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Trump Health Care Plan

slo1
Posts: 4,309
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10/15/2016 11:23:25 AM
Posted: 1 month ago
https://www.donaldjtrump.com....

There are major issues with Trump's healthcare plan.

1. Trump wants a larger national insurance market and proposes creating sales across state lines, yet companies have to compile with state law.

Any health insurance company can already sell across state lines by simply filing with the state. Many choose to not offer insurance in certain states due to the various regulation and laws which impact profitability. If Trump does not usurp state law and regulation he will not make any ground with expanding the number of companies selling in various states.

2. While not mentioned once it is safe to assume the elimination of pre existing conditions is planned, meaning if people are laid off and have a chronic condition they will not be covered for that condition. This is particularly devastating when medical emergencies happen during lapses of insurance coverage.

3. Block grants to expand Medicaid. What are the strings attached? Many states don't want to expand Medicaid.

I dont see one policy that reduces overall cost other than the eresumption of preexisting conditions.
twocupcakes
Posts: 2,748
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10/15/2016 1:31:48 PM
Posted: 1 month ago
At 10/15/2016 11:23:25 AM, slo1 wrote:
https://www.donaldjtrump.com....

There are major issues with Trump's healthcare plan.

1. Trump wants a larger national insurance market and proposes creating sales across state lines, yet companies have to compile with state law.

Any health insurance company can already sell across state lines by simply filing with the state. Many choose to not offer insurance in certain states due to the various regulation and laws which impact profitability. If Trump does not usurp state law and regulation he will not make any ground with expanding the number of companies selling in various states.

2. While not mentioned once it is safe to assume the elimination of pre existing conditions is planned, meaning if people are laid off and have a chronic condition they will not be covered for that condition. This is particularly devastating when medical emergencies happen during lapses of insurance coverage.

3. Block grants to expand Medicaid. What are the strings attached? Many states don't want to expand Medicaid.

I dont see one policy that reduces overall cost other than the eresumption of preexisting conditions.

Trump does not really have much of an alternative to Obamacare. He says he will "repeal Obamacare and replace it with something terrific". But, like his "secret plan" to defeat ISIS, he does not really have a plan. Trump is betting that by insulting and blaming others, people will flock to him. Trump is appealing to people with less than half a brain.

Also, Donald Trump has supported keeping pre-existing conditions in this election. Trump changes his position so often it is tough to keep up. But, if it were removed plenty of people would not be able to afford healthcare due to random chance. That is pretty 3rd world country.

TRUMP: I agree with that 100%, except pre-existing conditions, I would absolutely get rid of ObamaCare. I want to keep pre- existing conditions. It's a modern age, and I think we have to have it.

http://www.ontheissues.org...
Greyparrot
Posts: 14,212
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10/15/2016 1:35:47 PM
Posted: 1 month ago
At 10/15/2016 11:23:25 AM, slo1 wrote:
https://www.donaldjtrump.com....

There are major issues with Trump's healthcare plan.

1. Trump wants a larger national insurance market and proposes creating sales across state lines, yet companies have to compile with state law.

Any health insurance company can already sell across state lines by simply filing with the state. Many choose to not offer insurance in certain states due to the various regulation and laws which impact profitability. If Trump does not usurp state law and regulation he will not make any ground with expanding the number of companies selling in various states.

2. While not mentioned once it is safe to assume the elimination of pre existing conditions is planned, meaning if people are laid off and have a chronic condition they will not be covered for that condition. This is particularly devastating when medical emergencies happen during lapses of insurance coverage.

3. Block grants to expand Medicaid. What are the strings attached? Many states don't want to expand Medicaid.

I dont see one policy that reduces overall cost other than the eresumption of preexisting conditions.

The federal government will use the same trick it always does to change state laws, either invoke commerce clause, or just withhold funding.

As a matter of fact, the entire original reason why the founders put in the Commerce clause is to prevent states from setting up monopolies through laws like they do now.
slo1
Posts: 4,309
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10/15/2016 1:59:56 PM
Posted: 1 month ago
At 10/15/2016 1:35:47 PM, Greyparrot wrote:
At 10/15/2016 11:23:25 AM, slo1 wrote:
https://www.donaldjtrump.com....

There are major issues with Trump's healthcare plan.

