ObamaCare Double Whammy if You Make Over 48,000 dollars.

originally posted by: pavil

originally posted by: BELIEVERpriest
a reply to: Dem0nc1eaner

I'll ask you the same question I asked dfnj2015.

How is a single payer system going to help anyone?

Its a socialist's dogmatic mantra, but could you please explain the mechanics?

Is the current system serving all Americans and serving them equally? We have rudimentary single payer already with Medicare and Tricare. It works for the most part. What scares you about single payer? It would streamline things administratively at the very least. Other 1st world nations make it work with universal coverage at a lower percent of GDP. Our current system doesn't cover everyone and doesn't cover them equally at a huge cost to our economy. I'm willing to try alternatives.

agreed

Other countries do it and their medical outcomes are better and at most they cost 1/2 as much.

Can you imagine the business savings? No longer wasting their time/$$$ with insurance?

Isn't providing medical insurance a huge business expense that is deducted from taxes for business? In other words businesses pay less taxes because of the insurance.

a reply to: pavil

I bill medicaid, medicare, and tricare on a daily basis. Tricare isn't as bad as the other two. But medicaid and medicare cheat pharmacies and doctors out of reimbursements with stupid bureaucratic rules: ICD-10 Diagnosis Codes, Prior Authorizations, prefered formularies, refill limitations....they nit-pick about everything. Now they're signing deals with drug companies and choosing only to pay for exorbitantly expensive brand name drugs, when some generic alternatives are dirt cheap. These are all tax payer funded programs. Just image how much more corruption and red tape a socialized single payer system would breed.

A staff meeting at my pharmacy basically informed us that profits are in the negative. We're working harder and selling more rx's, but medicare, medicaid, and ACA plans (primarily) are cheating us on reimbursements. Its a matter of time before we're bought out.

originally posted by: BELIEVERpriest
a reply to: pavil

I bill medicaid, medicare, and tricare on a daily basis. Tricare isn't as bad as the other two. But medicaid and medicare cheat pharmacies and doctors out of reimbursements with stupid bureaucratic rules: ICD-10 Diagnosis Codes, Prior Authorizations, prefered formularies, refill limitations....they nit-pick about everything. Now they're signing deals with drug companies and choosing only to pay for exorbitantly expensive brand name drugs, when some generic alternatives are dirt cheap. These are all tax payer funded programs. Just image how much more corruption and red tape a socialized single payer system would breed.

A staff meeting at my pharmacy basically informed us that profits are in the negative. We're working harder and selling more rx's, but medicare, medicaid, and ACA plans (primarily) are cheating us on reimbursements. Its a matter of time before we're bought out.

Those are symptoms of the larger problems with our Healthcare in America. "Selling more Rx's"? That sounds troubling. We need to determine what is a fair reimbursement for goods and services in the Medical fields. Most will say prices are over inflated bit I'm sure the bureaucracy screws you on things and makes mistakes. That anyone thinks paying top dollar for name brands over generics is insane for the most part.

originally posted by: theantediluvian
Trump did it because he's trying to sabotage ObamaCare. This is exactly what he knew would happen and if he did it, knowing it would, then you can only reasonably assume it's what he wanted to happen.

No, Trump is complying with a federal judge's ruling saying that CSR payments are unconstitutional because they are not properly appropriate through congress. Because Obama and the Dems decided to write this debacle with very questionable skill and throroughness and then pass it in the dark of night on Christmas Eve does not mean that it's Trump's fault that he must deal with the illegal nature of some of the things contained within the law.

Quit making up things and manufacturing the president's intentions. Even if he wants the PPACA to fail (many of us do because it's a terrible law that oversteps the intent and authority of the federal government), the reality is that the CSR payments are unconstitutional and therefore must be nullified in the law.

The outcome of that nullification lies at the feet of Obama signing this garbage into law, not Trump for having to react to the illegal portions of it.

And btw, what happened to the great plan that he kept saying he had, just waiting to be rolled out first thing in his presidency? Hint: that was a lie.

Hint, hint--the president can't write and pass legislation, he can only sign it into law after, maybe, trying to influence it by saying what he will or won't sign. If the Republicans (and Democrats, quite frankly) in Congress can't pull their collective head out of their ass and fix this law that is full of bad legislation and some unconstitutional (yet vital) components that render the law unviable without them, it doesn't mean that it's Trump's fault.

We have separate branches of government for a reason.

But I can whine about failed promises about the previous president, too: Whaaaaaa...why is Gitmo still open? Whaaaaa...where is the government transparency promised? Whaaaaa...why is there still a war on drugs? Whaaaaa...why are we fighting additional wars? Whaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa...

Quit throwing the baby out with the bathwater--it's unbecoming in what should be a mature, logical discussion.

