Senate Health Bill Reels as C.B.O. Predicts 22 Million More Uninsured

[CaliCat 3,957]

And after 7 years, they come up with nothing. 

 

https://www.nytimes.com/2017/06/26/us/politics/senate-health-care-bill-republican.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=a-lede-package-region&region=top-news&WT.nav=top-news

 

WASHINGTON — The Senate bill to repeal the Affordable Care Act was edging toward collapse on Monday after the nonpartisan Congressional Budget Office said it would increase the number of people without health insurance by 22 million by 2026.

Two Republicans, Senators Susan Collins of Maine and Rand Paul of Kentucky, said Monday that they would vote against even debating the health care bill, joining Senator Dean Heller of Nevada, who made the same pledge on Friday. Senator Ron Johnson of Wisconsin hinted that he, too, would probably oppose taking up the bill on a procedural vote expected as early as Tuesday, meaning a collapse could be imminent.

“It’s worse to pass a bad bill than pass no bill,” Mr. Paul told reporters.

Ms. Collins wrote on Twitter on Monday evening that she wanted to work with her colleagues from both parties to fix flaws in the Affordable Care Act, but that the budget office’s report showed that the “Senate bill won’t do it.”

The report left Senator Mitch McConnell of Kentucky, the majority leader, with the unenviable choices of changing senators’ stated positions, withdrawing the bill from consideration while he renegotiates, or letting it go down to defeat — a remarkable conclusion to the Republicans’ seven-year push to repeal President Barack Obama’s signature domestic achievement.

 

 

[Dashinka 23,245]

Deja Vu?

 

 

[jg121783 3,907]

I do not support this bill (even though I am aware the democrats are distorting the facts on some aspects of it). I think both parties are going totally in the wrong direction on healthcare. We would save a lot of money if we had a medical system that was geared towards preventing disease and helping people stay healthy rather than treating diseases with expensive pharmaceuticals and surgeries after someone gets sick. Fighting over who will provide health insurance and how they will do it is a waste of time and will never lead to any real positive change.

 

We should attack the problem (expensive and ineffective healthcare) at it's root. We need to prevent illness rather than treat it after it happens. I don't claim to have all the answers but I do know there is a lot that natural medicine could contribute to our healthcare system for both prevention and treatment of illnesses that costs a lot less and that is way more effective in some cases than pharmaceuticals and expensive surgeries. Big pharma and the medical industrial complex go out of their way to let people get sick then treat them because that is where the big profits are.

[Dashinka 23,245]

So with the tags in this thread are you insinuating the Death Panels created by the ACA will be eliminated?

[Amica Nostra 4,803]

2 hours ago, jg121783 said:

I do not support this bill (even though I am aware the democrats are distorting the facts on some aspects of it). I think both parties are going totally in the wrong direction on healthcare. We would save a lot of money if we had a medical system that was geared towards preventing disease and helping people stay healthy rather than treating diseases with expensive pharmaceuticals and surgeries after someone gets sick. Fighting over who will provide health insurance and how they will do it is a waste of time and will never lead to any real positive change.

 

We should attack the problem (expensive and ineffective healthcare) at it's root. We need to prevent illness rather than treat it after it happens. I don't claim to have all the answers but I do know there is a lot that natural medicine could contribute to our healthcare system for both prevention and treatment of illnesses that costs a lot less and that is way more effective in some cases than pharmaceuticals and expensive surgeries. Big pharma and the medical industrial complex go out of their way to let people get sick then treat them because that is where the big profits are.

  we agree on a lot here

Edited June 28, 2017 by ccneat

[Amica Nostra 4,803]

1 hour ago, Bill & Katya said:

So with the tags in this thread are you insinuating the Death Panels created by the ACA will be eliminated?

Yes every death panel created by the ACA will be decommissioned.

[yuna628 9,528]

1 hour ago, jg121783 said:

I do not support this bill (even though I am aware the democrats are distorting the facts on some aspects of it). I think both parties are going totally in the wrong direction on healthcare. We would save a lot of money if we had a medical system that was geared towards preventing disease and helping people stay healthy rather than treating diseases with expensive pharmaceuticals and surgeries after someone gets sick. Fighting over who will provide health insurance and how they will do it is a waste of time and will never lead to any real positive change.