1. Trump wants a larger national insurance market and proposes creating sales across state lines, yet companies have to compile with state law.

Any health insurance company can already sell across state lines by simply filing with the state. Many choose to not offer insurance in certain states due to the various regulation and laws which impact profitability. If Trump does not usurp state law and regulation he will not make any ground with expanding the number of companies selling in various states.

2. While not mentioned once it is safe to assume the elimination of pre existing conditions is planned, meaning if people are laid off and have a chronic condition they will not be covered for that condition. This is particularly devastating when medical emergencies happen during lapses of insurance coverage.

3. Block grants to expand Medicaid. What are the strings attached? Many states don't want to expand Medicaid.

I dont see one policy that reduces overall cost other than the eresumption of preexisting conditions.

The federal government will use the same trick it always does to change state laws, either invoke commerce clause, or just withhold funding.

As a matter of fact, the entire original reason why the founders put in the Commerce clause is to prevent states from setting up monopolies through laws like they do now.

The effect of the Fed's taking away state level health care insurance regulation means a national coverage standard. That detail of coverage is not explained in Trump's plan.
Greyparrot
Posts: 14,212
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10/15/2016 2:02:40 PM
Posted: 1 month ago
At 10/15/2016 1:59:56 PM, slo1 wrote:
At 10/15/2016 1:35:47 PM, Greyparrot wrote:
At 10/15/2016 11:23:25 AM, slo1 wrote:
https://www.donaldjtrump.com....

There are major issues with Trump's healthcare plan.

1. Trump wants a larger national insurance market and proposes creating sales across state lines, yet companies have to compile with state law.

Any health insurance company can already sell across state lines by simply filing with the state. Many choose to not offer insurance in certain states due to the various regulation and laws which impact profitability. If Trump does not usurp state law and regulation he will not make any ground with expanding the number of companies selling in various states.

2. While not mentioned once it is safe to assume the elimination of pre existing conditions is planned, meaning if people are laid off and have a chronic condition they will not be covered for that condition. This is particularly devastating when medical emergencies happen during lapses of insurance coverage.

3. Block grants to expand Medicaid. What are the strings attached? Many states don't want to expand Medicaid.

I dont see one policy that reduces overall cost other than the eresumption of preexisting conditions.

The federal government will use the same trick it always does to change state laws, either invoke commerce clause, or just withhold funding.

As a matter of fact, the entire original reason why the founders put in the Commerce clause is to prevent states from setting up monopolies through laws like they do now.

The effect of the Fed's taking away state level health care insurance regulation means a national coverage standard. That detail of coverage is not explained in Trump's plan.

In this case, taking away state regulations through the constitutional Commerce Clause will destroy the insurance monopolies wholly dependent on those regulations for their survival. There's a lot for the elites to lose this election.
slo1
Posts: 4,309
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10/15/2016 2:03:13 PM
Posted: 1 month ago
At 10/15/2016 1:31:48 PM, twocupcakes wrote:
At 10/15/2016 11:23:25 AM, slo1 wrote:
https://www.donaldjtrump.com....

There are major issues with Trump's healthcare plan.

1. Trump wants a larger national insurance market and proposes creating sales across state lines, yet companies have to compile with state law.

Any health insurance company can already sell across state lines by simply filing with the state. Many choose to not offer insurance in certain states due to the various regulation and laws which impact profitability. If Trump does not usurp state law and regulation he will not make any ground with expanding the number of companies selling in various states.

2. While not mentioned once it is safe to assume the elimination of pre existing conditions is planned, meaning if people are laid off and have a chronic condition they will not be covered for that condition. This is particularly devastating when medical emergencies happen during lapses of insurance coverage.

3. Block grants to expand Medicaid. What are the strings attached? Many states don't want to expand Medicaid.

I dont see one policy that reduces overall cost other than the eresumption of preexisting conditions.

Trump does not really have much of an alternative to Obamacare. He says he will "repeal Obamacare and replace it with something terrific". But, like his "secret plan" to defeat ISIS, he does not really have a plan. Trump is betting that by insulting and blaming others, people will flock to him. Trump is appealing to people with less than half a brain.

Also, Donald Trump has supported keeping pre-existing conditions in this election. Trump changes his position so often it is tough to keep up. But, if it were removed plenty of people would not be able to afford healthcare due to random chance. That is pretty 3rd world country.

