Healthcare Reform Megathread: Can I sell my organs to pay this hospital bill?

The Something Awful Forums > Discussion > Debate & Discussion > Healthcare Reform Megathread: Can I sell my organs to pay this hospital bill?

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Spuckuk: Aug 11, 2009; Being a bastard works

SimonCat posted:

They buy into the horror-stories about other country's health care. My dad's favorite talking point is that apparently the British system doesn't cover knee replacements for the elderly.

Which apparently is bullshit because the NHS website claims that most knee replacements are performed on people between 60 and 80 years old.

http://www.nhs.uk/Conditions/Knee-replacement/Pages/Kneereplacementexplained.aspx

My Nan had both knees and her hip done into her 80s. Your healthcare industry is spreading abject lies

# ? Mar 8, 2017 15:52

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# ? Apr 24, 2024 11:56

hobbesmaster: Jan 28, 2008

Leon Trotsky 2012 posted:

They do "ration" out care for non-essential procedures if you want the procedure to be free and you aren't in an age group or medical state where it would be critical.

So, if you are 48 and have a bad knee, it could hurt all day every day, but it won't kill you and you are not likely to die from slipping. The NHS would schedule you 6 months out if they have hundreds of more critical patients who need knee surgeries first. Then you can wait or you can pay someone else to get it done immediately.

(Note: I'm not sure how Knee Surgeries are specifically defined under the NHS, but this is the case for many surgeries that deemed not medically essential)

I wonder if people that cite these "crazy" wait times have ever scheduled the same procedures in the US. 3 months to see the surgeon and then another 3 months to wait for the surgery wouldn't be surprising in the US for something like that. I think my dad scheduled his hip replacements over 6 months in advance. (He was only in his 50s too, apparently some genetic thing I have to look forward to!)

# ? Mar 8, 2017 16:16

eviltastic: Feb 8, 2004; Fan of Britches

The Hill has a list of House and Senate members who are or might be opposed. Annoyingly, there's no "yes" section; I doubt Ryan's position is that much in doubt. If anyone's got a better source counting noses, please post.

As I was typing this up:

https://twitter.com/PeterSullivan4/status/839514149961011201

# ? Mar 8, 2017 17:45

KillHour: Oct 28, 2007

quote:

Sen. Thom Tillis (N.C.) � �My Republican colleagues would be making a mistake if they become content with failing to produce the perfect at the expense of achieving good, practical solutions to reform our nation�s broken healthcare system,� Tillis said in a statement.

What the gently caress does this even mean?

# ? Mar 8, 2017 18:02

mdemone: Mar 14, 2001

KillHour posted:

What the gently caress does this even mean?

Well it is a sort of quadruple negative, but I gather that he's in favor of health care reform.

Funny that he voted No on Obamacare then.

# ? Mar 8, 2017 18:04

Shrecknet: Jan 2, 2005

KillHour posted:

What the gently caress does this even mean?

"don't let the perfect be the enemy of the good" is a pretty famous phrase; he's saying they need to vote for this poo poo bill now, rather than wait for a less-poo poo (to them) bill later.

# ? Mar 8, 2017 18:06

Subvisual Haze: Nov 22, 2003; The building was on fire and it wasn't my fault.

SimonCat posted:

They buy into the horror-stories about other country's health care. My dad's favorite talking point is that apparently the British system doesn't cover knee replacements for the elderly.

Which apparently is bullshit because the NHS website claims that most knee replacements are performed on people between 60 and 80 years old.

http://www.nhs.uk/Conditions/Knee-replacement/Pages/Kneereplacementexplained.aspx

As opposed to our glorious country where your insurance company can also deny you coverage for arbitrary reasons, and even if they do approve and cover it you can enjoy a big deductible and cost sharing.

And God have mercy on you if an anesthesiologist who is non affiliated with your plan somehow wanders into your room during a medical procedure. Enjoy paying that providers bill yourself.

Somehow every theoretical criticism of "government run" healthcare is actually even worse under the private system.

# ? Mar 8, 2017 18:08

Lord Harbor: Apr 17, 2005; Bruce Campbell: You've stolen my heart, but you'll never take my freedom; Nap Ghost

Anyone have a clear answer for these?

- Regarding the 30% increase following a gap, there seems to be no accounting for different levels of coverage. So could you spend a year on the cheapest possible coverage to eat the extra cost, before switching up to the insurance you really want? This is mostly in regards to young people gambling on no insurance for a decade or two, because it looks like even the minor penalty is gonna be almost nothing in the end.