 

We should attack the problem (expensive and ineffective healthcare) at it's root. We need to prevent illness rather than treat it after it happens. I don't claim to have all the answers but I do know there is a lot that natural medicine could contribute to our healthcare system for both prevention and treatment of illnesses that costs a lot less and that is way more effective in some cases than pharmaceuticals and expensive surgeries. Big pharma and the medical industrial complex go out of their way to let people get sick then treat them because that is where the big profits are.

But that's the thing really. There are many people that live decent fairly healthy lives and still end up with serious diseases because of genetics or for reasons completely unknown. Mom certainly didn't do anything to get herself cancer. Nor can I recall the guest of honor at our wedding who lost his life to the same cancer before the age of 40... what I'm saying is there is only so much that modern medicine can do to prevent illness... and there is only so much doctors can do to advise persons to try and stay healthy. A lot of problems we face are due to unhealthy lifestyles, but many are not. Pharmaceuticals my Dad needs costs thousands and he cannot take them because of the pricetag, and due to that his health is declining. There's really nothing else the doctor can do as far as treatment goes.

 

I have faith that our healthcare system of excellent doctors and nurses are still some of the best out there, but the cost of that care will continue to rise. I have to say one small reason is that our insurance companies we shell out such high premiums to (even medicare) are barely paying for the services offered and this trickles down to lower pay, stale wages for the employees, and doctors barely staying afloat. Mom had a pretty bad fall in early spring, and after 911 and being rushed to the ER, medication, and many attempts for hours at putting her shoulder back into place resulted in a bill about $4600. Now medicare and supplement covered it thank goodness so the cost to her was minimal. But a brief breakdown of the charges - it cost $2000 to put the shoulder back in! I was surprised but it did require a ton of doctors to attempt and it didn't go well (it was one of those fluke things where everything holding the arm in place is torn so if you pop it back in.. it falls back out). CT scan and xray of about everything in her body + a ton of medication cost another big chunk of money. And the remainder was a 10 minute ride to the hospital in the ambo for a whopping $800. Now who do you think received a decent payment for the services rendered? The doctors and techs who provided the services, or the ambo sent? ER doctors only saw about $200 but the ambo managed to nearly get all they charged! I just don't see that as fair. I notice that trend on almost every EOB I have seen for years now.

 

We continue to pay more for premiums from a few companies that hold virtual monopolies over states but they pay out less and less. It's not just that services are becoming more expensive (and yes drugs are even more so) but insurances are offering less and less. Insurance companies can complain about the ACA (as much as I'm sure they love it), but without sick people they wouldn't be making money. Big pharma is disgusting but insurance companies are too. They both always have been the original death panel.

[Cyberfx1024 7,978]

31 minutes ago, yuna628 said:

But that's the thing really. There are many people that live decent fairly healthy lives and still end up with serious diseases because of genetics or for reasons completely unknown. Mom certainly didn't do anything to get herself cancer. Nor can I recall the guest of honor at our wedding who lost his life to the same cancer before the age of 40... what I'm saying is there is only so much that modern medicine can do to prevent illness... and there is only so much doctors can do to advise persons to try and stay healthy. A lot of problems we face are due to unhealthy lifestyles, but many are not. Pharmaceuticals my Dad needs costs thousands and he cannot take them because of the pricetag, and due to that his health is declining. There's really nothing else the doctor can do as far as treatment goes.

