No, Medicare for all is not the answer!

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With all the talk of the Obamacare replacement and the failings of our medical system in America I decided to address this constant call from the far left that the Government should just impose Medicare for all and do away with all private insurance companies the way Canada did for so many years.

 

First of all, yes, I agree there are issues, large issues, with American medical care, but I do not believe Medicare or any form of mass Government control over health care is going to work well in America for several reasons.

 

The first and most obvious is the cost, we already have massive cost issues operating Medicare for the small portion we cover now as well as hundreds of Billions of dollars in Medicare fraud.  We can't accurately cover costs efficiently now with just 55 million Americans on the program, taking that total to 220 million people means that all the problems we have now will increase along with it, and most likely the problems will increase at greater rates because chasing down possible fraud and abuse is harder and harder the larger the system gets.

 

The second and less advertised huge problem with Medicare is the fact less and less doctors are willing to accept Medicare patients due to the low payouts and the extreme degree of costly documentation needed to process claims:

 

"And so I made a difficult decision.  I have decided to opt-out of Medicare, acknowledging that I can no longer play a game that is rigged against me; one that I can never win because of constantly changing rules, and one where the stakes include fines and even potential jail time. " 

 

In connection with my over 30+ years of commercial and residential construction I have had the great opportunity to be involved with all levels of the medical world from negative pressure isolation rooms to General Practice offices and I have taken the time to sit down with actual doctors to discuss medical related issues and patient care and insurance countless numbers of times.  The number 1 issue they all agree is a problem with Medicare is payouts that do not cover actual costs of care, and the second issue is paperwork and long waiting times to actually get paid for the services rendered.  I also have the benefit of my sister who managed a private office for her husband in general care as well.

 

If a Medicare patient goes to a GP doctor for a cold or basic complaint, the doctor will lose money on that visit, it will cost them more in processing and time spent documenting that basic care visit than they will get back from the Government, period.  This is why so many doctors try to add some testing and counseling and such to the visit to try and make up for the money they just lost.  So why does any doctor accept Medicare patients?  Because they actually care about society and their patients and want to help them, but they also need to pay their Bills so it becomes a constant battle to do both.

 

 

Now this is of course a bigger issue for private doctors than large medical corporations.  Those larger groups can more easily absorb the costs of paperwork and processing because they push through a much larger number of patients with the same office workers processing so it is a little easier to maintain.  That combined with the latest trend to use nurse practitioners instead of actual doctors helps these larger companies to keep costs lower.  

 

So then you may say that we just replace all private doctors with these large corporations right?  Well that sounds easier than it really is, smaller towns would not have enough patients to keep the facility constantly operating so they could not justify the cost in building a very expensive facility and staff it.  Besides, while these large companies may be making it work today, their profit margins are not that good and there are better ways to make money than this so there may not be enough motivation to chase those limited dollars.

 

 

Okay, so private industry does not want to serve those patients, we just have the Government do it and set up a nation wide medical system similar to the VA, right?  Well aside from all the bad publicity the VA is getting for not handling Veterans very well for their medical needs, you are now talking a massive amount of new entitlement spending that will rival our defense budget, where does the money come from?  And even if we do this, who do you staff it with?  The VA is recruiting doctors from other Countries because the pay is too low to entice Americans doctors to work for them, there is no expectation this would change for a Medicare only hospital system.  In fact it would most likely be much worse because even the corporation run hospitals get regular patients too so they have the higher payouts from private insurance to add to their Medicare funds, if you had a hospital that could only operate on Medicare funding levels the cost controls would be draconian.

 

 

Lastly, many of the states who saw Medicare expansion under Obama saw this effect first hand, just having a medicare card or a Obamacare card did not equal medical care, you have to first find doctors who were willing to accept these policies and today, there are not enough doctors to go around with the few low paying policies we have today, what happens when most Americans have only these low paying policies?

 

 

There are a lot more issues to consider, but look around at the various Countries who do provide socialized healthcare.  Many are severally cutting back, Canada had to allow private insurance and is currently operating a two tier healthcare system because of the massive waiting times for medical care under the Government system.  They have an annual meeting called the "taming of the queue" trying to address these long waiting lines but have not made any real changes to those waiting times in the last 10 years.

 

P.S.

 

I wanted to add at the end one of the problems with America that is unique is the way we are mostly spread out all over the place in America and the few places that seem to be doing a better job with socialized healthcare all have more dense populations making it easier to serve them.

 

Thank you for taking the time to read my story, all reasonable replies will be answered.

Comments

Meghen Suzanne Added Mar 13, 2017 - 11:30am
Your article was very informative, and I did learn from it.  Health care in this country has morphed into a giant nightmare for insureds and medical care providers/facilities.  
Bill H. Added Mar 13, 2017 - 11:38am
 
My concerns is that the medical insurance industries, medical service providers, and pharmaceutical companies will now be open to excessive profiteering without any controls whatsoever.
They will work together to increase pricing just as the big communications providers work together to keep their rates ever-increasing to the point of ridiculously excessive.
They will be the winners and the average citizen will suffer much worse than in the past.
Louis E Weeks Added Mar 13, 2017 - 12:22pm
Bill,
Competition is the heart of control of any business.  Working together to set pricing is already a federal crime, we need to open up more competition and also work harder to go after any kind of price fixing.
 
My biggest issue with Obamacare is it was set up as one size fits all, a married couple past the age of child bearing and no young adult children was forced to buy insurance that included pregnancy coverage and the ability to keep adult children on on their policy.  These two example are extremely high cost and if they were allowed to buy a policy without those benefits their out of pocket expense would be drastically lower.
 
There is a saying that the road to Hell is paved with good intentions.  
 
The most terrifying words in the English language are: I'm from the government and I'm here to help. ~  Ronald Reagan

Dino Manalis Added Mar 13, 2017 - 12:50pm
The single payer should be the patient or customer, but it has to be much more affordable, like buying auto; homeowner's; or life insurance.  It shouldn't be the employer's decision anyway, it's a personal health decision.
 
That's why we need market actions, like import foreign prescription drugs; cap medical malpractice compensation; streamline insurance bureaucracy and paperwork; and allow insurers to compete nationally.
Louis E Weeks Added Mar 13, 2017 - 12:59pm
Dino,
Great ideas all, the best way to let the free market work is to stop meddling with it, Government regulations against things like imported drugs reduces competition and drives up costs.  Paperwork is the same way, much of it is mandated by Government, not the insurance company.
 
Affordable is compared to cost, most people buying auto insurance never use it, health insurance will cost way more because they will use it, especially later in life.  But we can take steps to help make it less expensive.
EXPAT Added Mar 13, 2017 - 1:04pm
Louis. Medicare for all is not the answer, but it could be a temporary method of providing care while all the restrictive regulations are removed from the industry. Much like disaster relief.
 
The only cure for the sick American health care system, is to truly LOWER THE COST. Let International health care providers treat Americans. Let me buy pharmaceuticals from Germany, UK, France that have been in use for years. Eliminate Punitive Damages in Medical Mal Practice cases. Allow private certification for New Drugs.
 
I could go on about all the needles regulations that make USA health care the most expensive in the world, but you get the idea. Leave medical care to professionals who don't have to get elected. Free Enterprise works in all other industries, why not health care?
Louis E Weeks Added Mar 13, 2017 - 1:15pm
Expat,
Even temporary what doctors will take them?  Doctors are rejecting these patients today, a sudden increase in those relying on Medicare would need a doctor, where do we get the doctors?
 
I agree with you and Dino on the many issues with regulations driving up costs, we need to address those.
EXPAT Added Mar 13, 2017 - 1:22pm
Doctors who want to feed their family will take them Louis. All means All.
 
Louis E Weeks Added Mar 13, 2017 - 1:56pm
But there are lots of ways to feed your children, you do not have to accept patients that do not make you any decent income, that is why so many doctors refuse to accept those patients now as I explained in my story.
 
Do you propose "force"?  Should the Government force doctors to see patients and lose money doing so?
 
 
My issue with this is as we see in many countries, smart people deciding not to enter the medical field because the money has gone from it.  Why attend 8 to 10 years of advanced education to make around $200,000 a year and just one allegation could mean you can never practice medicine again?  Doctors are always on call, tend to work more hours a week than most other professions, and always have someone trying to see if they can sue them for malpractice.  Why go though all that mess and time and education to make $200k a year?
 
And now we want them to do it for even less money?  I know 4 year engineering workers who make almost that much money, they work a 40 hour a week job and get all holidays off and little to no stress.
 
 
Utpal Patel Added Mar 13, 2017 - 4:51pm
Given Filibuster Proof control of the Senate, sizable majorities in the House and the Presidency, not even the Democrats passed a bill providing Medicare for all.  So there is no reason to think Republicans are going expand Medicare for all either.  However, Obamacare is collapsing on itself and millions more people are finding out that they only qualify for Medicaid, in light of the fact there are no private insurance options. So no offense, but your article is nothing more than a statement of the obvious. 
 
