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Hieronymous Alloy posted:Trump will never resign of his own free will. But a removal for incapacity is more likely than impeachment. Man, imagine if you're one of the secret service agents that gets stuck on Trump's detail after he gets removed from office. Gotta be the worst position in the whole agency.
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Aug 2, 2017 04:10
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The California exchange has a not-so-elegant but interesting strategy to combat the administration's constant threats to end Cost Share Reductions while negotiating 2018 rates. They had the insurance companies create a set of rates for 2018 that assume the payments continue. Then, in anticipation of the feds going full moron and ending CSR payments, advised the insurance companies to add a hypothetical 12.5% surcharge to only the silver plans that would only take effect if payments aren't guaranteed in 2018. Lower co-pays, deductibles, and out-of-pocket maximums would be preserved for those eligible based on income. Because premium tax credits are based off the cost of the second-lowest silver plan, this would result in most people that are eligible for premium assistance receiving increased premium assistance resulting in equal or lower premium payments, regardless of the tier they are enrolled in. The hard part is going to be communicating to people that aren't eligible for premium assistance to wink-wink nudge-nudge either not enroll in a silver plan or enroll in an off-exchange silver plan offered privately by the insurance companies that would be exempt from the 12.5% surcharge. This would cost the federal government billions of dollars more than continuing to pay the cost-share reductions, due to the increase in premium assistance. It's insane that they even had to come up with this workaround, but it seems to be a possibly very effective deterrent to keep trump from pulling such a stunt.
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Aug 2, 2017 04:16
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That's pretty cool, actually. It's like The Incredible Machine, but with politics and lives instead of balls.
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Aug 2, 2017 05:07
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Cassidy-Graham seems to be picking up steam but the more I read about it the crazier it sounds. Like, they take the Medicaid expansion of the 30 states that have accepted it and redistribute it to all 50+DC? That's insane. It retroactively rewards the state leadership that cynically turned down free money and punishes big blue states like California for taking it. It seems to be just as bad as anything else that's been tried or put forward, but like the skinny repeal, it's "new" so no one has had time to pick through it and expose it widely, and so it's being entertained.
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Aug 2, 2017 08:41
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Won't that gently caress over the same medicaid-expansion-state Republican Senators that refused to vote for the BCRA. Like how is that better. Could they write a bill that just takes the expansion away from states with Democrat senators, that would probably pass.
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Aug 2, 2017 09:01
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SulphagneSocialist posted:Cassidy-Graham seems to be picking up steam but the more I read about it the crazier it sounds. Like, they take the Medicaid expansion of the 30 states that have accepted it and redistribute it to all 50+DC? That's insane. It retroactively rewards the state leadership that cynically turned down free money and punishes big blue states like California for taking it. it's not so much picking up steam as it's the only option left that hasn't been knocked down, but there's no indication it has 50 votes
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Aug 2, 2017 12:39
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with McCain gone I don't see it getting anywhere. Also hilarious to see Heller cuck out so hard. He was dead set against Medicaid cuts and helped torpedo BCRA 1.0 but Cassidy-Graham (which he's 100% behind) has much more savage Medicaid cuts.
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Aug 2, 2017 13:08
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DeadFatDuckFat posted:Man, imagine if you're one of the secret service agents that gets stuck on Trump's detail after he gets removed from office. Gotta be the worst position in the whole agency. Or the top position. You could live at the brothel.
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Aug 2, 2017 13:40
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are you guys familiar with what's going on with mission healthcare in western NC and BCBS? Has it been discussed in here?
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Aug 2, 2017 13:52
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FizFashizzle posted:are you guys familiar with what's going on with mission healthcare in western NC and BCBS? No. Can you provide details?
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Aug 2, 2017 14:26
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EugeneJ posted:Which is why I have been saying for 6 months that Bernie should try and meet with him and get single-payer into his head. This would make Trump all for single-payer for the next 24 hours or until he next watched Fox News, whichever is soonest.
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Aug 2, 2017 14:41
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axeil posted:No. Can you provide details? IIRC, there's no more insurance in nevada including some types of medicare.
