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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hobbesmaster: Jan 28, 2008

Electric Phantasm posted:

Is this saying states can automatically disenroll off your plan once you report your lottery winning? Also should we assume the worst and take high dollar to mean winnings you have to report?

It change the calculation of income to spread a lump sum lottery payment over time; up to 10 years for 1.2mil.

# ¿ Mar 7, 2017 15:21

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# ¿ May 3, 2024 00:26

hobbesmaster: Jan 28, 2008

BirdOfPlay posted:

This is a budget reconciliation bill. The Senate limits discussion on those, meaning there is no filibuster.

Right, but the "follow on" bills with selling across state lines or whatever would be subject to the filibuster.

# ¿ Mar 8, 2017 03:39

hobbesmaster: Jan 28, 2008

Mokelumne Trekka posted:

Why all the talk of this being DOA in Senate? Sorry, I know nothing despite the reading I've done

Republicans from states that trend blue* and bright into the Medicaid expansion are against it and the Rand Pauls are angry that it isn't just a repeal.

*yes I need this qualifier because Kentucky expanded Medicare.

# ¿ Mar 8, 2017 03:42

hobbesmaster: Jan 28, 2008

Family Values posted:

Supposedly, but I don't understand how this bill doesn't exceed the scope of the reconciliation process (which is supposed to just be 'spend more/less on X')

Obamacare itself was passed partly through reconciliation

# ¿ Mar 8, 2017 04:05

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

hobbesmaster: Jan 28, 2008

silence_kit posted:

You are truly a brilliant policy wonk.

But yeah, medicine is too important and medical costs are getting too high to allow doctors to cartelize the profession and jack up costs. We need to admit more people into medical schools and residencies, and medical schools should be structured so that you can enter after high school and not have to pay for four years of college for like maybe one and a half years' worth of pre-med education. It's wasteful.

Most require 2-3 years of chemistry. I guess you could complete a full ochem and pchem sequence in 2 years if you get the general chem courses knocked out from AP credit or the like

It seems like med school should be able to be setup like pharmacy school where you don't necessarily need the bachelors first just the curriculum.

The problem however is not a lack of qualified candidates for medical school, it's that med schools don't want to graduate doctors that cannot be placed in residencies. The number of residencies available has been staying flat because the overwhelming majority of funding for it is from the federal government.

hobbesmaster fucked around with this message at 21:06 on Mar 10, 2017

# ¿ Mar 10, 2017 21:03

hobbesmaster: Jan 28, 2008

A MD that has completed residency is not allowed to do anything on their own until completing their residency. They are considered a drain because everything they do is supposed to be checked by an attending.

This is different from a PA or NP who is allowed to operate independently within certain guidelines.

# ¿ Mar 10, 2017 21:15

hobbesmaster: Jan 28, 2008

silence_kit posted:

This sounds like you are agreeing with me, and you are saying that residents aren't a cost center for hospitals. By having residents doing the more menial work and having veteran doctors check it, you are increasing the productivity of the veteran doctors.

So the argument that 'we can't have more residents because it would be too expensive' doesn't make sense to me at all. It is more likely IMO that we don't have more residents because it would threaten doctors' paychecks.

You misunderstand. If you go to an ER at a teaching hospital, you will be asked the same questions by:
1. The triage nurse
2. Your "real" nurse
3. A 4th year med student
4. A resident MD
5. The attending MD

The resident is doing redundant work

# ¿ Mar 10, 2017 22:26

hobbesmaster: Jan 28, 2008

Accretionist posted:

That framing seems like a missed opportunity. There's no line item for Planned Parenthood, so how accurate is, "funding?"

Medicaid pays for healthcare from healthcare providers. PP provides healthcare.

It's not, "defunding PP." It's, "banning your healthcare provider."

Planned parenthood runs free clinics under some federal programs so I assume they're talking about that.

But it seems easy enough to bypass through some restructuring.

# ¿ Mar 13, 2017 22:38

hobbesmaster: Jan 28, 2008

Mantis42 posted:

Sure, but if things come down to the wire won't the hardcore repeal guys settle for Ryan's "Obamacare Lite" or something close to it? I mean if the alternative is nothing passing, they'll go for it, right? This whole situation feels like the germs trying to get into Mr. Burns kinda situation.

They haven't before.

# ¿ Mar 17, 2017 05:32

hobbesmaster: Jan 28, 2008

volts5000 posted:

So my mom thinks this is some wonderful selling point, but she can do this already?!

literally part of Obamacare

# ¿ Mar 24, 2017 15:51

hobbesmaster: Jan 28, 2008

esquilax posted:

SHOP marketplace is not the same, it does the same thing but is on an individual employer basis. Multiple employer plans (which when several employers band together to provide a single plan) for health and retirement have been around like forever.