TRUMP: I agree with that 100%, except pre-existing conditions, I would absolutely get rid of ObamaCare. I want to keep pre- existing conditions. It's a modern age, and I think we have to have it.

http://www.ontheissues.org...

Thanks for sharing the previous statements of preexisting conditions. I'm somewhat baffled why his own policy page does not state that.

Now I really don't see how his plans can lower health care costs.
Stymie13
Posts: 2,162
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10/15/2016 2:04:20 PM
Posted: 1 month ago
Please don't bring healthcare up. None of you know 5910 let alone pm call, utilization, true HIPAA (which eliminated pre-existing pursuant to continuity ... in 1996!).

All you will do is sound as misguided as dumbazz trump.

And yes, block grants are dumb. Expanding Medicaid DID come with strings... subsidies to the MCO's, which now make it cost prohibitive to offer plans in many states. Why the fvck do you think United, humans, anthem, etc.. pulled out of markets?
twocupcakes
Posts: 2,748
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10/15/2016 2:06:50 PM
Posted: 1 month ago
At 10/15/2016 2:03:13 PM, slo1 wrote:
At 10/15/2016 1:31:48 PM, twocupcakes wrote:
At 10/15/2016 11:23:25 AM, slo1 wrote:
https://www.donaldjtrump.com....

There are major issues with Trump's healthcare plan.

1. Trump wants a larger national insurance market and proposes creating sales across state lines, yet companies have to compile with state law.

Any health insurance company can already sell across state lines by simply filing with the state. Many choose to not offer insurance in certain states due to the various regulation and laws which impact profitability. If Trump does not usurp state law and regulation he will not make any ground with expanding the number of companies selling in various states.

2. While not mentioned once it is safe to assume the elimination of pre existing conditions is planned, meaning if people are laid off and have a chronic condition they will not be covered for that condition. This is particularly devastating when medical emergencies happen during lapses of insurance coverage.

3. Block grants to expand Medicaid. What are the strings attached? Many states don't want to expand Medicaid.

I dont see one policy that reduces overall cost other than the eresumption of preexisting conditions.

Trump does not really have much of an alternative to Obamacare. He says he will "repeal Obamacare and replace it with something terrific". But, like his "secret plan" to defeat ISIS, he does not really have a plan. Trump is betting that by insulting and blaming others, people will flock to him. Trump is appealing to people with less than half a brain.

Also, Donald Trump has supported keeping pre-existing conditions in this election. Trump changes his position so often it is tough to keep up. But, if it were removed plenty of people would not be able to afford healthcare due to random chance. That is pretty 3rd world country.

TRUMP: I agree with that 100%, except pre-existing conditions, I would absolutely get rid of ObamaCare. I want to keep pre- existing conditions. It's a modern age, and I think we have to have it.

http://www.ontheissues.org...

Thanks for sharing the previous statements of preexisting conditions. I'm somewhat baffled why his own policy page does not state that.

Now I really don't see how his plans can lower health care costs.

Yes, I completely agree with you that Trump's plan will do nothing to cut healthcare costs. Yet, he is continually bashing against Obamacare (which is Trump's same plan). Trump wants to convince voters that "he alone can solve" and that if he were in charge the country would have the same benefits of Obamacare but it would just cost less. It just does not make any sense. Only a fool would believe him.
twocupcakes
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10/15/2016 2:08:54 PM
Posted: 1 month ago
At 10/15/2016 2:04:20 PM, Stymie13 wrote:
Please don't bring healthcare up. None of you know 5910 let alone pm call, utilization, true HIPAA (which eliminated pre-existing pursuant to continuity ... in 1996!).

All you will do is sound as misguided as dumbazz trump.

And yes, block grants are dumb. Expanding Medicaid DID come with strings... subsidies to the MCO's, which now make it cost prohibitive to offer plans in many states. Why the fvck do you think United, humans, anthem, etc.. pulled out of markets?

If I am wrong, please correct me. How will Trump's plan reduce Obamacare costs, and what healthcare benefits will be lost?
Stymie13
Posts: 2,162
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10/15/2016 2:17:29 PM
Posted: 1 month ago
At 10/15/2016 2:08:54 PM, twocupcakes wrote:
At 10/15/2016 2:04:20 PM, Stymie13 wrote:
Please don't bring healthcare up. None of you know 5910 let alone pm call, utilization, true HIPAA (which eliminated pre-existing pursuant to continuity ... in 1996!).

