PILOT SPIN
Spin Zone => Spin Zone => Topic started by: asechrest on November 11, 2016, 04:57:13 PM
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Trump likes parts of it, may keep them.
http://mobile.nytimes.com/2016/11/12/business/insurers-unprepared-for-obamacare-repeal.html?_r=0&referer=https://news.google.com/
;)
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Trump likes parts of it, may keep them.
http://mobile.nytimes.com/2016/11/12/business/insurers-unprepared-for-obamacare-repeal.html?_r=0&referer=https://news.google.com/
;)
So? He's starting with removing the most egregious parts and keeping the parts that should have been the limited requirements in the first place. He doesn't have a supermajority like Obama had.
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So? He's starting with removing the most egregious parts and keeping the parts that should have been the limited requirements in the first place. He doesn't have a supermajority like Obama had.
It's a partial reversal already.
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I never saw the entire law being completely repealed anyway. I always figured that certain provisions would be kept (such as covering those with pre-existing conditions) while the individual mandate would be done away with.
Besides, The President-elect has to work with Congress on this. It's not just him that will decide what stays and what goes.
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Besides, The President-elect has to work with Congress on this. It's not just him that will decide what stays and what goes.
what a concept!
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Part of the reason I voted for Trump is because he is a dealmaker. And one of the things of making deals, is that all parties feel that they've gained something or achieved something. When I voted for Trump, I fully expect him to make deals that are good for America, and keep things moving. Being unyielding in expectations means nothing gets done.
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I never saw the entire law being completely repealed anyway. I always figured that certain provisions would be kept (such as covering those with pre-existing conditions) while the individual mandate would be done away with.
Besides, The President-elect has to work with Congress on this. It's not just him that will decide what stays and what goes.
The individual mandate is un-Constitutional, I don't give a rat's ass what SCOTUS said.
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Trump campaigned on a pledge of full repeal.
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Liberals never can understand the concept of looking at a problem as a business problem and not a political opportunity.
The one thing I do look forward to where the Donald is concerned is that he will NOT govern like a democrat or republican but approach every issue like it is a business decision that needs made.
That alone will cause liberal hads to explode, implode and shatter nto a million pieces.
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what a concept!
Bob, I love you. :-*
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Trump campaigned on a pledge of full repeal.
Yes he did.
I don't remember where I heard this; it may have been right here,
"Liberals took Trump literally, but not seriously, where Trump supporters took him seriously, but not literally".
And I'm sure some can correct me, but I seem to remember a lot of wording in the ACA that precludes repealing part of it without repealing the whole thing. That may have just applied to certain sections
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Trump campaigned on a pledge of full repeal.
Technically he campaigned on 'repeal and replace' which is the same message the House has been making - and, Trump has previously commented on pre-existing condition coverage and a few other elements as being 'good'.
I for one do not see this as in any way incompatible with his campaigning.
http://www.usnews.com/news/articles/2016-11-11/donald-trump-provides-details-of-health-care-policies
His first 100 days is going to be yuuuge.
'Gimp
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Trump campaigned on a pledge of full repeal.
Not true at all. He did campaign on "repeal and replace" but he is on record during a debate as saying there are parts of it that might stay.
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There are good parts of the law. There are also horrible parts of the law.
I like the part that says that insurance companies cannot charge you more for a pre-existing condition and that they have to have a single risk class with a single payment for each person.
I don't like that nobody is talking about fixing the actual problem, which is the "losses from trade" problem caused by the multi-level nature of the medical industry. The stratification is caused by law and by tort issues, resulting in specialization for everything. Until this issue is identified by national lawmakers and addressed, the basic cost of medical care will remain high no matter who is in charge.
But they're not listening to me.
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There are good parts of the law. There are also horrible parts of the law.
I like the part that says that insurance companies cannot charge you more for a pre-existing condition and that they have to have a single risk class with a single payment for each person.
