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None of them have to live with any of the plans that they actually implement. That's part of the problem. . .
TrumpCare Revealed Today
- Thread starter scagnt83
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The elected president is only a link in the chain of decision making and if you consider the length of the chain, he or she is the weakest one.
Having said that, all the promises uttered during the campaign are superfluous and only jargon meant improve the chances of being elected.
Two ways to run a no underwriting block.
Specified enrollment, such as the birthday month of the primary policyholder. Much like drivers licenses or insurance licenses in some states. Staggered enrollment over 12 months.
Another way is to allow enrollment at any time but impose 3 - 6 month waiting period which would be my preference.
or 3,000% depending on which speech you heard
The "state lines" deal is funny. Sounds great to those who don't understand health insurance, but you have to develop a network with doctors and hospitals outside of your state and now have that in all 50 states....that's going to be cheap to create, maintain, and administer...
They have no idea how complex health insurance is. It is not a one time service like buying a plane ticket.
I like Bob's idea on the waiting periods. Make people think twice about dropping it. Give them a 6 month waiting period if there was no coverage in place before hand. Proof of prior coverage waives the waiting period.
Like the idea of price transparency also.
They have no idea how complex health insurance is. It is not a one time service like buying a plane ticket.
I like Bob's idea on the waiting periods. Make people think twice about dropping it. Give them a 6 month waiting period if there was no coverage in place before hand. Proof of prior coverage waives the waiting period.
Like the idea of price transparency also.
Price transparency won't happen, except in the case of cash only negotiations.
In the age of managed care, the carriers either negotiate their reimbursement rates direct with the provider or via an MCO. The specific terms and reimbursement levels are trade secrets.
Blue doesn't tell Aetna how much they pay for procedures and vice versa.
Even within the carrier there are different levels of reimbursement for the same procedure with the same provider.
Joe goes to Dr Welby and presents his PPO card. Mary also goes to Dr Welby for the same procedure but has an HMO.
Dr Welby is paid different rates for Joe vs Mary.
This is further convoluted by the multiple PPO, HMO and POS networks each carrier has. Joe has a PPO through his large employer, Joe's twin Jim has the same carrier and a PPO but via his individual exchange plan.
Once again, possibly two different levels of reimbursement.
In some situations you MAY be able to negotiate a lower cash price for your procedure but a provider can get in trouble with the carrier if the carrier finds out they are accepting a lower price than the negotiated fee.
In the age of managed care, the carriers either negotiate their reimbursement rates direct with the provider or via an MCO. The specific terms and reimbursement levels are trade secrets.
Blue doesn't tell Aetna how much they pay for procedures and vice versa.
Even within the carrier there are different levels of reimbursement for the same procedure with the same provider.
Joe goes to Dr Welby and presents his PPO card. Mary also goes to Dr Welby for the same procedure but has an HMO.
Dr Welby is paid different rates for Joe vs Mary.
This is further convoluted by the multiple PPO, HMO and POS networks each carrier has. Joe has a PPO through his large employer, Joe's twin Jim has the same carrier and a PPO but via his individual exchange plan.
Once again, possibly two different levels of reimbursement.
In some situations you MAY be able to negotiate a lower cash price for your procedure but a provider can get in trouble with the carrier if the carrier finds out they are accepting a lower price than the negotiated fee.
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If you click the link and read it in detail there are further explanations on some stuff.
With the price transparency issue his point is that people should be able to shop the market for procedures. I am a huge fan of that idea.
I also am a huge fan of expanding HSAs like he seems to want to do. And letting them transfer tax-free to heirs could be a HUGE benefit. Think about grandparents being able to pass on HSAs tax free to grandchildren.
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You could still shop the cost within your network.
And all of that convolusion is a big reason that prices have been jacked up over the years. Not only does it raise administrative cost, but it creates an environment where it is close to impossible to "shop" for care.
Health insurance needs to be simplified, not made more complicated.
I like the idea of having a single statewide network (or a few regional networks) for each carrier. Either the doctor takes that carrier or they dont, period.
And as long as the cost of care is hidden and bundled up into the premiums of Co-Pay plans, then the cost of care will continue to spiral out of control.
My recent bloodwork at the doctor just cost $1200 more than it did last year because the doctor switched 3rd party vendors... no difference in care or OOP for me... but $1200 more billed to BCBS. Why they are $1200 better than the old vendor I have no clue. And of course you have no clue how much it will cost until you get the bill for it. What other profession does not even give the customer an estimate of the cotsts?????