All you will do is sound as misguided as dumbazz trump.

And yes, block grants are dumb. Expanding Medicaid DID come with strings... subsidies to the MCO's, which now make it cost prohibitive to offer plans in many states. Why the fvck do you think United, humans, anthem, etc.. pulled out of markets?

If I am wrong, please correct me. How will Trump's plan reduce Obamacare costs, and what healthcare benefits will be lost?

It won't. I wasn't defending him. He's statements are ignorant. Plans can already be offered in states but each state has a DOI which reviews every plan and makes sure it covers that's states min benefits.
slo1
Posts: 4,309
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10/15/2016 2:22:34 PM
Posted: 1 month ago
At 10/15/2016 2:02:40 PM, Greyparrot wrote:
At 10/15/2016 1:59:56 PM, slo1 wrote:
At 10/15/2016 1:35:47 PM, Greyparrot wrote:
At 10/15/2016 11:23:25 AM, slo1 wrote:
https://www.donaldjtrump.com....

There are major issues with Trump's healthcare plan.

1. Trump wants a larger national insurance market and proposes creating sales across state lines, yet companies have to compile with state law.

Any health insurance company can already sell across state lines by simply filing with the state. Many choose to not offer insurance in certain states due to the various regulation and laws which impact profitability. If Trump does not usurp state law and regulation he will not make any ground with expanding the number of companies selling in various states.

2. While not mentioned once it is safe to assume the elimination of pre existing conditions is planned, meaning if people are laid off and have a chronic condition they will not be covered for that condition. This is particularly devastating when medical emergencies happen during lapses of insurance coverage.

3. Block grants to expand Medicaid. What are the strings attached? Many states don't want to expand Medicaid.

I dont see one policy that reduces overall cost other than the eresumption of preexisting conditions.

The federal government will use the same trick it always does to change state laws, either invoke commerce clause, or just withhold funding.

As a matter of fact, the entire original reason why the founders put in the Commerce clause is to prevent states from setting up monopolies through laws like they do now.

The effect of the Fed's taking away state level health care insurance regulation means a national coverage standard. That detail of coverage is not explained in Trump's plan.

In this case, taking away state regulations through the constitutional Commerce Clause will destroy the insurance monopolies wholly dependent on those regulations for their survival. There's a lot for the elites to lose this election.

Insurance monopoly? Companies generally don't enter a market because of regulation and the pressure to be profitable. If those regulations are not addressed such as not allowing coverage exemptions for pre existing conditions the profit margin pressure is still there. Take away mandatory coverage, which brings low risk into the risk pool and the profit margin pressures are even larger causing price increases.

This is about regulation and coverage requirements, not monopolies.
Stymie13
Posts: 2,162
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10/15/2016 2:31:21 PM
Posted: 1 month ago
Damnit people. Pre-existing was made illegal in 96 unless:

1. One had individual insurance
2. One had no coverage for 6 months

It is a fvcking canard. Pre-existing is a term few understand.

https://www.dol.gov...
Greyparrot
Posts: 14,212
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10/15/2016 3:11:20 PM
Posted: 1 month ago
Backwards thinking: Monopolies be inefficient and bad for consumer...

Supports regulations and single payer system that creates a monopoly....
TeaPatriot
Posts: 203
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10/15/2016 4:04:24 PM
Posted: 1 month ago
At 10/15/2016 11:23:25 AM, slo1 wrote:
https://www.donaldjtrump.com....

There are major issues with Trump's healthcare plan.

1. Trump wants a larger national insurance market and proposes creating sales across state lines, yet companies have to compile with state law.

Any health insurance company can already sell across state lines by simply filing with the state. Many choose to not offer insurance in certain states due to the various regulation and laws which impact profitability. If Trump does not usurp state law and regulation he will not make any ground with expanding the number of companies selling in various states.

2. While not mentioned once it is safe to assume the elimination of pre existing conditions is planned, meaning if people are laid off and have a chronic condition they will not be covered for that condition. This is particularly devastating when medical emergencies happen during lapses of insurance coverage.

