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Is this where I wail and gnash my teeth
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Mar 7, 2017 03:27
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AbsolutelySane posted:The best we can hope for is that one group of morons (the Freedom Caucus) sabotages the other group of morons (Paul Ryan et. al) and they can't get anything done. If it goes through, it won't take long for it to cause a real health care crisis. That's without taking the Medicaid changes into account. Yeah. The lives of tens of millions of people now depend on the inability of the Republican congress to agree with itself. This is where poo poo really starts to get bad and Trump actually starts creating real honest to god crises that have direct impacts on huge swathes of the country (the immigration EO was relatively small potatoes).
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Mar 7, 2017 03:39
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Bueno Papi posted:If there's no CBO score, how can it pass reconciliation? The Republicans don't give a poo poo so long as gently caress the poors?
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Mar 7, 2017 03:51
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Confounding Factor posted:Not only the millions who will lose insurance, but how many jobs will be lost? There were reports of it being millions also. I think we should focus on all the kids this will kill. I'm not being hyperbolic. A lot of kids are on Medicaid. Tens of millions. If Medicaid is just a block grant, no longer need-based, then the states can cut those Medicaid services at will. We are talking millions and millions of children who are at risk of losing their medical coverage, many of them desperately ill. You think states are going to cover things like heart transplants for poor kids if they aren't being forced to by the federal government? Spoiler: they won't. This reform is legislative child murder. Mass murder. Class genocide. Hieronymous Alloy fucked around with this message at 04:11 on Mar 7, 2017 |
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Mar 7, 2017 04:06
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Hollismason posted:Weirdly Medicaid covers some transplant services the kicker though is that they often don't cover the anti rejection drugs. Current Medicaid must cover transplant services for children, under the EPSDT mandate. Block grant though? All those federal need-based requirements go POOF and when the smoke clears, dead children everywhere, dead of preventable conditions, because gently caress poors Leon Trotsky 2012 posted:The CHIP program covers kids. Sure, but that's just what's easiest to cut. There are already plenty of attempts to cut children's services in conservative states, because children's services are where most of the money is -- if you want to cut medicaid, you have to cut kids, one way or another. Due to the current federal limitations most current cuts are done via "prior authorization" requirements, which are allowed. But there really won't be any reason to not just cut out the middleman. That's the thing -- in conservative states that did not expand Medicaid, funding has still not recovered from the cuts in 2008. Lots of places in this country are *already* past the "first and second rounds" of tightening. Hieronymous Alloy fucked around with this message at 04:18 on Mar 7, 2017 |
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Mar 7, 2017 04:15
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Bueno Papi posted:Children are in most states the smallest part of their medicaid outlays. The fastest growing medicaid outlay after CLA's is payments to LTC facilities. In some states, especially in those that haven't expanded medicaid, it is the largest outlay. The whole LTC industry depends on medicaid and likewise all those patients. Ok, fair enough. I'm going by what I've picked up at the local level, not detailed study of the national numbers. I know that in my state 46% of the children in the state are on Medicaid, so, yeah . . . I'm not speaking hypothetically, I've already seen numerous attempts to cut children's services in my state (disguised as prior authorization requirements, usually). Long term care is the other side of the coin certainly. All those nursing home residents? Turn 'em out in the street. Gonna be like walking dead out there, but with Alzheimer's patients. Hieronymous Alloy fucked around with this message at 04:24 on Mar 7, 2017 |
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Mar 7, 2017 04:21
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Leon Trotsky 2012 posted:Kids are the most cost-effective Medicaid enrollees. Especially when you consider the lifetime savings gained from investing in children's care (as things like ABA therapy demonstrate). I'm not claiming that Republican legislatures will be rational. I'm just saying I've seen repeated attempts to cut children's services and I expect those attempts to be accelerated dramatically once federal oversight requirements are removed. Covering ABA therapy saves hundreds of millions over the long term, but the only reason my state covers it is because of the federal guidance requiring it issued year before last. Remove that requirement and that coverage is going to vanish as quickly as it appeared -- and that's just one treatment for one condition.
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Mar 7, 2017 04:27
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Ravenfood posted:Another aspect that you'll start seeing, and in some ways I think we might already have started, is that you're going to struggle to place patients in rehab facilities. So, hypothetically, someone comes into the ER with what is obviously early massive sepsis. So they get admitted to the ICU, go through a long, very costly treatment, end up trached/PEG'd because they're a failure-to-wean patient, and then...what? You've got them stabilized, but they're vent dependent and on tube feeds. They need to go to either a skilled nursing facility or a long-term acute-care facility, but those places are private with no obligation to treat like hospitals. So they'll refuse to take anyone who doesn't have insurance to cover the costs (like ones with a cap that have already been hit because sepsis is loving expensive), so the hospital is now stuck with the cost of trying to care for and wean a patient, in an ICU, that's going to have a long course of treatment because they can't discharge a patient either. This is already a constant issue due to low Medicaid reimbursement rates.
