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The Fix Is Worse Than the Problem

Category: Health Care
Posted: 01/24/17 12:09

by Dave Mindeman

Our House GOP friends have an interesting way of fixing things. The first thing they do with health care is to change basic coverages into optional coverages. This picture is a list of "optional" coverages under the Steve Drazkowski amendment...


We will again have to look for fine print in insurance policies. We will get more of those rejections in our bills that say, sorry, coverage denied.

Yeah, there may be reductions in premiums, but it will be far exceeded by increased bills from coverage denials.

As usual, with Republicans the fix is far more costly than the problem.
comments (1) permalink

Universal Access Is Not Universal Coverage

Category: Health Care
Posted: 01/24/17 11:59

by Dave Mindeman

The problems with the ACA are fixable. The main issue is in the individual markets, which is roughly between 2 and 5% of the population. The vast majority have health care that works. We could address the problem and find the solution, but rather than do that, the Republicans want to use this issue and extrapolate it as a symptom of Obamacare failure.

That is dishonest and to repeal the entire program is going to lead to chaotic healthcare issues in the future.

Rep. Price who is the choice to head up health and human services has been careful to say that any new program will guarantee "access" to health care for everybody. We have always had universal access. People without insurance will not be denied care at an emergency room. It is the drain on resources that result from non-insurance care that led to the ACA.

What Tom Price is talking about is a reversal on coverage. Going back to an insurance driven system where the carriers choose the conditions of coverage and the patients who most need health coverage are dumped into high risk pools that offer little in the way of basic day to day health care.

Gov. Dayton's state of the state speech (we all pray for a full recovery) offered a good alternative idea to Republican rhetoric. Expand MinnesotaCare and allow more people to buy into this state program. A public option if you will. This offers a good solution to the individual market problem and expand coverage options to more people.

But good ideas often fall on deaf ears when it comes to Republicans and health care. The truth is, they do not want to fix it. They want to continue to use the issue for electoral advantage.

Replacing the ACA is not as simple as the GOP would make it sound. Universal access is not the same as universal coverage.

Watch the wording - they use access for a reason.
comments (3) permalink

New York Times Gives Us OCare Details - A Little Late

Category: Health Care
Posted: 01/13/17 18:16

by Dave Mindeman

Great New York Times article on the basic protrections of the ACA. Why didn't the MSM put more of this out there over the last 6 years?

Anyway, here is a summation of what we got and what we may lose:

1) Obamacare insured millions through new insurance markets.

The health law reduced the number of uninsured Americans by an estimated 20 million people from 2010 to 2016. But if we lose it...With many fewer people buying coverage, the insurance markets are likely to become increasingly unstable. Many insurers will stop offering policies, and the remaining customers are likely to be sicker than current Obamacare buyers, a reality that will drive up the cost of insurance for everyone who buys it, and force more people out of the markets.

2) Obamacare insured millions more by expanding Medicaid.

The health law provided federal funds for states to offer Medicaid coverage to anyone earning less than about $16,000 for a single person or $33,000 for a family of four. Not every state chose to expand, but most did. The Republican plan is expected to eliminate federal funding for the expansion. An estimated 12.9 million people would lose Medicaid coverage, according to the Urban Institute's projections. A GOP proposal would push money back to the states to take care of this - so we go back to health care differences, depending on where you live.

3) Obamacare established consumer protections for health insurance

Here's a partial list: One of the law's signature features prevents insurance companies from denying coverage or charging a higher price to someone with a pre-existing health problem. The law included a host of other protections for all health plans: a ban on setting a lifetime limit on how much an insurer has to pay to cover someone; a requirement that insurers offer a minimum package of benefits; a guarantee that preventive health services be covered without a co-payment; a cap on insurance company profits; and limits on how much more insurers can charge older people than younger people. The law also required insurance plans to allow adult children to stay on their parents' policies until age 26.

4) Obamacare required individuals to have health insurance and companies to offer it to their workers.

To ensure that enough healthy people entered insurance markets, the law included mandates to encourage broader coverage. Large employers that failed to offer affordable coverage, or individuals who failed to obtain insurance, could be charged a tax penalty. The (GOP) bill is expected to eliminate the mandates. Some experts think that eliminating the individual mandate, in particular, could destabilize insurance markets by reducing incentives for healthy people to buy coverage. This mandate is important to keep the other costs down - GOP tells us that not enough healthy people are signing up...while that was true at the beginning, this year saw a big turnaround - In Minnesota, MNSure has over 100,000 sign ups for the private market.

5) Obamacare raised taxes related to high incomes, prescription drugs, medical devices and health insurance.

To help pay for the law's coverage expansion, it raised taxes on several players in the health industry and on high-income earners. The G.O.P. package may roll back those tax increases. Some of the (GOP) plans would limit the tax benefits offered to people who get their health insurance through work. That change would increase tax revenues, but would increase the cost of health insurance for many people who get it through work. Personally, I do not think that the Republicans are willing to balance the costs and expenses with their plan - they will simply let the deficit and debt balloon. Are you getting this, Erik Paulsen?

6) Obamacare made major reforms to Medicare payments.

The law cut the annual pay raises Medicare gives hospitals and reduced the fees Medicare pays private insurance companies. It created new incentives for hospitals and doctors to improve quality. It also set up a special office to run experiments in how Medicare pays doctors and hospitals for health care services. Those experiments are now widespread and have begun changing the way medicine is practiced in some places. (GOP)is expected to leave these changes alone,. although there is still talk of tinkering with it (they can't resist, because, you know, Medicare). This part of the ACA has worked well, primarily because hospitals and doctors made up the costs with fewer uninsured patients.

7) Obamacare made many smaller changes that will probably last.

Obamacare had a range of policies meant to improve health and health care, including requirements that drug companies report payments made to physicians, a provision written by the Iowa senator Chuck Grassley, a Republican; a requirement that chain restaurants publish calorie counts on their menus; and a rule that large employers must provide a space for women to express breast milk. It looks like the Republicans may leave these ancillary parts alone.

Despite the rhetoric, Obama's signature health plan has been an improvement. Reducing premiums and out of pocket costs has always been difficult - yes, there have been mixed results, but most analysts think that this transition period may be ending and stability will take over.

Of course, that would mean that we should resist radically changing things right now....and as we are well aware, radical change in health care is the new order of the day.

But, at least the facts are beginning to get out.
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