3. Block grants to expand Medicaid. What are the strings attached? Many states don't want to expand Medicaid.

I dont see one policy that reduces overall cost other than the eresumption of preexisting conditions.

Yeah I would prefer a private system
Chairman of Economic Forum Recovery
slo1
Posts: 4,309
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10/15/2016 4:23:08 PM
Posted: 1 month ago
At 10/15/2016 4:04:24 PM, TeaPatriot wrote:
At 10/15/2016 11:23:25 AM, slo1 wrote:
https://www.donaldjtrump.com....

There are major issues with Trump's healthcare plan.

1. Trump wants a larger national insurance market and proposes creating sales across state lines, yet companies have to compile with state law.

Any health insurance company can already sell across state lines by simply filing with the state. Many choose to not offer insurance in certain states due to the various regulation and laws which impact profitability. If Trump does not usurp state law and regulation he will not make any ground with expanding the number of companies selling in various states.

2. While not mentioned once it is safe to assume the elimination of pre existing conditions is planned, meaning if people are laid off and have a chronic condition they will not be covered for that condition. This is particularly devastating when medical emergencies happen during lapses of insurance coverage.

3. Block grants to expand Medicaid. What are the strings attached? Many states don't want to expand Medicaid.

I dont see one policy that reduces overall cost other than the eresumption of preexisting conditions.

Yeah I would prefer a private system

I would create a national healthcare insurance standard that uses high deductibles and remove all tax benefits for companies offering group plans to employees. To accompany that would be some sort of tax scheme for HSA accounts that can be used to pay for individual policy premiums, deductibles, etc so companies don't just pocket the money from not offering group insurance policies.

This would get people migrating to individual policies. The Fed can then work with states to provide assistance to subsidize premiums to whom they see fit.

Group insurance policies create very anti competitive environment and they cover fifty percent of all Americans. Individual policies and uninsured only accounts for 15 percent of the population. Trying to address health care costs by only addressing 15 percent of population is a waste of time and doomed to fail.

Move everyone to individual private policies including Medicare, Medicaid and Tricare and let's put in real competition to drive costs down.
slo1
Posts: 4,309
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10/15/2016 4:25:01 PM
Posted: 1 month ago
At 10/15/2016 4:10:44 PM, Stymie13 wrote:
Question for you smart folk: what is a sic? Why is it important?

I'm not smart so I don't know. What is a sic?
Tree_of_Death
Posts: 758
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10/15/2016 4:29:14 PM
Posted: 1 month ago
At 10/15/2016 4:10:44 PM, Stymie13 wrote:
Question for you smart folk: what is a sic? Why is it important?

When you're quoting somebody and there's a spelling or grammar error, you put [sic] afterwards to indicate that that was how the original author wrote it. I think it means "as written" or something like that.
"If life were easy, it wouldn't be difficult."--Kermit the Frog

#Treebrokethechurchbells--DD

"I am after all the purveyor of intellectually dishonest propaganda." --YYW
TeaPatriot
Posts: 203
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10/15/2016 5:06:31 PM
Posted: 1 month ago
At 10/15/2016 4:23:08 PM, slo1 wrote:
At 10/15/2016 4:04:24 PM, TeaPatriot wrote:
At 10/15/2016 11:23:25 AM, slo1 wrote:
https://www.donaldjtrump.com....

There are major issues with Trump's healthcare plan.

1. Trump wants a larger national insurance market and proposes creating sales across stiate lines, yet companies have to compile with state law.

Any health insurance company can already sell across state lines by simply filing with the state. Many choose to not offer insurance in certain states due to the various regulation and laws which impact profitability. If Trump does not usurp state law and regulation he will not make any ground with expanding the number of companies selling in various states.

2. While not mentioned once it is safe to assume the elimination of pre existing conditions is planned, meaning if people are laid off and have a chronic condition they will not be covered for that condition. This is particularly devastating when medical emergencies happen during lapses of insurance coverage.

3. Block grants to expand Medicaid. What are the strings attached? Many states don't want to expand Medicaid.

I dont see one policy that reduces overall cost other than the eresumption of preexisting conditions.

Yeah I would prefer a private system

I would create a national healthcare insurance standard that uses high deductibles and remove all tax benefits for companies offering group plans to employees. To accompany that would be some sort of tax scheme for HSA accounts that can be used to pay for individual policy premiums, deductibles, etc so companies don't just pocket the money from not offering group insurance policies.