- Regarding the maximum tax credit, the wording is, "The monthly limitation amount with respect to any individual for any eligible coverage month during any taxable year is 1⁄12 of" whatever payment you get, maxing out at $4,000 for a 60-year old. Does this mean that if you have a single month of expense, you only get back $4,000/12 = $333? Or is the tax credit strictly for insurance coverage, and won't contribute at all to deductables or procedures?

# ? Mar 8, 2017 18:10

ded redd: Aug 1, 2010

https://www.washingtonpost.com/news...m=.afb389d160f4

Rehashes a lot of what's covered in this thread, but here's a choice quote:

quote:

The president is also trying to use carrots, not just sticks, stepping up outreach to other 2016 foes. Tonight he�s having dinner with Ted Cruz. Yesterday he lunched with Lindsey Graham. The South Carolina senator, as a gesture of goodwill, gave the president his new cell phone number. This is notable because, during a 2015 rally, Trump read Graham�s old number aloud to a crowd and asked people to call him.

What an inglorious wonder this manbaby is.

# ? Mar 8, 2017 18:21

Duke Igthorn: Oct 11, 2012; by FactsAreUseless

So does the new Healthcare poo poo include a "Congress gets to go back to Socialized Medicine" section or is that going to be separate and suuuuuuuuuuuuper quiet?

# ? Mar 8, 2017 18:43

esquilax: Jan 3, 2003

Lord Harbor posted:

Anyone have a clear answer for these?

- Regarding the 30% increase following a gap, there seems to be no accounting for different levels of coverage. So could you spend a year on the cheapest possible coverage to eat the extra cost, before switching up to the insurance you really want? This is mostly in regards to young people gambling on no insurance for a decade or two, because it looks like even the minor penalty is gonna be almost nothing in the end.

- Regarding the maximum tax credit, the wording is, "The monthly limitation amount with respect to any individual for any eligible coverage month during any taxable year is 1⁄12 of" whatever payment you get, maxing out at $4,000 for a 60-year old. Does this mean that if you have a single month of expense, you only get back $4,000/12 = $333? Or is the tax credit strictly for insurance coverage, and won't contribute at all to deductables or procedures?

1. Yes, nothing preventing you from buying up to a richer health plan when you get sick except for the one-per-year open enrollment period. Same as under the ACA.

2. The tax credit is specifically for insurance coverage and not point-of-care cost sharing. Any point-of-care cost-sharing credits from the ACA are repealed and not replaced.

For a rational health care consumer, 30% isn't that much. However, for many people the size is roughly comparable to the ACA individual penalty ($695 / 2.5% of income) for a few years . It's a motivator, similar to the individual mandate and inspired by the 1%/month/lifetime Medicare Part D "no coverage" penalty. Even though it's comparable in size to the ACA penalty, it definitely seems less useful from a behavioral economics standpoint (you are mandated to buy this or pay $1500 now vs. if you don't buy this you will eventually pay $1500 when you do buy it) and I'm skeptical.

# ? Mar 8, 2017 18:55

Leon Trotsky 2012: Aug 27, 2009; YOU CAN TRUST ME!*

_{*Israeli Government-affiliated poster}

Duke Igthorn posted:

So does the new Healthcare poo poo include a "Congress gets to go back to Socialized Medicine" section or is that going to be separate and suuuuuuuuuuuuper quiet?

Congress never had socialized medicine. They had access to the Federal Employee insurance plans, which are generally very good, and they got a subsidy to cover part of their premium costs.

As part of a "gotcha" move the Republicans introduced an amendment to require members of congress to buy from the D.C. exchange and Democrats voted for it. Now members of congress buy the exchange plans and don't get a subsidy (which also applies to congressional staff and further compounds a problem where only the kids of rich or connected people can become congressional interns to work for free and live in DC for a couple years for the chance to eventually get hired as full time staff who barely make anything in DC.)

# ? Mar 8, 2017 18:57

evilweasel: Aug 24, 2002

esquilax posted:

However, for many people the size is roughly comparable to the ACA individual penalty ($695 / 2.5% of income) for a few years . It's a motivator, similar to the individual mandate and inspired by the 1%/month/lifetime Medicare Part D "no coverage" penalty. Even though it's comparable in size to the ACA penalty, it definitely seems less useful from a behavioral economics standpoint (you are mandated to buy this or pay $1500 now vs. if you don't buy this you will eventually pay $1500 when you do buy it) and I'm skeptical.