I guess that goes with the public's fundamental misunderstanding of insurance. The SHOP marketplace would be a larger group than any collection of small businesses so should be cheaper.

# ¿ Mar 24, 2017 16:06

hobbesmaster: Jan 28, 2008

esquilax posted:

Not necessarily, since each individual purchaser is still relatively small. I don't see any major reason why premiums would be lower than in the individual market, and a few reasons that they might be higher due to better benefits.

I thought it operated the same way as the normal individual marketplace and prices were the same for everyone?

# ¿ Mar 24, 2017 16:17

hobbesmaster: Jan 28, 2008

^^^ Jeb lost, no need for Terry Schiavo jokes

BarbarianElephant posted:

This sounds like a good plan, roughly comparable to "Democrats should register as Republicans in the primary and vote for Donald Trump as candidate, hur, hur."

All you have to do is phone the office and say you're against the bill and it'll go down as a tally mark in the "no calls" column. No need to say why. Now, if you're speaking against saying "no" as a general principle then that's different...

As a Twin Cities resident I should call my house rep and see if needs some popcorn or something

# ¿ Mar 24, 2017 16:24

hobbesmaster: Jan 28, 2008

BarbarianElephant posted:

Plan B may well be repeal without replace, hammered through somehow, if it seems popular.

Repeal drops a similar number of people off their health insurance but has no tax credits to go with it. For every HFC member they gain they'll lose 2 "moderates"

# ¿ Mar 24, 2017 16:34

hobbesmaster: Jan 28, 2008

BarbarianElephant posted:

I suspect that these "moderate Republicans", fewer in number, can be browbeaten/threatened/bribed more easily than the maniacs of the Freedom Caucus.

The moderates are in gerrymandered R+2 seats, they'll lose their general elections if they go along with it.

# ¿ Mar 24, 2017 16:38

hobbesmaster: Jan 28, 2008

BarbarianElephant posted:

Republican voters have the memories of mayflies. I'm not sure they can remember this issue in 4 years time, especially since the Republican propaganda machine will be stepping up the hate and making people forget all other issues apart from whatever minority ethnicity's existence most concerns them.

"Repeal and replace" based rhetoric has already survived 2 elections, it'll survive one more. Also heritage action won't forget and if there's anything in that "replace" part the moderates are losing a primary

# ¿ Mar 24, 2017 16:47

hobbesmaster: Jan 28, 2008

Shimrra Jamaane posted:

So what happens if Boss Baby Trump demands a vote no matter what gently caress the results. Will it have to take place?

It's 100% up to Paul Ryan. He has to decide whether or not he wants Trump to start campaigning for a primary challenger for Ryan's seat on Monday.

(Don't tell me Trump isn't petty enough to do this)

# ¿ Mar 24, 2017 17:51

hobbesmaster: Jan 28, 2008

evilweasel posted:

Trump already did that in 2016. The primary challenger got creamed something like 83-17. Ryan isn't at all worried about that, he's worried about his members who really don't want to take this no-win vote.

edit: it is, of course, entirely possible that 22 rebels vote to declare the speakership vacant, which the Democrats will happily support them on.

Ryan hadn't betrayed Trump at that point.

And previous failure has never stopped Trump from doing something before.

# ¿ Mar 24, 2017 17:57

hobbesmaster: Jan 28, 2008

BarbarianElephant posted:

Yeah. My husband and I are self-employed. Before ACA there was precisely one insurance provider who would insure a person for less than a ridiculous amount. Now we have some choice, and for the most part, it's better.

Unfortunately, for those who were not subsidized, such as us, the prices for plans go up crazy amounts per year. Within 5 years it's going to be more than our mortgage unless something is done. And I doubt if the Republicans give a poo poo.

Those prices are going up for employers too, employees may or may not be seeing this trickling down to them too.

# ¿ Mar 29, 2017 18:52

hobbesmaster: Jan 28, 2008

Leon Trotsky 2012 posted:

Tom Price was just in a hearing on Capitol Hill.

He came outright and said:

- HHS will not spend any money advertising Obamacare Open Enrollments going forward.

("We aren�t going to continue spending millions of taxpayers� dollars promoting a failed government program.")

- HHS is cutting the funds to states to help them advertise and enroll new people.

- The IRS is unlikely to enforce the individual mandate penalty (they already barely do, but having the director say that they won't will encourage more people to go without it)

- When asked about enforcing Essential Health Benefit Requirements, he said that they are the law, but they aren't going to go out of their way to check every single plan. They will look into them if someone files a complaint for a non-compliant plan. They will follow the law, though.

He thinks people probably won't complain because premiums would be lower and "Individuals ought to be able to select the kind of coverage they want, not that the government forces them to buy."

