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

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

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#### ronv

Joined Nov 12, 2008
3,770
Again, that's backwards. The housing bubble was a direct and predicted result of the government forcing lenders to provide easy credit to people that could never hope to pay it back. This caused an enormous and historical increase in the homeownership percentage in this country, i.e. a bubble. It popped. The banking industry gets blamed for some of the clever ways they sought to protect themselves from the risk they were forced to take on, some of which arguably included fraud, but the root cause of the risky situation was government fiat. The law of unintended consequences writ large.
I think it was a little more complicated that that.
When I moved here I had zero income, yet I was able to get a nice 5 year fixed/adjustable loan at about 3.25%. In the good old days that would never had happened because of regulations.
The money for all those loans would not have even been available if they hadn't allowed the investment banks to join in the housing market. Yep it took a village to pull that one off.

#### ronv

Joined Nov 12, 2008
3,770
For political reasons, the ACA wasn't allowed to improve. SSA and Medicare had enormous problems that needed to be addressed; so does ACA. Republicans couldn't kill the other two, but conditions might be right for them to, yet again, place their personal and/or party beliefs ahead of what is good for the majority of Americans.
Medicare and SS are more of a temporay problem as we work our way thru the baby boomer bubble.

ACA made health coverage available, mandated minimal coverage requirements, removed lifetime caps, and made coverage for pre-existing conditions mandatory; among other things.

What it didn't, and hasn't been allowed to, address was the affordability aspect. Prices for medical services and products are generally out of control The government needs to regulate the industry to make sure consumers aren't being taken advantage of, while allowing people in the medical related businesses to make a decent profit that will allow them to stay in business and continue to innovate.

What we don't need are, for example, drug companies that make huge, unjustifiable price increases on critical drugs; just because they can. When companies place undue emphasis on profits versus the good of mankind, they need to be regulated. That EPI pen fiasco was just one highly publicized instance. Come on, people need to buy them whether or not they actually use them because they can be life saving but have a limited shelf life. That's a captive market. People who need them have to buy until they die.

