# Future of AHCA? (U.S.A. American Healthcare Act)

## Will new version of the AHCA pass the senate?

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#### Aleph(0)

Joined Mar 14, 2015
597
So after hearing news I totally had to come on here and take another poll

Anyhow I'm thinking option 4 is prolly how it will end up But I'm nowhere near certain so I say this is harder question than last poll abt possible shutdown...

#### Hypatia's Protege

Joined Mar 1, 2015
3,226
Anyhow I'm thinking option 4 is prolly how it will end up
For the record I chose #3 -- if only that I tend toward foolish optimism (within reason)

Best regards
HP

#### JoeJester

Joined Apr 26, 2005
4,390
HP, there are always changes. You can't build a legacy without your fingerprint on legislation. Do you know who was regarded as the Education Senator?

#### Hypatia's Protege

Joined Mar 1, 2015
3,226
Do you know who was regarded as the Education Senator?
Paul Wellstone?

Best regards
HP

#### ronv

Joined Nov 12, 2008
3,770
I don't think the Senate is going to let the House dump the problem in their lap. So yes, I think they will pass something, but it may not survive reconciliation with the House.

#### Kermit2

Joined Feb 5, 2010
4,162
Just allowing competition among the insurance companies across state lines would be a great improvement.

I wonder how many millions their lobbyists are pledging to campaign funds to get that provision taken out?

#### ronv

Joined Nov 12, 2008
3,770
Just allowing competition among the insurance companies across state lines would be a great improvement.

I wonder how many millions their lobbyists are pledging to campaign funds to get that provision taken out?
I'm not a fan of the insurance companies, but I think you could eliminate their profits and you would still have a big problem. That's why they are having so much trouble coming up with a replacement. All they can do is trade coverage for cost. So they say we won't cover poor, sick or older people and save money for the healthy or vise versa. They are just moving around the deck chairs. The problem is the cost of care is out of control. The insurance companies have no motivation to hold down costs. They just pass it thru.
Think of it this way. Let's say they make a 10% net profit (I think that's high). If they did all that for free you probably still wouldn't be happy.

#### Hypatia's Protege

Joined Mar 1, 2015
3,226
I'm not a fan of the insurance companies, but I think you could eliminate their profits and you would still have a big problem. That's why they are having so much trouble coming up with a replacement. All they can do is trade coverage for cost. So they say we won't cover poor, sick or older people and save money for the healthy or vise versa. They are just moving around the deck chairs. The problem is the cost of care is out of control. The insurance companies have no motivation to hold down costs. They just pass it thru.
Think of it this way. Let's say they make a 10% net profit (I think that's high). If they did all that for free you probably still wouldn't be happy.
While unchecked, artificially inflated costs/fees are undeniable -- As far as I am concerned the central issue is the cowardice on the part of politicians vested in their inability to acknowledge the blatantly obvious! To wit: any civilized, equitable plan (i.e. sans caps, rationing, and/or other manifestations of fascism) will require new taxes! Said increased tax burden needn't be cause for consternation when one considers that even a high estimate of $2k additional liability per (middle class) taxpayer per year would be as a 'break' by comparison to the$3k to $5k many are currently paying (in premiums alone) for basic coverage! Do I hear someone whining 'Wealth redistribution'? 'Generational theft'? -- Apart from anything/everything else: Inasmuch as an upshot of access to quality healthcare is attainment of advanced age by 'the young' -- I call it responsible investment in one's future! - IOW what quality insurance is supposed to be! As I see it, leadership's decades-long struggle with this no brainier (here and abroad) is a good argument for banning politicians from public office! Most sincerely HP #### ronv Joined Nov 12, 2008 3,770 While unchecked, artificially inflated costs/fees are undeniable -- As far as I am concerned the central issue is the cowardice on the part of politicians vested in their inability to acknowledge the blatantly obvious! To wit: any civilized, equitable plan (i.e. sans caps, rationing, and/or other manifestations of fascism) will require new taxes! Said increased tax burden needn't be cause for consternation when one considers that even a high estimate of$2k additional liability per (middle class) taxpayer per year would be as a 'break' by comparison to the $3k to$5k many are currently paying (in premiums alone) for basic coverage!

