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TROIKA CURES GREEK posted:Nope. It's 100% correct, including rural and rust belt regions. The "uneducated" whites as you called them who tend to back Republicans, and I think it's dishonest to ignore minorities in these discussions anyway, typically have above median incomes and wealth. Think cops, carpenters, military personnel, private contractors etc.
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May 13, 2017 18:31
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So I've been in the US for a year and a half now and have supposedly really good insurance through work. A couple times now, one example being trying to get new orthotics, the doctor has to 'check' that's it's covered by the insurance. From what I gathered, this actually involved contacting the company and asking them? Is there really a shitload of people at Cigna or whatever that sit there all day making judgement calls over all these little things?? Or do I misunderstand... E: I guess my point is shouldn't it only be up to the doctor as long as it's covered... simmyb fucked around with this message at 19:14 on May 13, 2017 |
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May 13, 2017 19:12
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simmyb posted:So I've been in the US for a year and a half now and have supposedly really good insurance through work. Yes, yes, and yes.
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May 13, 2017 19:44
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baquerd posted:Yes, yes, and yes. There is also someone at the doctor's office (well, managing hospital, most likely, these days) whose job it is to decide whether or not they can get away with charging you extra based on that judgement call when they present the bill to your insurance company. There is also someone at the insurance company whose job it is to decide whether or not they can get away with telling the doctor "gently caress off, we're not paying for that, collect from the patient or nobody." There is also someone at the doctor's office whose job it is to decide whether or not they should fight that person over getting them to pay or if it'd be easier just to try to collect full cash value from you. We have built an amazing system here.
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May 13, 2017 20:05
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baquerd posted:Yes, yes, and yes. Most Payers have automated this. They run a portal which Providers can log into and request Prior Authorization for procedures.
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May 13, 2017 20:13
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Ze Pollack posted:There is also someone at the doctor's office whose job it is to decide whether or not they should fight that person over getting them to pay or if it'd be easier just to try to collect full cash value from you. Does this mean that if I take an expensive medicine every 8 weeks that without insurance costs $8000 (Remicade), that makes them more likely to fight it bc they're taking into account that I probably don't have that kind of cash?
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May 13, 2017 20:18
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FAT BATMAN posted:Does this mean that if I take an expensive medicine every 8 weeks that without insurance costs $8000 (Remicade), that makes them more likely to fight it bc they're taking into account that I probably don't have that kind of cash? Ahahahaha. No. Your financial status has nothing to do with this exercise. The debt collectors they'll sell the bad debt to will start hitting up your family members.
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May 13, 2017 20:23
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FAT BATMAN posted:Does this mean that if I take an expensive medicine every 8 weeks that without insurance costs $8000 (Remicade), that makes them more likely to fight it bc they're taking into account that I probably don't have that kind of cash? The most I've heard of a Provider doing is using credit score from one of the reporting bureaus. There could be more invasive systems out there, but I think they would be the exception to the rule.
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May 13, 2017 20:25
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Xae posted:The most I've heard of a Provider doing is using credit score from one of the reporting bureaus. When I worked in billing, the software we used looked up the value of your home as well. It was basically: see if we had any payment (or nonpayment) records from you on file, do a soft pull on your credit, look up how much your home was worth. Then you'd get scored on your propensity to pay based on the amount of your bill, your (self-reported) income, your credit score and your home value. FAT BATMAN posted:Does this mean that if I take an expensive medicine every 8 weeks that without insurance costs $8000 (Remicade), that makes them more likely to fight it bc they're taking into account that I probably don't have that kind of cash? For Remicade specifically (since it's a periodic outpatient thing) I imagine they put in a prior auth beforehand; if it gets declined they'll switch you to something else. Same deal if your insurer's formulary changes. They're not going to court over that.
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May 14, 2017 01:41
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So what you're saying is every time I go to the hospital and fill out ones of those forms I should put like 10k/year as my salary
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May 14, 2017 16:43
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rscott posted:So what you're saying is every time I go to the hospital and fill out ones of those forms I should put like 10k/year as my salary Good plan until they demand to see a paystub or withhold treatment
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May 14, 2017 17:32
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Peven Stan posted:Good plan until they demand to see a paystub or withhold treatment Nah what they do out here is demand payment up front for anything that isn't an acute medical emergency if they're unsure if you'll pay the margin/copay
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May 14, 2017 18:34
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I'm sticking with the kidnapping doctors and trade treatment for release. Seems simpler.