My preferred solution, seeing the Republicans don’t have the votes to pass their own healthcare bill and expanding Medicare is off the table, is to allow Obamacare to collapse.  This will push millions of people onto the uninsured rolls and pave the way for private solutions to medical insurance.  The Republicans can assist this transition by allowing high-deductible catastrophic policies and allow people to buy their insurance across state lines.   
Louis E Weeks Added Mar 13, 2017 - 7:51pm
Utpal,
It may seem obvious to you and me, but not to anyone on the left, and that is about half of America.
 
I agree the Republicans have little chance of passing much, and yes when the democrats had their super majority they did not pass it either, but there are still massive numbers of people who think Medicare for all is an answer.  Of course those are also the people who think Hillary Clinton winning the popular votes actually means something but we have to try and use repetition and consistent information if we stand any chance of educating those on the far left.
Cliff M. Added Mar 13, 2017 - 8:16pm
Louis, Maybe medicare for all is not the best option but going back to the individual market that existed before Obamacare is not the answer.A decent insurance plan that actually provides benefits now cost about $500 dollars a head per month. The average wage is about 48 K a year. Individuals forced into this market are getting killed. A family at the median wage is just about priced out. Why couldn't a public option where someone who does not get employer or government provided insurance could go a bad idea?
Patrick Writes Added Mar 13, 2017 - 8:17pm
I agree (for the most part).
 
I view it as Medicare covers more than half of the consumers of health care (the elderly). It's done so for 50 years. It's paid whatever the industry wanted to charge for 50 years with little or no downward pressure on costs. So inflation happens. (My understanding is insurance companies have traditionally tried to put caps on procedures but Uncle Sam has not, for the most part.)
 
It's the same general pattern of higher education and student loans. With so much government money flooding into the industry, massive inflation happens. And costs go up. 
 
In the U.K. nurses make half of their U.S. counterparts (after all the currency conversions). Half the money. It's the same job. Yes, it's marginally better care in the U.S. compared to the U.K. (mostly because of no wait times, not because once you're in the system, there is substandard care). The NHS in the U.K. uses generic drugs and exerts a lot of downward pressure on costs. I imagine doctors make considerably less money in the U.K. than than U.S.A. as well. 
 
So these doctors complaining about Medicare patients...what's their salary I wonder? $200,000 / year? $300,000 /year? 

Is that really what the market will pay, if you take the government out of the mix? Or is that because of inflation because of 50 years of government involvement via Medicare. 
 
Medicare in its current form, opened up to the entire country, would be a disaster because of the pattern of cost inflation would rise even higher in my opinion. 

It's a mess because doctors see the salary of $200,000 / year as kids and decide to go into the field and spend money on education expecting that salary, not realizing it's probably vastly inflated. 
 
And Medicare paying top dollar for all these drug patents, it's a mess. I've read that many drug companies use research provided free of charge by public universities and then go get a patent for that research and reap all the financial benefits even though taxpayers invested to develop the drug. 
 
But summarized simply, Medicare for all would bankrupt the country in a few short years and possibly lead to overthrowing of the government (since you'll have to print money to cover the massive budget deficit each year leading to loss of confidence in U.S. treasuries, possibly leading to a run on them). This, coupled with the fact that the petrodollar system is breaking up so even the budget deficits you've enjoyed for 30 years will be harder to cover. 
 
It's a pipe-dream, Medicare for all in my opinion. 
Patrick Writes Added Mar 13, 2017 - 8:24pm
Health insurance cooperatives are the answer in my opinion (ex: Lyons Club Health Insurance cooperative). 
 
Only employers could organize a group health insurance policy since WWII (where the entire company is on the same policy, the younger workers balance out the older, sicker workers and everyone pays the usually affordable premium). 
 
That's the model that's worked since WWII. But it's been tied to employers (still is with ObamaCare). Just break that link and let people group themselves into cooperatives, clubs, neighborhood associations, etc.... Join the group / cooperative, get on the group health insurnace policy with a pool of people. 
 
Individual policies don't work when put through the risk-o-meter, only 25 year olds in perfect health are deemed 'unrisky' by the insurance company. Anyone else is going to have astronomical premiums. It's just how insurnace works. And that's why no one should be put into these individual policies. And if insurance companies have to offer them, they'll just spread the "risk" across all policies so premiums go up for everyone. 
Patrick Writes Added Mar 13, 2017 - 8:26pm
There is nothing wrong with a single payer system like the U.K. or Canada has but that is NOT Medicare for all. That's rationed care, capped procedure costs, generic drugs galore, or simply many procedures not covered at all--pay out of pocket. That's what a single payer system looks like. America is not 'so great' that it can change the rules of reality. 
wsucram15 Added Mar 13, 2017 - 8:32pm
Actually..CliffM?  What insurance are you talking about, with subsidies, maybe?  I worked in HR in and around insurance policies before and after the PPACA and I cant recall any insurance policy costing 500 pp., unless you went perhaps into the early 90s, maybe.
 
Also medicaid is far cheaper and for the patient provides better coverage for shared cost.  I have had both medicaid and medicare and while both seem to be sought after, I have used both for my medicine.  Medicaid was far cheaper for medicines and for doctors overall, even WITH a secondary insurance on medicare.
 
The major benefit of medicare, is the cost control, which is what every other country in the WORLD with healthcare does.  This needs to happen here.  The problem in the US is the cost of medicine and treatment.
 
This should not even be a battle for any US citizen, we are one people and at the end of the day it is those people that will stand by your side, not the pennies you so dearly hold onto.   I was proud to see Republicans  stand in a town meeting and give their Senators a hard time about leaving the poor and disabled behind. 
 
If we can build a wall, and have the largest military in the world x 5..we can take care of our people first.
Cliff M. Added Mar 13, 2017 - 8:34pm
I used to be able to join a group sponsored by a labor union for about $90 bucks a year but this option was phased out about 15 years ago.I was able to get a good family plan for $650 a month with a $10 dollar copay on office visits,$50 emergency room visit and no deductible if you entered the hospital. This same plan now cost's well over $2000 a month. Insurance costs have more than tripled while salaries for most have remained the same.
Louis E Weeks Added Mar 13, 2017 - 8:40pm
Cliff,
 
I am one of those who buy my own Insurance on the open market, after Obamacare my premiums went way up, my deductible doubled and we lost our primary doctors, pretty much everything Obama said would never happen ended up happening to me.
 
Obama promised families would see a $2,500 reduction in premiums, instead I saw a $3,700 increase in premiums and doubled my deductible at that rate.
 
Yes, there were a few winners with Obamacare, but the vast majority of Americans were hurt, and hurt bad by Obamacare.  I feel bad for the few who won big with free or severely low cost insurance policies from the subsidies, I am sure it will be difficult for them, but we do not hurt hundreds of millions of Americans just to give away free medical to a few.
 
The cookie cutter, one size fits all insurance mandates drove up costs of Insurance dramatically.  
Cliff M. Added Mar 13, 2017 - 8:44pm
Wsucram15,
     It was a pretty good deal but once a year the insurance agent would have to change carriers. This went on for about 5 years in the late 90's. I remember one year Aetna was the carrier .I know people on Medicare but the 80/20 arrangement can be expensive.My father had his aortic heart valve replaced and it still cost $50K out of pocket. Medicaid can be a hassle but it covers just about everything at no to minimal cost.
Louis E Weeks Added Mar 13, 2017 - 8:46pm
Patrick,
I have a internet buddy in Canada I have known for more than 17 years now.  He blew out his knee and it took 15 months before he got to see a specialist and had an MRI completed.  Over two years from injury to finishing his rehabilitation.   80% of that time was waiting on a list for service of one type or another.
 
American medical does cost more, nobody is refuting that, but how much does it cost to be out of work for two years because the rationed care will not allow an MRI without a lot of hoop jumping?
 
I personally do not believe there is any true cost difference when you compare the two, you may get medical for free or super low cost in a place like Canada, but you lay on your back not able to work for two years or more so how much did that cost you in lost wages?
Cliff M. Added Mar 13, 2017 - 8:50pm
Louis , I have bought my own and worked for companies that provided good insurance plans. Now since the recession my income has fallen drastically to where I fall in the area where the policies I can afford are a total waste. I have actually paid the vig and gone without the last couple of years. I would go for anything that is consumer oriented instead of profit motivated.
Patrick Writes Added Mar 13, 2017 - 8:51pm
Last comment: I think the intention of ObamaCare, to cover pre-existing conditions is the downfall and caused insurance across the board to go up. 
 
I think ObamaCare hoped employers would organize group policies to cover their entire employee pool. But most employers are deciding rather to pay the penalty and not offer this. This sends the person into an individual policy.
 
If the person is 55 with diabetes, if the insurance company puts the person into the risk-o-meter, it comes out that this person could be at risk for heart attack, open heart surgery, all manner of expensive ailments. And they should rightly be charged $5000 / month premiums. In the old days, they'd say diabetes is a pre-existing condition and isn't covered which brings the premium down to $1000  / month.
 
