Dangers of a Trump Presidency--Part 7

[BittyBug]

I.... insurance because insurance in liberal New York state is such a poor value due to the mandatory inclusions. Given the state regulations, Obamacare in NY should be called the Unaffordable Care Act because it prohibits my friends and others from buying the types of affordable coverage available in other states.

The ACA sets uniform minimum coverage standards and plan design requirements that apply to all states. What is this "affordable coverage available in other states" that is not available in the State of New York?

And because the Democrats refuse to allow any sanctions against those who go on and off coverage, my friends can simply sign up for Obamacare with no repercussions if they end up needing treatment for something.

That's not exactly true. Unless you have a qualifying event (which developing an illness is not), you cannot sign up for coverage outside of the open enrollment period. So if your friends needed some type of urgent care before the next enrollment period, they would have to pay out of pocket.

(This is why I support punitive rates for those with pre-existing conditions who do not maintain continuous coverage.) It's promoting the very behaviors it seeks to avoid.

Or maybe the penalties for non-compliance aren't high enough.

I am also very wary of the government giving people "free" and/or "guaranteed" things because they're near impossible to take away. Losses hurt three times as much as gains feel good, etc. I think it's wrong and irresponsible to guarantee people coverage that's being funded by expanding the deficit and the national debt.

But that's a funding issue, not a coverage issue.

I just don't see how it's in society's best interests for people to be well. All of us benefit when each of us is able to contribute to our fullest. Having said that, I do think we will eventually need to acknowledge that we do not have unlimited resources and evaluate whether certain treatments make sense, but that's a separate issue.

 

[once_upon]

It's not as simple as @Louis contends. My husband's makes well over $125,000. If as indicators predict, I will be unable to purchase healthcare.

Even though we can afford to pay the $250.00 office visit, I cannot have access. They only accept patients with insurance. I must show my insurance card at the time of the appointment. If I don't have a card or they cannot verify that I have insurance, I am not allowed to see the doctor.

This is reality, it is happening today and into the future. As at least one poster has said to me, in healthcare there are winners and losers. You lose.

I can pay, the system won't let me. Because of loopholes created by Republicans to protect the insurance company's executives getting xx millions of dollars in compensation and bonuses.

I cannot buy access or pay out of pocket. This is what millions will find out on November 1. This is not capitalism, this is extinction of people who cannot buy insurance.

 

[PrincessLeppard]

@once_upon Check out this doctor in Lincoln. http://journalstar.com/lifestyles/health-med-fit/health/lincoln-doctor-opens-membership-based-insurance-free-practice/article_d595f959-c0de-56a6-ac78-596e56005811.html

 

[Louis]

I'm not saying anything is simple; I'm saying it's broken.

I agree people should not be able to opt in and opt out of insurance. Democrats want a mandate and a penalty. Republicans want no mandate, but punitive rates for people who do not maintain continuous coverage and need treatment. Neither addresses the problem, and we probably need both. My friends who abuse the system have little savings other than retirement accounts, which are protected from bankruptcy, so no skin off their back!

New York's unreasonable insurance laws are well known, and it's common knowledge that health insurance costs in the state are the highest in the country because of nanny-state provisions and get-out-of-jail-free cards, e.g., for immigrants and for pregnant women who do not have coverage. The qualifying events are also more liberal in New York. You may argue there's a societal benefit to this, and I don't entirely disagree, but it's an indisputable fact that abuse of the system is easier. Pay nothing, show up at the point where you need coverage, get coverage for the same price as those who have paid all along, then drop it. Where's the incentive to pay? Or the disincentive to not paying? If we're going to rely on a government system where people are simply trusted to do the right thing, then let's make tax collection optional, too.

onceupon, I don't entirely understand your situation, but I sympathize with it and hope the government addresses it. I know uncertainty is never comfortable. I do think there are enough other people like you that something will be done to prevent situations where people cannot buy insurance and cannot buy coverage on the free market.