This would get people migrating to individual policies. The Fed can then work with states to provide assistance to subsidize premiums to whom they see fit.

Group insurance policies create very anti competitive environment and they cover fifty percent of all Americans. Individual policies and uninsured only accounts for 15 percent of the population. Trying to address health care costs by only addressing 15 percent of population is a waste of time and doomed to fail.

Move everyone to individual private policies including Medicare, Medicaid and Tricare and let's put in real competition to drive costs down.

I agree with most of what you said but not with a national standard of health insurance

Private buisnesses will build the best possible insurance if they a they are allowed to
Chairman of Economic Forum Recovery
Ramshutu
Posts: 4,063
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10/15/2016 5:14:25 PM
Posted: 1 month ago
At 10/15/2016 2:22:34 PM, slo1 wrote:
At 10/15/2016 2:02:40 PM, Greyparrot wrote:
At 10/15/2016 1:59:56 PM, slo1 wrote:
At 10/15/2016 1:35:47 PM, Greyparrot wrote:
At 10/15/2016 11:23:25 AM, slo1 wrote:
https://www.donaldjtrump.com....

There are major issues with Trump's healthcare plan.

1. Trump wants a larger national insurance market and proposes creating sales across state lines, yet companies have to compile with state law.

Any health insurance company can already sell across state lines by simply filing with the state. Many choose to not offer insurance in certain states due to the various regulation and laws which impact profitability. If Trump does not usurp state law and regulation he will not make any ground with expanding the number of companies selling in various states.

2. While not mentioned once it is safe to assume the elimination of pre existing conditions is planned, meaning if people are laid off and have a chronic condition they will not be covered for that condition. This is particularly devastating when medical emergencies happen during lapses of insurance coverage.

3. Block grants to expand Medicaid. What are the strings attached? Many states don't want to expand Medicaid.

I dont see one policy that reduces overall cost other than the eresumption of preexisting conditions.

The federal government will use the same trick it always does to change state laws, either invoke commerce clause, or just withhold funding.

As a matter of fact, the entire original reason why the founders put in the Commerce clause is to prevent states from setting up monopolies through laws like they do now.

The effect of the Fed's taking away state level health care insurance regulation means a national coverage standard. That detail of coverage is not explained in Trump's plan.

In this case, taking away state regulations through the constitutional Commerce Clause will destroy the insurance monopolies wholly dependent on those regulations for their survival. There's a lot for the elites to lose this election.

Insurance monopoly? Companies generally don't enter a market because of regulation and the pressure to be profitable. If those regulations are not addressed such as not allowing coverage exemptions for pre existing conditions the profit margin pressure is still there. Take away mandatory coverage, which brings low risk into the risk pool and the profit margin pressures are even larger causing price increases.

This is about regulation and coverage requirements, not monopolies.

From what I understand, regulations have little to do with it. I mean, while there is variation, what is the prohibitive regulatory cost of starting to offer insurance in Nebraska or Kansas if you already offer it in New York, sure things like licenses and approvals to offer the insurance in the first could be an additional cost, it isn't like they are prohibitive for profit in a new state,

What regulations are there that a large insurance company offering insurance in a new state that would be solved by federal level regulation?

From what I understand, the barrier to entry is more concerning the inability for new companies to negotiate cheaper terms with doctors and hospitals; which I don't believe falls into the realm of things that are regulated for.
Stymie13
Posts: 2,162
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10/15/2016 5:19:57 PM
Posted: 1 month ago
At 10/15/2016 4:25:01 PM, slo1 wrote:
At 10/15/2016 4:10:44 PM, Stymie13 wrote:
Question for you smart folk: what is a sic? Why is it important?

I'm not smart so I don't know. What is a sic?

You and tree: sic means service industry code. Analytics, Ge, gender determines premium. It's not the only factor but primary driver. Everything is based on numbers and analytic predictive modeling. Don't know the diff between icd 9 -10? Listen don't talk. Those clowns in DC have no clue, neither does your hr rep. Please humor me: what's a cert?
Greyparrot
Posts: 14,212
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10/15/2016 5:41:52 PM
Posted: 1 month ago
At 10/15/2016 5:14:25 PM, Ramshutu wrote:

From what I understand, the barrier to entry is more concerning the inability for new companies to negotiate cheaper terms with doctors and hospitals; which I don't believe falls into the realm of things that are regulated for.