But the ObamaCare says the insurance company can't do that. It must cover the diabetes and must not try to increase the person's premiums above the regular rate. So the insurance company spreads that extra $4000 / month of risk across all their policies, raising the costs for all. I think that's what's happening. 
 
Get rid of the individual policies and get those people into group policies (of a pool of people) and the risk-o-meter finds that as unrisky usually--so long as there are a handful of young, healthy people in the pool. And premiums should come back down to reality in time. 
Patrick Writes Added Mar 13, 2017 - 8:54pm
@Louis, many Canadians with means get private health insurance to cover such cases. 
Louis E Weeks Added Mar 14, 2017 - 12:09am
Patrick,
Now yes, Canada only recently allowed private insurance.  Those without private insurance are still stuck with the very long waiting times.
 
The Canadian Government said they never would allow that two tiered system because they felt it was not fair but after so many years of failure in the public system they really had no choice.
 
But it also made a bad situation worse because the most competent doctors and nurses have quit the public system and moved to the private system to make more money, the shortage of doctors and nurses in the public system is expected to get critical in the next 10 years.
 
 
 
Louis E Weeks Added Mar 14, 2017 - 12:15am
Cliff,
 
What exactly is "consumer oriented"?  You mean you support the Government run system?
 
I already detailed how that will never work on a larger scale.
 
 
 
 
You want to know why medical care costs so much?  Insurance.  Generations of those getting the care not paying for it has driven up costs drastically.  When you are sick and go to the doctor you don;t ask what treatment will cost, you just flash a magic card and pay a tiny co-pay and leave the cost to the insurance company to deal with, the consumer plays no part in cost controls because the consumer does not care.  Other people are paying the bill.
 
So year after year the medical profession has not had to limit their costs to what the average person can afford to pay the way an unexpected car repair would be dealt with by a family and the repair shop.
 
 
Patrick Writes Added Mar 14, 2017 - 1:11am
Insurance companies and the government are able to come together to cap out procedure payouts but my understanding is they don't (not collectively anyway like the government would in a single payer system). 
 
Without health insurance, you're arguing for a single payer system. Is that what you're arguing for? 
 
I mostly agree with you in your last comment but Medicare is what exasperates this. The working person can always have their premiums raised next year but the elderly person truly doesn't care. They can have as many tests, x-rays, as possible and cost never enters their mind (why should it the way the system is designed?). 
Patrick Writes Added Mar 14, 2017 - 1:16am
Remember the elderly, although (guessing) 20% or less of the population is probably more than half of the consumers of health care. You can't get a hold of the problem of healthcare costs in American without getting a hold of Medicare. 
 
Everyone knows of cases of the 95 year old dying woman who has procedure after procedure after procedure done to prolong her life a few more months at great cost to the working families and taxpayers of America. 
 
Even my own grandpa, in hindsight, had a quadruple bipass heart surgery at 78 or 79 that he never fully recovered from (he had one in his early 60's as well) and he died about 4 years later. So that prolonged his life 4 years but he wasn't the same healthy guy after it was done. What is the cost / benefit for stuff like that? I don't know...I imagine the surgery cost well over $100,000...it's a complex issue.  
wsucram15 Added Mar 14, 2017 - 5:32am
Patrick;
what caused the premiums to go up was the mandate, preexisting conditions isnt the problem, its the cost. I know this because I have a lifelong condition that has been excluded from even employer insurance. IDK why, my only cost is for medicines, since I have no problems but I must pay higher premiums in every type of insurance, including life (which is ridiculous its not life threatening). 
Here is the thing though, the coverage is now there and was challenged over 50 times.   I know this must be fixed to be fair to everyone, but at this point Im not sure you can do that.
Its not a moral question anymore, but Im not sure yet, it being debated by far more educated people than myself.
The new plan repeals insurance for people in areas that NEVER had it prior to the PPACA and will NEVER get it again.  The damage to the Trump administration and GOP would be devastating. There is a section in the PPACA that covers miners specifically for black lung after 15 years and their widows, which has never happened before. Those are rural Trump voters, some in Mitch McConnell country.  It will eliminate coverage for opioid and heroin addiction treatment, one of the major issues in rural places like WV. Not to mention the elderly on fixed incomes.
It repeals insurance over time for the poor and increases premiums 25% along with standard health insurance increases (they happen every year) for the ones who can afford it.  The blanket credit given to the older folks is 4,000 when annual coverage is about 12,000 to 14,000 per year, thats what they make in a year on social security, especially if they are in a high risk pool. 
Now Im not guessing, I worked in insurance when I did HR. The company payouts in our company since we did ok, were about 65% of the premium.  We were in a larger pool shelf plan and the  cost varied in 2011-2013 for BC/BS, depending on deductible, whether it was and HMO, PPO, family or single, etc... I dont have exact figures.   I know what mine was and it was 1284 for parent and child for a PPO.  I paid 138 per week ( I also had life, LTD and dental), which at that time was outstanding.  I know my boss had a premium plan better than mine and his for family of four was over 2k, I remember him complaining about it.  But he would have paid..about 180.00 a week plus whatever he added.  I remember many people were unhappy with that plan at that time due to the cost so they went with the HMO.  I bet they would love that plan now.
 
But I went where I wanted and saw who I wanted that took BC/BS, which is pretty much everyone.  There was no waiting period for my disability when we joined, like Aetna or the previous company that didnt cover it at all.
Now on medicaid, there were specific doctors and the care was less as was the treatment.  But it paid for medicines.
I had a doctor drop me in the middle of a treatment due to medicare, even though I have a secondary coverage as well.
 
So in my opinion, there is good and bad in all healthcare...but we are the only country that argues about this.  ALL MAJOR developed countries in the WORLD provide healthcare to their citizens and all of them provide universal healthcare while keeping costs lowered.  WE have the lowest rated healthcare with the highest cost.   THIS IS THE PROBLEM..NOT JUST the mandate.
You cannot penalize the elderly or the sick.  Most of them paid into the system just like you do now. Likewise you cannot penalize the healthy. So this needs to be accepted by the people.   This has become a partisan issue driven by both of the parties and media.
The problem is, 98% of people never read a bill, much less understand what it says.
How many people have actually read the PPACA?  I have. It has problems..but its a good foundation, actually a Republican foundation, truth be told.  Obama wanted a single payer system.
It needs fixed or we need single payer universal healthcare.
Billy Roper Added Mar 14, 2017 - 7:22am
With Socialism, once you give a large parasite population something for free, it's hard to take it away again without an uprising, especially with the controlled media poking them to.
 
"ALL MAJOR developed countries in the WORLD provide healthcare to their citizens and all of them provide universal healthcare while keeping costs lowered."
 
Bullshit. Look at the tax rates the productive segments of their population pay to support the consumptive majority, even in formerly homogeneous nations where Socialism wasn't as parasitic because people had more similar abilities and needs to be Marxistically redistributed. Now, with their nonWhite invasions, Scandinavian countries are floundering to support the invaders.
Cliff M. Added Mar 14, 2017 - 8:55am
In the 12-15 years before the ACA premium prices more than tripled on the individual market making coverage cost prohibitive to way to many.Is government run healthcare the answer? To those with lower incomes it makes coverage more attainable. To those who have prospered private insurance to fit their needs is always attainable. To those stuck or falling from the middle insurance is quickly becoming cost prohibitive. The problems that exist in the healthcare industry on the healthcare side are massive.So far every fix has turned out to address partisan issues.With the healthcare industry one sixth of the economy and the healthcare lobby larger than all of the other lobbyist groups combined trying to fix it will be a fight to the death. It is amazing how trying to improve the health and wellness of people is making everyone sick.
Louis E Weeks Added Mar 14, 2017 - 10:37am
wsucram15,
 
ALL MAJOR developed countries in the WORLD provide healthcare to their citizens and all of them provide universal healthcare while keeping costs lowered. 
 
Simply not true, the Government does not supply anything, they tax the piss out of society and then use that money to pay for those things but even with their cost controls and severe rationing most are still spending more money than they take in.  The people in society still pay for it, it is just universally bad for all.
 
On top of that their models can't work in America, I already explained this.  Those Nations that have a Universal system have more concentrated population so their delivery system (hospitals and such) are fewer in number to maintain.  In America we are more spread out so you close to double our delivery costs compared to those other Nations.  If those other Nations are digging massive financial holes with their systems then it stands to reasons it will be twice as hard for America to do it.
 
How many people have actually read the PPACA?  I have. It has problems..but its a good foundation, actually a Republican foundation, truth be told. 
 
Again, simply not true, the ACA was written by Johnathan Grubber, there has never been any Republican health care plan that looks anything like Obamacare.
 
Where the uneducated get this false idea from is a Right leaning think tank discussed some similar elements like the individual mandate in their theoretical discussions, but just because a think tank talked about similar items, that does not make it a Republican plan.  And even if a Republican had offered a similar plan for consideration there was never any widespread support for any such plan so it is a lie to claim anything was a Republican plan when Republicans never supported any such plan.
 
Yes, the ACA had some similar ideas included that conservative think tanks talked about, but that does not make them the same.
 