 

[Vash01]

No real teeth in there yet. Just



However, this kind of corruption (threatening or imposing punishment on a whole population for a vote or political endorsement of their elected representatives) is what got the Bridgegate guys jailed in NJ. I cannot see the Trump justice department pursuing it, but perhaps the State of Alaska will?

Alaska should investigate this threat

 

[Vash01]

Why do I feel so sorry for General John Kelly? Poor man. Does he realize what he has signed on for? How long will it be before he runs screaming from the Nut House...I mean...the White House begging for sanctuary...anywhere? Please, somebody, help that poor man!

I don't feel sorry for him one bit. He knows exactly what he is getting into. He will have a title, power, his name will be everywhere. So what if he gets fired later? It will still look good on his resume. He is not just a military man, he actually 'served' as COS for a POTUS.

 

[Buzz]

I barely had the tv on for 10 minutes and already they are interviewing Trump voters AGAIN! Is there such a thing as a Trump voter who has not been interviewed on television yet?!

 

[Vash01]

I barely had the tv on for 10 minutes and already they are interviewing Trump voters AGAIN! Is there such a thing as a Trump voter who has not been interviewed on television yet?!

It's ridiculous. Why do they even need to be interviewed? It's not like they are suddenly seeing the truth. They never will.

 

[Susan1]

Previously, on Dangers of a Trump Presidency--Part 6:

Reince Priebus was fired; Ret. Gen. Kelly is in.

Scaramucci has a foul mouth and his wife has filed for divorce.

Trump is still Trump.

Carrying on the theme, this morning, Joy Reid said "next week on Survivor, White House edition..." And they were showing the magazine cover. I wonder if they will do another with a blank space where Priebus was, and then another without the next one to get eliminated and the next..............

This isn't even funny.

 

[DORISPULASKI]

@once_upon Check out this doctor in Lincoln. http://journalstar.com/lifestyles/health-med-fit/health/lincoln-doctor-opens-membership-based-insurance-free-practice/article_d595f959-c0de-56a6-ac78-596e56005811.html

In fact, search for concierge medical practices in your area, if you are in Nebraska, there are a number of them.

As insurance companies will generally not help with their membership fees, they do not require that you have insurance!
Here's FAQs about this sort of practice.
https://www.members.md/blank-3

@cruisin was used to be a fan of concierge practices because doctors in her area would not take Medicare or something like that.

 

[bardtoob]

Report: Reince Priebus literally got kicked out of the presidential motorcade

https://www.vox.com/2017/7/28/16060352/reince-priebus-motorcade-air-force-one-departure?yptr=yahoo

"Most staff was off before we moved into position but Reince Priebus and Steven Miller and Dan Scavino loaded into one suburban then moments later Miller and Scavino got out and loaded another van."

"As word spread about Priebus' dismissal, some reporters got up close to Priebus' car, taking cell photos and such."

"Priebus' car then pulled aside, out of the POTUS motorcade. Priebus car and a follow up departed at 458PM."

“Looked like Priebus departed for home while the rest of us head to the White House,” Gerstein tweeted. “Seems there's a good chance the firing went down as AF1 circled near Andrews. Flight was longer than typical short hop from NY."
-----

The is the former Chair of the Republican National Committee he unceremoniously dispatched ... Did Trump fire the Republican Party?

 

[VGThuy]

Report: Reince Priebus literally got kicked out of the presidential motorcade

https://www.vox.com/2017/7/28/16060352/reince-priebus-motorcade-air-force-one-departure?yptr=yahoo

"Most staff was off before we moved into position but Reince Priebus and Steven Miller and Dan Scavino loaded into one suburban then moments later Miller and Scavino got out and loaded another van."

"As word spread about Priebus' dismissal, some reporters got up close to Priebus' car, taking cell photos and such."

"Priebus' car then pulled aside, out of the POTUS motorcade. Priebus car and a follow up departed at 458PM."

“Looked like Priebus departed for home while the rest of us head to the White House,” Gerstein tweeted. “Seems there's a good chance the firing went down as AF1 circled near Andrews. Flight was longer than typical short hop from NY."
-----

The is the former Chair of the Republican National Committee he unceremoniously dispatched ... Did Trump fire the Republican Party?