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Mar 7, 2017 14:59
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Concerned Citizen posted:the senate can only pass 1 reconciliation bill a year. a part b and part c bill requires 60 votes. My understanding is that that's part of the plan. Use reconciliation to blow everything up, force the Democrats to capitulate in order to put it all back together. Hostage strategy updated for the majority.
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Mar 7, 2017 19:19
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So how much time before this passes? How quickly is it being forced through?
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Mar 7, 2017 23:22
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Mokelumne Trekka posted:Let's assume republicans are all in for this. Can it pass without some Dem votes in favor as well??? Still not hearing a clear answer (i probably have a middle school level understanding of the process) If the Republicans are unified they can do whatever they want.
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Mar 8, 2017 03:28
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Noctone posted:I mean, only if they torpedo the filibuster, right? If the Republicans are unified, they can do whatever they want.
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Mar 8, 2017 03:35
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EugeneJ posted:If Dems put up Medicare for All as a counter-proposal, how many GOP senate members would have to jump across the line to pass it? Two thirds, to override a presidential veto.
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Mar 8, 2017 04:40
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TROIKA CURES GREEK posted:
I think of it more as a bill title. It's totally possible to expand Medicare and Medicaid to cover all americans. It would require other improvements also, chiefly increases in payment rates, but it's completely doable.
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Mar 8, 2017 13:56
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Sundae posted:The dumb part would still be necessary because the risk calc of not having insurance ignores all the thousands of minor things that aren't organ transplants that can still wipe out all your savings and/or bankrupt you if you don't have insurance. Well, a lot of Americans these days are functionally operating on the assumption that at some point they will go bankrupt, and just trying to forestall that day as long as possible.
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Mar 8, 2017 14:15
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Even simple bloodwork will run you a grand at cash-payer price these days--mine was just $953 before insurance adjustments down to $3.72. 
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Dmitri-9 posted:Being the silent, passive party with no ideas or beliefs doesn't strike me as a good strategy. If they can't make political hay out of stupid policies no progress will be made, the status quo will be eroded out from under them. There is only one winning strat right now in health care politics, it is Medicare for All/ public option Medicare, and it is politically impossible until after the Republicans fall on their faces. Health care is in a state of market failure and anything short of single payer is just going to force the party in power to own that failure.
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Mar 10, 2017 19:22
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Leon Trotsky 2012 posted:1) The Supreme Court decision is a huge stumbling block You'd have to make it fully federally funded.
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Mar 10, 2017 19:22
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call to action posted:It's sort of weird seeing people defend PPACA as a jobs program when they'd never do the same for the F-35 program. If the F35 saved lives that would be an argument, but it's a flying deathtrap (when it manages to fly).
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Mar 10, 2017 23:42
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Azhais posted:He's literally Marie Antoinette More a Randian Richelieu
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Mar 12, 2017 20:51
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HappyHippo posted:CBO score due at 4PM apparently I have a real fear that the CBO has dramatically cooked the books on this, and the entire past week has been an exercise in getting Democrats to talk up how important and reliable the CBP score is. Paul Ryan picked the guy running the CBO these days, didn't he?
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Mar 13, 2017 21:04
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evilweasel posted:That's medicare. Medicaid is poor people, medicare is old people. Old people who are not yet old enough for medicare are really shafted by the change in the maximum ratio you can charge young people vs. old people in this bill and I think it sets up future medicare cuts by depleting the trust fund but doesn't do them here. Old people are mostly also poor though. Medicare does not cover nursing home care, only Medicaid does.
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Mar 13, 2017 22:07
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HappyHippo posted:Does anyone other than Ryan actually like this bill? Seems like literally all its support is "well we gotta do something cause we said we would" Well, presumably it makes some people very wealthy.
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Mar 14, 2017 15:56
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Spaced God posted:The fact that we're discussing how much a fictional character makes and will lose under AHCA is what's wrong with politics tbh. Harry Potter metaphors are for education cuts.
