Rand Paul unveils his healthcare bill
 

Summary of bill here

https://www.paul.senate.gov/imo/medi...ctSections.pdf

Key points:
No mandate
2 year open enrollment
Pre-existing condition protections
Interstate insurance
Employees can deduct premiums from earnings
Unlimited HSA with up to $5k tax deduction
Interstate trade association insurance plans

After 2 years no pre-existing condition enrollment and only current insurance holders with pre existing conditions can transfer to HIPPAA for limited coverage :disgust

At first read it seems OK for me because I have a good income and a preexisting condition.

However, it allows for uncontrolled premium increases. Premium increases need to be inflation capped at the very least. Or, maybe an 100% tax credit if your premiums are more than 8% of your net income (pre tax) -- the difference deduced from your owed tax.

It also does not address insurance for the working 'poor' that cannot afford insurance -- which is so Republican wrong -- as usual.

Trump promised no one will be left out on healthcare -- so let's hear from him.

I don't have any medical issues or medications, so any healthcare plan looks great to me! As long as I don't have to pay anything!!!!! :thumbsup

Competition drives down prices. Since the insurance companies can sell across the US it will drive down the premiums. Also the reason why they pull out of certain states because they are basing income and losses on each state.

The one thing I don't like about it is self-insured doesn't receive the same tax benefits as employer insured.

Don't we already have competition? I can pick from multiple healthcare companies here in California.

I'm in the same boat here in Oregon, but there are states where there are only 1 or 2 options.

Yes, it does. Which is why hospitals and other healthcare providers are almost completely opaque about their pricing, which makes comparison shopping not only time-consuming, but next to impossible, and makes the idea that there's a competitive healthcare marketplace in place just laughable.

As other developed nations have demonstrated, the best way to keep down healthcare costs is not by creating an illusion of competition, but by having a single payer (i.e., the government) deal with providers, pharmaceutical companies, etc.

Nope, there are 2 maybe 3 companies to choose from where I'm at on Obamacare. 3 of the major companies pulled out. You likely have more choices there because you have a larger population. With them being able to compete across state lines there will be a bunch of different companies to choose from for everyone..

The insurance itself is just a racket.. The hospital,doctor or whatever is for the most part going to get roughly the same amount of money from you the individual being insured or not. For example, my son had a motorcycle accident about a year and a half ago. He thought he was insured under his mom so this is what he told them. They based his billing on what they assumed was his insurance. He started receiving the bills and in total it was in excess of $30k for the 8-10 hours he spent in the er. Once they figured out he didn't have insurance they changed all the billing to the "cash payer" billing and it miraculously reduced what he owed to around $5k. So basically the hospitals and such mark up the price 5-6x or more if you are insured and then bill you the 10-20% depending on your plan. Grant it with insurance you're only out of pocket at most $10k-$12k or so a year. But for a healthy person that's catastrophic insurance.

I agree single payer would be great but I don't see that happening, right now anyway.

Insurance is the middleman strangling America and infating drug prices.

Single payer with Medicaid expansion cuts out the middleman and allows negotiating drug prices like every if he Western country does, but us :thumbsup

artificial intelligence will take out lots of the middle men careers: lawyers, insurance, accountants ...

People may resist but as prices continue to sky rocket there will be no choice. Good bye lawyers! (: Goodby accountants, goodbye!!!!!

Often times with prescriptions the opposite is true. You pay more if you pay with cash. Insurance companies negotiate prices with pharmacies and tell the pharmacies how much they are willing to pay for a specific drug. Say, for example, the insurance will pay $50 for a drug and you have a $10 co-pay. The pharmacy will then charge $60 for it. If you are paying cash, the pharmacy is free to charge you $80, $100, or more if they want.

It's not really a negotiation. There's just a base price set (actual price) and then pharmacy inflated price. You can pick up a free "discount" card pretty much anywhere and achieve the same goal. Same thing with dental insurance. I had some work done last year and instead of using my actual dental insurance it came out much cheaper to use a "discount" card. If you really want to get into cost savings try first using the discount card and then send the reduced bill to your insurance company and have them reimburse you. All insurance is a racket.