Breitbart would be very happy about that.

 

[bardtoob]

Breitbart would be very happy about that.

Yes, but the implication is that Trump is no longer connected to the Republican Party establishment.

I think it is the firing of Preibus that will have a more profound impact on Trump than firing Sessions or Mueller. Preibus is going to get on the phone and sink Trump from a dark corner.

 

[VGThuy]

Yes, but the implication is that Trump is no longer connected to the Republican Party establishment.

I think it is the firing of Preibus that will have a more profound impact on Trump than firing Sessions or Mueller. Preibus is going to get on the phone and sink Trump from a dark corner.

And then all the die-hards will see that as validation that Washington is corrupt and can't handle a real revolutionary who wants to drain the swamp. It's going to get really ugly in this country, even more so than it is now.

 

[snoopy]

Trump has made a lot of enemies and you'd think those chickens would come home to roost eventually. But if the Bushes and Clintons couldn't sink him, I don't think Reince will.

The one thing that I have seen -finally - pierce the veil in the ardent support of trump's base is trump LOSING. Trump said he is going to win big league and all this losing is getting on some of their nerves. It's the first time I've seen some of them care about his lying.

 

[bardtoob]

But if the Bushes and Clintons couldn't sink him, I don't think Reince will.

I think Reince has a different set of resources than the Bush Family or Clinton Family. Reince has access to the donor network and Republican office holders, elected and unelected. He could cutoff money and cooperation (aka black ball) for Trump while the Bush Family and Clinton Family could only publicly disagree with policies. If there is a so-called "Deep State", it is not exclusively composed of Democrats.

 

[once_upon]

@Louis - the fallacy of thinking by getting rid of mandates and having an open market purchase is just that - fallacy. I finally got partially through to my therapist the real issues facing us with preexisting conditions and removing mandates to cover us. Let's see if I can do a semi condensed and probably still no way near the real dire situation.

Regardless how theoretically the concept of an the open market without mandates sounds, it means that without regulations saying companies must accept preexisting conditions, the companies will reject us. taking away the market to us that can pay, means insurance companies control who is and is not worthy of life. Been there done that 4 times already.

Without standardized purchase pricing, the preexisting conditions and age will increase your premiums many fold. Think the opposite of teen driver insurance. Only because you assume will cost more without an opportunity for good health management discounts. Ever.

Regardless of mandates or not, your premiums and costs will reflect all those "users". Hospital, physicians, and insurers write off costs by adding them to you. Has happened all my adult life. When I had my first miscarriage I asked for an itemized bill. There were at least three procedures that I did not undergo - I was informed enough to know what that medical jibberish meant and asked to have those charges removed. That practice continued until mid 80's, padding your bill.

Insurance companies/hospitals knew it was happening. Medicare got wise in the mid 80's and demanded ICD coding directly related to charges. Then hospitals asked for tax protection since they were absorbing those costs. There was hospital emergency room denial resulting in huge number of deaths. EMTALA regs put into place to prevent undue burden on any one hospital. As of current, EMTALA will remain.

In 2017 Nebraska open market plans, there were 4 or 5 options for those of us on open market for 2017. Costs were spread across several entities, work load, physician demand etc. across many. Including open market and employer subsidized plans. Which despite what you may or may not believe actually kept your cost down.

If the rumor mill is true, we may have medica as an option. Now one small little company may (again if rumors are true) will cover a 4 state region. To increase that number of enrollees just in man power will probably be unimaginable. Plus no longer are costs disturbed across four or five or more insurers, just one. The collapse of the one will increase the burden on providers/hospitals who then will demand the costs be passed onto your insurer then passed on to your employer then passed on to you.

As hard as it is the swallow deregulation adds to costs. Mandates begins to equalise the costs.