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May 14, 2017 19:03
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rscott posted:So what you're saying is every time I go to the hospital and fill out ones of those forms I should put like 10k/year as my salary Then you'll have to explain why you don't want the Medicaid forms
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May 14, 2017 19:04
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hobbesmaster posted:Then you'll have to explain why you don't want the Medicaid forms I live in Kansas so that would not be an issue
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May 14, 2017 21:33
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hobbesmaster posted:Then you'll have to explain why you don't want the Medicaid forms It's pointless if he doesn't have kids and doesn't live in an expansion state. Unsurprisingly I know a few people who have had kids in order to get on Medicaid. The social safety net we have in the US really incentivizes questionable life decisions. It's kind of a mess.
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May 15, 2017 15:19
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There's no way this doesn't wreck the GOP and go to Single Payer by 2022. The one way you lose voters is changing their standard of living, and enough people have been ruined by medical bills that it counts.
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May 16, 2017 13:55
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Gumbel2Gumbel posted:There's no way this doesn't wreck the GOP and go to Single Payer by 2022. The one way you lose voters is changing their standard of living, and enough people have been ruined by medical bills that it counts. I thought the same thing in 2007
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May 16, 2017 14:08
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Gumbel2Gumbel posted:There's no way this doesn't wreck the GOP and go to Single Payer by 2022. The one way you lose voters is changing their standard of living, and enough people have been ruined by medical bills that it counts. Genuine question: How do you intend to convince the 100m+ Americans who are happy/extremely happy with their current (typically employer-sponsored) health coverage to give that up for a hypothetical government-sponsored program?
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May 16, 2017 14:11
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Paracaidas posted:Genuine question: I've thought about this a lot and the best way is to allow opt-in to Medicare + Medicaid. Everyone keeps what they have but natural market churn would gradually transition us to single payer.
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May 16, 2017 14:12
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Paracaidas posted:Genuine question: They're happy because it isn't as bad as it will be when the new law goes through the Senate. It covers things now. People get really loving mad when you take stuff away, people have a huge loss aversion instinct. They're already anticipating losing any sort of meaningful coverage, that is why everyone is loving pissed. If Comcast calls you up and says "We're going to still charge you $125, but you're getting half the channels", you'd be furious. If you bought into that 2nd plan with half the channels that everyone was already getting you'd be like, "well it sucks but whatever."
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May 16, 2017 14:19
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Hieronymous Alloy posted:I've thought about this a lot and the best way is to allow opt-in to Medicare + Medicaid. Everyone keeps what they have but natural market churn would gradually transition us to single payer. I think this makes a lot of sense-it allows the programs to grow and expand into their new roles(rolls?  ) rather than jumping there immediately while maintaining continuity for the HealthcareNIMBYs on the left. The reason I asked is because I can't imagine it being even a 50/50 split by G2G's 2022 date.It also could qualify as UHC despite the presence of multiple payers-depending on the details of the plan. Gumbel2Gumbel posted:They're happy because it isn't as bad as it will be when the new law goes through the Senate. It covers things now. People get really loving mad when you take stuff away, people have a huge loss aversion instinct. They're already anticipating losing any sort of meaningful coverage, that is why everyone is loving pissed. The polling predates the AHCA push, so that's definitely not it. It does illustrate the problem though-People do get really loving mad when you take stuff away, specifically their stuff (see: 2010 and the GOP lies associated with it). HA's plan covers this by allowing people to maintain their coverage while expanding and demonstrating the Single Payer alternative(s). Single Payer by 2022 wouldn't permit that transitional phase, and even HA's plan is susceptible to a similar backlash as the ACA. So do you have a mechanism for winning over the majority of American voters who are happy/very happy with their coverage? Because Single Payer, by its definition, means that they're losing that coverage.
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May 16, 2017 14:33
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Paracaidas posted:I think this makes a lot of sense-it allows the programs to grow and expand into their new roles(rolls? My opinion is basically a prediction that American Companies are incredibly short sighted and that the Republican plans will make them slash benefits and provide terrible, bare bones coverage. I have 0 faith, backed by every development in American history, that American companies will go to bat for their workers voluntarily once they get the option to provide the worst health care coverage ever and call it a benefit. And people are going to be furious.
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May 16, 2017 14:52
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Paracaidas posted:Genuine question: A lot of americans aren't happy with their employer plan. My dad's plan left him hanging for 20k in hospital bills that weren't covered when he had to stay four days for pneumonia. I know multiple people that have to carry two insurance plans because their employer plan doesn't cover everything.
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May 16, 2017 15:07
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Gumbel2Gumbel posted:My opinion is basically a prediction that American Companies are incredibly short sighted and that the Republican plans will make them slash benefits and provide terrible, bare bones coverage. Mr. Nice! posted:A lot of americans aren't happy with their employer plan. My dad's plan left him hanging for 20k in hospital bills that weren't covered when he had to stay four days for pneumonia. I know multiple people that have to carry two insurance plans because their employer plan doesn't cover everything. I'm not trying to defend the US health care system, but it's helpful to discuss why Single Payer routinely flames out on the ballot despite the positive polling. Some of it is the inherent difference between federal and state level plans, some of it is that polling tends not to address funding mechanisms, but a significant chunk is that most American voters are happy with their healthcare.