I don't like that nobody is talking about fixing the actual problem, which is the "losses from trade" problem caused by the multi-level nature of the medical industry. The stratification is caused by law and by tort issues, resulting in specialization for everything. Until this issue is identified by national lawmakers and addressed, the basic cost of medical care will remain high no matter who is in charge.
But they're not listening to me.
Out of curiosity, why do you like that insurance companies are required to accept those with pre-existing conditions at a higher premium?
Looking at it one way, an insurance company is in business to make money. They provide a service and you pay for that service. Healthcare is not a right so if the insurance companies deem that they are having to take more of a risk, then you should pay more for it. In theory it could also create competition because Company A may want to charge you at a certain rate but Company B may choose to charge you less to gain your business.
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requiring insurance companies to provide INSURANCE to people with pre-existing conditions is like requiring insurance companies to provide insurance to home owners that just had their house burned to the ground or to provide coverage to car owners that just totaled their cars.
People need to find a better name for it. But one thing it isn't is "insurance"
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requiring insurance companies to provide INSURANCE to people with pre-existing conditions is like requiring insurance companies to provide insurance to home owners that just had their house burned to the ground or to provide coverage to car owners that just totaled their cars.
People need to find a better name for it. But one thing it isn't is "insurance"
I'd love to understand the actuarial math behind Trump's plan that retains that part of Obamacare.
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I can see keeping the part about pre-existing conditions. Not so sure about the children up to age 26 except, perhaps when they are enrolled full-time in college. Opening up across state lines would be a big thing. It really shouldn't matter what state you live in who you buy your insurance.
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A true capitalist approach cannot include a mandate to insure the nigh uninsurable. I especially don't see how you can divorce the individual mandate from the preexisting condition clause.
Seems like Trump wants a have your cake and eat it too approach. Is that possible, here?
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A true capitalist approach cannot include a mandate to insure the nigh uninsurable. I especially don't see how you can divorce the individual mandate from the preexisting condition clause.
Seems like Trump wants a have your cake and eat it too approach. Is that possible, here?
I don't believe Trump, or the actual people that will be working this out will be going to online forums to see what the solutions are.
I'm willing to wait to see what they propose and how they propose doing it before making judgement.
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A true capitalist approach cannot include a mandate to insure the nigh uninsurable. I especially don't see how you can divorce the individual mandate from the preexisting condition clause.
Seems like Trump wants a have your cake and eat it too approach. Is that possible, here?
You do not have to have an unconstitutional individual mandate that forces THE PEOPLE to buy insurance in order to have a policy requirement that Insurers OFFER insurance to certain high-risk pools.
There may well be math that works for a high-risk pool, and since you are talking about less than 3 million people it may be a case where limited government involvement makes sense either as the insurer ala medicare/medicaid or in providing subsidies to individuals who choose to buy insurance from companies with appropriately priced high risk policies. Far more sense than changing the law for every man woman and child in the nation to try and change the situation for 10-15 million uninsured.
Nothing is impossible, the real difference is the approach to the use/avoidance of the power of government which is in the end the primary difference between the Left and the Right.
'Gimp
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Trump campaigned on a pledge of full repeal.
And replace. Why did you skip that piece in your statement?
Replace can include the few components that work.
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requiring insurance companies to provide INSURANCE to people with pre-existing conditions is like requiring insurance companies to provide insurance to home owners that just had their house burned to the ground or to provide coverage to car owners that just totaled their cars.
People need to find a better name for it. But one thing it isn't is "insurance"
Bob, this already exists in the employment world and COBRA. It actually worked quite well before ACA, and will work well later.
However, it requires someone to remain covered. That's just good policy.
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I'd love to understand the actuarial math behind Trump's plan that retains that part of Obamacare.
Just look at COBRA.
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COBRA is outrageously expensive.
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You do not have to have an unconstitutional individual mandate that forces THE PEOPLE to buy insurance in order to have a policy requirement that Insurers OFFER insurance to certain high-risk pools.