 
Saying the ACA is a Republican plan is like saying a Model "T" Ford is the same as a Porsche 918.  Sure they both have steering wheels, tires, windows, and motors so if you just look at the descriptive words between the two you may try to believe the two are identical, but if you go beyond the words and look at the reality you could never mistake one for the other.
 
Louis E Weeks Added Mar 14, 2017 - 10:46am
Patrick,
 
In every other segment of life there is no larger entity paying our expenses for us.  Why treat medical treatment any differently?  If I am driving down the road and suddenly my engine blows up will the Government step in and buy me a new engine or a new car?
 
So if I have an unexpected medical problem, why should Government pay for it?
 
The only reason medical costs are so- high is there is a faceless entity paying for everything.  Government or insurance companies, the one paying the bill is not the one getting treatment so this has allowed the industry itself to constantly invent ways to justify   higher and higher and higher costs and consumers do not care because they do not pay the bill when it is due.
 
 
If you did away with insurance and Government paying all the bills, the medical industry would have to figure out how to operate without the cash cows dumping money into their laps.  yes it would mean some big changes, but much of that extra money is being spent on unneeded garbage.  Why do you need a private room if you are sick as one example.  There are tens of millions of ways we can cut down costs but we have to want to do it, and the consumer will never want to give them up while they never have to pay for it.
 
 
I know, getting rid of insurance will never happen at this point, but that does not mean we can't point to that insurance as the real reason medical costs are so high.
Cliff M. Added Mar 14, 2017 - 12:25pm
Louis, If you are around my age. I'll be 60 we will take a huge hit under the current GOP plan. They want to raise rates from 3 to 5 times more than they charge young ,healthy people.
Thomas Sutrina Added Mar 14, 2017 - 4:24pm
Ryan Care phase 1 had tight requirements to meet the 51 senate vote requirement.  Yet every Democrat senator should vote for it since it has kept the regulations created by Obama Care ACA.   It has kept the state structure of health care insurance, and will cover those that can not pay as well as Obama Care.  The major change is that it has a tighter death spiral and you can choose not to get coverage.  Which is in reality not a very big change since people just refused to buy useless coverage.  
 
An IQ that use to be defined as retarded would tell Ryan that no Democrat would vote for phase 2 or 3  once the GOP took over the responsibility for health care, the death spiral.
 
I had a Aha moment this morning.  Trump would not purchase a building without the blue prints and information on the final product, a building.  He would know how he is going to pay for it etc..  So using these standards he should have thrown Ryan's plan out the door.  Maybe Trump has phase 2 and 3  but we do not.  Poor transparency if that is true. 
 
No one would rent space in a building that Trump would build without knowing almost as much as Trump.  That for health care are the people living in the USA.  And we have receive noting.  
 
Health care that Trump sold is a Shining Emerald City on a Hill.   So let us see phase 2 and 3, that city, while the Democrats have responsibility for ACA health care that everyone must use.  The bills and Price generated regulations will be contingent on the repeal of the present ACA regulations and bill requirements.  These two bills will be voted into law in the House and Senate.  And the bills and regulations will be provided to the public, transparency.  
 
If it is a Shining Emerald City on a Hill then Democrats that own ACA and the present health care will be preventing the implementation of the Shining Emerald City on a Hill.  Now for those senators that are in states that Trump won and up for election in 2018 will be under tremendous pressure.  I think they will get there 61 votes.  
 
Then phase 1 with everything in place can repeal and start the engine of the replacement already in position with all the health care system in the company prepared because they saw it rolled out months earlier and saw the effort to pass them into law.
Louis E Weeks Added Mar 14, 2017 - 6:37pm
Cliff that is simply not true, I saw my insurance almost double under Obamacare, and there is noting in the replacement that forces up costs, not 1 thing.
 
We should see large reductions by removing mandated coverage I do not need to buy, that was always the problem with Obamacare, one size fits all insurance policies stacked up with all sorts of benefits many Americans will never need.
 
 
Cliff M. Added Mar 14, 2017 - 6:37pm
Thomas, You are extremely optimistic.Unless you are wealthy or young this bill is a vomit job. Tax cuts for the wealthy on the backs of the working poor and elderly. It will be lucky to get out of the house. It is a dead issue if it reaches the senate. If you have noticed Trump has only backed this bill from a distance. If it passes he loses many of the voters who elected him. For him it is better off dying on it's own. I do not see a way forward for this bill.What placates the conservatives alienates the moderates.
Cliff M. Added Mar 14, 2017 - 6:45pm
Louis, I have never seen insurance get cheaper in my lifetime. A bill tailor made by the insurance industry leaves me skeptical. I hope your right. If shit follows suit this will only mean more profits for the insurance industry.
Patrick Writes Added Mar 14, 2017 - 7:37pm
@Louis - are you arguing for no Medicare, Medicaid, or health insurance? 
 
In a sense you are right, if those systems disappeared, costs would come down to reality. But it would be a horrible, messy few years with potentially people dying in the street for that to happen.
 
But there has to be downward pressure on cost. So at the very least, Government and insurance companies have to come together to jointly put a cap on costs and procedures. 

If doctors and nurses don't like it, too bad. $300,000 / year isn't enough money? If their counterparts in other countries like Canada and the U.K. make half the money that they do, then that is probably closer to what a "real market" wage is for their work in my opinion. 
Patrick Writes Added Mar 14, 2017 - 7:42pm
I still maintain that if you decouple group insurance policies from employers (currently only a business can do this for its employees--for the most part, seems people are finding ways around this now)--but if you let collections of people form a cooperative, a pool to get a group health insurance policy, the same way employers do today, you've solved the problem. 
 
When a pool of people are put into a risk-o-meter that insurance companies use, it comes out "unrisky" (because on average the healthy balance out the sick). But individual policies where it's a pool of you only, this comes out as "risky" for anyone who's not young and healthy. This is why the system is a mess now because ObamaCare is forcing millions into these individual policies. 
Louis E Weeks Added Mar 14, 2017 - 7:52pm
Cliff, 
We were promised $2,500 in policy rate savings for the average American family with Obamacare, did we get it?
 
Early "predictions" you make now are based on your own biases against anything the Right does,  but there is nothing in the proposed legislation (so far) that will drive up any costs.
 
I have shopped around for insurance and found better deals in the past, and I have seen rate increases too, but I have never in my life seen the kinds of rate increases in out of pocket expenses explode the way they did after Obamacare, my out of pocket easily doubled under Obamacare and most of my friends who are self-insured saw the same thing or worse.
 
In the last couple years some of those Obamacare exchanges saw more than 50% rate increases year to year, there is simply no part of Obamacare that is working as it was promised to work.
Louis E Weeks Added Mar 14, 2017 - 8:04pm
Patrick,
 
I am pointing out the fact that medical costs have gone way up because the consumer is not the one paying the bill.  Medicare and such was the vehicle of this fact but at this point we are trapped in it.
 
 
The average income for doctors is about $200k, compared to their level of education that is horrible, compared to the number of hours they work and their liability and stress it is ridiculous.  there is a reason why most areas with Government controlled healthcare are hurting for doctors and nurses, the pay is not comparable to the work requirements.
 
Anyone who is smart enough to be a doctor can be engineers and businessmen or professional politicians or lawyers and make as much money or more, work less, have less stress and spend more quality time with their family, so why work as a doctor?  You can't force people to work their ass off for pennies.
 
 
I do not understand the comment of downward pressure, how exactly do you think that happens?  Insurance companies already negotiate prices for procedures, so does Medicare, everyone already does try to fix pricing, how do you think that can be done better?
 
 
Are you advocating for Government imposed price fixing?
Cliff M. Added Mar 14, 2017 - 8:26pm
Louis, Under the new plan insurers get to cherry pick customers who they think are good risks. What happens to the elderly and the poor? They are forced back into the emergency room which is the most expensive way. Hospitals and caregivers are forced to raise rates to cover these cost's.Healthcare gets even more expensive. The cost of everything goes up. The only winners are the insurance companies. The hospitals and healthcare providers that provide for the 24 million that lose are left in a dark bad place.
Cliff M. Added Mar 14, 2017 - 8:56pm
Knocking millions of Americans off the healthcare rolls and giving huge tax cuts to the wealthy is the republican way of improving healthcare. Why is this plan so far from what Trump preached repeatedly when he campaigned. This is not the populist approach he campaigned on.
Thomas Sutrina Added Mar 14, 2017 - 9:38pm
Health care cost will not decrease so long as money does not flow through the hands of consumers.  We need to vote with out feet for every day health care.  Plastic surgery that is not dependent of insurance is an example.   
 
Even welfare that today use credit cards is a vote with their feet system.  Medicaid costs will decrease when like welfare the amount of money is limited and the patents can shop around.  Doctors will not know the difference or care where the money comes from.  
 
Why the Democrats and the RINO Republicans do not want this type of system and why ACA and AHCA are similar is that they must please the insurance company that like a system that does not publish prices and creates a wild west market.  Where money can be skimmed of the top by all the players.  The doctors and insurance companies set the prices that medicare and medicaid charge.  And they place a high value on there services.  The up roar of citizens that do not like the total price they pay in taxes as prevented steeper increases.  The division into state markets prevents interstate commerce laws from investigation them.  And it also separates states so the amount paid in a coastal state is higher then fly over country.  No reason except ability to pay.
 
