Discussion: The Devil Is In The Details Of Latest GOP Obamacare Repeal Plan

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Premiums in high-risk pools are guaranteed to be very high. Almost no one will be able to afford them without very large subsidies. So you can give everyone a modest subsidy and require them to join, as Obamacare does, or you can give some people a huge subsidy and let the others opt in or out. So, what’s the difference?

As for the idea that people spending money from HSAs will “shop for the best deal”, that is almost unworkable in the real world. Have you ever tried calling a doctor’s office and asking how much it will cost? They can’t tell you because they don’t know what you have. And hospitals are even worse. Imagine pricing an operation-but then you get complications.

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“The ability of the replacement measures to work will depend on how much money GOP lawmakers are willing spend on them…”

Okay, this just made me giggle.

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The thing is, people don’t always make the best decisions about health care - maybe because we’re dumb, maybe because we’re crazy, or maybe because we’re just too busy and tired and it’s fucking complicated.

You know how I know that we don’t make the best decisions?

Because millions of people voted for Donald Fucking Trump, aka PeePee LeSpew.

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Trumpcare is gong to be great. Just you watch the greatness of millions of people losing their health care. For decades the new Trumpcare replacement plan will have Americans talking about the good old days of Obamacare, remembering when they actually had real health care insurance.

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How to understand everything Republicans have, are, or will be proposing:

A good deal for younger and healthier people with money, a life-worsening and life-shortening screwing for everybody else.

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This kind of sober-faced wonkage probably amounts to little more than a move in the normalization game, providing cover for the crude heist now underway. “But these reasonable ideas in theory are very complicated in their details…” Immediate corollary: they were not ‘reasonable’ in the first place, because ‘theory’ includes details. Further corollary: never going to happen.

The Republicans have no interest in providing universal health care. They have a well-documented interest in carting off the vast sums involved. The devil is not in the details — it’s in the goals.

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the difference is that a black guy didn’t implement it.

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Any Republican plan will benefit the rich. Period. The “value-based” health care decisions for millions will be - “Do I buy medication or food this month?” “Do I get the operation or just suffer and die?”

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This analysis is way too complicated for political purposes. Ds have the ACA. If Rs want to replace the ACA, that is their business. Ds should confine themselves to asking Rs:

(1) Where does it say “insurance for everybody”?

(2) Is this insurance “better” than what people currently have?

(3) Is the insurance not only better, but “cheaper”?

Trump promised.

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Could it also be that most of us didn’t go into either the medical or insurance/business field? Could it be that if I or my child hurt their arm I want the pain to go away and my options for pricing or zero if it’s 9PM and urgent care/doctor’s office is closed?

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First I just want to preface this question with I’m waiting for the coffee to get done brewing.

So how many people think that if your employer offered you and your family insurance, but under the PPACA decided that they would drop the offer to cover your wife and children to control their costs, that they would go back to offering a form of insurance that lowered their costs and covered you and your family? I heard this one a lot in the aftermath of the PPACA rollout.

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Even if Republicans gave a shit about health care – which they don’t – they’re too cheap to pay for anything. They know their old warhorses (HSA’s, high risk pools, etc.) won’t get the job done. The numbers were crunched decades ago.

In the end, the whole “replacement” thing will be a Frank Luntz production. Lies and more lies.

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Yep, and all those things too.

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" … by encouraging a system where people ration for themselves what kind of health care they seek, they won’t spend on unnecessary treatments"
I have this awful abdominal pain, but since I’m not bleeding, maybe another 2 Advils will do the trick.

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How many people are really getting “unnecessary” treatments? Aren’t people getting treatments based on their doctor’s recommendations?

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Doctors have an incentive to over-treat and they often do. That is a real problem that the GOP plan doesn’t address in any way. Obamacare does, but not strongly enough. The sensible solution would be to strengthen the cost control mechanisms in Obamacare. The fact that that is sensible means it won’t happen.

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TLDR summary for the Republican health care plan: Curl up and die suckers.

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Doctor’s get paid by the procedure. The more procedures they do, the more they get paid. Specialists sit on and drive the costs on the pricing review boards. Specialists get paid more, family doctors get paid less.

It’s a system that puts incentives in the wrong place.

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And for the young, they think they’re immortal and will never need it.

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