Right now, in nearly every state, insurance is regulated at the state level. If you live in New York, like I do, you can"t buy insurance from a company in Connecticut or New Jersey, or even better, Utah. Why does this matter? Because state governments, at the behest of lobbyists, enact insurance mandates requiring all plans in a state to cover, say, acupuncture or fertility treatments. Insurance mandates can raise the costs of premiums by 30-50 percent. If I could buy insurance from another state, where regulations are less onerous, I might not be forced to buy a policy that covers drug-abuse counseling.

State insurance mandates drive up premium costs

Even more onerous are the regulations in states like New York that have guaranteed-issue and community rating laws, without an individual mandate, such that young, healthy people are forced to pay far more for insurance than they should, leading many to drop out of the system. Again, I could buy a more affordable plan if I could buy insurance in a state that doesn"t have those mandates. "Allowing individuals and businesses to purchase coverage across state lines would create more competitive insurance markets," notes Devon Herrick.

http://www.forbes.com...
slo1
Posts: 4,309
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10/15/2016 10:39:57 PM
Posted: 1 month ago
At 10/15/2016 5:41:52 PM, Greyparrot wrote:
At 10/15/2016 5:14:25 PM, Ramshutu wrote:

From what I understand, the barrier to entry is more concerning the inability for new companies to negotiate cheaper terms with doctors and hospitals; which I don't believe falls into the realm of things that are regulated for.

Right now, in nearly every state, insurance is regulated at the state level. If you live in New York, like I do, you can"t buy insurance from a company in Connecticut or New Jersey, or even better, Utah. Why does this matter? Because state governments, at the behest of lobbyists, enact insurance mandates requiring all plans in a state to cover, say, acupuncture or fertility treatments. Insurance mandates can raise the costs of premiums by 30-50 percent. If I could buy insurance from another state, where regulations are less onerous, I might not be forced to buy a policy that covers drug-abuse counseling.

State insurance mandates drive up premium costs

Even more onerous are the regulations in states like New York that have guaranteed-issue and community rating laws, without an individual mandate, such that young, healthy people are forced to pay far more for insurance than they should, leading many to drop out of the system. Again, I could buy a more affordable plan if I could buy insurance in a state that doesn"t have those mandates. "Allowing individuals and businesses to purchase coverage across state lines would create more competitive insurance markets," notes Devon Herrick.

http://www.forbes.com...

Exactly, which reinforces my point. Trump will have to create a national standard and usurp state regulation. He however has not indicated what the coverage or mandates are. They could be mandates which raise, keep the same, or lower premiums. If he is not requiring all to purchase plans and is keeping the current pre existing conditions mandates he will not reduce premiums without slashing coverage elsewhere.
Ramshutu
Posts: 4,063
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10/15/2016 10:56:33 PM
Posted: 1 month ago
At 10/15/2016 5:41:52 PM, Greyparrot wrote:
At 10/15/2016 5:14:25 PM, Ramshutu wrote:

From what I understand, the barrier to entry is more concerning the inability for new companies to negotiate cheaper terms with doctors and hospitals; which I don't believe falls into the realm of things that are regulated for.

Right now, in nearly every state, insurance is regulated at the state level. If you live in New York, like I do, you can"t buy insurance from a company in Connecticut or New Jersey, or even better, Utah. Why does this matter? Because state governments, at the behest of lobbyists, enact insurance mandates requiring all plans in a state to cover, say, acupuncture or fertility treatments. Insurance mandates can raise the costs of premiums by 30-50 percent. If I could buy insurance from another state, where regulations are less onerous, I might not be forced to buy a policy that covers drug-abuse counseling.

State insurance mandates drive up premium costs

Even more onerous are the regulations in states like New York that have guaranteed-issue and community rating laws, without an individual mandate, such that young, healthy people are forced to pay far more for insurance than they should, leading many to drop out of the system. Again, I could buy a more affordable plan if I could buy insurance in a state that doesn"t have those mandates. "Allowing individuals and businesses to purchase coverage across state lines would create more competitive insurance markets," notes Devon Herrick.

http://www.forbes.com...