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May 16, 2017 15:28
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The thing is, those who have an employer plan and are happy with it are dwarfed by those on medicaid/care, an exchange plan they can't afford, or just flat out have no coverage. It's a matter of getting those people off their asses just as much as it is convincing the guy that makes 40k and has to carry secondary insurance because his employer HSA is actually poo poo that he has bad insurance. I think part of it is shifting compensation that previously went to healthcare to the worker, but  at employers raising someone's wages.
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May 16, 2017 15:32
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Paracaidas posted:Fair enough. I'm not convinced it'll be worse than the pre-ACA status quo. Which was unconscionable, but not sufficient to bring about Single Payer. It'll have a much worse reaction because it's going to be back to the bad old times of people getting kicked off their insurance and having to take care of a dying parent whose cancer melts the entire family's savings.
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May 16, 2017 15:37
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Mr. Nice! posted:The thing is, those who have an employer plan and are happy with it are dwarfed by those on medicaid/care, an exchange plan they can't afford, or just flat out have no coverage. It's a matter of getting those people off their asses just as much as it is convincing the guy that makes 40k and has to carry secondary insurance because his employer HSA is actually poo poo that he has bad insurance. Kaiser still has the majority of Americans covered by private insurance (and the more than 60% of all with any coverage). So the number of happy people are a minority, but "getting off their asses" is an odd way to phrase it for medicaid and medicare enrollees who, based on the demographic makeup, are among the most likely people to vote. And in the case of Medicare enrollees, do not tend to vote for candidates who support UHC-much less single payer. Buncha fygm olds. The other point also applies to Gumbel2Gumbel: Don't assume that dissatisfaction with the current (or future) system means they'll be open to your alternative. To an extent, it's the mirror of the conservative arguments against ACA, where they ignored that a substantial portion of the dissatisfaction was from the left.
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May 16, 2017 16:30
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The ACA was supposed to shift employer paid insurance gradually over time to the exchanges. Rahm Emanuels brother Ezekiel predicted by 2020 employer paid plans would be rare. The botched rollout unfortunately damaged that prediction as well as not fixing the issues of narrow networks and high deductibles.
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May 16, 2017 17:26
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Peven Stan posted:The ACA was supposed to shift employer paid insurance gradually over time to the exchanges. Rahm Emanuels brother Ezekiel predicted by 2020 employer paid plans would be rare. The employer mandate, the small group exchanges, and the significant penalties against health reimbursement arrangements directly opposed a shift away from employer insurance to individual market. The overarching goal of the ACA was to fix the individual market, but the IRS and other executive departments spent a significant amount of time and regulatory effort making sure that it didn't cause everyone to be "dumped on the exchanges". A movement from employer healthcare to individual healthcare was what McCain was touting on the 2008 campaign trail and what republican replacement plans in 2013-2016 were focused on, in opposition to Obama.
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May 16, 2017 17:45
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I think the only way we'll ever shift away from employer sponsored insurance is to remove the tax advantage of employer paid premiums.
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May 16, 2017 17:52
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Hieronymous Alloy posted:I've thought about this a lot and the best way is to allow opt-in to Medicare + Medicaid. Everyone keeps what they have but natural market churn would gradually transition us to single payer. I've been saying this since the start of the thread. I'll have to be on it anyway when my backbone plan bankrupts me anyway. I'd rather just pay into that system. Then give a company money to tell me to pound sand when I actually get hurt. As an employer I am not on the hook anymore. I can even offer a pay bump to offset that cost without killing me. It would be the single biggest boon to small businesses that could be done. Just the option to opt in. Not asking to gently caress with YOUR healthcare. Your insurance company does that already. The difference being the government is mandated to provide care if I'm involved. An insurance company is mandated to provide profit for its shareholders. This would be by law. Anyone who defends the current system needs to chew on that thought for a second. We are forced into a system to provide profit for insurance companies. It's wrong. It's a forced gamble that I can't even afford the table stakes for. BlueBlazer fucked around with this message at 18:54 on May 16, 2017 |
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May 16, 2017 18:50
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Reik posted:I think the only way we'll ever shift away from employer sponsored insurance is to remove the tax advantage of employer paid premiums. well the Cadillac tax implementation got kicked back a few years but otherwise ppaca is going to do exactly that over time since its purpose is to put everyone with employer plans onto the exchanges eventually
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May 16, 2017 19:03
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BlueBlazer posted:I've been saying this since the start of the thread. I'll have to be on it anyway when my backbone plan bankrupts me anyway. I'd rather just pay into that system. Then give a company money to tell me to pound sand when I actually get hurt. You see, I don't think healthcare is a right, though. It's just a commodity. Plus, all of those socialized healthcare systems have horrible problems I heard about. Busses of canadian seniors coming to the USA because the wait times in Canada would kill them. I also don't trust the government and think that this should be a state issue. I like my employer provided HSA because if I don't get sick it's just free money coming to me and a break in taxes. Sure I have to pay for a secondary insurance plan, but that's just being prudent. Those aren't my thoughts, btw, but rather what Republicans really believe. I have been given these answers among a myriad of others why I shouldn't have to pay for susy fatcakes insurance she should quit guzzling soda and cupcakes and get a job to pay for her own.