There may well be math that works for a high-risk pool, and since you are talking about less than 3 million people it may be a case where limited government involvement makes sense either as the insurer ala medicare/medicaid or in providing subsidies to individuals who choose to buy insurance from companies with appropriately priced high risk policies. Far more sense than changing the law for every man woman and child in the nation to try and change the situation for 10-15 million uninsured.
Nothing is impossible, the real difference is the approach to the use/avoidance of the power of government which is in the end the primary difference between the Left and the Right.
'Gimp
It's not about "healthcare", it's about CONTROL.
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COBRA is outrageously expensive.
COBRA is what you would pay if your employer didn't pay part.
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COBRA is what you would pay if your employer didn't pay part.
COBRA is what you would pay if your employer didn't pay part.
Plus an additional administrative fee.
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Bob, this already exists in the employment world and COBRA. It actually worked quite well before ACA, and will work well later.
However, it requires someone to remain covered. That's just good policy.
COBRA is not what we're talking about. COBRA is a temporary extension of coverage after a qualifying workplace event for someone already within the risk pool of the insurance company. The mandate as it exists in Obamacare regarding pre-existing conditions is that health insurance companies -- even ones evaluating a new insured -- may not deny coverage or charge more for an individual with a pre-existing condition. That's certainly not the capitalist, hands-off approach.
Further, the theory was that the individual mandate would help counteract the effects of ruining a health insurance company's underwriting process of forcing them to take on a risky insured and preventing them from charging an appropriate premium. Requiring healthy and less-risky individuals to carry insurance would allow balance from the pre-existing condition mandate.
Now from what I can tell, Trump is no fan of the "unconstitutional" individual mandate, yet wants to retain the pre-existing condition details of Obamacare. I don't know how that math works, though, granted, health insurance is not my forte. The devil will certainly be in the details.
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Further, the theory was that the individual mandate would help counteract the effects of ruining a health insurance company's underwriting process of forcing them to take on a risky insured and preventing them from charging an appropriate premium. Requiring healthy and less-risky individuals to carry insurance would allow balance from the pre-existing condition mandate.
In other words, redistribution of wealth at the point of a government gun.
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In other words, redistribution of wealth at the point of a government gun.
Yep, the preexisting condition mandate is wealth distribution from the healthy to the not so healthy. Makes me wonder why Trump is a fan.
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If we are going to force insurance companies to issue insurance policies regardless of pre-existing conditions, I think it should be reserved only for the young (eg; < 21 (voting age)). I would also be ok with Federal Tax subsidies for that so that the public can eat the bill instead of private insurance companies.
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Yep, the preexisting condition mandate is wealth distribution from the healthy to the not so healthy. Makes me wonder why Trump is a fan.
I bought the Kindle version of his book "The America We Deserve" which was written in 2000 - it lays out the positions he held back then. On health care insurance there is this quote (text bolding is mine, does not appear in the original):
"The structure of the healthcare industry is confusing and expensive at every level, and there’s no simple solution. Since the Truman administration our country has been trying to implement a system that protects all citizens. I’m a conservative on most issues but a liberal on this one. We should not hear so many stories of families ruined by healthcare expenses. We must not allow citizens with medical problems to go untreated because of financial problems or red tape."
Later on is written:
"Though we need to make radical improvements, we must not try to go too swiftly in reinventing the system. Rule number one: Take a lesson from Hillary Clinton’s attempt to “fix” the healthcare system. No one can deny her good intentions. Clinton’s was the first administration in years with the ambition to try to help healthcare. But Mrs. Clinton was and is politically committed to a world view that would have done for modern American medicine what Joseph Stalin did for Ukrainian agriculture. We don’t want more government control of the healthcare industry, which is what the Clinton plan called for. There’s more than just a little of the den mother at work here. Hillary Clinton thought she knew best, but her plan would likely have created huge bureaucratic nightmares and inefficiencies."
