Trump's Promises

[Just_A_Guy]

I quite agree. 

[anatess2]

On 11/29/2016 at 2:22 PM, unixknight said:

It may surprise you to learn that there are plenty of people who can't afford to stash money away in an HSA account AND aren't blowing their disposable income on popcorn and movie tickets.

This is one of the things about this oversimplification that I find irritating.  It just assumes that if only people managed their money better everybody could afford everything.  Turns out, no.  Surgery is expensive, and it doesn't take much to propel the cost of a procedure into the 5 digit range.  If you can imagine a single mother with a couple of kids, a low income job who is barely making rent, then you tell me how she will magically be able to stash away enough in an HSA to deal with it if she were to be diagnosed with cancer or one of her kids is in a severe accident.  As I've been saying repeatedly, the core issue is healthcare itself is too expensive to begin with.  We can argue all day long about ways to help people pay for it but the real solution is to fix the disease, not he symptom.  (c wat I did thar?)

Start addressing the factors that artificially jack the price up instead of ignoring them and chasing our tails trying to find more money which, as you said, doesn't grow on trees to pay for it.

Unixknight... you're not seeing the picture... HSA is not the end-all be-all of healthcare.  Surgery is expensive yes.  That's why you hold catastrophic insurance.  So, for example - when I had the HSA, I also had a Hospital and Surgical insurance that goes with it.  You can have cancer insurance, etc. etc.  You can even use your HSA to buy insurance.  The thing is - YOU control your healthcare because you are paying for it.  Now, if you think the government should pay for it, then you are basically saying you want universal healthcare.  I disagree with that completely.

Now, if you're thinking... cancer... I can't possibly afford that living paycheck to paycheck even with insurance... yes.  And your house can also burn down and you can also end up not being able to find 2 pennies to buy the cheapest of Ramen...  That's what the government "safety net" (HUD, food stamps, Medicaid, and whatever the States will come up with for healthcare, etc.) is all about.

Yes, healthcare is artificially expensive.  I just outlined to you how the HSA can help with that.  But like I said, the HSA is not the end-all be-all of the healthcare replacement bill.  The Republican version of the bill - in general - will put healthcare back to the capitalistic paradigm so that you can treat it in the exact same way that you treat food, shelter, and every other life's necessities.

By the way, college also needs to be restored to the capitalistic paradigm to lower the price of higher education.

[unixknight]

32 minutes ago, anatess2 said:

Unixknight... you're not seeing the picture... HSA is not the end-all be-all of healthcare.  Surgery is expensive yes.  That's why you hold catastrophic insurance.  So, for example - when I had the HSA, I also had a Hospital and Surgical insurance that goes with it.  You can have cancer insurance, etc. etc.  You can even use your HSA to buy insurance.  The thing is - YOU control your healthcare because you are paying for it.

I see the picture fine.  But earlier you were (somewhat condescendingly) trumpeting HSA as if it were the magical cure.  I'm glad you have a more realistic view than that, but this still doesn't solve the problem for the poor who can neither afford a savings account and who may have pre-existing problems.  Like I said earlier, we can dance around all these solutions until we're old and gray but it doesn't address the core problem of healthcare's expense.

32 minutes ago, anatess2 said:

Now, if you think the government should pay for it, then you are basically saying you want universal healthcare.  I disagree with that completely.

I disagree with it too.  I don't know why you're telling me this. 

32 minutes ago, anatess2 said:

Now, if you're thinking... cancer... I can't possibly afford that living paycheck to paycheck even with insurance... yes.  And your house can also burn down and you can also end up not being able to find 2 pennies to buy the cheapest of Ramen...  That's what the government "safety net" (HUD, food stamps, Medicaid, and whatever the States will come up with for healthcare, etc.) is all about.

The trouble with a safety net for healthcare catastrophes is that it still obscures the problem of cost.

32 minutes ago, anatess2 said:

By the way, college also needs to be restored to the capitalistic paradigm to lower the price of higher education.

Agreed. 

 

[anatess2]

14 hours ago, unixknight said:

I see the picture fine.  But earlier you were (somewhat condescendingly) trumpeting HSA as if it were the magical cure.  I'm glad you have a more realistic view than that, but this still doesn't solve the problem for the poor who can neither afford a savings account and who may have pre-existing problems.  Like I said earlier, we can dance around all these solutions until we're old and gray but it doesn't address the core problem of healthcare's expense.