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May 16, 2017 19:16
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Mr. Nice! posted:You see, I don't think healthcare is a right, though. It's just a commodity. Plus, all of those socialized healthcare systems have horrible problems I heard about. Busses of canadian seniors coming to the USA because the wait times in Canada would kill them. I also don't trust the government and think that this should be a state issue. I like my employer provided HSA because if I don't get sick it's just free money coming to me and a break in taxes. Sure I have to pay for a secondary insurance plan, but that's just being prudent. Who gives a poo poo about what republicans believe right now? Implement UHC and they'll defend it to the hilt once they see that they'll benefit from it personally. For an example, see the furor over repealing the ACA once the GOP base realized that it was going to take away their healthcare.
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May 16, 2017 19:24
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Cerebral Bore posted:Who gives a poo poo about what republicans believe right now? Implement UHC and they'll defend it to the hilt once they see that they'll benefit from it personally. For an example, see the furor over repealing the ACA once the GOP base realized that it was going to take away their healthcare. I'm talking about the republican base. I'm talking about the general population of west texas, north florida, kansas, oklahoma, etc. Like it or not, these are the people that you have to reach out to right now because they're the only people that actually get the gently caress out and vote. These are the people I argue with and try to convince daily because they're the ones we have to convince. It won't happen unless these people specifically vote out sitting republicans. These are the mid term voters. If you've got another route to actually get poo poo done I'm all ears, but progressive gotv is a hot garbage fire at actually getting people to pull loving levers. I'm attempting to help locally as much as possible, but realistically there are only two ways to enact change via the 2018 election: get republicans to vote a different republican into office or get democratic voters to the polls. The latter option is a far cry based upon historical trends. However your rural republican base (also the source of most of the senate seats up for grabs) does show up at mid terms. If I can convince enough people that Mac Thornberry has got to go, we might be able to get a seat that supports better healthcare. It's still going to be a republican. You won't flip the Amarillo area to the democratic party without something drastic happening between now and then. It might be possible to convince republicans, though, that they'll save money in a single payer system and get them on board that people like Mac Thornberry or Ted Cruz are out to gently caress them personally. I've convinced some already that would vote against the incumbent for a primary challenge, but that's really the only way you're going to see change in these districts.
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May 16, 2017 19:35
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Cerebral Bore posted:Who gives a poo poo about what republicans believe right now? Implement UHC and they'll defend it to the hilt once they see that they'll benefit from it personally. For an example, see the furor over repealing the ACA once the GOP base realized that it was going to take away their healthcare. But they are still doing it, aren't they? And the base will find some way to rationalize it.
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May 16, 2017 19:39
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My dad vehemently refutes UHC because everyone from the UK he knows pays a lot in taxes and it doesn't help them much. It takes forever to do things and they have to have private insurance to get anything done. He says what's the point of waiting six months for an MRI if you're dead? To which I explained it would still be better than nothing if Trump took everything away again. I asked him how would you get treated if you didn't have insurance and he said you can go to a hospital they have to treat you. But when I asked who do you think pays for the bankruptcy a lot of people will file because of the bills they can't pay, that kind of shut him up. This is the dumb poo poo you have to deal with. UHC is only going to improve the countries prosperity regardless of its disadvantages and that should be the number one goal. I wish people would understand that.
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May 16, 2017 19:50
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Yeah, there's a lot of poo poo wrong with various healthcare systems. I bitch about the Canadian system all the time and I think it could and should be improved. I even considered going to the US for an operation that wasn't strictly medically necessary, to avoid the wait time it would've taken in Canada (I eventually got it done in one of the rare private hospitals in Canada itself, mostly covered by my province's healthcare). That being said, no loving way would I ever consider taking the US system over what I have now. Those who point to the problems that our system has, and how people sometimes go to the States or elsewhere for quicker treatment, are missing the larger point that 95% of the time it works extremely well, and I never, ever have to worry about choosing between healthcare and solvency.
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May 16, 2017 20:04
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