is rather unrealistic and for the poor it doesn't really matter if X procedure costs $1500 or $2500. If they can't afford it they can't afford it. Obamacare has made healthcare costs astronomical, even for the subsidized who can't afford the deductibles and out of pocket costs.
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It doesn't matter if they can or cannot afford it. Without price transparency, many will just assume they can't afford it and suffer, or worse, wind up in the emergency room for a condition that could have been treated for a small fraction of the cost if the patient hadn't been terrified of even going to the doctor.

If we're going to leave these people on their own, we need to do something to balance the authority of healthcare providers. Otherwise, we're just ****ing everyone over other than the providers, who roll in cash because of our bloated, overpriced, underwhelming healthcare system.
 
Re: No Deal on Health Care Bill After Conservative Meeting With Trump

Absentglare said:
It doesn't matter if they can or cannot afford it. Without price transparency, many will just assume they can't afford it and suffer, or worse, wind up in the emergency room for a condition that could have been treated for a small fraction of the cost if the patient hadn't been terrified of even going to the doctor.

If we're going to leave these people on their own, we need to do something to balance the authority of healthcare providers. Otherwise, we're just ****ing everyone over other than the providers, who roll in cash because of our bloated, overpriced, underwhelming healthcare system.
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You're not listening. Not many can even afford Obamacare, even if they get subsidies for the premiums. Price transparency is worthless because, for the most part, people don't have a choice. When you're in the hospital and you need an aspirin, what are you're realistic choices?
 
Re: No Deal on Health Care Bill After Conservative Meeting With Trump

Moderate Right said:
You're not listening. Not many can even afford Obamacare, even if they get subsidies for the premiums. Price transparency is worthless because, for the most part, people don't have a choice. When you're in the hospital and you need an aspirin, what are you're realistic choices?
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...

Price transparency would help make our current system better for those who are uninsured. No amount of willful ignorance can change that fact.
 
Re: No Deal on Health Care Bill After Conservative Meeting With Trump

Absentglare said:
...

Price transparency would help make our current system better for those who are uninsured. No amount of willful ignorance can change that fact.
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The thing is, we don't have a choice in our healthcare. We have to either take what we get or not get it. That's the choice. If someone wanted to, they could shop around now and do but then they get a bill which is not what they expected. Happens all the time where people ask what it is going to cost and then are in for a rude awakening when the fine print is revealed. My wife talks to these people every day working for a large hospital chain call center who were told one thing and then they find out one of the many providers in their care was not in the network and they get socked with a big bill.
 
Re: No Deal on Health Care Bill After Conservative Meeting With Trump

Moderate Right said:
The thing is, we don't have a choice in our healthcare. We have to either take what we get or not get it. That's the choice. If someone wanted to, they could shop around now and do but then they get a bill which is not what they expected. Happens all the time where people ask what it is going to cost and then are in for a rude awakening when the fine print is revealed. My wife talks to these people every day working for a large hospital chain call center who were told one thing and then they find out one of the many providers in their care was not in the network and they get socked with a big bill.
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You aren't following me. I am well aware that someone whose appendix is about to burst isn't going to shop around, in fact, i have made that point myself numerous times.

We aren't talking only about emergency care. We are talking about healthcare. It can be improved with price transparency.

My favored solution is single payer. However, if the republicans are going to implement a solution that is ideologically right of Obamacare (which is already extremely far to the right), it has to incorporate price transparency. Without insurance, we need something to apply downward cost pressure on non-emergency care, price transparency is the only way that lone consumers can apply this pressure.
 
Re: No Deal on Health Care Bill After Conservative Meeting With Trump

Absentglare said:
You aren't following me. I am well aware that someone whose appendix is about to burst isn't going to shop around, in fact, i have made that point myself numerous times.

We aren't talking only about emergency care. We are talking about healthcare. It can be improved with price transparency.

My favored solution is single payer. However, if the republicans are going to implement a solution that is ideologically right of Obamacare (which is already extremely far to the right), it has to incorporate price transparency. Without insurance, we need something to apply downward cost pressure on non-emergency care, price transparency is the only way that lone consumers can apply this pressure.
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I still say you work from the bottom up, not the top down. We've been doing top down for years and years and it has never worked.
 
Re: No Deal on Health Care Bill After Conservative Meeting With Trump

IMO

If you don't want insurance, you shouldn't be forced to have it. Insurance should work like so: let's say you have a plan with a deductible. The fees you pay partially go toward a your deductible. Once you've encompassed your deductible your fees shrink. We should be able to purchase across state lines. That along with not being forced to buy insurance will make companies compete to give us something we actually want. I can't speak for everyone, but my insurance has a $250 copay if I use an ER. Why? If it's an actual emergency, especially if you don't use the insurance any other time, it should be covered.

Or

There could be plans that let you pick what you want covered: I have a family history of cancer, so I'm going to want that covered, but I don't have any warning signs of heart disease, so I wouldn't want that covered.
 
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