Health Care Reform

[Primula Baggins]

Which will put 33 million, rather than a mere 22 million, off insurance.

This will earn him back one of his four no votes, but I think more moderates will switch to no.

This is, of course, assuming he's telling the truth and not planning to pull some midnight switcheroo.

[Voronwë the Faithful]

What he is actually doing (though his statement doesn't quite say this), is offering to make the repeal now and replace later the first amendment to the already passed House bill, if the Senate votes to open debate on the bill, instead of making the now-dead Senate version the first amendment. I doubt that even the procedural vote will pass.

[Primula Baggins]

From your keyboard to God's eyes, Voronwë.

[Voronwë the Faithful]

There has already been three GOP senators who have said that they will not vote to advance a bill that rolls back the ACA without a replacement in place, Lisa Murkowski of Alaska, Shelley Moore Capito of West Virginia and Susan Collins of Maine. Which dooms the effort before it ever starts.

[Frelga]

Lee and Moran also said they oppose it. I hope it's toes up, but this monstrosity has a tendency to rise from the grave.

I'm hoping everyone with a Republican Senator is calling their offices.

ETA: my bad, Lee and Moran opposed the Senate version of the bill, not the repeal-only rider. I think.

[River]

What's bizarre about this is how the GOP so far has shown no interest in talking to anyone but themselves about this. They're using a procedural method that allows them to cut the Democrats out. They're not consulting the AARP, they're not consulting the AMA, or any of the big insurance or hospital groups. I'm not sure they're even paying attention to state governors within their own party. And so, naturally, without any sort of groundwork, when they present a bill everyone affected by it freaks out because its not what they want or need. And the GOP response is to hide even more. In Colorado we make jokes about how scarce Sen. Gardner has gotten. Sen. Moran was photographed literally leaping over subway tracks to dodge reporters. If they've made any genuine attempt to sell their legislation to the public at large it's fallen completely flat - the most recent bill had an approval rating below 25%. What exactly are they trying to achieve and on whose behalf??

[Primula Baggins]

You know who else they haven't involved—women. Even women Republican senators were completely excluded from the process.

My guess is that this has nothing to do with anyone's health or well-being. It has to do with cutting taxes on the wealthy and, to enable even larger cuts in future, beginning the process of ending all entitlements and social insurance. They don't want to be told who it's hurting, or who it might hurt, because they have always fully intended to do it anyway. They're safe. Their clients the conservative billionaires are safe. The rest of us can suffer and die. It's what we're for. Read Dickens, or Upton Sinclair. That's how we're meant to live, those of us who aren't rich. Their version of God commands it.

[Frelga]

It was pointed out to me that all three Senators who came out against the repeal-only bill are women.

[Voronwë the Faithful]

I noticed that right away.

But apparently the effort is back from the dead. McConnell latest push is to get his caucus to vote to allow debate on the bill and allow any and all amendments. It is unclear whether this will get any traction.

[Dave_LF]

Got a letter today from the office of my doctor of nearly 10 years saying that, due to all the uncertainty, they will no longer be accepting ANY health insurance and are instead switching to a (very expensive) subscription model. So I guess it's time for me to move along, assuming they don't all do that.

[Griffon64]

We got a letter like that from one of our doctors a few years back. Bid the doc farewell. Not sure what kind of money they think common folks have when they throw out that kind of subscription prices.

[Jude]

Is a subscription price something like a regular monthly price, and then they guarantee to treat you no matter what treatment you need at no cost beyond the subscription price?

[Dave_LF]

Something like that, but it would only cover office visits and tests/procedures they do in their own (GP) office; if you need surgery or wind up in the ER or whatever, it's a whole separate payment system.

[Sunsilver]

Dave, I don't understand how that would work. Does that mean you'd have to get Medicaid coverage if you wound up in hospital? Or would you have to pay the fees yourself?

[yovargas]

Dave, I don't understand how that would work.

That's because it wouldn't.

[Dave_LF]

You'd still need insurance for that, but that insurance would be useless for ordinary Dr visits.

The only way I can imagine it would be economical is if you have insurance and go to the doctor so many times per month that your copays etc. add up to more than the new subscription fees.

[Sunsilver]

How much a month is the subscription fee?

[Primula Baggins]

I'd be curious to hear, too.

That model is popping up down here, too, although I most recently read about it in the form of "concierge medicine," where wealthy people pay very large subscription fees and in exchange get personal service on a level mere humans cannot imagine—if they need surgery, the concierge service lines up a world-class specialist, and care is delivered on the luxury floor of the best hospital in the country. And it's scheduled within days, not weeks or months out, with other services like limousine service to and from the hospital and gourmet meals while you're in.

[Inanna]

That's the version I have heard in NYC too - concierge medicine.

The subscription model would work if you could easily buy extreme insurance & the subscription price was cheap enough not to bite. In India, people who buy health insurance do so only for major surgeries, hospital visits etc. Usual doctors visits & prescriptions are cheap enough. And are available at multiple price points for the entire population. Of course, the problem is that the price point affects the care - in the US that at least is not the case.

[Cerin]

I don't suppose any Democrats would have been willing to cooperate on a repeal of the ACA, which might be a reason the Republicans are talking only to themselves.