 

I have faith that our healthcare system of excellent doctors and nurses are still some of the best out there, but the cost of that care will continue to rise. I have to say one small reason is that our insurance companies we shell out such high premiums to (even medicare) are barely paying for the services offered and this trickles down to lower pay, stale wages for the employees, and doctors barely staying afloat. Mom had a pretty bad fall in early spring, and after 911 and being rushed to the ER, medication, and many attempts for hours at putting her shoulder back into place resulted in a bill about $4600. Now medicare and supplement covered it thank goodness so the cost to her was minimal. But a brief breakdown of the charges - it cost $2000 to put the shoulder back in! I was surprised but it did require a ton of doctors to attempt and it didn't go well (it was one of those fluke things where everything holding the arm in place is torn so if you pop it back in.. it falls back out). CT scan and xray of about everything in her body + a ton of medication cost another big chunk of money. And the remainder was a 10 minute ride to the hospital in the ambo for a whopping $800. Now who do you think received a decent payment for the services rendered? The doctors and techs who provided the services, or the ambo sent? ER doctors only saw about $200 but the ambo managed to nearly get all they charged! I just don't see that as fair. I notice that trend on almost every EOB I have seen for years now.

 

We continue to pay more for premiums from a few companies that hold virtual monopolies over states but they pay out less and less. It's not just that services are becoming more expensive (and yes drugs are even more so) but insurances are offering less and less. Insurance companies can complain about the ACA (as much as I'm sure they love it), but without sick people they wouldn't be making money. Big pharma is disgusting but insurance companies are too. They both always have been the original death panel.

I totally agree with you on a majority of this except for the bolded part. You have to agree with me that a large majority of the illnesses people have can be prevented if they lead a healthier lifestyle and helped cured if caught early. Genetics DOES play a role in people's health and I am not denying that at all. But sometimes people use their genetics to try and let them lead a unhealthy lifestyle, which eventually will lead to ruin.

I come a line of alcoholics on my father's side with the associated illnesses that come with that. I have known that for several years now that I have to watch out my drinking or else it can lead to something I don't want to happen. My brother unfortunately did not take that into account when he was younger and ended up having a number of DWI's and spent years in jail due to his drinking problem. He has finally wised up to it and what it causes him to do, so now he hardly ever drinks at all. 

 

I hope your Mom is doing fine now I really do. I have to agree with you about the cost of services that hospitals charge people. My wife gave birth through a C-section in January. I saw the bill that they tried to send to my insurance company and it was $38k dollars for the c-section and 2 1/2 days in the hospital. The is outrageous but luckily I didn't have to pay a thing, but my insurance did pay $17k. 

[yuna628 9,528]

10 hours ago, cyberfx1024 said:

I totally agree with you on a majority of this except for the bolded part. You have to agree with me that a large majority of the illnesses people have can be prevented if they lead a healthier lifestyle and helped cured if caught early. Genetics DOES play a role in people's health and I am not denying that at all. But sometimes people use their genetics to try and let them lead a unhealthy lifestyle, which eventually will lead to ruin.

I come a line of alcoholics on my father's side with the associated illnesses that come with that. I have known that for several years now that I have to watch out my drinking or else it can lead to something I don't want to happen. My brother unfortunately did not take that into account when he was younger and ended up having a number of DWI's and spent years in jail due to his drinking problem. He has finally wised up to it and what it causes him to do, so now he hardly ever drinks at all. 

 

I hope your Mom is doing fine now I really do. I have to agree with you about the cost of services that hospitals charge people. My wife gave birth through a C-section in January. I saw the bill that they tried to send to my insurance company and it was $38k dollars for the c-section and 2 1/2 days in the hospital. The is outrageous but luckily I didn't have to pay a thing, but my insurance did pay $17k. 

Mom has never smoked or drank a day in her life. Like a lot of people she's a little overweight but that comes with the fact of limited mobility with RA and thyroid removal when she was young. She has had other health problems related to genetics and risk factors passed onto her via her parents, but otherwise she's the first I can think of on that side at least to have cancer. She was diagnosed at the same time our family friend was.. except he went from a seemingly healthy man to stage 4 within months and there was nothing they could do. His son has genetic markers giving him a higher likelihood of having the same cancer or a related one in the future. Mom's cancer was caught in time, but the doctors are always concerned it will reappear so it's going to be constant tests for her. After her fall a good bit of those tests were pushed back. The damage to her arm was pretty bad, but the doctors are reluctant to do surgery on an old person so she's been in PT for months. Medicare will also pay for this thankfully, but the therapist says if she ever reaches a point where she's just not improving or improving too slowly... they will refuse to pay.