Here's the reality of the situation: The OP is correct in pointing out that this law can turn an average household income earner (which is about $59k right now) into a net-income lower-class family because of the subsidizing that we have to do because of the piss-poor legislation that is the PPACA. Just because you don't like it doesn't mean that the OP is whining or that it's Trump's fault.

a reply to: pavil

The larger problem is government stepping into the business arena. So a single payer system would just compound the problem. That's why insurance companies bully the prescribers and pharmacies around the way they do. Its bad enough that 3rd parties alone drive up cost (single payer or not), but government intervention and regulation give third parties a licence to steal.

It would be better to cut back government regulation. Stop federal funding to third parties, and let the free market work unimpeded across state lines.

So defund Obamacare, kill the Individual Mandate, and let the system crash. That is by far the most efficient solution.

originally posted by: BELIEVERpriest
a reply to: pavil

The larger problem is government stepping into the business arena. So a single payer system would just compound the problem. That's why insurance companies bully the prescribers and pharmacies around the way they do. Its bad enough that 3rd parties alone drive up cost (single payer or not), but government intervention and regulation give third parties a licence to steal.

It would be better to cut back government regulation. Stop federal funding to third parties, and let the free market work unimpeded across state lines.

So defund Obamacare, kill the Individual Mandate, and let the system crash. That is by far the most efficient solution.

Is there a more expensive medical system than the for profit US system?
All the other single payer systems without exception is cheaper, and most industrialized nations "socialized" systems have better medical outcomes.

im an artist, and i called my old school (which i graduated from) asled if they have a health insurance program. they have no group plan. yet i can go there and buy computers and books at discount still.

that is what needs to be done, until a system comes into place. more 'groups' so premiums can come down for each group.

the reason they would never have a single payer option is because the bad guys want to make it a 'haves and have nots' society. the inter-nationalists who rule the land and the minions who make upper middle class money do not worry about 1500 a month for health insurance.

its the same reason why they are making eductional systems more difficult to succeed. and why private college prices have skyrocketted. this way the inter-nationalist children who can afford anything they want will easily succeed. the second class will find it harder to move up.

the bad guys do not want a middle class. so anything that seems simple to fix if you help out the middle classes will never be fixed.

this was all protocolled in the 1800s. and now its just coming to fruition.

a reply to: pavil

Yeah, and we're selling more rx's than ever. IMO, that's a problem with the entire medical system. Most people don't need diabetes and blood pressure drugs. What they need is a strict ketogenic diet to get their insulin resistance and metabolic system under control...but then the doctors wouldn't get their monthly visits, which means less rx's written for brand names like Kombiglyze, Lantus, Victoza, etc.

Most American's are sick because of their habits, not genetics or environment. Thats part of why the system is so overwhelmed.

Sadly, I'm not in a position to offer any sort of advice. I will be permanently leaving the medical system very soon. Its not about helping the sick anymore. Its about enabling poor lifestyle habits and making government cronies rich in the process.

This is why I will NEVER advocate for a single payer system.

originally posted by: seasonal
a reply to: pavil

Our system was, and still is designed to pay into and not to take out of.

The US medical system is designed for one thing-make money and if sick people get taken care of, that is a side effect.

It used to be that a small-town high school graduate could afford to go to med school for a few years, then come back and set up his own practice. University hospitals handled all the tricky cases like infectious diseases. But then, everything started going out of whack simultaneously. Doctors started charging more because the insurance companies were needed to cover the cost of litigation. Insurance companies put up their insurance rates because the doctors were sued more. The doctors were also charging more because the med schools saw how much the doctors were making and wanted a slice of the pie. The doctors put up their fees because medical school was so expensive. Medical treatments are expensive because of the research required.

a reply to: seasonal

A for profit system would be much cheaper if government would just let the free market fulfill its role.

Single payer systems are far more expensive than ours. You just dont see it because the cost is converted to monetized debt. Look at the single payer nations, and look at their debt and economic problems. How much foreign aid and loans are they receiving to stay afloat??? Look at the EU. Its ao bad that Greece and Britain wanted out.

Look beneath the shiny surface. Government always likes to white wash their work...always.

Doctors started charging more because the insurance companies were needed to cover the cost of litigation.

a reply to: stormcell

Have a source for this?

a reply to: seasonal

Its actually common knowledge in medical circles.

a reply to: BELIEVERpriest

So no source?

originally posted by: BELIEVERpriest
a reply to: pavil

Yeah, and we're selling more rx's than ever. IMO, that's a problem with the entire medical system. Most people don't need diabetes and blood pressure drugs. What they need is a strict ketogenic diet to get their insulin resistance and metabolic system under control...but then the doctors wouldn't get their monthly visits, which means less rx's written for brand names like Kombiglyze, Lantus, Victoza, etc.

Most American's are sick because of their habits, not genetics or environment. Thats part of why the system is so overwhelmed.

