2017 ACA

Parent Cafe
481

“No one is saying we posters need to go door knocking to convince people.” Doesn’t mean they are already convinced. It responds to, “I don’t see why I must continue to tell them it’s for their own good.” You don’t have to. Recent events show people are what they are.

That doesn’t change the need, as a society.

NoVADad, maybe one part of it is this: if we stopped treatment for people who can pay, maybe they would see it differently. Maybe they could understand what those on the edge feel. (I do not mean we should, but perhaps they can envision how it would feel.)

Try to remember, we’re educated folks on this thread, not the people some scorn, who are fat, sedentary, testing the limits of their health, abusing medical technology, living on welfare, eating mayonnaise sandwiches and chain smoking. Real people on this thread, helped by some subsidies.

482

I am not sure that is Igloo’s position. I think at least I hope that was a hypothetical example that was referenced solely for the effect of the statement

483

I also thought perhaps he/she was referring to the ethical questions many face, eg, with elderly relatives. Or for ourselves: at what point is maximizing care not necessarily the right decision, for quality of life? (Anyone on the Parents Caring for Parents thread knows how hard this can be, how we barely speak it.)

And I do not mean we take away services from those who can afford them. But wish some of the secure could envision what it is like to be insecure, to face the dilemma of not having coverage, having a high deductible, or being under-insured for families with an ill loved one. Not caring is just as bad.

484

^tom, thank you for clarifying that on my behalf. I didn’t even have to say death panels before getting run over.

485

Here is what I would like to see

Expand Medicaid on the low income side. Expand Medicare on the age end down to 60.

Have both plans provide the same benefits schedule

End the beneficial treatment of employer health care. Provide a subsidy to offset premium costs for everyone else so that a policy offering the same benefits of the Medicaid/Medicare plans cannot exceed 10% of income.

Either that or full expansion of Medicare for everyone as a base with the ability to purchase a gap policy if you want one on the private market

486

Emilybee- I just want to make sure you understand that you have shared so much identifying information that anyone can figure out who you are. Maybe you don’t care, but with the tone of many of your posts, I would think you would want to be anonymous. Well, you aren’t!

487

Here’s what Aetna CEO had to say about medicare. He suggests lowering the age to 55.

http://finance.yahoo.com/news/health-care-premiums-next-unless-160135754.html

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I remember reading several years ago that the health of people is generally better when the baseline of the population has better health. In other words, a person in the US with good coverage and services is LESS healthy that an equivalent person in the UK or Canada where everyone is covered. We are all healthier together. I will look for the studies that back this up.

489

I don’t care, MOWC. If people want to waste their time figuring out who I am they can go right ahead.

490

My state further restricted Medicaid after passage of the ACA.

491

States that expanded Medicaid after ACA have healthier populations than states that didn’t. Seems like a no brainer to me but maybe there are no brains out there!

492

Despite having read about the ACA, pros and cons, I don’t have a good understanding of viable solutions to controlling health care costs and premium costs.

I mentioned upthread that we have not had employer based health insurance since the kids were babies, so about 18 years. I don’t want to go back to the days of pre-exisiting conditions resulting in denial of insurance or unaffordable premiums.

But, what can we do from preventing the alternative universe version of that happening? Meaning, for example, insurance companies know which medications are used for illnesses that turn out to be very expensive, and the cost is being passed on with increasingly high out of pocket bills (less coverage for those particular medications on top of already high monthly premiums).

The insurance companies “know” we are currently a healthy family with few medical needs (big, big knock on wood) because we shop price. We buy the crappiest lowest price plan to keep our premiums down.

So, it seems to me, insurance companies ARE finding a way to charge sick people more. People who have high health care needs go for plans with more comprehensive coverage and seek out plans that cover their medications.

I suppose, continuing, that someone has to decide what’s covered and what’s not, be it the government, the insurance companies, or both. Color me naive, but I was so surprised when the ACA came out and I discovered that mammograms and colonoscopies were included in covered preventative care.

Of course, I can see the argument that preventative care is foundational, but then I thought, but what if I don’t want either of those? What if research shows that thermagrams are the way to go, or an occult stool test is just as effective? Is the ACA nimble enough to adjust to new research coming out?

In my fantasy world, everyone has major medical coverage. Personally, I would like lower premiums and less “comprehensive coverage”. If we were saving on the cost of premiums, we could decide where to use our health care dollars. Maybe a priority in our family is replacing a cracked dental crown this year, and not a colonoscopy. Or, getting a year’s worth of therapy with a skilled practitioner (we ended up going out of network and paying through the nose). I’d like…more choice on what is a priority for each member of our family.

With premiums, on the worst least expensive plan, for two 50-somethings and two college kids is almost equal to our mortgage payment, there just isn’t a lot of money left over for what we feel are priorities for our health.

Is there a solution for this? A best of all worlds scenario?

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And then there’s this: http://nymag.com/daily/intelligencer/2016/11/paul-ryan-says-medicare-privatization-is-on.html

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^This is not new. They have wanted to privatize Medicare for years.

Just like they want to get rid of SS.

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Yes…it’s not new, but now those who desire it are in a stronger position of making it a reality.

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The president elect has clearly stated that the protection of Medicare and social security were not negotiable.

I will follow the dynamics between him and the republicans with great interest

497

Colonoscopies being covered would have saved my Mother’s life. She died at age 63 because it was considered that colon cancer wasn’t a risk for women. This was only 17 years ago.

Medical knowledge is always changing and advancing, and any insurance policy or public health policy should be constantly changing to reflect the best information. Unfortunately, with a profit driven system, we have something different.

498

This thread has wandered all over the place. I would like to take a detour back to the beginning.

I need to decide what to do next years but so many things are in flux.

In January, Trump assumes office. He has made it clear that he wants to appeal ACA on day 1. The general consenus is that it is not that simple. However, it seems clear that he will be able to immediatedly elminate the cost sharing aspects and probally the subsidies. So my concerns are:

What would the effective dates of these change be? Since the terms of the insurance contract (cost sharing) are changing does the insurance company have the right to cancel my insurance or modify the terms? Will I be able to continue the policy if I pay the full premium. If I can’t afford it, will I be able to purchase a policy on the open market? If the insurance company cancels the policy or I can’t afford it, is it a qualifing event? Will my daughter be able to sign up for school insurance in this case? Right now the school’s insurance company says only if it is a qualififing event. However this is not listed as a qualifing event. Can I drop to a lower cost plan?

What is so fustrating that there are no details. These are basic questions. I would like to think that there will be an orderly phase out but after this election who knows. The safe route for my student would be to sign up for the school insurance. For the rest of the family there might not be a safe route.

Thoughts?

OT, what happen to spell check?

499

@greenwitch I’m so sorry. That should not happen in the wealthiest country in the world. Shameful.

500

No name Paul Ryan has just said privatization of Medicare is on.

I wait with interest the president elects response to that