 

 

[Dashinka 23,245]

12 hours ago, yuna628 said:

But that's the thing really. There are many people that live decent fairly healthy lives and still end up with serious diseases because of genetics or for reasons completely unknown. Mom certainly didn't do anything to get herself cancer. Nor can I recall the guest of honor at our wedding who lost his life to the same cancer before the age of 40... what I'm saying is there is only so much that modern medicine can do to prevent illness... and there is only so much doctors can do to advise persons to try and stay healthy. A lot of problems we face are due to unhealthy lifestyles, but many are not. Pharmaceuticals my Dad needs costs thousands and he cannot take them because of the pricetag, and due to that his health is declining. There's really nothing else the doctor can do as far as treatment goes.

 

I have faith that our healthcare system of excellent doctors and nurses are still some of the best out there, but the cost of that care will continue to rise. I have to say one small reason is that our insurance companies we shell out such high premiums to (even medicare) are barely paying for the services offered and this trickles down to lower pay, stale wages for the employees, and doctors barely staying afloat. Mom had a pretty bad fall in early spring, and after 911 and being rushed to the ER, medication, and many attempts for hours at putting her shoulder back into place resulted in a bill about $4600. Now medicare and supplement covered it thank goodness so the cost to her was minimal. But a brief breakdown of the charges - it cost $2000 to put the shoulder back in! I was surprised but it did require a ton of doctors to attempt and it didn't go well (it was one of those fluke things where everything holding the arm in place is torn so if you pop it back in.. it falls back out). CT scan and xray of about everything in her body + a ton of medication cost another big chunk of money. And the remainder was a 10 minute ride to the hospital in the ambo for a whopping $800. Now who do you think received a decent payment for the services rendered? The doctors and techs who provided the services, or the ambo sent? ER doctors only saw about $200 but the ambo managed to nearly get all they charged! I just don't see that as fair. I notice that trend on almost every EOB I have seen for years now.

 

We continue to pay more for premiums from a few companies that hold virtual monopolies over states but they pay out less and less. It's not just that services are becoming more expensive (and yes drugs are even more so) but insurances are offering less and less. Insurance companies can complain about the ACA (as much as I'm sure they love it), but without sick people they wouldn't be making money. Big pharma is disgusting but insurance companies are too. They both always have been the original death panel.

So what you are saying is let's transfer the partial insurance monopoly to a complete government monopoly?  Personally, I have no idea what is the best plan out there, there are pros and cons for each, and I am sure complaints will be there regardless.  In a lot of ways I say just go single payer and let the government take all the hits, transfer the costs to the future generations and be done with it.  Short of that, maybe just expand Medicaid so more and more of the middle class can take advantage of that.

[yuna628 9,528]

1 hour ago, Bill & Katya said:

So what you are saying is let's transfer the partial insurance monopoly to a complete government monopoly?  Personally, I have no idea what is the best plan out there, there are pros and cons for each, and I am sure complaints will be there regardless.  In a lot of ways I say just go single payer and let the government take all the hits, transfer the costs to the future generations and be done with it.  Short of that, maybe just expand Medicaid so more and more of the middle class can take advantage of that.

Not making a conclusion as to what the best answer is. Some say buying across state lines is the answer but there is an enormous amount of regulation to consider in this that no one wants to dip a toe into, and I still think it would take thousands of companies involved to get it down to levels like Rand Paul suggested. Single payer has problems but for many it works. And while Medicaid does provide service to many of the poor and sick I am often concerned as to the level of care those patients receive too (just as I am with the NHS actually). We have the right to life, liberty, and happiness. I heard someone ask the question last week that does safeguarding at least access to healthcare equate somewhere in those three? Does the government have a responsibility to provide for the safety of it's citizens (one of the reasons why our crumbling infrastructure gets me so mad) and is healthcare involved in that? If employers didn't have to pay out health insurance anymore they could be free to pay employees more and take in greater profits too. At the same time buying plans as individuals demand us to pay a nearly impossible price tag and effectively means we have plans we can't even afford to use.