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"So our objective is to make reforms for the moment and, longer term, to find an equivalent of the single-payer plan that is affordable, well administered, and provides freedom of choice. Possible? The good news is, yes. There is already a system in place— the Federal Employees Health Benefits Program— that can act as a guide for all healthcare reform. It operates through a centralized agency that offers considerable range of choice. While this is a government program, it is also very much market based. It allows 620 private insurance companies to compete for this market. Once a year the participants can choose from up to two dozen different plans, which vary in benefits and costs. The 1998 Candidate’s Briefing Book says that this is about the only system that allows families so much variety in their healthcare."
I could quote in more detail on his plan, but the above should give some idea of his position 16 years ago. Given what has transpired in the 16 years since that book was written, hard to say what will happen going forth. Besides, Trump has to get any changes past congress, and vice-versa.
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I bought the Kindle version of his book "The America We Deserve" which was written in 2000 - it lays out the positions he held back then. On health care insurance there is this quote (text bolding is mine, does not appear in the original):
Thanks for posting that. What he said then is true today. I would like to see him implement something similar, especially since he acknowledges that creating a huge Federal bureaucracy is the wrong way to do it.
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I bought the Kindle version of his book "The America We Deserve" which was written in 2000 - it lays out the positions he held back then. On health care insurance there is this quote (text bolding is mine, does not appear in the original):
Snip
I could quote in more detail on his plan, but the above should give some idea of his position 16 years ago. Given what has transpired in the 16 years since that book was written, hard to say what will happen going forth. Besides, Trump has to get any changes past congress, and vice-versa.
Interesting... appreciate you posting that. Another good book on the evolution of health care (in particular - ObamaCare - or as more accurately named - BaucusCare) is "America's Bitter Pill" by Steven Brill. Well researched and referenced. Gives a somewhat different picture on the development of the ACA than commonly portrayed.
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I bought the Kindle version of his book "The America We Deserve" which was written in 2000 - it lays out the positions he held back then. On health care insurance there is this quote (text bolding is mine, does not appear in the original):
"The structure of the healthcare industry is confusing and expensive at every level, and there’s no simple solution. Since the Truman administration our country has been trying to implement a system that protects all citizens. I’m a conservative on most issues but a liberal on this one. We should not hear so many stories of families ruined by healthcare expenses. We must not allow citizens with medical problems to go untreated because of financial problems or red tape."
Later on is written:
"Though we need to make radical improvements, we must not try to go too swiftly in reinventing the system. Rule number one: Take a lesson from Hillary Clinton’s attempt to “fix” the healthcare system. No one can deny her good intentions. Clinton’s was the first administration in years with the ambition to try to help healthcare. But Mrs. Clinton was and is politically committed to a world view that would have done for modern American medicine what Joseph Stalin did for Ukrainian agriculture. We don’t want more government control of the healthcare industry, which is what the Clinton plan called for. There’s more than just a little of the den mother at work here. Hillary Clinton thought she knew best, but her plan would likely have created huge bureaucratic nightmares and inefficiencies."
[...]
"So our objective is to make reforms for the moment and, longer term, to find an equivalent of the single-payer plan that is affordable, well administered, and provides freedom of choice. Possible? The good news is, yes. There is already a system in place— the Federal Employees Health Benefits Program— that can act as a guide for all healthcare reform. It operates through a centralized agency that offers considerable range of choice. While this is a government program, it is also very much market based. It allows 620 private insurance companies to compete for this market. Once a year the participants can choose from up to two dozen different plans, which vary in benefits and costs. The 1998 Candidate’s Briefing Book says that this is about the only system that allows families so much variety in their healthcare."
I could quote in more detail on his plan, but the above should give some idea of his position 16 years ago. Given what has transpired in the 16 years since that book was written, hard to say what will happen going forth. Besides, Trump has to get any changes past congress, and vice-versa.
Thanks for posting that. I may pick that book up.
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Thanks for posting that. I may pick that book up.