The trouble with a safety net for healthcare catastrophes is that it still obscures the problem of cost.

Agreed. 

 

You keep bringing up the same issues and I keep on answering them and you keep on saying the issue is still not addressed.  So, let's see if you see this now.  Everything I said here I already said in detail in previous posts.  I understand that I write too much so people tend to just bypass the wall of text... so hopefully this relatively short summaries help clarify.

1.)  The Poor

The Trump proposal is to issue Fed bloc funding (subsidies) to the States.  The States are then required to create their own healthcare solution for the welfare state with the help of this Fed subsidy.  I also gave the example of State solutions that have been in existence since before Obamacare that are successful - Harris County, Texas and the entire state of Massachusetts.  Other states can copy these solutions or create their own.

 

2.) Cost including pre-existing conditions.

Bring healthcare back to the Capitalism paradigm by striking out regulations that prevent healthcare providers from competing and creating regulations that empower consumers to make market choices.  I mentioned that before Obamacare pre-existing conditions are always covered by the health benefits of corporate health insurance groups. Regulations prevent consumers from forming groups outside of their jobs such that if you lose your job you're out of luck with pre-existing conditions.  This will change.

One thing I haven't mentioned before in regards to cost is malpractice litigation reform.  I did not mention this because I already mentioned that the capitalistic paradigm brings doctors and patients together again without health insurance providers dictating how to treat patients.  Doctors will then become part of "market choices" as they become encouraged to practice patient-centric medicine again.

 

14 hours ago, unixknight said:

I disagree with it too.  I don't know why you're telling me this. 

 

From our conversations it seems like you are resistant to people paying for their own healthcare.... so I couldn't be entirely sure of where you are sitting on that fence.

14 hours ago, unixknight said:

I see the picture fine.  But earlier you were (somewhat condescendingly) trumpeting HSA as if it were the magical cure.

I was trying to be funny to lighten things up.  I apologize that it came out condescending.  It wasn't my intent.  But yes.  HSA is the magical cure that will unleash the power of capitalism and empower Americans to self-determination - the 2 things that can make America's healthcare great again.  This cultural shift will drive the healthcare industry to reform.

 

 

Okay, these are not short.  I think I am just totally incapable of being succint.

Edited December 1, 2016 by anatess2

[unixknight]

51 minutes ago, anatess2 said:

The Trump proposal is to issue Fed bloc funding (subsidies) to the States.  The States are then required to create their own healthcare solution for the welfare state with the help of this Fed subsidy.  I also gave the example of State solutions that have been in existence since before Obamacare that are successful - Harris County, Texas and the entire state of Massachusetts.  Other states can copy these solutions or create their own.

I understood that point perfectly before.  My issue is STILL that it does nothing to reduce the cost of healthcare.  Whether it's paid for by taxpayers, insurance companies or the individual... it's still too high cost and people seem utterly disinterested in attacking THAT problem.

51 minutes ago, anatess2 said:

Bring healthcare back to the Capitalism paradigm by striking out regulations that prevent healthcare providers from competing and creating regulations that empower consumers to make market choices.  I mentioned that before Obamacare pre-existing conditions are always covered by the health benefits of corporate health insurance groups. Regulations prevent consumers from forming groups outside of their jobs such that if you lose your job you're out of luck with pre-existing conditions.  This will change.

Maybe in some cases pre-existing conditions were covered, but not always.  There were still people who had to deal with that problem and it was one of the issues trotted out to force Obamacare through.

51 minutes ago, anatess2 said:

One thing I haven't mentioned before in regards to cost is malpractice litigation reform.  I did not mention this because I already mentioned that the capitalistic paradigm brings doctors and patients together again without health insurance providers dictating how to treat patients.  Doctors will then become part of "market choices" as they become encouraged to practice patient-centric medicine again.

I don't see how that would impact malpractice litigation.

51 minutes ago, anatess2 said:

From our conversations it seems like you are resistant to people paying for their own healthcare.... so I couldn't be entirely sure of where you are sitting on that fence.