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Aug 2, 2017 14:54
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BarbarianElephant posted:This would make Trump all for single-payer for the next 24 hours or until he next watched Fox News, whichever is soonest. Bernie would have to start hanging around him all the time like a doting grandpa or something *Pence walks into the Oval Office and there's like crumbs everywhere* "Ohhhh did Bernie give you cookies again? Great, now you're not going to go to sleep and it's already your bedtime!!"
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Aug 2, 2017 15:10
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FizFashizzle posted:are you guys familiar with what's going on with mission healthcare in western NC and BCBS? Background http://www.citizen-times.com/story/news/local/2017/07/30/blue-cross-nc-mission-hospital-split-would-affect-thousands-wnc/514214001/ Basically major health care provider and major insurance company are arguing over billing threatening health coverage to residents.
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Aug 2, 2017 15:16
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FizFashizzle posted:are you guys familiar with what's going on with mission healthcare in western NC and BCBS? There's a recent trend in provider/insurer agreements to tie prices to the value that the hospital provides to patients. This is generally called value based care or pay-for-performance, and gives providers "skin in the game" in regards to providing higher quality care to patients and reducing hospital readmittance. BCBS NC wants to keep the reimbursement-per-service flat, with future increases being solely on pay-for-performance agreements. Mission wants inflationary increases, with pay-for-performance increases on top. If they can't come to an agreement, there's a big PR hit in there for someone. They are both trying to sell their side to the public to deflect the potential PR blow and improve their negotiating position. BCBS NC's position is more consistent with recent trends in insurer/provider arrangement, but attributing "fault" is not really helpful.
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Aug 2, 2017 15:57
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http://www.concordmonitor.com/lawmakers-vote-on-health-insurance-stabilization-fund-11609100 The New Hampshire health insurance market is probably going to collapse next year and if it doesn't the cost will increase by 43%.
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Aug 2, 2017 17:12
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farraday posted:Background Having worked on this kind of stuff before, these contract disputes don't usually make it this far unless the hospital system is asking for an unreasonable amount. Skimming the medicare admission average charge data for 2014 in Asheville, NC shows that the Mission Hospital seems to consistently have higher rates. By looking at the rates per DRG you probably remove most of the case mix differential, but there still could be some. code:Reik fucked around with this message at 17:41 on Aug 2, 2017 |
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Aug 2, 2017 17:38
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OhFunny posted:http://www.concordmonitor.com/lawmakers-vote-on-health-insurance-stabilization-fund-11609100 Why do all these Northern States have issues with their markets when all the southern states seem to be doing just fine? This just doesn't add up to me.
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Aug 2, 2017 18:18
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JailTrump posted:Why do all these Northern States have issues with their markets when all the southern states seem to be doing just fine? The southern states aren't doing fine? Southerners are so used to our lovely Republican governments screwing us we don't complain about it as much anymore.
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Aug 2, 2017 18:46
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JailTrump posted:Why do all these Northern States have issues with their markets when all the southern states seem to be doing just fine? Southern States didn't fall for the trick of medicaid expansion and still have tens of millions of uninsured people who they let die of preventable disease.
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Aug 2, 2017 18:53
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New Hampshire isn't a real northern state E: for actual healthcare related chat, before we got married my wife was on the NH exchange for a bit in grad school. We moved to MA after and her employer health insurance was the same company as the one administering the NH exchange policy. They messed that up for a year and renewed her NH policy 6 months after we moved out of NH, when she had an employer plan as well. She had a surgery and the insurance company gave the hospital the info for the NH plan instead of the employer one, even though we only gave them the employer plan information at the hospital. The Slack Lagoon fucked around with this message at 19:01 on Aug 2, 2017 |
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Aug 2, 2017 18:56
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McCain just took a beating with his approval rating among GOP voters. But he's net positive with Dems and Indies now. Hell of a price to pay for his vote but I doubt he cares at this point.
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Aug 2, 2017 20:04
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axeil posted:McCain just took a beating with his approval rating among GOP voters. But he's net positive with Dems and Indies now. Hell of a price to pay for his vote but I doubt he cares at this point. Why would he care? He's 80 years old, he isn't up for election until 2022, and his cancer has a poor prognosis. Ironically, if he *did* have to win an election this year, he might just have cinched it with the independents to make up for the Republicans hating him.