For some reason, Republicans oppose regulating the pharmaceutical industry; or hospitals. $2-5 for the paper cup that nurses use to put pills in?? They use those cups for their convenience, not the patient. Next they'll be charging for hazardous waste disposal when you use the toilet; or maybe they already do?? I'm with you on this one. All they are doing is moving the deck chairs around. If it actually costs X dollars to provide coverage to all people one way is no better than the other. So what they are really doing now is not figuring out how to make it better but rather how to screw the fewest number of their voters to get some money for tax cuts. Talk now is they will phase out Medicaid over a longer period of time - 7 years vs 4. You have to ask, if it's a good idea in 7 years why isn't it a good idea now. It's a reverse Robin Hood. #### dl324 Joined Mar 30, 2015 13,846 Talk now is they will phase out Medicaid over a longer period of time - 7 years vs 4. You have to ask, if it's a good idea in 7 years why isn't it a good idea now. It's a reverse Robin Hood. As with all government programs, there are those who abuse them and take benefits they don't deserve. That makes it harder on people who really need the helping hand to get to a better place where they can become contributing members to society. What many Republicans refuse to acknowledge is that a significant portion of the people on Medicaid are senior citizens who didn't have long term health care insurance. When Republicans kick them off Medicaid, the children of those seniors will be expected (or at least should) provide elder care. It's likely that many of those children voted for the politicians who are out to screw them. Medicaid in my state covers all children under 19 whose parents make less than a certain income. That income is above the poverty level; maybe the 400% that ACA uses to determine tax subsidy amount. I think it makes good sense to care for those children because they are our collective futures. But there should be incentives for people to not have more children than they can support. That way thinking makes them and their children a burden on society. #### ronv Joined Nov 12, 2008 3,770 As with all government programs, there are those who abuse them and take benefits they don't deserve. That makes it harder on people who really need the helping hand to get to a better place where they can become contributing members to society. Absolutely. I would support some type of program like they had during the depression where people could do good honest useful work in return for a living wage. We are spending the money anyway. What many Republicans refuse to acknowledge is that a significant portion of the people on Medicaid are senior citizens who didn't have long term health care insurance. When Republicans kick them off Medicaid, the children of those seniors will be expected (or at least should) provide elder care. It's likely that many of those children voted for the politicians who are out to screw them. There is that and the fact that a lot of people are only in the program until they can get back on their feet. Some you see again because of their type of work or by design of course. If you read their plans once you get off you can't get back on. That's how they shrink it. Medicaid in my state covers all children under 19 whose parents make less than a certain income. That income is above the poverty level; maybe the 400% that ACA uses to determine tax subsidy amount. I think it makes good sense to care for those children because they are our collective futures. I'm with you on this one. But there should be incentives for people to not have more children than they can support. That way thinking makes them and their children a burden on society. I'm with you on this on to, but not sure how to implement it. But I don't think getting rid of Planned Parenthood, not covering contraceptives, and making abortion illegal is the path forward. #### dl324 Joined Mar 30, 2015 13,846 I'm with you on this on to, but not sure how to implement it. Amounts above and beyond the "norm" should be considered loans that must be repaid with interest. The government should have the right to garnish wages to insure that tax payers get their money back. Unemployed people, or people who don't make enough money for necessities, can work picking up litter, cleaning graffiti, or whatever their skills allow. But I don't think getting rid of Planned Parenthood, not covering contraceptives, and making abortion illegal is the path forward. Politicians should stay out of women's reproductive choices. That's between them, their family, and their god. Planned Parenthood provides a lot more services than abortions; which are never funded with tax payer dollars anyway. Politicians have no right to force their beliefs upon others if it infringes on their lawful rights. If they can't separate their personal beliefs from their job, they shouldn't be allowed to hold office. #### ronv Joined Nov 12, 2008 3,770 Amounts above and beyond the "norm" should be considered loans that must be repaid with interest. The government should have the right to garnish wages to insure that tax payers get their money back. Unemployed people, or people who don't make enough money for necessities, can work picking up litter, cleaning graffiti, or whatever their skills allow. The only problem with this is that many, if not most, are single moms. It's become a way of life for many of them. #### dl324 Joined Mar 30, 2015 13,846 The only problem with this is that many, if not most, are single moms. It's become a way of life for many of them. Find the fathers and make them pay. For women who are too ignorant to change, more drastic measures will be required. Maybe putting the children in foster care would allow single moms to pay their debt to society. #### ronv Joined Nov 12, 2008 3,770 Find the fathers and make them pay. For women who are too ignorant to change, more drastic measures will be required. Maybe putting the children in foster care would allow single moms to pay their debt to society. Hee hee, I think in many cases the fathers are living off the girl friends welfare. Somewhere I saw a really good documentary, done by Bill Moyer I think, about this. Let me see if I can find it again. #### ronv Joined Nov 12, 2008 3,770 Find the fathers and make them pay. For women who are too ignorant to change, more drastic measures will be required. Maybe putting the children in foster care would allow single moms to pay their debt to society. Warning! Painful to watch. #### Reloadron Joined Jan 15, 2015 6,324 For some reason, Republicans oppose regulating the pharmaceutical industry; or hospitals.$2-5 for the paper cup that nurses use to put pills in?? They use those cups for their convenience, not the patient. Next they'll be charging for hazardous waste disposal when you use the toilet; or maybe they already do??
That simply is not true. The paper cup is only a buck and the aspirin in the cup is $5 bring the total to$6.