[Dashinka 23,245]

1 minute ago, yuna628 said:

Not making a conclusion as to what the best answer is. Some say buying across state lines is the answer but there is an enormous amount of regulation to consider in this that no one wants to dip a toe into, and I still think it would take thousands of companies involved to get it down to levels like Rand Paul suggested. Single payer has problems but for many it works. And while Medicaid does provide service to many of the poor and sick I am often concerned as to the level of care those patients receive too (just as I am with the NHS actually). We have the right to life, liberty, and happiness. I heard someone ask the question last week that does safeguarding at least access to healthcare equate somewhere in those three? Does the government have a responsibility to provide for the safety of it's citizens (one of the reasons why our crumbling infrastructure gets me so mad) and is healthcare involved in that? If employers didn't have to pay out health insurance anymore they could be free to pay employees more and take in greater profits too. At the same time buying plans as individuals demand us to pay a nearly impossible price tag and effectively means we have plans we can't even afford to use.

That is the conundrum isn't it. 

[smilesammich 10,727]

14 hours ago, cyberfx1024 said:

I totally agree with you on a majority of this except for the bolded part. You have to agree with me that a large majority of the illnesses people have can be prevented if they lead a healthier lifestyle and helped cured if caught early. Genetics DOES play a role in people's health and I am not denying that at all. But sometimes people use their genetics to try and let them lead a unhealthy lifestyle, which eventually will lead to ruin.

I come a line of alcoholics on my father's side with the associated illnesses that come with that. I have known that for several years now that I have to watch out my drinking or else it can lead to something I don't want to happen. My brother unfortunately did not take that into account when he was younger and ended up having a number of DWI's and spent years in jail due to his drinking problem. He has finally wised up to it and what it causes him to do, so now he hardly ever drinks at all. 

 

i don't understand how people 'use genetics to try and let them lead an unhealthy lifestyle'. one of the pretty certain results of having a terminal illness or genetic disease is depression. depression usually manifests in many ways, but one is not taking care of oneself. depression isn't necessarily something that can be avoided or self 'cured' and often, medications don't help either. think about it, you've got an illness that severely limits you in many aspects of life FOR LIFE. financially, your condition will eat up a good chunk of your income, even with good insurance FOR LIFE.  you're at a strict disadvantage and there's no escape - no cure. i certainly don't fault a person in this position for sometimes having bad days, months, years even. the reality of living with a genetic or fatal disease that is always going to cost you a significant amount of money is a burden i wouldn't wish on anyone. the financial stress alone probably contributes to many of these peoples' well being and ability to maintain a positive attitude. i'm all about personal responsibility, but i take issue with people who apply this to disease. its the same as certain sects of christianity that believe illness is punishment from god. even with children, their parents offended god. it's convenient to point the finger elsewhere, but its certainly not helpful to the person actually dealing with the disease.

[bcking 3,157]

http://www.cancerresearchuk.org/health-professional/cancer-statistics/risk/preventable-cancers#heading-Zero

 

Granted this is in the UK, so obviously the numbers will be different but I doubt it is grossly different in the USA (though I admit obesity is a larger problem here).

 

If we were a perfect society (with regards to individual choices related to our health) we would be far healthier, for sure. But we would still have cancer. We would still have to care for the old. If we were all much healthier we would have a longer life expectancy which equates to caring for more age-related conditions. Some of which are, you guessed it, cancer!

 

I agree 100% with the idea that we need to focus on prevention more than we are. The shift to "Managed Care" in the 1980's - 1990's (pretty much all insurance companies are some form of "Managed Care" now) was supposed to provide incentives to preventative care, and it was supposed to unify incentives to that different aspects of healthcare aren't benefiting from different outcomes. It has failed pretty miserable considering practically no insurance companies focus on preventative care, and the true "managed care" organizations (Kaiser) don't do it as well as they could, and don't align incentives appropriately. 