Trump is a deal maker so we as citizens need to sent him a clear message as Ran Paul suggested.  Ryan's plan must fail.  Trump will only keep his campaign promises when we hold him to them.  And now is a promise we must hold him to.  As with business he will take advantage of every weakness.  So write your congressmen.  You can tweet any congressman.  I in Illinois have no Senator that will listen and living close to Chicago also do not have a Representative.  So I have been tweeting the three closest representatives that will listen.
 
 
Louis E Weeks Added Mar 15, 2017 - 12:35am
Cliff, the elderly still get Medicare, are you now trying to claim Trump is removing Medicare too?
 
All you have are unfounded fears, consumers will get back choice Cliff.  Instead of one size fits all extremely high priced policies all Americans will have choices and the power to select what they believe is right for them.  Employers will have the right to offer basic insurance again instead of opting out and paying the fine as they did by the millions under Obamacare.  Normal Americans like me will be able to save thousands of dollars a year by buying similar policies we had before Obamacare destroyed them all.
 
 
And I notice you never reply to my point that not one of the biggest promises made to the American public about Obamacare came true.  Especially the lower costs we were all promised, instead all Americans saw a huge increase in rates.
 
 
 
You want to talk about Insurance companies winning?  That is exactly what they got under Obamacare with all that free Government subsidy money for policies few could find a doctor to accept.  An insurance card is not the same thing as healthcare Cliff.
 
Clearly you did not check out my links, Read this and tell me how successful Obamacare was.
Cliff M. Added Mar 15, 2017 - 7:50am
Louis, I hope you are right and I am wrong if this policy happens.Forgive me for not believing any of the bullshit or rhetoric.Doublespeak has become the norm with promising one thing and then doing another.
Louis E Weeks Added Mar 15, 2017 - 10:01am
Cliff,
 
I am not asking you to believe anything, just stop spreading gloom and doom about this new legislation when you do not have any real idea what will happen.  You are swallowing the lies of the left when they first said Obamacare would be all good and now the same dishonest people are claiming the replacement will be all bad.
 
 
The truth is there will be a mix of good and bad, unlike Obamacare that was only good for a small group of those getting expanded Medicare and subsidies that paid for all or most of their insurance cost, but even those few were having a hard time finding a doctor to accept their new coverage as I posted twice now and you still refuse to comment on.
 
 
No, the replacement will not be perfect, and if perfection is your standard then nothing done will ever measure up.  The question is will it address most of the bad things about Obamacare and the answer to that question is yes.
Cliff M. Added Mar 15, 2017 - 6:58pm
Louis, If you want prices to go down on private insurance go for a public option. This will give choice for all to go private or use the option. It will also force the private insurer's to compete with the public option to see which is the better deal. This way everyone has a fair chance to obtain coverage. Why do you think private insurer's are so against a public option. Because people could decide not to go with the outrageous prices in the private market.
Patrick Writes Added Mar 15, 2017 - 8:12pm
Government and insurance companies should come together, formally, and basically set prices for procedures, yes. How else do you get costs to come down? 
 
The insurance competition point is a croc. A heart surgery is going to cost different prices depending on your insurance? No. Insurance companies could cover this procedure and not cover that one, but the price is the price.
 
But the only thing that happens with insurance "competition" coupled with Medicare is simply cost inflation over time. That brings us to the current state. 
Louis E Weeks Added Mar 16, 2017 - 10:28am
Cliff we had Government mandated coverage and prices for policies exploded, and I already explained why what you call the public option (Medicare for all) can't work.
 
Yes, when you give the public a choice of "free" medical coverage but you have to wait a long time for treatment and travel far distances, yes, many will choose that option because Humans love free stuff, even if it is lower standard than what they have to pay for.
 
But just because people want free stuff, that does not mean the Government has to give it to them.
 
 
Put simply, Medicare for all will break America's medical system.  An insurance card is not medical care, if you make it so anyone in the delivery system can't survive, you force them to close down.  You still have not been capable of absorbing this point, hospitals and private offices the same will have to close their doors.
 
 
You would have to do a lot of other things, for example, you would have to make all doctors immune to lawsuits.  One of the biggest costs doctors and Hospitals have today is medical malpractice insurance.
 
 
And Government is not supposed to compete against private industry, if the Government decides to kill the medical industry we will see another depression.
Louis E Weeks Added Mar 16, 2017 - 11:04am
Patrick,
Cost controls never work, and our Government was never designed to do such things.  Cost controls are why so many doctors are refusing new Medicare patients such as the doctor letter I linked proves.
 
Are all heart transplants exactly the same?  All doctors exactly the same?  
 
If you look up the top heart surgery hospitals it is no shock you find places like the Cleveland Clinic and the Mayo Clinic at the top of that list while it is also not much of a shock that other Hospitals have extremely poor ratings like Jackson Memorial Hospital University of Miami or Methodist Specialty and Transplant Hospital who both get SRTR ratings of 1 (worse rating).
 
So should a patient pay the same amount of money for a transplant conducted at the Jackson Memorial Hospital as they do at the Cleveland Clinic?
 
 
I would say no myself, but I am assuming a "Government solves everything" guy like yourself would say yes?
 
 
 
Cost inflation is a factor in all areas, and is caused more by Government printing money, not any actions by individual groups or consumers.
 
Watch this!
Cliff M. Added Mar 16, 2017 - 1:42pm
Louis, The conservatives that squawk about the free stuff argument have a very short memory. They seem to forget all about all of the tax cuts and deductions that only the wealthy and well to do qualify for. Why don't they call this "Free Stuff" and an entitlement? In a progressive tax system where rates are supposed to be highest on the top why are they paying at rates of people well down the income ladder? And still looking for more advantages. Debating about free stuff is a whole other issue. The health and welfare of every American should be the goal.Look at the way the tax system has rewarded people over the last 30 years. More poor and wealthy while the middle is getting killed. It goes without saying who created this current Republican sham of a replacement bill. Yesterday Trump actually said on Fox news to Tucker Carlson that this bill does great harm to many who voted for him.
Louis E Weeks Added Mar 16, 2017 - 3:32pm
Cliff,
 
You are running in circles, you were demanding free stuff when you asked for what you call the "public option" all I did was point out how that can never work.
 
An entitlement is something you get for free, a tax cut is a reduction of responsibility to pay, you really do not understand the difference?
 
 
Now you are trying to drag in all sorts of unrelated and childish things to cover up your lack of ability to justify pushing free medical care for all without any way to actually make it work.  My story and responses are limited to this fact, you seem to want to avoid addressing this fact.
 
So get back to the point, stop trying to change the subject.  
 
So let's hear it, I detailed why the "public option" is impossible, so if you care to refute the many points made then do so. if not stop spamming off topic and unfounded garbage just because you are emotionally connected to pushing an idea for political loyalty reasons.
Louis E Weeks Added Mar 16, 2017 - 3:37pm
Cliff,
 
I will not allow further off topic stuff from you, get on topic or go away.  In reply to your attempt to attack Trump on a personal level as a distraction I will simply say this, aren't politicians supposed to do what is right and not what will make them popular?  I believe that is at the very heart of the Representative Democracy purpose to avoid mob rule as our Founding fathers warned us against.
 
Sometimes our leaders need to do things for the good of the country that may upset some of it's citizens.
 
So I answered your childish attack, that is the end of it.  Now get back on topic.
Ari Silverstein Added Mar 17, 2017 - 11:10am
The assumption that we can’t afford a public option is false. Our country can afford anything it likes.  We do so by borrowing money, printing money and taxing the populace.  Perhaps one day the rubber will meet the road but we’re $19 trillion in debt and it hasn’t yet.  Pretty soon we’ll raise the debt ceiling and go in further in debt to pay for things like Obamacare among others.  Hopefully Trumpcare passes as it forces more people to pay for their own healthcare insurance rather than get it for free/subsidized.  My point is that I wouldn’t be so dismissive of the public option on the grounds it can’t work.  Don’t believe me, take a look at the rest of the industrialized world, let alone many third world countries, many provide their healthcare via the public insurance option.  Or look at our own country, Medicare and Medicaid cover more people as a percentage of our population every day.
Louis E Weeks Added Mar 17, 2017 - 11:31am
Ari,
That is what Greece did, do you want to emulate their successes by just keep on borrowing money we can't pay back until the door is shut?
 
 
Those other Nations are a great example of why we can't pay for it, have you been watching the news concerning the cutbacks and massive funding shortfalls those other Countries are dealing with?
 
I detailed above why we can't pay for it, you could take the time to read my story and then reply on the points if you really believe you have the answers but just blurting out we can do it is not a rational reply to the points.
 
