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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Lane3 who wrote (41404)	3/10/2017 2:25:38 PM
From: i-node	Read Replies (1) \| Respond to of 42652

I don't know to what extent that would encourage people to stay in or not. As a person who has never had any kind of medical crisis, I might say, "I'll roll the dice." As a person whose doctor thinks he's a walking heart attack, I'm not sure lol. You have to think there have been some discussions with insurance companies and actuaries on this; after all, they presumably don't want to enact legislation that they know will not work. Still, you end up with the problem of uncompensated care, since a good number of those people aren't going to have the 30% (I suppose the hospital could pay it for them and come out well on it). I don't know. I wonder if there are any data on this based on other programs? If there is a way to keep IRS out of the picture I vote for that...

To: Lane3 who wrote (41404)	3/10/2017 3:02:02 PM
From: i-node	Read Replies (1) \| Respond to of 42652

A little different topic (i.e., no segue) but I read the other day that the total healthcare economy last year amounted to 3.35 trillion, and 1/2 of that was spent on 5% of patients. I think I decided that was about $10,345 per patient, except for the 5% which would be closer to 100k. Kinda makes me wonder if there isn't a cheaper way to service this group of ~16-17 million patients.

To: Lane3 who wrote (41404)	3/10/2017 7:37:57 PM
From: John Koligman	Respond to of 42652

This conservative thinks the 30% rule will not encourage the healthy to buy. Entire article at the link. Perhaps the clearest example of this problem is one of the more peculiar features of the new proposal: the 30 percent surcharge on premiums for people who have not been continuously insured. This is an echo of the protection for continuously covered people that has been part of many Republican health-care proposals in recent years. But it is distorted by the fact that Obamacare’s rules would remain in effect. Its goal, presumably, is to discourage people from waiting to buy coverage until they are sick by making insurance more expensive to people who haven’t been insured for a while. But in practice, this kind of penalty would probably have the opposite effect. It would create a disincentive for everyone who hasn’t been continuously covered to get coverage, by making insurance more expensive for them. But that disincentive would do more to drive away healthy people than sick people, since the added premium is more likely to be worth it to someone who otherwise would have higher costs than to someone just looking to get insurance for a rainy day. It would, in other words, exacerbate the problem it is trying to mitigate. And why have such a peculiarly designed continuous-coverage feature? Because Obamacare’s rules would remain in effect. The way continuous coverage protection has usually been thought of in prior conservative proposals assumed you’d get rid of Obamacare’s form of community rating and then re-introduce a version of community rating available only to people who have been continuously insured (in a system where everyone could afford to be continuously insured with at least catastrophic coverage). So as a benefit of being continuously covered you get guaranteed renewability of your existing plan regardless of changes in your health and also some constraint on risk rating when switching plans. That would make insurance much more attractive to healthier people, since they could get in at a lower rate and then either keep their plan at that rate or have some protection from the full effects of pre-existing conditions on their premium when switching to another plan. It would be a strong reason to get covered when you’re healthy, rather than a reason not to. The architects of the House proposal seem to think they can’t do this because they can’t alter Obamacare’s community rating in reconciliation. So they opt for a new surcharge instead of a rule change. But (as suggested above) it’s not clear why they should be able to get this new surcharge through reconciliation but not be able to get rid of or alter the terms of community rating through reconciliation. As a chapter heading called “continuous coverage protection” this could be excusable. As a specific policy provision, I don’t think it can. Other structural elements of the proposal seem to be functions of a similar process of imaginary negotiation with an imaginary Senate parliamentarian. Not all, of course. The absence of a cap on the employer tax exclusion, for instance, seems to have its roots in more familiar political pressures. It, too, is a serious mistake that needs to be remedied. nationalreview.com

To: Lane3 who wrote (41404)	3/10/2017 8:22:46 PM
From: John Koligman	Read Replies (1) \| Respond to of 42652

And this conservative actually makes eminent sense when he says: "Next, the GOP should address the value of the tax credits for households just above Medicaid eligibility. It is not necessary to replicate the ACA’s credits, but it is also important to recognize that households at 200 percent of the federal poverty line (around $24,000 for a single person) will need more than $2,000 or $3,000 or even $4,000 to get a health insurance plan. Higher credits for this population would not jeopardize the GOP’s goal of less complex and affordable tax credits." realclearhealth.com I cannot fathom what 'RyanDon'tCare' was thinking when he removes all the taxes on the highest earners in the US and simultaneously drastically cuts assistance to the lowest income ACA buyers. Since 'stupid' probably isn't the right word, 'don't care' might be...