Do I hear someone whining 'Wealth redistribution'? 'Generational theft'? -- Apart from anything/everything else: Inasmuch as an upshot of access to quality healthcare is attainment of advanced age by 'the young' -- I call it responsible investment in one's future! - IOW what quality insurance is supposed to be!

As I see it, leadership's decades-long struggle with this no brainier (here and abroad) is a good argument for banning politicians from public office!

Most sincerely
HP
I'm afraid your right. To much water over that dam to reverse it. But I think there is enough money in the system if you where willing to really mess up the doctors, pharmaceuticals, and hospitals. I offer this as an example:
The survey, which reflects May 2014 salary and employment data gathered from more than 1 million businesses, found that 16 of the nation's top 30 highest-paying occupations are in the medical field. On average, anesthesiologists in the US earn an average annual salary of $246,320. http://www.businessinsider.com/top-paying-jobs-in-america-2015-9 Unless they are ready to bite a real bitter bullet they might as well leave it alone. #### cmartinez Joined Jan 17, 2007 7,524 I think that the all powerful farmaceuticals have too many interests in this matter for there to be a simple and affordable solution to the universal health care ideal... #### Hypatia's Protege Joined Mar 1, 2015 3,226 the survey, which reflects May 2014 salary and employment data gathered from more than 1 million businesses, found that 16 of the nation's top 30 highest-paying occupations are in the medical field. On average, anesthesiologists in the US earn an average annual salary of$246,320.
Unless they are ready to bite a real bitter bullet they might as well leave it alone.

Fully qualified anesthesiologists (as opposed to CRNAs and their ilk) earn it (IMO they're grossly under-compensated)! -- as do most well compensated practitioners! -- The 'rot', as it were, is to found in institutional administration - whom being 'aided and abetted' to no small degree by the insurance/underwriter 'industry' (with, I hasten to add, the connivance of Washington!)

@ronv One wonders why you insist upon 'needling' me in areas of (essential) concurrence? -- Granted, liberals will be liberals, still...

Very best regards
HP

#### GopherT

Joined Nov 23, 2012
8,012
I think that the all powerful farmaceuticals have too many interests in this matter for there to be a simple and affordable solution to the universal health care ideal...
Don't just blame the big Pharma companies. The hospitals (and their crop of doctors) are to blame as well. A community used to share an MRI in rural areas- mounted in trailers and hauled from town to town. Now, one of those towns has a little hospital with three MRIs. How do you pay for them? Use them more! Said like Oprah- "you get an MRI! you get an MRI, Everyone must get an MRI! Good old fashioned diagnostics are gone with the wind. A coworker was just diagnosed as passing a kidney stone with an MRI - keep those expensive machines working - billable hours is the name of the game. What happen to a urine test and an X-ray?

Did you say, "not my local hospital, it's a non-profit". So is the UPMC (university of Pittsburgh Medical Center). The "CEO" has two "corporate" jets and UPMC recently bought hospitals in Italy and Sweeden. The CEO goes to check on them every other month. Then the executive team pays bonuses to the docs and each other to make sure they don't make a profit. Yeah!

#### Hypatia's Protege

Joined Mar 1, 2015
3,226
The hospitals (and their crop of doctors) are to blame as well. A community used to share an MRI in rural areas- mounted in trailers and hauled from town to town. Now, one of those towns has a little hospital with three MRIs.
How terrible of 'them'! - The very idea of bringing medical imaging into the 21'st century then making it available to all and sundry sans interminable delay! For shame!

Good old fashioned diagnostics are gone with the wind.
I'll grant you that...

The "CEO" has two "corporate" jets and UPMC recently bought hospitals in Italy and Sweeden.
As I pointed out:
The 'rot', as it were, is to found in institutional administration - whom being 'aided and abetted' to no small degree by the insurance/underwriter 'industry' (with, I hasten to add, the connivance of Washington!)

Then the executive team pays bonuses to the docs and each other to make sure they don't make a profit. Yeah!
@GopherT Do you enjoy the comfort and peace of mind attending availability of 'first world' healthcare? If yes -- then why begrudge the providers (Spec the practitioners) of said boon their well earned compensation?

Undercompensated folks -in all fields- not uncommonly resort to administrative 'tricks' -- that doesn't mean they are unworthy of their income!