I have no idea what gave you that idea.  Maybe you're thinking of someone else, but I never expressed a problem with people paying for their own healthcare. In fact, one of the reasons I Have a problem with the cost of healthcare is that it prevents people from doing EXACTLY THAT.  Where did you get the idea I didn't want people to pay for their own healthcare?  You keep accusing me of missing your points but there seems to be a mote in your eye there... 

51 minutes ago, anatess2 said:

I was trying to be funny to lighten things up.  I apologize that it came out condescending.  It wasn't my intent.  But yes.  HSA is the magical cure that will unleash the power of capitalism and empower Americans to self-determination - the 2 things that can make America's healthcare great again.  This cultural shift will drive the healthcare industry to reform.

I think HSAs can be an important part of the solution, but not a magical cure.

And no worries.  It's just really easy to misunderstand each others' tone on here.

 

 

[anatess2]

16 minutes ago, unixknight said:

I understood that point perfectly before.  My issue is STILL that it does nothing to reduce the cost of healthcare.  Whether it's paid for by taxpayers, insurance companies or the individual... it's still too high cost and people seem utterly disinterested in attacking THAT problem.

Maybe in some cases pre-existing conditions were covered, but not always.  There were still people who had to deal with that problem and it was one of the issues trotted out to force Obamacare through.

I don't see how that would impact malpractice litigation.

I have no idea what gave you that idea.  Maybe you're thinking of someone else, but I never expressed a problem with people paying for their own healthcare. In fact, one of the reasons I Have a problem with the cost of healthcare is that it prevents people from doing EXACTLY THAT.  Where did you get the idea I didn't want people to pay for their own healthcare?  You keep accusing me of missing your points but there seems to be a mote in your eye there... 

I think HSAs can be an important part of the solution, but not a magical cure.

And no worries.  It's just really easy to misunderstand each others' tone on here.

 

 

 

Okay, I'm confused now.  So you don't think Capitalism is a cost driver?

[unixknight]

1 hour ago, anatess2 said:

Okay, I'm confused now.  So you don't think Capitalism is a cost driver?

It should be but with all the over regulation and excessive Government interference there's very little true free market influence.

[anatess2]

20 minutes ago, unixknight said:

It should be but with all the over regulation and excessive Government interference there's very little true free market influence.

Okay, I'm still confused.  I just spent pages of posts here talking to you about how the Replacement Bill that is designed to correct all that so the healthcare industry can go back to the Capitalistic paradigm .  Are you saying that you don't correct over regulation and excessive government interference through the legislative process?  How else are you going to solve it?

[unixknight]

6 minutes ago, anatess2 said:

Okay, I'm still confused.  I just spent pages of posts here talking to you about how the Replacement Bill that is designed to correct all that so the healthcare industry can go back to the Capitalistic paradigm .  Are you saying that you don't correct over regulation and excessive government interference through the legislative process?  How else are you going to solve it?

It's got to be a combination.  A lot of what's going on with Obamacare was done through Executive Orders.  Trump can easily undo that himself.  The Congress is going to have to do most of the heavy lifting though.

[anatess2]

14 minutes ago, unixknight said:

It's got to be a combination.  A lot of what's going on with Obamacare was done through Executive Orders.  Trump can easily undo that himself.  The Congress is going to have to do most of the heavy lifting though.

Actually, that's not quite accurate.  Obamacare is law.  Obama created executive orders so he doesn't have to comply with his own law.... for example, the individual mandate was supposed to start in 2010.  Obama made an executive order to delay it, then when that delay expired, temporarily pardoned fines, etc...  Yes, Trump can undo all that but it wouldn't make any sense because without those EO's Obamacare is fully activated again.  So, what he needs to do there is to push for that repeal that Congress has sent to Obama that got promptly vetoed.

But, Obamacare is not what made healthcare costs so high.  The pre-Obamacare regulations made healthcare costs so high... hence the push for a healthcare reform bill for decades that the Democrats eventually mucked up by the dumb passing of Obamacare as the reformation of healthcare.  So, just Repealing Obamacare is not going to solve that problem of cost.  A REAL healthcare reform bill is needed - hence, Replace.

In conclusion:  Trump can't really do anything about healthcare except to push Congress to Repeal and Replace current regulations with a better solution - in the same way that Obama pushed Congress to pass Obamacare.