The difference is that the mandate penalty applies each year you go without coverage. The 30% applies once. You're always incentivized to get coverage under the ACA penalty so you stop paying it, while once you trigger the Trumpcare penalty there is no additional penalty for additional time continuing to go uncovered.

# ? Mar 8, 2017 19:18

Monkey Fracas: Sep 11, 2010; ...but then you get to the end and a gorilla starts throwing barrels at you!; Grimey Drawer

Am I misremembering or is medical debt/bankruptcy somehow classified differently when compared to normal debt now?

Would be even more of an incentive to just sorta roll the dice on a medical bankruptcy happening to you as a young person rather than pay out the rear end for garbage insurance. And if you develop some horrible condition that is slow enough to allow you to get insurance before you get care you only pay a 30% penalty for a year!

# ? Mar 8, 2017 19:23

Discendo Vox: Mar 21, 2013; We don't need to have that dialogue because it's obvious, trivial, and has already been had a thousand times.

https://www.congress.gov/bill/115th-congress/house-bill/1275?q=%7B%22search%22%3A%5B%22hr+1275%22%5D%7D&r=1

Is that the replacement plan? Is that really the title?

# ? Mar 8, 2017 19:34

Duke Igthorn: Oct 11, 2012; by FactsAreUseless

They got tax payer supported healthcare, something a whole lot of them tried desperately to deny other Americans. Tomato tomahto.

# ? Mar 8, 2017 19:36

Typo: Aug 19, 2009; Chernigov Military Aviation Lyceum
The Fighting Slowpokes

Discendo Vox posted:

https://www.congress.gov/bill/115th-congress/house-bill/1275?q=%7B%22search%22%3A%5B%22hr+1275%22%5D%7D&r=1

Is that the replacement plan? Is that really the title?

look they need donald trump's signature on it wut do you want them to do

# ? Mar 8, 2017 19:39

HappyHippo: Nov 19, 2003; Do you have an Air Miles Card?

Discendo Vox posted:

https://www.congress.gov/bill/115th-congress/house-bill/1275?q=%7B%22search%22%3A%5B%22hr+1275%22%5D%7D&r=1

Is that the replacement plan? Is that really the title?

No this is a different bill.

I don't think this one will have an "official" name because it's part of the reconciliation process? Someone tell me if I'm wrong.

# ? Mar 8, 2017 19:41

Leon Trotsky 2012: Aug 27, 2009; YOU CAN TRUST ME!*

_{*Israeli Government-affiliated poster}

Monkey Fracas posted:

Am I misremembering or is medical debt/bankruptcy somehow classified differently when compared to normal debt now?

Would be even more of an incentive to just sorta roll the dice on a medical bankruptcy happening to you as a young person rather than pay out the rear end for garbage insurance. And if you develop some horrible condition that is slow enough to allow you to get insurance before you get care you only pay a 30% penalty for a year!

All debt is treated the same in personal bankruptcy except for student loans, civil judgements, and penalties issued by a court or government agency.

# ? Mar 8, 2017 19:50

Accretionist: Nov 7, 2012; I BELIEVE IN STUPID CONSPIRACY THEORIES

Since UHC is off the table, are there any advantageous UHC-components we could push?

Like, is there an angle in 'universal provider-networks?' Are networks raw overhead that insurers would happily pawn off onto the public sector? Are they a competitive thing that they'd like to keep private?

# ? Mar 8, 2017 22:02

The MUMPSorceress: Jan 6, 2012; ^SHTPSTS; Gary’s Answer

Accretionist posted:

Since UHC is off the table, are there any advantageous UHC-components we could push?

Like, is there an angle in 'universal provider-networks?' Are networks raw overhead that insurers would happily pawn off onto the public sector? Are they a competitive thing that they'd like to keep private?

A "network" is simply shorthand for "the providers we have contracts defining rates with". In-network pricing is "good" (better than out of network) because the insurer has a contract with the provider that says "no matter what you bill, you're getting paid this and you can't pass it on to the patient". The only way to have something analogous nationally would be for the government to mandate prices for all services. Which is a thing other countries do, Japan has had success with it, but it wouldn't fly with America's brokebrains free market religious fervor.