That could be an awesome future :thumbsup

And here is why it would FAIL

People in this country have come to see healthcare as a RIGHT.

Someone has to pay for it when someone get sick. hit by a truck etc and does not have insurance or the money to pay for the healthcare

inevitably people will opt out and then need their life saved.

so healthcare costs go UP for people who pay for it to cover the people who dont.

bottom line is we have to make it universal or say sorry you die if you cant pay

It really is that simple...if it is a right then everyone has to pay for it via a VAT or whatever no amount of opt in free market bullshit is going to change that simple fact.

Ultimately these are our two basic options. The cost of healthcare continues to rise for several reasons. Eventually, we are either going to have to make a choice where those who can't pay suffer or we take profit out of the equation and make it available to everyone.

There is a version of the second option where everyone gets a base level of care and you can pay extra for extra stuff.

MFA
Medicare for All
We all pay some tax like a VAT -- food and medicine is VAT exempt.
Primary residence, retirement investments, school tuition, books are exempted.
Financial trades are subject to a lower tax -- maybe 1% on every trade.
This day will come eventually ...

Anything short of a single payer system is no better than Obamacare.. Throwing a Republican name on it, doesn't make it better, it's likely worse given Republican's track record..

Single Payer or bust, IMO OP.

if you ask serbia or cuba nicely they could organize your healthcare they are ranked right up there with you guys...you are americans you can not solve this :2 cents:...look at you discussing the pros and cons of the new rape plan and what lubricant you are being offered and how much of it in what case :1orglaugh:1orglaugh:1orglaugh:1orglaugh let communism set you free...

Dude, You're like a scorned woman stalking your abuser. Is posting here some kind of therapy for you? You're obsessed bro ..Just crawl back to your fuckhole that we bombed the shit out of 20 years ago :1orglaugh

Look at survival rates for serious diseases like cancer. Cuba and Serbia are not even in the same ballpark as the US.

these aren't 2 basic options, the 2 options mikesouth pointed out is a red herring...

the core of the problem is that cause of rising costs is not even discussed and so nothing is getting done at all about it...

costs are not rising because people do or do not have insurance... proof is that more people have insurance now than before, and yet health care costs are rising faster than ever...

so discussing how we can give more people free/discounted health insurance is absurd, we need to be discussing why costs are rising and what could be done to slow it down... :2 cents:

I can't believe what I just read.

You are having hard time understanding that competition between multiple companies in one state and competition between all companies in all states are not the same thing?

Jesus Christ....

unfortunately you got the correct answer. why are you so dumb about everything else?

:1orglaugh

actually they are:
ALL CANCERS DEATH RATE BY COUNTRY

serbia is near the top of the list because we die from lung cancer like mother fuckers due to high smoking...has little to do with healthcare and more to do with smoking :1orglaugh:1orglaugh:1orglaugh

kenya is right above the USA on the list tho :1orglaugh:1orglaugh:1orglaugh

he was talking about "survival rates"...

http://b-i.forbesimg.com/theapotheca...RD-table12.jpg

:1orglaugh:1orglaugh:thumbsup

I don't know about you guys, but I wouldn't want to get prostate cancer in the UK, 50% chance of beating it vs nearly certainty you will beat it the US..

so are socialist health care systems really "best" like some tried to argue earlier? you guys can take the 50% odds of surviving, I'll stick with the 90%+...

the bottom line is this... as long as healthcare in this country remains "for profit" then no gubberment plan is going to change a thing... doesn't matter if it's obummercare, ryancare, trumpcare or wtfevercare, as long as healthcare remains a for profit business, we are all fucked.