It was a tough decision to part with the $7.99 for the dubious utility of finding out what Trump was claiming his positions were 16 years ago. I was curious about his ghost author and found some additional insights from him here:
http://www.wsj.com/articles/another-time-another-trump-1450742675 (http://www.wsj.com/articles/another-time-another-trump-1450742675)
He does have a policy book written for the 2016 election, but I have yet to buy that.
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It is kind of fun to watch progressives apply all or nothing to health insurance.
It is also entertaining to watch/listen to progressives apply all or nothing to repeal or replace obamacare.
The blind ideologues can't distinguish between repeal and replace, and blow up and start over. The myopia is kind of charming in a three year old child kind of way.
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COBRA is outrageously expensive.
I don't believe COBRA is any more expensive than the full price of the policy your former employer paid.
But that's not my point. My point is the model exists. The ACA didn't give us a new-to-the-industry concept of covering preexisting conditions. It already existed. We can improve on it, certainly.
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I don't believe COBRA is any more expensive than the full price of the policy your former employer paid.
But that's not my point. My point is the model exists. The ACA didn't give us a new-to-the-industry concept of covering preexisting conditions. It already existed. We can improve on it, certainly.
Would have to check, but I think COBRA is only good for a limited period of time. It was not meant to be long term health insurance.
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Would have to check, but I think COBRA is only good for a limited period of time. It was not meant to be long term health insurance.
It is good for one or two years if I recall. But once again, that wasn't my point. It was just that the scheme to cover preexisting conditions already exists in some form.
At some point, if you're covered under long-term health insurance, it's no longer a preexisting condition, is it?
You could have people with preexisting conditions covered by a state's high risk pool or even Medicare until such time as that condition is resolved, at which point the individual could go to private insurance.
Blowing up insurance companies' underwriting models was just a ridiculous power grab.
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Would have to check, but I think COBRA is only good for a limited period of time. It was not meant to be long term health insurance.
18 mos, at least it was before ACA.
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It is good for one or two years if I recall. But once again, that wasn't my point. It was just that the scheme to cover preexisting conditions already exists in some form.
At some point, if you're covered under long-term health insurance, it's no longer a preexisting condition, is it?
You could have people with preexisting conditions covered by a state's high risk pool or even Medicare until such time as that condition is resolved, at which point the individual could go to private insurance.
Blowing up insurance companies' underwriting models was just a ridiculous power grab.
"And basically, call it the 'stupidity of the American voter' or whatever, but basically that was really, really critical to getting the thing to pass.”
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It is good for one or two years if I recall. But once again, that wasn't my point. It was just that the scheme to cover preexisting conditions already exists in some form.
At some point, if you're covered under long-term health insurance, it's no longer a preexisting condition, is it?
You could have people with preexisting conditions covered by a state's high risk pool or even Medicare until such time as that condition is resolved, at which point the individual could go to private insurance.
Blowing up insurance companies' underwriting models was just a ridiculous power grab.
I believe that COBRA is only available for employer sponsored insurance. Don't know of any employee sponsored insurance that excludes pre-existing conditions. So, if one has an employee sponsored plan, and is terminated, laid-off or leaves, COBRA is available for 18 months. What happens to that person after the 18 months? I think you are saying that those people should go to a high risk pool subsidized by the taxpayers?
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It is good for one or two years if I recall. But once again, that wasn't my point. It was just that the scheme to cover preexisting conditions already exists in some form.
At some point, if you're covered under long-term health insurance, it's no longer a preexisting condition, is it?
You could have people with preexisting conditions covered by a state's high risk pool or even Medicare until such time as that condition is resolved, at which point the individual could go to private insurance.
Blowing up insurance companies' underwriting models was just a ridiculous power grab.
I don't understand your point. COBRA is nothing like the mandate that companies cover potential insureds with pre-existing conditions and at the same rates as those without those conditions. COBRA is an extension of existing coverage. The insurance company is already on the risk. They already know the medical history of the insured. It actually has nothing to do with pre-existing conditions.