Concierge doctor services might be the answer for some, but realistically can they accept 100,000+ new patients in Nebraska Jan 1? Are there concierge physicians in the specialty I need? What happens if I need hospitalization - just for the record last occurred in 1996 and before that was 1988, so I really think I've paid thousands and thousands more in premiums - there are no concierge hospitals that I know of. What happens to the $500+ asthma meds I need, which can be gotten in Australia or Canada for less than $100?

The fallacy is that one with continuous employer subsidized insurance who has racked up $2 million in cancer treatment isn't costing you more and those with preexisting conditions not eligible for insurance is costing you much, much more just because they are a coworker and I'm not.

Am I bitter? You bet. I'm not the only loser in this healthcare disaster. I'm just a million more times aware. I'm angry with the Republicans, I'm angry with the people who are rejoicing in the skinny repeal defeat. Because unless starting December 31 Medicare for all is implementing, I and millions are condemned to bankruptcy and death.

As I said one poster here and on Facebook said in healthcare there are winners and losers. You are one of the losers.

Except the ironic thing is, we are all losers. Some of us much sooner.
.

 

[Prancer]

No, it's voluntary. Insurance companies set premiums; people or employers can choose to buy / pay or not.

I suppose that's true in theory. But for most people, that choice comes down to 1 and 0--if I want insurance, I have to take whatever insurance package my employer offers at the price the employer sets. Sometimes employees get choices within that framework, but IME, at least, that isn't usually the case. You get what you get.

I think it's wrong and irresponsible to guarantee people coverage that's being funded by expanding the deficit and the national debt.

Now that I totally agree with. If we are going to do this, we are going to have to raise taxes to pay for it. We cannot have both low taxes and nice things. I do think people recognize this, but it is human nature to avoid pain as long as possible.

It's not as simple as @Louis contends. My husband's makes well over $125,000. If as indicators predict, I will be unable to purchase healthcare.

I thought Nebraska was still going to have one ACA provider in 2018?

Even though we can afford to pay the $250.00 office visit, I cannot have access. They only accept patients with insurance. I must show my insurance card at the time of the appointment. If I don't have a card or they cannot verify that I have insurance, I am not allowed to see the doctor.

Is this true for all doctors? I don't mean to discount this as an issue, because I think it's important to see the same doctors when you have chronic conditions, but I know that there are doctors here who not only take patients who do not have insurance (some boutique, some not) but give discounts to anyone who pays cash.

Of course, even if such things are possible, it's a lot of work and stress and hassle for those who have to deal with it, ((((once_upon))))).

My fear would be more that under those circumstances, a crisis would be bankrupting. I know I would be bankrupt at this point without insurance and I am not even particularly sick.

 

[once_upon]

Sorry for the double post, but the other question I have to ask myself is "is the burden of my asthma, my chronic migraines, my autoimmune disease of erthyomagalia, and serotonin deficiency and hearing loss fair to ask that my husband of 44 years takes on to the point bankruptcy, loss of everything he has worked for for the last 47 years?"

I don't think I can bear being the reason his life is so impacted by my existence

 

[bardtoob]

I contemplated the extreme other option ... Make all health insurance illegal. The result would be:

1) A massive shock to the global economy because healthcare is 1/6 of the US economy.

2) Wages would need to increase overnight.

3) Almost all with rare conditions would die because the intersect of high income and rare disease would be low.

4) The definition of "Elective" and "Medically Necessary" would change. More intermediate forms of managing a condition would be employed.

5) Life expectancy would decrease.

6) Employing rapid, all available, and innovative treatments would slow, thereby decreasing their effectiveness if time is a factor.

 

[once_upon]

@Prancer , yes in theory there will be one ACA provider. Except there are no agents, no one to contact, and I won't be able to see if there are any options until Nov. 1. If I've done the math correctly that's 94 days from today.

For 2 of my specialists, there are either no one who does private pay or taking on new patients or both. My dermatologist and rheumatologist may take private pay, I may be able to find an internist other than my current one, but pulmonologist or others - there just aren't that many to be wanting to care for non insured.

This is consuming my life. Because really it is my life.