I wonder how much of that is early detection. Here in the US there are constant commercials and ads recommending you get checked for cancer. When you go to the doctor they ask you about it and suggest screenings if you are of a certain age or have a history of it in your family. I wonder if they do that with the same amount of diligence there or if it is a case of less early detection equaling more deaths.

that's an interesting question...

everyone in the UK is covered? so everyone has access to screening and early detection? so it would actually mean that more people in the UK should get their prostate cancer detected earlier? unless UK doctors are fools not aware of dangers of prostate cancer? which probably is unlikely?

this example illustrates potential pitfall of "free" healthcare for everyone, as one can see here, "free" healthcare for everyone doesn't necessarily mean better healthcare in any sense... not better for an average person, and certainly not better for someone who can afford decent health insurance...

it's also worth pointing out that all these stats for the US above include perhaps 20% uninsured, who more likely than not only seek healthcare as late as possible greatly reducing their odds of survival...

if we were to exclude these non-typical health care users from the statistics, the gap between the US and the rest of the health care systems would be even more remarkable...

I am still waiting to see Trump's plan that will affordable to all ...

https://www.washingtonpost.com/polit...c9c_story.html

So cut the shit already ...

interstate, dummy

it is even worst then that :

vote for us , but fuck you !

A lot of early detection falls on the patient and not the doctor. Doctors know certain things like if you are at or past a certain age you should be screened for certain things. They don't know what you don't tell them. If you have a family history of cancer, for example, the doctor has no way of knowing that unless you tell them. If you don't actively participate or understand how you should you won't get the quality of care you need.

The "healthcare" is just the tool. How you use that tool is what matters. A potential comparison might be the NFL. They have a salary cap so all the teams have a limit on how much they can spend on paying players. No one team can just buy up all the best players. With all the teams having the same amount of money to spend some manage to put together a good, competitive team year after year while others can't seem to get their shit together and ever get a winning team.

Why do people take medications and drugs? So stupid

I don't think the difference between survival rates between UK and US is because US health care customers are more informed and are able to better manage their health care or are more open about their family history, etc...

one of the reasons why early detection may be more common in the US is simple, US doctors have in a way skin in the game, there is $$ to be made...

let me illustrate with an example: imagine 50 year old man going to a doctor with a flu...

UK:
the doctor is overworked, gets flat salary from NHS or whatever they call it... so he talks with the guy for 5 minutes prescribes him some antibiotics, sends him on his way... thought of mentioning prostate exam crosses his mind, but figures "fuck that, I'll have to fill out a form, and it's 6pm already with 20 people still waiting to see me, so I'll mention it next time since chances of him having cancer are pretty slim anyway..."...

US:
the doctor has pretty free schedule, he is self employed, so he collects $100 or whatever for each visit... he talks with the guy for 5 minutes prescribes him some antibiotics, and on the way out... "by the way, I see you are 50 years old, at this age it's good idea to perform a prostate exam.. talk to my secretary and make an appointment and we'll do it next week"... patient gets "upsold", doctor makes more $$, but as a result he gets better healthcare = everyone is happy

so paradox of free healthcare that many seek, is that as more and more people have free healthcare, the situation turns more from one labeled as "US" to one labeled as "UK"... and no one really wins as a result, on average everyone ends up with worse healthcare (as illustrated by cancer survival rates earlier)

:1orglaugh:1orglaugh

In this example, the type/quality of healthcare can play a major role. Every time I have gone to the doctor and been offered something like a flu shot or cancer screening etc. it has always been by the nurse who comes in first and takes vitals, asks questions, checks basics etc that offers it to me. Mostly, the doctor comes in, we talk for a few minutes and they leave and then the nurse comes back and finishes up.

I can see where if offering a screening or mentioning it to a patient meant more paper work it could create doctors who are less interested in offering them because of the headache of the process. If done correctly, however, we could have a system where people are offered screenings and early detection in prioroitized and still not have doctors who are swamped with patients. Of course, that would require a high-quality system and "government run" and "high-quality" typically don't go together.