With the price transparency issue his point is that people should be able to shop the market for procedures. I am a huge fan of that idea.
I also am a huge fan of expanding HSAs like he seems to want to do. And letting them transfer tax-free to heirs could be a HUGE benefit. Think about grandparents being able to pass on HSAs tax free to grandchildren.
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You could still shop the cost within your network.
And all of that convolusion is a big reason that prices have been jacked up over the years. Not only does it raise administrative cost, but it creates an environment where it is close to impossible to "shop" for care.
Health insurance needs to be simplified, not made more complicated.
I like the idea of having a single statewide network (or a few regional networks) for each carrier. Either the doctor takes that carrier or they dont, period.
And as long as the cost of care is hidden and bundled up into the premiums of Co-Pay plans, then the cost of care will continue to spiral out of control.
My recent bloodwork at the doctor just cost $1200 more than it did last year because the doctor switched 3rd party vendors... no difference in care or OOP for me... but $1200 more billed to BCBS. Why they are $1200 better than the old vendor I have no clue. And of course you have no clue how much it will cost until you get the bill for it. What other profession does not even give the customer an estimate of the cotsts?????
Tyler, my blogging partner and I have gone back and forth on the transparency issue for years and we are still at a standstill.
If you have a brain tumor do you want the cheapest oncologist or the best? Are you really going to call around and price shop?
Transparency is fine for cash and routine procedures but not for the more complex items.
I can shop oil changes online but how much to diagnose and repair that whine in my transmission?
FWIW I had a car with a transmission problem a few years ago and took it to a chain (vs. Joe's transmission and donut shop). Cost me $1200 and they still didn't get it right. They eventually refunded half of what I paid but I had to come up with $1600 to get it fixed right at the dealer.
I like the HSA too but far too many people don't "get" it and even fewer fund it. I equate this to buy term and invest the difference. Most folks bought the term and spent the difference. Same happens with HSA's.
I do think expanding the HSA concept and liberalizing the rules to allow plan designs other than HDHP is a good idea. Not real sure how many will take advantage of it.
So I am not adverse to the HSA expansion. Just think the impact on the cost of health care, which is the real drivers of premiums, will be negligible.
This is like candidates talking about balancing the budget. Probably 90% of the voting public don't know or care about the budget.
Romney talked a lot about deficits and budgets and his message didn't resonate. Of course that isn't what sunk his campaign, it was his personality (or the lack thereof). But most people did not relate or understand his message.
Newt had a similar problem. Few understood him and even fewer liked him.
Trump, for all his negatives, has hit a nerve with his message and it is one that resonates with most people. There are plenty of things not to like about the guy, and I am not a fan, but it is his message and the way he excites people that is driving his candidacy.
Pretty sad that we had qualified candidates, like Rick Perry and Jeb Bush that probably would have been good presidents. But the country, at least the right side, is fed up with politicians and this is the year of the non-politician.
I am afraid our choice will be Trump or Hillary which is a very sad statement given the talent pool we had at the start.
Yes, and I do on some things. I have used the online price comparison feature with my carrier for simple things like scans.
I have had UHC, Cigna and BX in the past and all 3 had online pricing estimates. I understand not all carriers have this. That's a shame.
Lab work is a mess. Very high mark ups. Switching from Labcorp to Quest (and vice versa) can make a big difference. You need to know which one is in network and make sure your doc uses the one on the preferred list.
If you have a brain tumor do you want the cheapest oncologist or the best? Are you really going to call around and price shop?
Transparency is fine for cash and routine procedures but not for the more complex items.
I can shop oil changes online but how much to diagnose and repair that whine in my transmission?
FWIW I had a car with a transmission problem a few years ago and took it to a chain (vs. Joe's transmission and donut shop). Cost me $1200 and they still didn't get it right. They eventually refunded half of what I paid but I had to come up with $1600 to get it fixed right at the dealer.
I like the HSA too but far too many people don't "get" it and even fewer fund it. I equate this to buy term and invest the difference. Most folks bought the term and spent the difference. Same happens with HSA's.
I do think expanding the HSA concept and liberalizing the rules to allow plan designs other than HDHP is a good idea. Not real sure how many will take advantage of it.
So I am not adverse to the HSA expansion. Just think the impact on the cost of health care, which is the real drivers of premiums, will be negligible.
This is like candidates talking about balancing the budget. Probably 90% of the voting public don't know or care about the budget.