My doctor was speechless last week when I told her she was one of the well meaning but useless democrats who thought a no vote on repeal was a win. And she is one whose income will be impacted. She keeps telling me things will be ok, and 2018 will be a game changer. I told her to go to talk with her office business manager. July 1st was the magic day.

 

[bardtoob]

I will point out one terrible reality ...

Regardless of if the stabilized revenue stream comes from the private sector or public section, insurance is a redistribution of wealth with the lowest risk paying more than they receive and the highest risk receiving more than they pay.

 

[allezfred]

If we are going to do this, we are going to have to raise taxes to pay for it.

Or you cut spending in another area. I can think of one that is prime for a trim.

I contemplated the extreme other option

Thinking about extremes is part of the problem though. It is possible to have universal healthcare AND private health insurance. Might not be as profitable for the insurance and pharmaceutical companies, but they still do business in countries that have universal healthcare.

 

[WildRose]

Tweet from Bernie Sanders (@SenSanders)
"I do hope that one day soon Republicans finally catch on so we can join the industrialized world and guarantee health care as a right"

 

[Prancer]

This is consuming my life. Because really it is my life.

Yes, I am sure it is terrifying.

She keeps telling me things will be ok, and 2018 will be a game changer.

Maybe. But even if it is, "change" doesn't always mean something positive.

I will point out one terrible reality ...

Regardless of if the stabilized revenue stream comes from the private sector or public section, insurance is a redistribution of wealth with the lowest risk paying more than they receive and the highest risk receiving more than they pay.

That was my point in the last thread that Louis responded to--that other people were paying for my medical issues because I have insurance and I take out more than I pay in, to which he replied that that is different because employers and employees have the choice of getting that insurance or not.

 

[bardtoob]

That was my point in the last thread that Louis responded to--that other people were paying for my medical issues because I have insurance and I take out more than I pay in, to which he replied that that is different because employers and employees have the choice of getting that insurance or not.

I did not catch that.

I was thinking of this in contrast to the other extreme position I stated . . . Making all health insurance illegal.

 

[VGThuy]

I did not catch that.

I was thinking of this in contrast to the other extreme position I stated . . . Making all health insurance illegal.

This thread inspired me to read a law journal article comparing the U.S. Constitution and various state constitutions and analyzing interpretations on the right to health care, if any. Montana is one state that has a constitution that explicitly talks about health, but the state courts there have interpreted that to mean one has the right to seek health care without the state government interfering, rather than it being an affirmative right that should be given by the state.

I was looking for it to see what states have been the closest in recognizing a right to health care. One of the first things I learned was that states cannot take away rights provided by the federal government, but they can always give more rights and protections.

 

[bardtoob]

@VIETgrlTerifa obtaining healthcare is not equal to obtaining health insurance. Healthcare is services, like seeing a doctor, getting medication, etc. Health Insurance is about fiduciary responsibility.

 

[once_upon]

And without insurance you may not be able to obtain services.

 

[VGThuy]

@VIETgrlTerifa obtaining healthcare is not equal to obtaining health insurance. Healthcare is services, like seeing a doctor, getting medication, etc. Health Insurance is about fiduciary responsibility.

In the U.S., access to health care often times means access to health insurance since that's the only way most people can obtain health services practically-speaking unless they qualify for a state-sponsored program. The article I read was analyzing and discuss relevant case law and trends in recognizing health care as a right or duty. About 1/3 of the 50 states' constitutions recognize health. That said, it hasn't been seen as established right for the most part, but of course policy has been going in the direction of recognizing the necessity of health coverage, whether it be creating an exchange where people receive health coverage through private insurance companies or other schemes. If we were to make health insurance illegal, then I can see an argument about impeding people's practical ability to receive health coverage since I'm assuming there wouldn't be a state-sponsored single-payer option to replace it but rather people will have to pay out-of-pocket, which would lead to your reality. Then are constitutional issues about right to contract and various states will challenge the constitutionality of such a law, especially if their constitutions mention health.