Anyone seen the commercials for that new drug Viberzi? My doctor prescribed it for me and gave me about 150 sample pills. I was taking two a day, morning and evening. Pharmacy did not have any as it is a new drug but works for that darn IBSD. Then my insurance would not pay. Doctor gave me more and called the insurance company. OK, the insurance approved 50% payment. Then I saw what the stuff cost. Wow! My co-pay was going to be or is $600 a month. I researched the stuff and yes, that is what it cost. They seem to forget to tell you that in those nice TV commercials. Damn, Kathy and I are doing well in retirement and I am not about to go back to work but... I think after the summer I will stop taking the stuff and deal with IBSD as I did before. Ron #### dl324 Joined Mar 30, 2015 13,846 Hee hee, I think in many cases the fathers are living off the girl friends welfare. If the fathers can't support their children and the mothers of their children, they need to be dealt with appropriately. It seems like men feeling like they're responsible for themselves and their dependents has gone out of style. Or maybe that's what they learned from their parents, assuming they had two... Women who want to be mothers without having spouses or significant others need to be able to provide for their children. If they can't, well, I guess laws need to be made for them... Last edited: #### dl324 Joined Mar 30, 2015 13,846 The paper cup is only a buck and the aspirin in the cup is$5 bring the total to $6. When my Son was in the hospital, the nurses told us to take anything we wanted. There were signs stating how much some things costed. Maybe that makes them feel better about overcharging insurance companies. BTW, did you know that the cost of medical services depends on who's paying for it? Medicare, private insurance, auto insurance, and individuals all pay different prices. I don't know about you, but I'd be pretty upset if the grocery store told me that the price for a gallon of milk, or anything for that matter, depended on who was paying; or perhaps how much money they had. #### ronv Joined Nov 12, 2008 3,770 That simply is not true. The paper cup is only a buck and the aspirin in the cup is$5 bring the total to $6. Anyone seen the commercials for that new drug Viberzi? My doctor prescribed it for me and gave me about 150 sample pills. I was taking two a day, morning and evening. Pharmacy did not have any as it is a new drug but works for that darn IBSD. Then my insurance would not pay. Doctor gave me more and called the insurance company. OK, the insurance approved 50% payment. Then I saw what the stuff cost. Wow! My co-pay was going to be or is$600 a month. I researched the stuff and yes, that is what it cost. They seem to forget to tell you that in those nice TV commercials. Damn, Kathy and I are doing well in retirement and I am not about to go back to work but... I think after the summer I will stop taking the stuff and deal with IBSD as I did before.
Ron
Holy ---- , Bad analogy, I mean wow!
I have a similar problem with my COPD medicine. They know you will pay to keep breathing. One of mine was set to go generic so they re-branded it so they could keep the price up.

#### djsfantasi

Joined Apr 11, 2010
8,080
As I understood it, costs of various items are determined based on their actual cost plus an allocated amount of the overhead.

So, a $5 cup may be • 0.02 for the cup, • 0.50 for the HVAC, • 2.74 for the nurses, • 0.24 for security, • 0.12 for the parking valets, • 0.28 for the janitors • 0.78 for shipping and receiving and • 0.22 for the electricians. You get the idea... #### Reloadron Joined Jan 15, 2015 6,324 Now you have me worried, because I went for an Advantage plan and no supplement. What convinced you you needed a supplement? It's kind of the basis for insurance that some get a bargain and some just loose their money, but I think you are talking more about the sliding scale based on income? Because Medicare only covers so much. Medicare for example, if they approve the charges, cover 80% on hospitalization. A surgery with a few MRIs tossed in can easily run 75 to 100 grand leaving you owing an easy 20 to 25K. You really need a supplement. We used United Health Care as a supplement. Medicare deductibles can literally bankrupt a retired couple. Medicare is not a great catch all. People get a supplement so they don't lose a home and everything they worked for in medical bills. One major catastrophic illness and you can lose it all. When turning 66 there is considerable homework that needs done. The income really does not play into it that much unless you are in poverty. Fortunately my wife got there two years ahead of me and she was on my work policy which acted as her supplement till I retired. You really want to start getting things inline at about 65.5 years of age allowing yourself 6 months to figure out what you want. While I was still working my wife thought she may have a urinary tract infection and it began to hurt. No big deal, doctor visit and anti-biotics. A few weeks later still pain and now blood in urine. Back to doctor who sent her to a urologist specialist. Before her visit the urologist ordered a scan that morning. He examined Kathy but was unable to scope her which he wanted to do. OK that was Tuesday and he scheduled her for Thursday so she could be sedated and he could scope her. That evening he called us. Forget the scope, stage 2 kidney cancer and her left kidney was disintegrating. Thursday morning was major surgery here in Cleveland's University Hospital Sideman Cancer Center. The surgery went well, her lymph nodes were all cancer free and all subsequent scans were cancer free over the next few years. All in all that surgery was about$100K. Had that happened today? Good thing we have a supplement insurance.