 

There ultimately is no perfect system, only a lot of different imperfect systems. My feeling though is an employer-based private insurance system is doomed to fail. First you are relying on employment to provide healthcare, which seems counter-intuitive when the sickest people won't be employed (hence why we have our national Medicaid/Medicare systems, which need far more support than what they have). Then you put the insurance into the hands of mostly for-profit institutions. Their bottom-line encourages them to seek out the healthiest people and leave off the sickest. The more "choice" you give them when it comes to choosing whom to insure (deny for pre-existing conditions, deny for age, deny for child bearing or whatever), the more selective they will be to improve their bottom line. It's just the way it works. There is too much power and too many incentives focused on insurance companies. There is no "shared incentive" system going on. If hospitals provide care more efficiently, in a "fee for service" based system they will generally make less money. Insurance companies may save, but that is just more for them. Things are shifting more towards a lump-sum based system (DRGs and their associated labels) where hospitals and paid a flat fee for a certain condition. But generally those have been designed with the insurance companies in mind and people are delusional if they think they exist to help the hospitals get reimbursed more. 

 

As for whether healthcare is a right I firmly believe that "life, liberty and the pursuit of happiness" means that healthcare is a right of citizens within the state. I know many disagree with me on that.

[Amica Nostra 4,803]

31 minutes ago, bcking said:

http://www.cancerresearchuk.org/health-professional/cancer-statistics/risk/preventable-cancers#heading-Zero

 

Granted this is in the UK, so obviously the numbers will be different but I doubt it is grossly different in the USA (though I admit obesity is a larger problem here).

 

If we were a perfect society (with regards to individual choices related to our health) we would be far healthier, for sure. But we would still have cancer. We would still have to care for the old. If we were all much healthier we would have a longer life expectancy which equates to caring for more age-related conditions. Some of which are, you guessed it, cancer!

 

I agree 100% with the idea that we need to focus on prevention more than we are. The shift to "Managed Care" in the 1980's - 1990's (pretty much all insurance companies are some form of "Managed Care" now) was supposed to provide incentives to preventative care, and it was supposed to unify incentives to that different aspects of healthcare aren't benefiting from different outcomes. It has failed pretty miserable considering practically no insurance companies focus on preventative care, and the true "managed care" organizations (Kaiser) don't do it as well as they could, and don't align incentives appropriately. 

 

There ultimately is no perfect system, only a lot of different imperfect systems. My feeling though is an employer-based private insurance system is doomed to fail. First you are relying on employment to provide healthcare, which seems counter-intuitive when the sickest people won't be employed (hence why we have our national Medicaid/Medicare systems, which need far more support than what they have). Then you put the insurance into the hands of mostly for-profit institutions. Their bottom-line encourages them to seek out the healthiest people and leave off the sickest. The more "choice" you give them when it comes to choosing whom to insure (deny for pre-existing conditions, deny for age, deny for child bearing or whatever), the more selective they will be to improve their bottom line. It's just the way it works. There is too much power and too many incentives focused on insurance companies. There is no "shared incentive" system going on. If hospitals provide care more efficiently, in a "fee for service" based system they will generally make less money. Insurance companies may save, but that is just more for them. Things are shifting more towards a lump-sum based system (DRGs and their associated labels) where hospitals and paid a flat fee for a certain condition. But generally those have been designed with the insurance companies in mind and people are delusional if they think they exist to help the hospitals get reimbursed more. 

 

As for whether healthcare is a right I firmly believe that "life, liberty and the pursuit of happiness" means that healthcare is a right of citizens within the state. I know many disagree with me on that.

The history of how Employment and HealthCare became linked goes back to WW2.  After a long depression the competition for workers heated up in the shipyards and factories causing Inflation.  Roosevelt mandated that Defense suppliers could not bid up wages to  poach workers from each other.  The wage restriction did not apply to healthcare and benefits which became the new tool to poach workers. Additionally health insurance was tax free income.  After the war Truman tried to uncouple employment and healthcare with Universal coverage, but congress balked at the "socialism" 

 

Long story short: it is an accident of history that we do not have Universal Coverage in this country

 

Edited June 29, 2017 by ccneat