 
But met me add another point, today millions of people work in the Health insurance industry and related fields, every doctor office has at least 1 person in the office dedicated for just processing insurance claims, then there is the companies themselves.  Even if you could get Medicare for all paid for, we will get a sudden and painful loss of millions of jobs at the same time, I do not believe any politician wants to go on record for that but even if they did it would be a large enough impact to push us back into a recession and drive up unemployment again, you have to look at the big picture.
Jenifer Frost Added Mar 17, 2017 - 1:05pm
The second problem would be eliminated in a Medicare for all situation as other than Medicare the only other payment option would be cash which is a very small payment percentage, not enough for doctors to feed their families. My brother who is disabled but works what he can has Medicare thanks to the ACA and for the first time in his adult life has a doctor and treatment for high blood pressure which would have possibly killed him without it. Why put people's lives at risk for corporate profits? 
Mike Haluska Added Mar 17, 2017 - 4:08pm
Bill H's problem with health care is that a few corporations have monopoly control of the market (true).  His solution?  Give control of ALL aspects of health care to a SINGLE ENTITY (federal government)!  Why?  Because he thinks the government will regulate costs and run the heath care delivery system more efficiently.
Mike Haluska Added Mar 17, 2017 - 4:21pm
Ari - do you really believe your statement:
 
"The assumption that we can’t afford a public option is false. Our country can afford anything it likes."
 
is rational?  Just how does any country "afford anything it likes"?  Has any country in history been able to sustain such schemes?  What happens when other nations and wealthy individuals lose confidence in the USA's ability to repay the $20 trillion debt?  Will the USA do like the Germans after WWI and turn on the treasury printing presses and "print" the money it owes its creditors?  What will printing trillions of dollars of unbacked paper currency do to our savings accounts, investments, salaries, grocery bill, etc.?
 
It is the eleventh hour and our politicians in Washington need to grow a spine, act like adults and support Trump's spending cuts.  Whining about cutting NPR's budget and people in Vermont not getting to listen to NPR radio programs about making Maple Syrup shouldn't be tolerated as legitimate reasons to spend everyone into oblivion.  
Louis E Weeks Added Mar 17, 2017 - 10:59pm
Jennifer,
Not sure of the first part of your comment, are you saying medicare for all and eliminating all insurance related jobs is a good thing?  I do not see it that way if you are.  Millions of people suddenly shoved into the unemployment lines?
 
I am also not sure of the part about your brother, if he is disabled and only works a little he should have easily qualified for Medicare and if he draws disability from the Government I believe he is already enrolled is he not?
 
High blood pressure can be diagnosed by an emergency room doctor as well and some stores have a no-insurance free or very low cost series of drugs for high blood pressure, for example the Publix drug store has I believe 3 different drugs they fill for free that deal with blood pressure issues.  On top of that most local areas have Christian service centers and Catholic charities (no you do not need to be religious to get help) who will gladly help people with basic medical needs like helping them get blood pressure medication.
 
People do not need Government to fix every aspect of their lives,  we are not pets, the Government does not need to micro manage every aspect of your life for you, there are solutions, especially to easy issues like blood pressure meds.
Jenifer Frost Added Mar 17, 2017 - 11:16pm
I'm not concerned about health insurance employees losing their jobs, there are various other types of insurance jobs available (life, home, automotive, etc). Bad business job are bad jobs, take for instance jobs in the fossil fuel industry or child porn distribution. Those are jobs. I don't view jobs at any cost as some irrational prime directive. 
 
My brother has PTSD but does not draw disablity. He can't work full time only part time. He qualifies for Medicare under the ACA but not without it (he would have to quit his job and become homeless for at least a year to,maybe, perhaps qualify - outrageous!). He also has gout and needs medication for that which Medicare covers. But not if Trump doesn't at least keep Medicare for the working poor as the ACA allows in states where the governors aren't sadist pigs. 
 
Why should I give a shit about anyone such as insurance employees when no one gives a shit about people like my brother? 
Louis E Weeks Added Mar 17, 2017 - 11:47pm
I'm not concerned about health insurance employees losing their jobs, there are various other types of insurance jobs available (life, home, automotive, etc).
Those other jobs are already filled, so we have to admit that we are dooming millions of American workers to unemployment as part of this plan and it's costs to society and Government.   Claiming they will just get new jobs is other insurance jobs is simply not true Jennifer, you know this so please be more genuine in your replies.
 
Please.
 
 
Bad business job are bad jobs, take for instance jobs in the fossil fuel industry or child porn distribution. Those are jobs. I don't view jobs at any cost as some irrational prime directive. 
 
These replies are making me sad Jennifer, I thought so much more of you before these disingenuous comments you are making.  Oil industry and kiddie porn are exactly the same to you?  Really?
 
Oil and related products are the original embedded tax kings.  Oil is taxed at every step it takes, even raw plastics are taxes when produced and taxed again when transformed into various consumer products.  All our roads are funded by oil.  Eliminate oil use and no roads.  County, State, and Federal taxes off oil and related products are massive and without them we would see a National crisis in funding of so many things.
 
My brother has PTSD but does not draw disablity. He can't work full time only part time.
 
 
Well if the PTSD is work related he is automatically covered by someone, if not he can get disability, I know several people who get disability for PTSD.  If he is only working part time but still makes too much money to qualify for help he must make a lot of money part time, wow.  What State does he live in I would like to research this because it does not sound right, I have helped many people get help and pretty much anyone on part time minimum wage could get Medicaid and other help depending on the area they live in.  Those who are disabled can qualify for both medicare and Medicaid if they are low income so I am not sure how the story you tell can be true.
 
(he would have to quit his job and become homeless for at least a year to,maybe, perhaps qualify - outrageous!).
 
 
Not true, more disingenuous commentary.  I have worked in helping people go through the process for over 20+ years now volunteering at our local Christian service center. I have directly helped at least 60 people myself,m taking them to appointments and helping them fill out forms and getting documents together from their doctors to help and yes it can be nerve racking but it is not impossible, you just need to do the work.
 
He also has gout and needs medication for that which Medicare covers. But not if Trump doesn't at least keep Medicare for the working poor as the ACA allows in states where the governors aren't sadist pigs. 
 
Again, if he is disabled and only working part time he should qualify, again what State is this we are talking about?  I may be able to help.  I have a lot of experience with the system.
 
Why should I give a shit about anyone such as insurance employees when no one gives a shit about people like my brother? 
 
So what you are saying is as long as you get what you want, screw everyone else in the world?
 
Do you care about your brother?  You seem to be pretty well off, extremely smart and doing well, can you help your brother?  If you do not want to do it why should the Government?  I know this, my Brother would never go without if he was disabled, he would live with me and we would figure it out together.
 
 
By the way, my brother died from complications with diabetes.  He had medical coverage but did not respect his disease and would eat a bunch of food then try to take extra insulin to cover it.  Several comas and seizures later his body started shutting down, eyes, kidneys, extremity pain, then his heart, he died a slow and painful death.
 
A couple years ago one of my best friends died from brain cancer, she got to see her daughter graduate high school before she died.  I was at her side every day at Hospice and she also died a slow and painful death.
 
We all watch loved ones suffer Jennifer, striking out at others does not make it any better.
 
Jenifer Frost Added Mar 18, 2017 - 7:55am
Let's break this down, first, yes I do view health insurance, fossil fuel, and child porn jobs all the same. All jobs which hurt others to make a buck for themselves, selfish and amoral. Watch people die with pre-existing conditions, watch the entire future of the planet burn and the world’s children suffer, or hurt children right now. All evil businesses to which I have zero mercy. Next. 
 
Being that the current system allows people like my brother to live and not suffer, fucking it over to give the rich a tax break to fuck over people who are responsible (like my brother) and don't need to suffer is irresponsible and outrageously unacceptable. He lives in Ohio and applied for disability twice before. The Social Security system and lawyers told him he has to quit being responsible, quit his job and become homeless for at least a year to qualify for disability. So yes I believe them, numerous others have said the same. Only if he lies and pretends he's insane can he hope to qualify even then we are told. Real "nice" system. At least the Medicare through the ACA works now even our Republican governor agrees so let's fuck that over to give the rich a tax cut, makes sense screw working people right? So yes, I don't give a damn about slime balls jobs that hurt others if my brother who does all he can to make a living and live healthy has to suffer to give the greed ball rich fucks a Goddamn tax cut that they don't deserve, and obviously don't need unless you are saying money for the rich that they will never need or spend trumps people's lives. 
Cliff M. Added Mar 18, 2017 - 10:05am
Louis, This will be my last comment on this thread. Medicare for all may not be the answer but the current GOP healthcare replacement plan that does great harm to millions of Americans while rewarding those who need it least is not what President Trump campaigned on. If you get the proposed plan it will only sow more discord and change the election landscape for 2018 in a very negative way for the Republicans who support it. I try to be pragmatic but the current replacement plans negatives far outweigh the positive aspects which the GOP claims it will attain.
Louis E Weeks Added Mar 18, 2017 - 10:10am
Cliff,
 
How can you make that prediction when you were all wrong about how wonderful and perfect Obamacare would be?  You are making an assumption based on political loyalty, not knowledge.  This Bill may not pass, we may be stuck with Obamacare and it will fall apart on it's own because it was flawed at it's core from day one.  You prefer to just watch it slowly die and cause even more harm than replacing it?
 