# ? Mar 8, 2017 22:16

evilweasel: Aug 24, 2002

cis autodrag posted:

A "network" is simply shorthand for "the providers we have contracts defining rates with". In-network pricing is "good" (better than out of network) because the insurer has a contract with the provider that says "no matter what you bill, you're getting paid this and you can't pass it on to the patient". The only way to have something analogous nationally would be for the government to mandate prices for all services. Which is a thing other countries do, Japan has had success with it, but it wouldn't fly with America's brokebrains free market religious fervor.

Also insurers like narrow networks because then you can negotiate steeper discounts (because the provider gets a lot more customers by being in your network since many people then have to go to them).

# ? Mar 8, 2017 22:26

Hollismason: Jun 30, 2007; Get ready for Price Time, Bitch

If they enact the changes your going to see a rise in deaths from HIV complications. Right now a lot of that is funded and subsidized by Medicaid and other programs.

# ? Mar 8, 2017 22:31

Confounding Factor: Jul 4, 2012; by FactsAreUseless

Leon Trotsky 2012 posted:

All debt is treated the same in personal bankruptcy except for student loans, civil judgements, and penalties issued by a court or government agency.

It makes me wonder if Republicans are going to float the idea later to somehow make it much harder to get medical debt dischargeable in bankruptcy. I mean that only contributes to half of all bankruptcies that are filed but hey I wouldn't put it past them to try to reform bankruptcy the way they did it in 2005.

# ? Mar 8, 2017 22:36

call to action: Jun 10, 2016; by FactsAreUseless

Spuckuk posted:

Every day I find it hilarious and sad that people in the US, people fight tooth and nail to deny themselves Universal Health Care that every other first world country has.

It's never even presented as an option, and when it is, it's shown in a terrible light. To even know what UHC is in America makes you a policy wonk.

# ? Mar 8, 2017 22:39

Shrecknet: Jan 2, 2005

cis autodrag posted:

The only way to have something analogous nationally would be for the government to mandate prices for all services. Which is a thing other countries do, Japan has had success with it, but it wouldn't fly with America's brokebrains free market religious fervor.l

Maryland totally does this, though. An appendectomy costs the exact same no matter where you get it done. So it's not impossible.

Shrecknet fucked around with this message at 22:42 on Mar 8, 2017

# ? Mar 8, 2017 22:39

Subvisual Haze: Nov 22, 2003; The building was on fire and it wasn't my fault.

Hollismason posted:

If they enact the changes your going to see a rise in deaths from HIV complications. Right now a lot of that is funded and subsidized by Medicaid and other programs.

AIDS Drug Assistance Programs are in their own world at least. Same with most Ryan white programs, they're payers of last resort even after Medicaid.

Helping a recent immigrant get access to hiv meds for no cost from my pharmacy via the ADAP is one of few times I felt non hateful feelings toward our healthcare system this year. It was like a two page application and next day they could get their $4000/month meds for free.

# ? Mar 8, 2017 23:22

TROIKA CURES GREEK: Jun 30, 2015; by R. Guyovich

Monkey Fracas posted:

Am I misremembering or is medical debt/bankruptcy somehow classified differently when compared to normal debt now?

Would be even more of an incentive to just sorta roll the dice on a medical bankruptcy happening to you as a young person rather than pay out the rear end for garbage insurance. And if you develop some horrible condition that is slow enough to allow you to get insurance before you get care you only pay a 30% penalty for a year!

I don't know about bankruptcy, but it is sometimes treated differently in certain kinds of credit modeling, and when they do it's usually in the consumers favor. For example medical debt's importance in a mortgage application might be a lot less than say credit or auto debt. This is because a person defaulting on medical debt often still pays their mortgage and car payments, but someone defaulting on credit card debt is much more likely to be in serious financial trouble in many other ways.

TROIKA CURES GREEK fucked around with this message at 23:47 on Mar 8, 2017

# ? Mar 8, 2017 23:41

esquilax: Jan 3, 2003

Dr. Angela Ziegler posted:

Maryland totally does this, though. An appendectomy costs the exact same no matter where you get it done. So it's not impossible.

An all-payer system like that isn't exactly the same as no networks, and networks still exist in Maryland. Health plans can and do create networks (broad and narrow) to limit benefits to providers who are high quality, or to take into account a relationship with the providers (e.g. Kaiser).

# ? Mar 9, 2017 00:57