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Aug 2, 2017 20:09
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JailTrump posted:Why do all these Northern States have issues with their markets when all the southern states seem to be doing just fine? NH is a population of only 1 million, their population is aging, and its hard to create rural markets in Healthcare for such a small populace. Add to the fact that Southern NH is anchored by the Massachusetts economy...
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Aug 3, 2017 03:40
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Spiritus Nox posted:They can call it "The Aristocrats" for all I care, just so long as they stop trying to loving touch it You should check out this video and skip to the 2 minute mark. https://www.topic.com/the-nib/take-me-to-your-nazis
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Aug 3, 2017 16:12
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DeadFatDuckFat posted:Man, imagine if you're one of the secret service agents that gets stuck on Trump's detail after he gets removed from office. Gotta be the worst position in the whole agency. You'd spend your time at a golf club or in a trailer outside Trump Tower. Sounds pretty sweet to me, except for the whole "guarding one of the most hated figures in politics" deal. Do presidents get secret service details if they go to prison? Hmm...
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Aug 4, 2017 22:08
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The secret service doesn't guard the Trump Tower anymore. There was a billing dispute and the Trumps don't live there anymore anyways.
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Aug 5, 2017 06:38
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They still guard it. They have a trailer outside.
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Aug 7, 2017 18:58
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Well, at least they aren't renting one of the floors anymore.
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Aug 7, 2017 21:50
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https://uk.reuters.com/article/us-hikma-prices-idUKKCN1B00R5quote:NEW YORK (Reuters) - Hikma Pharmaceuticals Plc's U.S. subsidiary has raised the price of a common diarrhea drug by more than 400 percent and is charging more for five other medicines as well, the Financial Times reported on Sunday. Medicine not being affordable sucks. 
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Aug 21, 2017 06:21
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I say geeya you say teen! Geeya!
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Aug 21, 2017 07:00
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OhFunny posted:https://uk.reuters.com/article/us-hikma-prices-idUKKCN1B00R5 Y'know, I can't help but feel that it takes one extra special rear end in a top hat to do something like hiking up the price of diarrhea medicine. Making people have to choose between filling their brown pants or paying out the rear end for something so utterly basic that everyone else takes for granted is just a lovely move. Especially in countries like the US where you might not have the choice as to which version of the medicine you get even if a monopoly isn't involved. Which means that if some part of the healthcare system wants to make a quick buck they can just assign you that med and let you rack up the bills. Archonex fucked around with this message at 07:31 on Aug 21, 2017 |
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Aug 21, 2017 07:10
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There is that one antiworm drug that's like 30 cents a pill in India but costs $884 dollars a pill here because only one company is licensed to make it.
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Aug 25, 2017 21:54
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There's a lot of that. The brand name drug companies hiking their prices draws the most attention, but generic companies are happily manipulating the market in even more dramatic ways. They've been rapidly buying each other out, and once only 1-3 manufacturers are making a specific product they can set whatever price they please. The last 5 years at my pharmacy have been an endless roller-coaster of drugs repeatedly going on suspicious shortages and prices getting gouged anywhere from double to 10x their original price over the course of a few months as the shortage continues or drugs return to the market with new price tags attached. For decades the inherent assumption was that once drugs went generic and could be produced by multiple manufacturers, the free market would naturally lower prices over time through competition. Whoops! The new favorite trick of drug companies is to just repackage their old stuff with new a NDC (drug product identifier codes that are used in billing). All those years of competitive biddings and contracts with PBMs will generally lower the reimbursement and prices for your product, but often that reimbursement is tied into a product's specific NDC in the billing software. Just let the old stock run dry, put the pills in a new package with a new NDC on the front and now you can set the price of this "new product" to whatever you want. This works especially well for gaming Medicaid rebates/340b price, which would otherwise have punished a company for inflating their prices on a product over time with lower reimbursement, but now don't because it's a new product with a different NDC.
