Affordable Care Act NEW TAXES

I share your frustration.

It may be helpful for us to remember what Democrats proposed to include in Obamacare in 2009. For the first time, Medicare would pay for doctors' appointments for patients to discuss living wills, health care directives and other end-of-life issues. The appointments were optional, and the AARP supported the measure. That's it.

What we then had was the GOP running wild with allegations that President Obama and the Democrats were creating "death panels". Sarah Palin, Betsy McCaughey, Virginia Foxx, Chuck Grassley, Newt Gingrich, and unknown more of their sick ilk they all whipped up right-wing hysteria with the bullshit claim that the President and his party intended to just kill sick people in order to save money. I remember, and that's exactly what they were doing.

Who cares what the GOP thinks? I do, because the country needs the cooperation of both parties to get stuff done. It's very rare for one party to get the fragile degree of control (President, Senate, Congress) the Dems had for about twenty weeks in 2009 and 2010. I don't think today's GOP is capable of getting to 60 Senate votes ever, and the Dems are unlikely to do again for some time. We need them to work together, and so we need to care what each side's approach is.

You're not going to get the nonrevokable DNR insurance discounts you want until we have a sea change in the GOP's demagogic approach to end-of-life care. That's just reality.

I'm absolutely on board with this notion. My wife and I have an understanding that there is no way either of us want to be or get to such a state...PULL THE PLUG! I say. Funny, I don't think it's an unpopular idea either, I've actually had this conversation with a few people and they;ve all said the same thing.

J

Ok...AlanLeroyCare is gaining some consensus.

Let's move on and fix another huge cost driver of medical care...The Truly Non Competitive nature of major surgery in the USA. Someone here posted a great link to a NY Times Article that told the tale of a man who needed Hip Replacement Surgery.

https://www.nytimes.com/2013/08/04/health/for-medical-tourists-simple-math.html?_r=0

The surgery would have cost $100,000 in the US, but cost $13,000 in Belgium...for the same part and the same level of care.

AlanLeroyCare encourages Insurance Companies to outsource these kinds of ridiculously marked up surgeries to certified facilities in other countries. Yes, we're outsourcing parts of our medical care. But we're not doing it in a coercive fashion. I call it 'The Medical Tourism Benefit'.

Here's how it works. If you are in the situation similar to the one identified above with an $87,000 difference in cost on US Soil vs a Certified International Facility, you're offered a Choice...Have the Surgery Here with the normal Max Out of Pocket of $12,000 or take an Expenses Paid trip to Belgium with your Wife...pay no out of pocket cost AND get a 10K bonus payment.

So the Deluxe International Surgery Package ends up costing the insurance company $35,000 instead of $100,000, you and your wife get a nice vacation (+ an extra 20K in your savings account) and medical costs are reduced by $65,000 in the USA. Everybody wins...except of course the clearly inefficient US Medical Surgery providers who are going to have to sharpen their pencils and figure out how to compete in a global economy....Like many of us in other industries have been doing for decades.

Call these panels whatever you like; allocation panels, death panels, qualification panels. There is a group of government employees who will decide who does and doesn't qualify for certain procedures.

This happens today within the private sector, which I much prefer. The IRS is running around causing conservative groups problems. Image what the power a group wields with the ability to withhold medical care.

Boiler, you are clearly a victim of propaganda. The "death panels" that people had a fit about were nothing more than insurance paid meetings between families and doctors to discuss care options for terminally ill members of the family. There is no government entity in that meeting. And its something conservative champions like Paul Ryan, Sarah Palin, and Mitt Romney all endorsed right up until President Obama did too.

AlanLeroy is right...there's tons of work to be done to reign in costs of medical care in general. The current law does not do enough on this front....but it does do some significant things that many critics like to ignore like:

- create published transparency in pricing from all medical providers so consumers can make better choices
- electronic medical records and sharing to eliminate redundant, unnecessary testing
- caps on insurance profits to make sure spending goes to care instead of corporate jets
- exchanges for insurance to set up competitive pricing
- requirements for young people to get insured which lowers prices for everyone
- considerably more manpower to chase after medicare fraud and abuse which has saved 20 billion to date
- An IPAB board to recommend best practices from the most efficient hospitals in the country

Is there more that can be done? Absolutely. And we should. The only question is where is a better point to start from? WIth Obamacare or from the previous system?

Isn't it a better platform to build on where insurance companies cant discriminate against sick people...or women? Isn't it better to start with a system that insures 20-30 million more people? Isn't it better to start with a system that allows college kids to stay on their parents insurance plan until they graduate and get a job? Isn't it better to start with a system that is already measured to be more fiscally responsible than the one that preceded it? Seems like a no brainer to me.

In my mind it's unfortunate that there are thousands of Pages of 'Obamacare' yet it fails to effectively deal with many of the most obvious problems, deals incorrectly with some lesser priorities and often creates new problems where once there were none. That's NOT to say it's ALL BAD. But it's almost like it was written by lobbyists for the Insurance Industry, Big Pharma and the AMA. The Canadian Legislation that essentially Socialized Medical Insurance was only 19 pages IN ENGLISH AND FRENCH for crying out loud.

That being said, I see no other way to really fix healthcare in the US than to build on what we have now...after all, it's what we have now....and where else would we start? You'll note that even though I complain about many aspects of the legislation, I do not call for it's repeal. I do not want to throw the baby out with the bathwater, but damn it, let's at least drain the friggin' tub.

I call for common sense solutions that will drive real costs out of health care. Solutions like fixing the Obscene Cost of End Of Life Care, Opening up Health Care and Health Insurance to Interstate and International Competition, Breaking the Big Pharma Protection Racket, and making the Ambulance Chasers Pay if they lose a frivolous lawsuit....and a whole lot more.

Obamacare could be highly successful if the policy prices, out of pocket limits and deductibles were slashed by 50-75% with the same level of medical care. It could be the best thing we've ever done as a society. I think Mr. Malibber could even live with that....and I mean that literally. That's not going to happen until we address the real issues of cost. I think we could do that as a nation if cutting the massive remaining unnecessary and uncompetitive costs were moved to the front of the current debate.

I don't see any way to do that at this point as too many people are too affixed to one side or the other, and politicians on both sides are using this as a political wedge...and I admit that I have fallen into that trap from time to time. I do hope the small snippet of AlanLeroyCare has given pause to some to think outside the box on some new solutions instead of another rehash of the old.

And to Poor Old Don Diego...I must decline. "I shall not seek, and I will not accept, the nomination of my party for a term as your president.” Of course I have no party, except the ones I throw myself.