Romney talked a lot about deficits and budgets and his message didn't resonate. Of course that isn't what sunk his campaign, it was his personality (or the lack thereof). But most people did not relate or understand his message.
Newt had a similar problem. Few understood him and even fewer liked him.
Trump, for all his negatives, has hit a nerve with his message and it is one that resonates with most people. There are plenty of things not to like about the guy, and I am not a fan, but it is his message and the way he excites people that is driving his candidacy.
Pretty sad that we had qualified candidates, like Rick Perry and Jeb Bush that probably would have been good presidents. But the country, at least the right side, is fed up with politicians and this is the year of the non-politician.
I am afraid our choice will be Trump or Hillary which is a very sad statement given the talent pool we had at the start.
Yes, and I do on some things. I have used the online price comparison feature with my carrier for simple things like scans.
I have had UHC, Cigna and BX in the past and all 3 had online pricing estimates. I understand not all carriers have this. That's a shame.
Lab work is a mess. Very high mark ups. Switching from Labcorp to Quest (and vice versa) can make a big difference. You need to know which one is in network and make sure your doc uses the one on the preferred list.
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Letting HSA contributions transfer tax free is a joke, a few thousand dollars doesn't make much of a difference on a $5.4M+ estate (if the estate is worth less than that, no tax in the first place). People like being told they won't be taxed, even if they wouldn't be taxed in the first place...
We all agree selling across state lines is a joke. Just not going to happen.
"Remove barriers from importing medication overseas" will basically mean "invalidate the FDA and DEA". Not going to happen. The issue isn't that we can't import the medication, it's that it's not FDA/DEA approved. It hasn't mattered where the approved medication is manufactured. A huge portion of the medication available here is imported from overseas. Ever get a drug made by Bayer? It's probably from Germany. Cipro, for example, is made in Germany and Italy, as noted on the last page of the FDA's guidance on it: http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/019537s701984744198575120780282147325l.pdf. Yaz (the birth control pill)? Xarelto? Nexavar? All produced in Germany. There's thousands of other common drugs imported from overseas.
Price transparency is a flawed idea. When you have a defined deductible/copay, you're incentivized to get the most expensive (perceived as the "best") care available. Making rates available will likely drive up cost overall as people try to get the "best value" from their plan by visiting the "best doctors" available.
We all agree selling across state lines is a joke. Just not going to happen.
"Remove barriers from importing medication overseas" will basically mean "invalidate the FDA and DEA". Not going to happen. The issue isn't that we can't import the medication, it's that it's not FDA/DEA approved. It hasn't mattered where the approved medication is manufactured. A huge portion of the medication available here is imported from overseas. Ever get a drug made by Bayer? It's probably from Germany. Cipro, for example, is made in Germany and Italy, as noted on the last page of the FDA's guidance on it: http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/019537s701984744198575120780282147325l.pdf. Yaz (the birth control pill)? Xarelto? Nexavar? All produced in Germany. There's thousands of other common drugs imported from overseas.
Price transparency is a flawed idea. When you have a defined deductible/copay, you're incentivized to get the most expensive (perceived as the "best") care available. Making rates available will likely drive up cost overall as people try to get the "best value" from their plan by visiting the "best doctors" available.
Only way to control the health care problems is to follow the Peeler Plan...
You can only control the health care problems is to control the health care cost... control the spending... hence, control what providers can charge...
Next, provide high deductible blanket policy to ALL and allow the masses to select a supplement policy if they so choose..... those with the cash can select a medicare supplement type policy.... those below a FPL point can elect a MAPD style offering with copays and such so they have skin in the game. If you term you supplement mid cycle(enrollment year) then you can get back in with full underwriting or wait till your birthday month of primary tax payer. If you are getting in without coverage you are burdened with a 6 month pre existing clause..
There, The Peeler Plan... same basic plan I proposed back in 2008
You can only control the health care problems is to control the health care cost... control the spending... hence, control what providers can charge...
Next, provide high deductible blanket policy to ALL and allow the masses to select a supplement policy if they so choose..... those with the cash can select a medicare supplement type policy.... those below a FPL point can elect a MAPD style offering with copays and such so they have skin in the game. If you term you supplement mid cycle(enrollment year) then you can get back in with full underwriting or wait till your birthday month of primary tax payer. If you are getting in without coverage you are burdened with a 6 month pre existing clause..
There, The Peeler Plan... same basic plan I proposed back in 2008