With the indigent the hospitals eat the bill but if you have something, like a house, you can bet they will get their money. Get chest pains and need a quad bypass and poof! Anyway, with medicare you really need a supplement.

Ron

#### ronv

Joined Nov 12, 2008
3,770
When my Son was in the hospital, the nurses told us to take anything we wanted. There were signs stating how much some things costed. Maybe that makes them feel better about overcharging insurance companies.

BTW, did you know that the cost of medical services depends on who's paying for it?

Medicare, private insurance, auto insurance, and individuals all pay different prices. I don't know about you, but I'd be pretty upset if the grocery store told me that the price for a gallon of milk, or anything for that matter, depended on who was paying; or perhaps how much money they had.
Yeah, I've seen two good examples of the 3 way pricing.
My wife went in for colonoscopy. Two weeks later my neighbor went in for one. Same doctor, same hospital. The wife was on Medicare, the neighbor still on his GM insurance. His cost was nearly an order of magnitude higher. This was of course what the insurance paid, not what we paid.
The second was my across the street neighbor. His 24 year old son got testicular cancer. No insurance of course. So his dad has to step in to cover it. He fought and fought with them to get them to lower the price to the same an insurance company would pay. No dice. He is no longer my neighbor. He had to downsize.

#### ronv

Joined Nov 12, 2008
3,770
Because Medicare only covers so much. Medicare for example, if they approve the charges, cover 80% on hospitalization. A surgery with a few MRIs tossed in can easily run 75 to 100 grand leaving you owing an easy 20 to 25K. You really need a supplement. We used United Health Care as a supplement. Medicare deductibles can literally bankrupt a retired couple. Medicare is not a great catch all. People get a supplement so they don't lose a home and everything they worked for in medical bills. One major catastrophic illness and you can lose it all. When turning 66 there is considerable homework that needs done. The income really does not play into it that much unless you are in poverty. Fortunately my wife got there two years ahead of me and she was on my work policy which acted as her supplement till I retired.

You really want to start getting things inline at about 65.5 years of age allowing yourself 6 months to figure out what you want. While I was still working my wife thought she may have a urinary tract infection and it began to hurt. No big deal, doctor visit and anti-biotics. A few weeks later still pain and now blood in urine. Back to doctor who sent her to a urologist specialist. Before her visit the urologist ordered a scan that morning. He examined Kathy but was unable to scope her which he wanted to do. OK that was Tuesday and he scheduled her for Thursday so she could be sedated and he could scope her. That evening he called us. Forget the scope, stage 2 kidney cancer and her left kidney was disintegrating. Thursday morning was major surgery here in Cleveland's University Hospital Sideman Cancer Center. The surgery went well, her lymph nodes were all cancer free and all subsequent scans were cancer free over the next few years. All in all that surgery was about \$100K. Had that happened today? Good thing we have a supplement insurance.

With the indigent the hospitals eat the bill but if you have something, like a house, you can bet they will get their money. Get chest pains and need a quad bypass and poof! Anyway, with medicare you really need a supplement.

Ron
Okay. Thanks! Now I feel better. It was the 20% with no limit that pushed me to the advantage plan. It had a maximum out of pocket - I think 6 or 7K. So I made that trade off on purpose. We have been very fortunate not to have had anything major so we haven't had to test it.

Joined Jan 15, 2015
6,324
Okay. Thanks! Now I feel better. It was the 20% with no limit that pushed me to the advantage plan. It had a maximum out of pocket - I think 6 or 7K. So I made that trade off on purpose. We have been very fortunate not to have had anything major so we haven't had to test it.
Be glad you have not tested it and may you never need to test it.

Ron

#### dl324

Joined Mar 30, 2015
13,846
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