Edited December 1, 2016 by anatess2

[unixknight]

7 minutes ago, anatess2 said:

Actually, that's not quite accurate.  Obamacare is law.  Obama created executive orders so he doesn't have to comply with his own law.... for example, the individual mandate was supposed to start in 2010.  Obama made an executive order to delay it, then when that delay expired, temporarily pardoned fines, etc...  Yes, Trump can undo all that but it wouldn't make any sense because without those EO's Obamacare is fully activated again.  So, what he needs to do there is to push for that repeal that Congress has sent to Obama that got promptly vetoed.

Right, but it's still Congress that has to do the heavy lifting.  Hopefully Trump won't have to push at all since I would expect the Republicans in Congress to do what they got elected to do.

7 minutes ago, anatess2 said:

But, Obamacare is not what made healthcare costs so high.  The pre-Obamacare regulations made healthcare costs so high... hence the push for a healthcare reform bill for decades that the Democrats eventually mucked up by the dumb passing of Obamacare as the reformation of healthcare.  So, just Repealing Obamacare is not going to solve that problem of cost.  A REAL healthcare reform bill is needed - hence, Replace

Nobody said it was ObamaCare that made the costs high.  Yeah, regulation is a huge part of it but I think it started when insurance companies started to cover EVERYTHING and people weren't feeling the effects directly anymore.  And, as we talked bout, too many malpractice cases.

[Just_A_Guy]

2 hours ago, anatess2 said:

Actually, that's not quite accurate.  Obamacare is law.  Obama created executive orders so he doesn't have to comply with his own law.... for example, the individual mandate was supposed to start in 2010.  Obama made an executive order to delay it, then when that delay expired, temporarily pardoned fines, etc...  Yes, Trump can undo all that but it wouldn't make any sense because without those EO's Obamacare is fully activated again.  So, what he needs to do there is to push for that repeal that Congress has sent to Obama that got promptly vetoed.

Then again, revoking all the waivers and letting these leftist crony corporations spend six months stewing in their own juices as they try to comply with Obamacare just like the rest of us have been--that may be an effective way of muffling Democrat opposition when the Republicans finally get around to killing the thing once and for all. 

[anatess2]

4 hours ago, unixknight said:

Right, but it's still Congress that has to do the heavy lifting.  Hopefully Trump won't have to push at all since I would expect the Republicans in Congress to do what they got elected to do.

Nobody said it was ObamaCare that made the costs high.  Yeah, regulation is a huge part of it but I think it started when insurance companies started to cover EVERYTHING and people weren't feeling the effects directly anymore.  And, as we talked bout, too many malpractice cases.

Yes, Congress.  Trump will have to push.  Well, it's Price now (can I get a big YEAY!!!!) to push.  Tom Price has his own healthcare plan that he sent to... I think it was already Ryan, or maybe it was still Boehner.  The plan Ryan passed with no support from the Senate so it went nowhere is different from Price's especially the part where Price's plan has the funding bloc to the States for people with pre-existing conditions who can't afford private health insurance - this did not make it into Ryan's bill.  So, now, maybe they can all get this straightened out as Trump is pushing for the funding bloc.  Oh!  Price also has the $1,200 fixed tax credit to jumpstart the HSA.  Everyone gets it - rich, poor, vets, govt empoyees... everybody.  The tax credit can only be used to purchase private health insurance, I think.  Trump also touted this for the Vets to ditch the VA if they so desire and go to the private market.  So, Price and Ryan can duke it out... then whip up the Senate to shape up and get on the ball.  Anyway, Ryan's plan will need some tweaking but at the very least, it already has the "bring back Capitalism" elements to it.

It would be super interesting to see what finally comes out of Congress...

[Mike]

On 11/29/2016 at 9:30 AM, anatess2 said:

If you have been an employee of a corporation - before Obamacare - you know that Group insurance for employers cover pre-existing conditions.  And I know this personally because I was 5 months pregnant when I became employed and the company insurance covered my entire pregnancy including the unpaid balances (I did not have insurance prior to being employed) for procedures done before I became an employee.  This is because they are a big Group.

As a point of fact this was true (since you say so) under the insurance plan of the corporation you worked for, but it was the opposite of the general rule for decades in many if not most corporations including a couple huge ones that I worked for as well as small ones. 