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Aug 27, 2017 00:26
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Matt Yglesias just posted an uncharacteristically good piece on healthcare, wonkery, and the political slot it occupies on the left. Many of the usual suspects have jumped on it, with the typical outofcontext and nuance-challenged twitter dunkings, so I'm assuming this will be a trashfire. I'd still recommend reading the actual piece though: https://www.vox.com/policy-and-politics/2017/8/29/16196608/wonks-single-payer In brief, the piece reflects on the challenges of Single Payer, its new status as litmus for the left, and the dearth of actual policy work done on the topic. Basically, it squares with my view that there are three main issues- 1. An unwillingness by ~technocrats~ to put together actual proposals for functional UHC and/or Single Payer - out of a belief that it's not politically feasible. This complaint hasn't stopped them before, and is quickly becoming less true. 2. An opposition to details from vocal segments of the left (largely for political expediency)-people will rally around the buzzy name that suggests improved healthcare, but putting out details before being elected is foolish and will kill momentum. We can sort it out after* does not apply to Vermont, Cali, or the Conyers bill 3. "The transition problems are solvable" is both true and also not a solution. Are you killing the private market? If so, how do you plan to win over the 80% of those people who are somewhat or very satisfied with their health coverage? If we shift from employer-financed coverage, how is that corporate windfall being distributed? How will this new model interact with the VA, prisons, and other existing programs? Is an incremental shift to UHC and then Single Payer acceptable-and are there costs to SP or Bust as a negotiating strategy if UHC -> SP is the more likely path? The think tanks need to get their poo poo together. Someone besides UMass needs to do analysis and proposals. "Your solution isn't workable, or even a real bill" needs to not be an invitation for a firing squad. Obamacare was an incremental change that took an immense amount of time despite (sort of) a senate supermajority and huge margins in the house. It's unlikely 2021 will look much friendlier and avoiding the shitshow of a process we saw this year should be a key goal. Much as the GOP couldn't pass something fitting with principle because of their Repealmania, I fear an incremental (and more attainable) UHC solution will be rejected on the basis of not being The Single Payer That Was Promised. Surely there's a middle ground between Obama compromising before negotiations began and preemptively poisoning what would be a massive policy win.
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Aug 29, 2017 18:03
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Paracaidas posted:Many of the usual suspects have jumped on it, with the typical outofcontext and nuance-challenged twitter dunkings, so I'm assuming this will be a trashfire. I'd still recommend reading the actual piece though: quote:The tax issue, for example, is a critical substantive lacuna in the major health care bills. There’s no serious doubt that America could afford a heavier tax burden to finance a publicly provided health care system. But the design of that tax burden still makes a big difference. If you finance the system mostly with a value-added tax like many European countries do, for example, then senior citizens who already get Medicare will end up paying higher taxes in exchange for a program that doesn’t help them. But if you finance the system mostly with higher payroll taxes (how Social Security and Medicare work), you are creating a pretty strong new disincentive to work, since everyone would get the benefit whether or not they pay for it. Yes, people would just not work, because you can afford shelter and food by using free healthcare instead! 
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Aug 29, 2017 18:11
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WampaLord posted:Yes, people would just not work, because you can afford shelter and food by using free healthcare instead! It also ignores the fact that progressive tax systems are intentionally structured to place the largest burden on the people who can afford it. This isn't going to raise your taxes if you're working part time at McDonalds.
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Aug 29, 2017 18:22
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Paracaidas posted:3. "The transition problems are solvable" is both true and also not a solution. Are you killing the private market? If so, how do you plan to win over the 80% of those people who are somewhat or very satisfied with their health coverage? If we shift from employer-financed coverage, how is that corporate windfall being distributed? How will this new model interact with the VA, prisons, and other existing programs? Is an incremental shift to UHC and then Single Payer acceptable-and are there costs to SP or Bust as a negotiating strategy if UHC -> SP is the more likely path? Do you actually need to kill private market? Out here in Poland we have universal healthcare and extensive private healthcare, often provided by employers.
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Aug 29, 2017 18:25
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ill people... might not drag themselves into work? what nightmarish world is this where such hellish realities might come to pass
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Aug 29, 2017 18:29
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Aumanor posted:Do you actually need to kill private market? Out here in Poland we have universal healthcare and extensive private healthcare, often provided by employers. We don't have to... but we'd sure like to. 
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Aug 29, 2017 18:29
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