Premium increases need to be inflation capped at the very least. What about the costs of the aging population and advances in science that cost more?

The only way to reduce costs is to go to the head of the problem. The Private Healthcare industry.

I agree 100%


Sorry Paul but living as long as possible is not trending now, at least not in America.

We've legalized assisted suicide in many states now and it's an honorable way to go with ceremony and people planning everything in advance.

I disagree about people not wanting to live as long as possible. Yes, we have assisted suicide, but not very many people use it. In my state we have had that since 1997 and in that roughly 10 years there have only been about 1,000 people who have actually used it. 100 people per year is not very many.

On the contrary, my mom is 77 and lives in a retirement community. All the people there are at least 65 and most of them are taking tons of medication, seeing doctors all the time, and doing everything they can to hang on to life for as long as they can.

the thing is US healthcare is nowhere near the top on any serious list...I am sure you will find 99% survival rates on some charts like you will find obama is a reptilian...

https://www.bloomberg.com/news/artic...east-efficient

among developed countries you are LAST:

http://blogs-images.forbes.com/danmu...6/TCFchart.png

Look Serbia is ranked higher :1orglaugh:1orglaugh:1orglaugh:1orglaugh:1orglaugh

https://assets.bwbx.io/images/users/.../v3/800x-1.png


I can get some serbs to come over and run shit for you? :1orglaugh:1orglaugh:1orglaugh

Nobody in their right mind can defend the cost and delivery of healthcare services in the USA.

Those charts are just cherry picking bullshit.

Take the uninsured people and the people without money to pay for healthcare services out of the sample group and the success rates and survival rate for people who can pay in the USA are the best.

Go to a hospital without insurance you get the minimum treatment required by laws.

The hospital I use will send you away bleeding in the ambulance, or in a life threating situation do the minimum necessary to stabilize you then ship you out to the county shoot and stab hospital, if you have no insurance to pay them. I had to change my insurer this year at a additional cost of $1,200/yr so this private hospital and its doctors were in the HMO network. I can afford to pay sorry if you can't ...

That is the way it works in the USA.

yea, multiple studies published in world renowned peer reviewed medical journals are not "serious", but some pseudo-propaganda published by bloomberg is? :1orglaugh :error

for example:
https://www.ncbi.nlm.nih.gov/pubmed/...?dopt=Abstract

BACKGROUND:

Only recently have extensive population-based cancer survival data become available in Europe, providing an opportunity to compare survival in Europe and the United States.

METHODS:

The authors considered 12 cancers: lung, breast, stomach, colon, rectum, melanoma, cervix uteri, corpus uteri, ovary, prostate, Hodgkin disease, and non-Hodgkin lymphoma. The authors analyzed 738,076 European and 282,398 U.S. patients, whose disease was diagnosed in 1985-1989, obtained from 41 EUROCARE cancer registries in 17 countries and 9 U.S. SEER registries. Relative survival was estimated to correct for competing causes of mortality.

RESULTS:

Europeans had significantly lower survival rates than U.S. patients for most cancers. Differences in 5-year relative survival rates were higher for prostate (56% vs. 81%), skin melanoma (76% vs. 86%), colon (47% vs. 60%), rectum (43% vs. 57%), breast (73% vs. 82%), and corpus uteri (73% vs. 83%). Survival declined with increasing age at diagnosis for most cancers in both the U.S. and Europe but was more marked in Europe.


CONCLUSIONS:

Survival for most major cancers was worse in Europe than the U.S. especially for older patients. Differences in data collection, analysis, and quality apparently had only marginal influences on survival rate differences. Further research is required to clarify the reasons for the survival rate differences.

why do people breathe ....


( mainly you )

you are right the bloomerg report from the World Health Organization is pseudo science but your predatory healthcare examining itself is "world renowned" :1orglaugh:1orglaugh:1orglaugh

are you sure you do not want me to call some serbs to take over your healthcare? :1orglaugh:1orglaugh:1orglaugh