Basically, giving a green light to companies and individuals to not follow the law.

That's a silly thing to say about the EHB because providers will jump all over any insurer that isn't giving them money they're required to by law.

# ¿ Mar 29, 2017 20:24

hobbesmaster: Jan 28, 2008

Xae posted:

It is right abound 10k right now for a single plan.

If they change it you'll probably end up in a High Deductable plan since those are all the rage these days.

"Low" deductible health plans are likely to hit the mins for high deductibles from what I've seen. A HDHP is "only" $1300 for a single person, $2600 for a family.

# ¿ Mar 29, 2017 23:05

hobbesmaster: Jan 28, 2008

Rhesus Pieces posted:

https://twitter.com/topherspiro/status/855067932623347712

Trumpcare: Metastatic cancer? Ooh, that's no good. Have you considered blowing your brains out?

So you add $4020 to those values to get the total cost per year?

# ¿ Apr 20, 2017 18:56

hobbesmaster: Jan 28, 2008

Presumably they'd add those surcharges as soon as they can after getting sick.

Or always if you're a woman before menopause.

# ¿ Apr 20, 2017 19:34

hobbesmaster: Jan 28, 2008

dalstrs posted:

Maybe Texas is different but several years ago I tried to find a lawyer for this. It is incredibly hard to find one who does the work and none of them would work on contingency. I seem to remember being told by a couple that here they can't get enough from the insurance companies, beyond what they are supposed to pay, to pay for their time.

Insurance is mainly regulated by the states so of course you're getting hosed in Texas.

# ¿ Apr 28, 2017 17:41

hobbesmaster: Jan 28, 2008

cis autodrag posted:

Yep, they were definitely ignoring the icd 10 extension.

You're saying that the insurer caused this mess because they truncated the input to just "arthritis"?

# ¿ Apr 30, 2017 05:17

hobbesmaster: Jan 28, 2008

Fulchrum posted:

So, this is it for the year, right? They needed a budget resolution to be able to repeal Obamacare, they need to do the budget now, so they've lost this years window to actually repeal, and will need to try again in 2018, when the threat of voter backlash is worse?

A simple majority of either house can suspend the rules and vote on anything the presiding officer (speaker of the house/president of the senate) puts up for a vote.

So as a practical matter, hopefully, but its up to Paul Ryan. Or McConell I guess, but he'd have to kill the filibuster.

# ¿ May 2, 2017 00:56

hobbesmaster: Jan 28, 2008

Paul Ryan was the last to say "not it"

# ¿ May 2, 2017 02:49

hobbesmaster: Jan 28, 2008

DaveWoo posted:

https://twitter.com/mj_lee/status/859910442973614080

Because it's DOA in the senate

# ¿ May 4, 2017 00:31

hobbesmaster: Jan 28, 2008

clockworkjoe posted:

How are premiums going to go down next year? The health insurance industry is losing $1 trillion from government subsidies alone if they repeal the ACA. I don't see how this chaos is going to do anything but give insurers an excuse to raise premiums.

health insurers will be allowed to sell plans that cover nothing for $50/month

# ¿ May 4, 2017 02:33

hobbesmaster: Jan 28, 2008

Does the thread title need updating then? :negative:

# ¿ May 4, 2017 19:23

hobbesmaster: Jan 28, 2008

oldskool posted:

It's a race to see who can look worse
https://twitter.com/byrdinator/status/860196932374978560

I'm sure singing Sha Na Na as a bill that kills people passes will be fine. Nobody in the GOP will twist this.

Is there video?

# ¿ May 4, 2017 19:53

hobbesmaster: Jan 28, 2008

I saw in the freeper thread that some of the anti abortion folk are saying this "defunded planned parenthood"? Is there any other source for that? And what mechanism did they use, because I'm pretty sure its not planned parenthood billing medicaid but whatever random independent contractor OB/GYN billing them, right?

# ¿ May 5, 2017 00:17

hobbesmaster: Jan 28, 2008

esquilax posted:

It's section 103 of the bill. It prevents federal payments to states to cover medicaid payments to PP and it affects any "affiliates, subsidiaries, successors, or clinics of the entity".

So its an illegal bill of attainder. Got it.

# ¿ May 5, 2017 01:03

hobbesmaster: Jan 28, 2008

Simplex posted:

Don't get confused, the ACA is a pretty garbage piece of legislation. It's just that Republican healthcare plans somehow always manage to be worse.

A lot of the problems are due to the Supreme Court case that made the Medicaid expansion optional and deliberate sabotage of the funding sources.

You should reserve "garbage" for what the house just passed. The AHCA did far more good than ill.

# ¿ May 5, 2017 06:12