[anatess2]

1 hour ago, Mike said:

As a point of fact this was true (since you say so) under the insurance plan of the corporation you worked for, but it was the opposite of the general rule for decades in many if not most corporations including a couple huge ones that I worked for as well as small ones. 

I'm not sure about all other states but at least Ohio, California, Florida, and Texas corporations offered these group insurances.  Usually, a corporation offers different levels of insurance - there's usually the cheap HMO option (doesn't cover much of anything) and the cadillac plans (covers everything).  The corporation subsidizes the premiums and they garnish the premium gap from wages, so if you don't want to spend too much money, you pick the HMO.  So, in all the places I've worked (including the time when I worked for the insurance companies in those 4 states I mentioned), I have always cashed out my insurance coverage - that is, I decline the benefit in exchange for a higher per hour rate.  Then I go buy the catastrophic individual coverage that only covers hospital and surgical and nothing else for super cheap and put some money into an HSA.

In any case, whether a corporation offered it or not is irrelevant to the discussion, actually.  What is relevant is that pre-existing conditions CAN be covered in a big group.  So, how do we create these big groups without having to tie it to your employer?  Easy... let capitalism do its work.  There are tons of people who want pre-existing conditions covered.  They can band together and form their own group.  Across state lines even.  This used to be illegal before Obamacare.

 

 

Edited January 26, 2017 by anatess2

[Guest MormonGator]

On December 1, 2016 at 0:56 PM, unixknight said:

A lot of what's going on with Obamacare was done through Executive Orders. 

Very true. What is done by executive order can be undone by executive order. That sounds swell, than in four years when a democrat takes over the cycle begins again. Nothing is forever in politics 

[Mike]

34 minutes ago, anatess2 said:

What is relevant is that pre-existing conditions CAN be covered in a big group.  So, how do we create these big groups without having to tie it to your employer?  Easy... let capitalism do its work.  There are tons of people who want pre-existing conditions covered.  They can band together and form their own group.  Across state lines even.  This used to be illegal before Obamacare.

Yes, they can be covered in a big group--depending upon factors that may or may not seem fair.  And since fair is subjective, some are left to fend for themselves, others adapt meaning go somewhere else to work, live without what they can't afford, etc. There were tons of people who wanted pre-existent conditions coverage but couldn't have it no matter how badly they wanted or needed it. Banding together wasn't really always a viable option. Yes, this was illegal before Obamacare. And since people getting something they want or need often ratchets our collective living conditions upward, it may be that Congress will take the good things that were largely unavailable before Obamacare and keep them. (President Obama himself claimed he didn't mind so much if Obamacare were repealed as long as it would be replaced with something better.) However, it may also be that those who benefited the greatest $-wise before Obamacare will have their ways again--we'll see how "that hopey changey thing works out" for us. 

[anatess2]

3 minutes ago, Mike said:

Yes, they can be covered in a big group--depending upon factors that may or may not seem fair.  And since fair is subjective, some are left to fend for themselves, others adapt meaning go somewhere else to work, live without what they can't afford, etc. There were tons of people who wanted pre-existent conditions coverage but couldn't have it no matter how badly they wanted or needed it. Banding together wasn't really always a viable option. Yes, this was illegal before Obamacare. And since people getting something they want or need often ratchets our collective living conditions upward, it may be that Congress will take the good things that were largely unavailable before Obamacare and keep them. (President Obama himself claimed he didn't mind so much if Obamacare were repealed as long as it would be replaced with something better.) However, it may also be that those who benefited the greatest $-wise before Obamacare will have their ways again--we'll see how "that hopey changey thing works out" for us. 

Yes, of course, greed is a mainstay in a free society.  Hopefully, the government can leverage competitive capitalism to check this greed instead of legislating competition out of the system.

[Mike]

4 minutes ago, anatess2 said:

Yes, of course, greed is a mainstay in a free society.  Hopefully, the government can leverage competitive capitalism to check this greed instead of legislating competition out of the system.

 We'll see, won't we. 

[anatess2]

7 hours ago, Mike said:

 We'll see, won't we. 

Of course.  All that is currently theory.  And you sunrise looks super fun!

Edited January 27, 2017 by anatess2