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Mar 14, 2017 17:31
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Xae posted:Insurers want a single national standard. Not just in Healthcare, but all types of insurance. They also don't want to have to deal with pesky state regulations like "you have to cover what you promised to cover" and so forth. Badger of Basra posted:No one is talking about keeping the Medicaid expansion which seems like a bigger deal. They do want to add work requirements to it though because of course. In Texas I'm not even sure if you could get on Medicaid if you had actually a full time job (even minimum wage) because the requirements are nuts. Not just the medicaid expansion. AFAIK they still awnt to convert medicaid to cap-and-cut rather than a need-based program. Arglebargle III posted:So if you take the House proposal, but put a lot more funding into it, you get Obamacare with a $600 billion tax cut. It's not just funding, it's specifically *where* they took that funding from: Medicaid.
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Mar 15, 2017 04:50
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Reik posted:The carrier I work for operates in a handful of states. Putting together a competitive provider network in that state is a much bigger hurdle than state regulations. Good luck getting the same or better deals at major hospital systems when you have no market share. I haven't met another Actuary that thought "selling across state lines" was a good idea for anyone, insurers included. I would expect that local companies would be bought out or just technically change their official state of business to [Delaware] or wherever has the lowest regulations.
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Mar 15, 2017 15:26
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I'm wondering if they'll be able to pass a budget at all.
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Mar 16, 2017 22:23
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Re Aetna: Remember how we didn't get a public option because Obama took it off the table to make sure the insurance companies were on board?
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Mar 17, 2017 17:39
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sharkbomb posted:Fired U.S. Attorney Preet Bharara Said to Have Been Investigating HHS Secretary Tom Price Don't worry, they've taken care of that now! (unless Preet Bahara gets hired by a state government prosecutor's office)
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Mar 18, 2017 00:19
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evilweasel posted:Yeah I think any state-based UHC will need to be residents-only (at least at the beginning), which requires a private system to still stay in effect. Medicaid already does this so it's not exactly rocket science.
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Mar 21, 2017 18:27
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blackmet posted:
The only feasible path is universal Medicare/ Medicaid, and even that is a colossal stretch that requires a Democratic leftist wave election as a sine qua non.
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Mar 22, 2017 00:30
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BlueBlazer posted:How about open enrollment into Medicare/Medicaid? Functional ly the same thing. Private market would be run out of business by the structural advantages.
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Mar 22, 2017 01:45
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Sloober posted:The huge takeaway is what will be the end goal here for healthcare during their power? They have never had an end goal other than re-election. They especially don't have an actual goal in terms of health care policy, because caring about sick people is not something they have ever done.
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Mar 22, 2017 15:30
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evilweasel posted:That's not quite true. A lot of them sincerely believed in repealing obamacare to lower taxes on the rich because using money from the rich to heal the poor is unrandian. They just never had an alternative plan, or a desire to explicitly run on "gently caress you, poor people". If they could have repealed Obamacare before people were actually using it, they absolutely would have. Right, but that's a tax policy goal not a health care policy goal, if I can extend my argument out like that.
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Mar 22, 2017 15:36
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Craig K posted:he's getting Lots of Calls so i got the voice mail and left a message. I've also been using Resistbot to send faxes. It automatically figures out your representative when you give it your street address.
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Mar 22, 2017 18:01
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If they hold a vote and it fails that would be amazing.
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Mar 23, 2017 17:59
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Rhesus Pieces posted:I just can't see how a bill with a goddamn 17% approval rating as-is can possibly pass. That's guaranteed political suicide no matter what the "lol nothing matters embrace death" crowd thinks. Because Congress, especially Republicans, do not represent the general public. They represent rich people and radicalized whackos and both those groups want this bill or more, either for tax cuts at any cost, or because they're insane.
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Mar 23, 2017 18:31
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Flip Yr Wig posted:If they don't have the votes, why doesn't Ryan just take the McConnell approach and rip off the bandaid? I get that it's a much bigger humiliation for him than McConnell, but the problem isn't going away for him. Ryan's real dumb and let himself be put in this position, but he thinks he's smart enough to find a way out of it (he ain't, there's no such answer)
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Mar 23, 2017 18:38
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I think this is a result of constituent pressure. He's been asking for feedback on his facebook page and the comments are like 100 to none against the bill.
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Mar 24, 2017 15:21
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evilweasel posted:genuine american hero: This dude for prez
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Mar 24, 2017 17:30
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Hastings posted:That is some serious delusion they had to go ahead and make these ads and air them, when it was known that this Act was hated from the beginning. I almost think it didn't even occur to them they would lose this hard. On the other hand, this was totally worth it for the laughs. loving up this badly is kinda inconceivable if you don't accept the premise that the Republican Party is fundamentally incoherent and incompetent. They control all three branches!
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Mar 25, 2017 04:23
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