 
Louis E Weeks Added Mar 18, 2017 - 10:32am
Jennifer,
Let's break this down, first, yes I do view health insurance, fossil fuel, and child porn jobs all the same.
 
 
So you lack the capacity to see shades of grey in the world, only black and white.  I thought more of you.  Sorry to learn this about you.
 
But you are wrong, all actions have a negative side, all of them, you can't name a single thing that is 100% positive.  For example, most solar panels are produced in plants where they do not take many considerations for the environment, it is all about making the panels as cheap as possible.  We do not have a way to recycle most of these poorly made panels so they go into the landfills when they fail or get damaged.  That is a lot of heavy metals and chemicals being shoved into the land fills.  so there is a negative to solar.  
 
So based on your own standards that means all solar workers are the same as child porn producers.....right?  remember, no shades of grey, just black or White in your world.
 
Being that the current system allows people like my brother to live and not suffer, fucking it over to give the rich a tax break to fuck over people who are responsible (like my brother) and don't need to suffer is irresponsible and outrageously unacceptable.
 
The current plan under consideration is not giving tax breaks to the rich, not sure what has confused you into believing that but it will mostly help small business owners to middle sized and those individuals who buy their own insurance a massive break in costs.
 
Your brother who is not working should already qualify for public assistance without the expansion.
 
 
He lives in Ohio and applied for disability twice before. The Social Security system and lawyers told him he has to quit being responsible, quit his job and become homeless for at least a year to qualify for disability.
 
 
I am sorry but that is simply not true.  Lawyers do not tell people to be homeless, they may tell you to drop some assets that are pushing outside of the income window sure, like if you own a fancy home worth a lot of money they will tell you that you need to sell that but you do not need to be homeless to get disability, that is not true, as I said I have a lot more experience in this stuff than you do so you can't bullshit me.
 
What is typically done in a case like this is you sell to a friend or family member then they turn around and rent you the home, yes you may need to do something with the profits  for a couple years to get outside of the windfall (usually 5 years) but then you can get approved easily.
 
I looked up some info on Ohio, if you earn less than $20,000 a year you qualify for a huge list of welfare programs to include being eligible  for Ohio Medicaid if you earn less than $990 a month and from what you say your brother should easily qualify, you can verify this fact here, click me!
 
So yes, I don't give a damn about slime balls jobs that hurt others if my brother who does all he can to make a living and live healthy has to suffer to give the greed ball rich fucks a Goddamn tax cut that they don't deserve, and obviously don't need unless you are saying money for the rich that they will never need or spend trumps people's lives. 
 
Well again, there is no tax break, and you being greedy and demanding free stuff is okay but others wanting to keep some of what they earned is evil?  How do you balance that mindset?  From all evidence I have seen your brother does qualify for help if he wants it, but maybe there are things you have left out?
 
 
As I pointed out above, I have seen loved ones die slow and painful deaths, I could not share what I saw my mother went thorough because it is too painful to talk about for me, we all suffer, money and getting free Government goodies does not make suffering go away.
John Minehan Added Mar 18, 2017 - 3:42pm
Couple of thoughts:
 
---Medicare is an 80-20 circa -1965 BC/BS Plan.  If you can't afford a good Medi-Gap policy, but have too many resources to be dual-eligible for Medicaid, it is basically unaffordable. 
 
---If you wanted to make a current Federal Health Program universal, you might want to use Medicaid, since it already covers broad demographics and is a state-Federal program as Canadian Medicare is federal-provincial.
 
---Until the "Doc Fix," Medicare was indispensable for most medical practices.  Reimbursement was low, but it paid net 45 days on a clean claim and generated cash flow while you were dancing the "prompt payment dance" with more remunerative private payers.  However, Medicare became slower and slower . . . .
 
---There was a logical reason for Medicare in 1965.  The advent of Experience Rating made Health insurance unaffordable at around age 65 . . . but keeping everything Community Rated would have made things expensive for everyone else/
 
---Now, however, it is not uncommon to find a lot of working people in their 60s and 70s on normal commercial group plans.
 
---It seems like non-employment-based Group Plans might be a way to replace both the individual market and Medicaid.  http://www.writerbeat.com/articles/15844-Some-Further-Thoughts-on-Non-Employer-Based-Groups
 
  
John Minehan Added Mar 18, 2017 - 4:04pm
"Government and insurance companies should come together, formally, and basically set prices for procedures . . . ." 
 
That is basically how discounted fee-for-service works using the Medicare Fee Schedule in that Catchment area.
Jenifer Frost Added Mar 18, 2017 - 7:17pm
Louis writes "Your brother who is not working should already qualify for public assistance without the expansion." 
OK, I never said he doesn't work. He works all he can, which is part time being that he has PTSD. He was told by Social Security administration themselves he has to be jobless for a year minimum to qualify for disability. Jobless is homeless if one isn't rich, he isn't. So your saying that they lied, his lawyer lied to him. OR you are wrong. I choose to believe the latter. If it doesn't make sense it isn't true. Also my brother lives in a rent assisted HUD apartment, he has no assets. No house, not even a car. Just a cell phone and a TV, that's it. Don't know where you get this idea everyone is well off. Not realistic. 
 
Also I never said everything is black and white. Pretty damn black (evil) to be selling child porn, or destroying the future of the world producing fossil fuels, or watching people die because they have preexisting conditions. Like my friend Cathy who was diagnosed with colon cancer. She couldn't afford health insurance so no doctor until she was already sick. Then the precious health insurance companies you love so denied her any help. So she got sicker, her family went bankrupt and she died slowly and painfully. Should have been those parasites in the insurance company, so FUCK THEM let them lose their jobs and become homeless! Damn vermin scumbags! Like I said, as bad as child porn producers. Evil to the core vampires. May they all rot in your Hell! Cast them all out of work? You bet ya! I would love to see them pay a hell of a lot worst. 
Louis E Weeks Added Mar 18, 2017 - 8:23pm
John,
 
But you still do not cover doctors who can't accept Medicare or Medicaid only patients.  Normal local doctors can't stay in business with those payouts, a insurance card is not medical care.
John Minehan Added Mar 18, 2017 - 8:34pm
"But you still do not cover doctors who can't accept Medicare or Medicaid only patients.  Normal local doctors can't stay in business with those payouts, a insurance card is not medical care."
 
Since, I suggest replacing Medicaid with Non-employer-Based-Groups, that might explain that. 
 
Docs would then take the "Medicaid" population as an adjunct to people  covered at the Group rate. 
 
There might be some Antitrust issues there ("tying") but there is probably a legislative fix to that.
 
Prior to Medicaid, Medical Societies mandated "sliding fee schedules" so the concept is nothing new. 
  
Louis E Weeks Added Mar 18, 2017 - 8:55pm
Jennifer,
 
OK, I never said he doesn't work. He works all he can, which is part time being that he has PTSD.
 
 
You said he works part time so his income should easily be inside the income limits for Ohio's Medicaid program as the link I provided details.
 
So my point is you do not have to see the loss of the ACA as the end of the world.
 
You do understand even if Trump does nothing the ACA will end.....right?
 
 He was told by Social Security administration themselves he has to be jobless for a year minimum to qualify for disability. Jobless is homeless if one isn't rich, he isn't. So your saying that they lied, his lawyer lied to him. OR you are wrong. I choose to believe the latter.
 
I am telling you that is not the law so whatever people are telling you in this regard it is simply not true so either they lied to you or you are mistaken about what they said.  There is simply nothing in the rules about someone needing to be homeless to get disability.
 
Take that any way you want but if you are being honest about what was said you need to find a competent lawyer because that one you have is a fool.  Here in Florida we have a lot of retired and disabled people dealing with the system, we know what the rules say and what they do not.
 
 
Don't know where you get this idea everyone is well off. Not realistic. 
 
Would you mind directly quoting my words saying that or admitting you are being dishonest about what I have said?  I hate it when people insert things I never said and then attack me personally over what they dishonestly inserted.
 
If you take the time to read what I actually said I was detailing out the process of how to deal with those who do have assets, I never said everyone is well off, please refrain from this tactic in the future.
 
Also I never said everything is black and white.
 
 
Actually you did, you said all were exactly the same.  Now you are trying to back peddle but that is what you said.
 
Selling kiddie porn and making it is something that deserves instant execution, pumping gas to feed your children is not comparable to anyone with a honest mind.
 
Then the precious health insurance companies you love so denied her any help.
 
Again, this is a dishonest tactic to insert words into my mouth I never said.  I agree there are problems, there were problems before and there will be problems in the future.  There is no such thing as perfection Jennifer, you are trying to make everything black and white and flat refusing to see there must always be grey area in all topics that deal with mass numbers of people like this.
 
The ACA is doomed to fail, people will be much worse off if we do not replace it before it fails.
 
So she got sicker, her family went bankrupt and she died slowly and painfully.
 