Best regards
HP

#### ronv

Joined Nov 12, 2008
3,770
Fully qualified anesthesiologists (as opposed to CRNAs and their ilk) earn it (IMO they're grossly under-compensated)! -- as do most well compensated practitioners! -- The 'rot', as it were, is to found in institutional administration - whom being 'aided and abetted' to no small degree by the insurance/underwriter 'industry' (with, I hasten to add, the connivance of Washington!)

@ronv One wonders why you insist upon 'needling' me in areas of (essential) concurrence? -- Granted, liberals will be liberals, still...

Very best regards
HP
Hi, Not trying to needle you just trying to expand the conversation. For example why do you think it is the "institutional administration" that is the problem.
With genuine interest,
Ron

#### joeyd999

Joined Jun 6, 2011
4,477
Anyhow I'm thinking option 4 is prolly how it will end up...
Big government will be great when the Republicans do it...

#### shortbus

Joined Sep 30, 2009
8,966
Big government will be great when the Republicans do it...
You don't pay much attention to government do you? Or does the "big government" only apply to helping the 'little guy' not the rich and corporations? Really look into where 'big government' starts.

#### GopherT

Joined Nov 23, 2012
8,012
How terrible of 'them'! - The very idea of bringing medical imaging into the 21'st century then making it available to all and sundry sans interminable delay! For shame!

I'll grant you that...

As I pointed out:

@GopherT Do you enjoy the comfort and peace of mind attending availability of 'first world' healthcare? If yes -- then why begrudge the providers (Spec the practitioners) of said boon their well earned compensation?

Undercompensated folks -in all fields- not uncommonly resort to administrative 'tricks' -- that doesn't mean they are unworthy of their income!

Best regards
HP
I don't mind paying a market price for goods or services when there is a free market for goods and services. When those who are well compensated decide how many new competitors are allowed to enter the "market" each year, the market is not exactly open. There seems to be some conflict of interest there. Engineers and chemists don't decide how many people enter engineering school each year.

I Think there are still only three med schools in Minnesota - UMinn main campus, Mayo and, not surprisingly, University Minnesota -Duluth. Who decides how many seats are available for Med school each year?

The other thing that chaps my ass is the under-the-radar process that an anethesiologist or radiologist is selected to put me to sleep or read my X-ray. Sometimes the best guy sends me a bill, sometimes it is just the most expensive guy (and my insurance company decides he/she is not part of my plan or I must pay the balance of his charges because the insurance only pays "normal and customary".

There should be clear, upfront process for picking all the people that will send me a bill with a price list posted in advance. Bills shouldn't just come in the mails some weeks after a procedure.

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#### Hypatia's Protege

Joined Mar 1, 2015
3,226
Engineers and chemists don't decide how many people enter engineering school each year.
Perhaps not, howbeit it is my observation that the numbers of practicing professionals (even tradesmen) --in most fields-- is subject to some manner of artificial control -- That said, 'the wiles of organized labor' are to some degree mitigated in this regard via 'common practice' whereby implementation of said 'collateral protectionism' is --as a practical matter-- merit weighted... Don't get me wrong! I'm no apologist for organized labor (including 'professional associations')! Even so, honesty compels my assertion that their effect is 'net positive' (Re: quality of service) in areas with which I am familiar...

Sometimes the best guy sends me a bill, sometimes it is just the most expensive guy (and my insurance company decides he/she is not part of my plan or I must pay the balance of his charges because the insurance only pays "normal and customary".
There should be clear, upfront process for picking all the people that will send me a bill with a price list posted in advance. Bills shouldn't just come in the mails some weeks after a procedure.
No disagreements there! Though I daresay it would be folly to 'hold your breath' so long as 'private' underwriters are part of the 'picture'

Very best regards
HP

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#### Hypatia's Protege

Joined Mar 1, 2015
3,226
why do you think it is the "institutional administration" that is the problem.
Your question would seem to offer a study in classic anthropology?...

It seems humans are at their worst in 'numbers' in that they (albeit with many, many exceptions) tend to 'cede' their morality (and, hence, conscience, sense of responsibility/culpability -indeed even guilt- for their actions) to the 'mob', as it were... Add to this shameful proclivity the 'distance' provided by the many levels of abstraction intervening 'care' and 'administration' and there it is...

So... cynical tho it may sound -- The reply to your question:
Because they can

Very Best regards
HP

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