Sadly, I'm not in a position to offer any sort of advice. I will be permanently leaving the medical system very soon. Its not about helping the sick anymore. Its about enabling poor lifestyle habits and making government cronies rich in the process.

This is why I will NEVER advocate for a single payer system.

It's not that I'm such a fan of single payer more so that the "market" hasn't reduced premiums and costs keep going up at 2 to 3 times the rate of inflation. They have had their chance and failed miserably at the task of providing quality affordable Care to all Americans. That's all I want, crazy idea huh?

I doubt single payer can be much worse than our current system. What are rates going to go up 170% in a year? The system is broken and can't be fixed IMO. A new way forward has to be tried.

I don't blame you for being disillusioned. We spent most of last year fighting to get our insurance reinstated after a insurance company canceled our insurance (which we had prepaid the entire year for) for lack of payment. They wanted us to pay $154,000 for my wife's cancer treatments since they retroactively removed our coverage for the whole year by "mistake". It took a U.S. Senator to intervene and help us. I'm firmly convinced stuff like that happens all the time and people don't know how to fight for their rights.

originally posted by: BELIEVERpriest
a reply to: seasonal

Its actually common knowledge in medical circles.

Back in the day, our family Dr ran an office that was just him....no nurse, no receptionist, no billing specialists.

There was no billing, You paid by either check or cash and a sick visit was $20. This was in metropolitan major city.

He made most of his money I'm guessing by his surgery days.

I still make jokes about him.
"Doc my arm hurts when I move it like this"
Doctor : " Then stop doing that"

I miss him....

a reply to: carewemustsee thats the rub americans want what alot of countries enjoy universal healthcare . the insurance companies bankrolled that fool barry why because if we the people got universal health care would kill the healthcare industry so they come up with this scam to get as much money as they can while they can they got barry elected with the plan he would tell people this is a good compromise and everyone would have insurance and its wonderful. then told congress to sign it without reading it which should never be allowed. then we found out if we chose not to get it we were getting a fine. wtf. good for trump maybe he will help us kill this scam and get real universal healthcare started

originally posted by: BELIEVERpriest
a reply to: dfnj2015

How would a single payer system help anything?

Single payer acts like a larger insurance company. The way insurance works, is that they build a network and negotiate lower individual prices using the leverage that their company will pay for many services. Single payer in a nation as large as the US takes this to an extreme. Where a single insurance provider might be able to negotiate on behalf of 100,000 people, a large government can negotiate with 320,000,000 people and generate even bigger margins.

To put this example in action, lets take something like cancer. Cancer diagnosis are about 450 people per 100,000 per year. If you use an average 5 year treatment, that means an insurance company can fight for 2250 treatments per year. If the treatment costs the doctor 1000 to administer (obviously it's more, but I want to keep the numbers small) and the doctor markup is 100%. An insurance company can tell a doctor they'll pay $1400 per rather than $2000 per. Then the insurance company tacks on their 10% profit margin for $1540 per. The patient gets a discount, and the doctor makes it up in volume.

Single payer pushes this to an extreme, because instead of $1400 per they could offer $1100 per, and the doctor gets 5x the work to still make the same takehome pay.

But, there's something else single payer does too. The government can offer lots of treatment. For example, if they project needing 1000 prosthetic limbs over the next year, they can offer that up in 4x 250 limb lots. And companies are forced to compete with each other to make the lowest bids, to get those large lots. In contrast a company with a doctors office, may only contract for 5 lots over the year. So under single payer the patients pay less, because they gain negotiating power, and the device manufacturers become more competitive because they can focus on securing a single high revenue contract instead of fighting for every single sale.

originally posted by: BELIEVERpriest
a reply to: pavil

Yeah, and we're selling more rx's than ever. IMO, that's a problem with the entire medical system. Most people don't need diabetes and blood pressure drugs. What they need is a strict ketogenic diet to get their insulin resistance and metabolic system under control...but then the doctors wouldn't get their monthly visits, which means less rx's written for brand names like Kombiglyze, Lantus, Victoza, etc.

Most American's are sick because of their habits, not genetics or environment. Thats part of why the system is so overwhelmed.

Sadly, I'm not in a position to offer any sort of advice. I will be permanently leaving the medical system very soon. Its not about helping the sick anymore. Its about enabling poor lifestyle habits and making government cronies rich in the process.

This is why I will NEVER advocate for a single payer system.

I'm glad you brought that up, diet and processed foods.
If it is white do not eat it-(except cauliflower)
It it tastes good (sweet) spit it out.
Sugar is literally killing us.

a reply to: Aazadan

What if I'm personally dissatisfied with the services that a single payer has to offer? What other choice would I have? One sized doesn't fit all.

a reply to: BELIEVERpriest

Single payer just refers to who foots the bill. You could still give patients a choice in which contractor they choose to go with, which is actually more choice than your insurance company gives you now.