As did my friend, my brother, my mother, do you think better health insurance means nobody suffers?  You can prolong endings sometimes sure, but you can't stop people from dying.
 
I saw the exact same kinds of endings in my family and they all had great insurance.  My friend died of brain cancer under 40 years old, having great insurance, and it did not save her.
 
Should have been those parasites in the insurance company, so FUCK THEM let them lose their jobs and become homeless! Damn vermin scumbags! Like I said, as bad as child porn producers. Evil to the core vampires. May they all rot in your Hell! Cast them all out of work? You bet ya! I would love to see them pay a hell of a lot worst. 
 
This is what happens when people wallow in negative emotions and ignore logic and reality.  Why did your Cathy not have insurance before she got sick?  You said she was turned down for pre-existing so that means she went without insurance and only considered insurance coverage when she got sick.
 
This means she only wanted insurance when it meant someone else was paying for her medical bills and she would not contribute to the system when she was well.
 
So Cathy was greedy too, she was evil herself wanting to take advantage of an insurance company then drop the insurance after she was better or died.  
 
Sorry but even Obama said everyone needs to be in the game to make it work and people waiting to get sick before getting insurance is morally wrong.
 
I am sad your friend got sick, but her waiting to get insurance until she was sick was her choice, she tosse
Jenifer Frost Added Mar 18, 2017 - 9:05pm
Once again you assume everyone is well off. Cathy was not. After rent and bills and caring for her two kids she could not afford health insurance, like thousands of other people in the country. Now tell me how you didn't say what you said about here being greedy. Yeah greedy to feed her kids. Not loving and generous like the beneficent health insurance companies (*sarcasm*). Now her kids are minus a mother, real nice of the health insurance companies to have helped murder her by pricing insurance out of range. But according to some it's always the victims fault of course. 
Louis E Weeks Added Mar 18, 2017 - 9:26pm
Jennifer,
 
Once again you assume everyone is well off.
 
Again you are inserting words into my mouth, I have asked you to not use that dishonest tactic.  I never claimed Cathy or anyone else is well off so why do you lie and claim I did?
 
I am sorry but you are breaking your own rules for conduct in these discussions, why?
 
 
 
If she could not afford to pay insurance premiums before she was sick, why could she afford it after she was sick?  Clearly most people can afford basic insurance, it is all about prioritizing your money.  How many people have cellphones today?  how many people have cable tv and buy coffee from starbucks?   Drive nice cars and have nice clothing?  
 
 
If people like your friend Cathy only buy insurance when they get sick how can insurance function Jennifer?  Cathy wanted to buy the policy, force the insurance company to spend a million dollars on her cancer and end of life care, then she dies, right?  If everyone did exactly like your friend Cathy how can an insurance company survive?
 
Let't be honest, it is unfair to the insurance company and the other paying customers to allow this sort of last second enrollment.  If they let Cathy do this then everyone else must pay more.  You complain about pricing insurance too high but you advocate for people like your friend taking advantage of insurance companies so you can't have it both ways.
 
 
 
Murder?  More like suicide because she made the informed choice to not buy insurance until she was sick.  Waiting till the last second was not the fault of the insurance company.  It was Cathy's fault.  so Cathy was having a difficult time caring for her children?  Did the Insurance company force her to make children she could not afford too?  How many things can you blame on the Insurance company?  The problem is a lot of irresponsible people pumping out babies with no idea how to take care of them or even themselves.
Jenifer Frost Added Mar 18, 2017 - 9:49pm
I am sorry but you are breaking your own rules for conduct in these discussions, why?
 
Because my rules only apply on my article discussion threads (obviously - as made perfectly clear in the Rule of Three guidelines) not that I'm threatening anyone, slandering anyone, or producing fake news anyhow. 
 
And again, you describe Cathy as well off. I'm sure you will again refute that and ask me to not say that you are saying what you keep saying, so I'll end this as it's impossible to follow whatever your very unclear rules here are until you clarify them. My point was she (Cathy) had TWO children not 22, 2 is perfectly reasonable and was affordable. Health insurance was not reasonably priced until the ACA. By then it was too late for Cathy, she died right before it was enacted. Had it been around before she would probably still be around. I'll never forgive the greed of the insurance companies for this and the many others they have murdered. No word play can change those facts, that history. A complete dismantling of the health insurance companies nationwide would be only justified IMHO and I will support any plan that works for that end. 
Louis E Weeks Added Mar 18, 2017 - 10:12pm
Jennifer,
 
Because my rules only apply on my article discussion threads
 
So you are more than happy to do things in other people's stories that you will not allow in your own, gotcha.
 
And again, you describe Cathy as well off. I'm sure you will again refute that and ask me to not say that you are saying what you keep saying, so I'll end this as it's impossible to follow whatever your very unclear rules here are until you clarify them.
 
What is your definition of well off then Jennifer because to me being well off is upper middle class lifestyles, you rich or something?  You seem disconnected from reality.
 
I have no set rules, but being dishonest and inserting words into my mouth I never said then attacking me on a personal level for what you dishonestly inserted is really a bad tactic and proves you are unwilling to have a reasonable exchange of ideas.
 
My point was she (Cathy) had TWO children not 22, 2 is perfectly reasonable and was affordable.
 
 
 
Clearly the facts show at this point two children were way beyond her capacity to afford if she could not maintain insurance.
 
Health insurance was not reasonably priced until the ACA.
 
All rates leaped up after Obamacare.  Some try to claim they went down based on offsetting costs with subsidies but the base rates were all drastically increased.  The other dishonest claim they make is while premiums drastically increased, people are getting more for their money because they get more coverage.   That is certainly debatable because not all people use the mandated benefits their policy now covers like two gay men with a family policy will never use birth control and pregnancy coverage but they are still paying for it.
 
By then it was too late for Cathy, she died right before it was enacted. Had it been around before she would probably still be around. I'll never forgive the greed of the insurance companies for this and the many others they have murdered. No word play can change those facts, that history. A complete dismantling of the health insurance companies nationwide would be only justified IMHO and I will support any plan that works for that end. 
 
Or she could have not waiting till she got sick to buy insurance and had family coverage for well visits, checkups, etc as all responsible parents do for their children.
 
But no, she wanted to roll the dice and gamble with her own life and the lives of her children.  Now her children do not have a mother because their mother refused to buy insurance before it was too late.
 
The insurance company did not force her to make babies she could not afford to care for and they did not force her to wait till after she was sick to try and buy insurance.
 
 
I feel bad for her and her children, unfortunately children always suffer for the bad decisions of their parents.
 
Jenifer Frost Added Mar 18, 2017 - 10:46pm
Just to clarify, when not posting on my own articles threads, I follow the rules set forth by the author of said article and Autumn's rules, which are as follows, no:

Slander, personal attacks or abusive, hateful, offensive language or material.
Spam or links to spam (repeated attempts to redirect readers to another website are considered spam).
Comments off-topic to the article.
All capital letters.
Intentionally inflammatory rhetoric.
Links to inappropriate or unrelated content.
Identical, repetitive comments posted on multiple articles.
Excessively long URLs
Blatantly promotional content.
Reproduced copyrighted articles from other sources: provide a link only.
Mike Haluska Added Mar 20, 2017 - 9:20am
As long as the insurance companies are protected from monopoly laws by the McCarran–Ferguson Act, we will not get lower health care premiums, variety of policies, etc..  Congress didn't repeal this arcane law with Obamacare and you can bet Paul Ryan won't unless Trump pushes him to do it!!!
John Minehan Added Mar 20, 2017 - 12:05pm
On the health insurance side, I'm not sure repealing McCarran Fergusson wouldn't increase market concentration.
 
Only the large, national payers (the Blues, United, etc.) have the reach to develop panels in all 50 states, which is a requirement with any kind of managed care product.
 
Further, although having the laws of the least restrictive state become a de facto national standard (Delaware with incorporation and South Dakota for credit cards) is a sort of a national tradition, I'm not sure it isn't, at least to some degree, an affront to Federalism.
Victor Crain Added Apr 14, 2017 - 11:43pm
Let's look at data.  Life expectancy varies by income level in the US and by state. You die much earlier if you make less than $40,000 per year or live in Nevada. The quality of healthcare statewide is basically subpar in places like Mississippi, Kentucky and West Virginia. Not knowing better people pay for that with their lives. That's what the legacy of politics has produced. (The data supporting all of this, with footnotes, are on my blog.) Now, how do you feel about that?
 
I know of a woman in Miami who died of a brain tumor recently, when it might have been cured had she sought care at Duke.  She didn't know and her doctor probably didn't either. How do you feel about that?
 
Nobody is proposing an actual reduction in insurance rates. The CBO (the head of which was appointed by the GOP) forecast a 20% increase in rates each year for three years if Trump's AHCA bill had passed.
 
Life expectancy in the US is on a par with Bosnia, yet we spend more on healthcare per capita than any other country. Move to Canada or Hong Kong, and you live an average of two years longer; Monaco and you gain 12 years.
 
So, pray tell, why do people want to return to a system that was failing before the ACA came along. Aren't we bright enough to do better?