That makes a little sense! Obviously, if health insurance is mandated to include certain features, it will drive premiums up.

However, it seems that the argument being presented is one that is a bit arse-about-face.

The reason it is a little bit arse about face; is that what you're talking about doesn't really have much to do with Monopolies.

After all, if a state mandates X features in the provided insurance, then any company should be able to provide insurance that has those features.

While it would be true that NY health insurance maybe more expensive than, say, Nebraska insurance; there shouldn't be any logical reason why multiple companies can compete in NY that would drive the costs down.

Obviously, it would be true that your premiums would be higher than someone in another state; but what you're talking about doesn't seem to be particularly related to the preventing a state-wide monopoly, does it?

As I said, the barrier to entry isn't the regulation; and this seems to still be true here. If a relatively large company operating in a different state wants to compete in NY; even though there are more mandates, those mandates themselves aren't the problem, it's the ability to get cheaper deals with the doctors and hospitals that provide them.

As I said, while the insurance would be higher cost in NY vs NE, you should still be able to have competition and drive costs down; after all, everyone is playing by the same rules.

Now what you're actually suggesting is, I suspect, actually rather sneaky. Lets take a hypothetical example of Mental Health; i don't know what the state and federal mandates are but lets say, for the sake of example, that NY mandates mental health coverage, and NE doesn't.

Ignoring the personal opinions of many people here, I'm sure; you decide that you don't need coverage for Mental Health, and decide to buy a policy from Nebraska from a different company that doesn't operate in NY.

In that case, there most certainly needs to be some sort of agreement, or regulation to allow that other company to pay doctors and hospitals the same amount as an insurance company has negotiated in NY; which in itself would be the solution that allows for competition.

So you pay less for your insurance in NY; but people who are living in NY and have a NY policy have to then pay more; because the people who use mental health facilities in NY paid for by NY insurance (and presumably other states that mandate it to) now have fewer people paying their premiums, so that increases the cost of NY insurance premiums.

So, it would seem on the face of it, that if enough people did that; the cost of insurance for people who need or want Mental Health insurance now becomes prohibitive.

The only real solution is to make federal level mandates that everyone can agree on to ensure that the cost is spread around all policy holders; which seems to undermine the very argument you are making to decrease prices by allowing insurance policies to cross state.

But, I suspect that isn't what you mean; what you really mean, and hence the sneaky part; is to roll back the mandates at a federal level.

While I'm sure there are some mandates I'm sure you and I would agree on, there are some that I won't for the reasons I've outlined above.

In reality, I think the whole system is pretty insane; because it's a system that incentivizes providers providing health care that is justifiable but not strictly speaking necessary, and incentivizes insurance companies to not insure people who need health care; neither of which are in the best interests of the people who need healthcare.
Stymie13
Posts: 2,162
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10/17/2016 12:09:38 AM
Posted: 1 month ago
At 10/15/2016 10:56:33 PM, Ramshutu wrote:
At 10/15/2016 5:41:52 PM, Greyparrot wrote:
At 10/15/2016 5:14:25 PM, Ramshutu wrote:

From what I understand, the barrier to entry is more concerning the inability for new companies to negotiate cheaper terms with doctors and hospitals; which I don't believe falls into the realm of things that are regulated for.

Right now, in nearly every state, insurance is regulated at the state level. If you live in New York, like I do, you can"t buy insurance from a company in Connecticut or New Jersey, or even better, Utah. Why does this matter? Because state governments, at the behest of lobbyists, enact insurance mandates requiring all plans in a state to cover, say, acupuncture or fertility treatments. Insurance mandates can raise the costs of premiums by 30-50 percent. If I could buy insurance from another state, where regulations are less onerous, I might not be forced to buy a policy that covers drug-abuse counseling.

State insurance mandates drive up premium costs

Even more onerous are the regulations in states like New York that have guaranteed-issue and community rating laws, without an individual mandate, such that young, healthy people are forced to pay far more for insurance than they should, leading many to drop out of the system. Again, I could buy a more affordable plan if I could buy insurance in a state that doesn"t have those mandates. "Allowing individuals and businesses to purchase coverage across state lines would create more competitive insurance markets," notes Devon Herrick.

http://www.forbes.com...

That makes a little sense! Obviously, if health insurance is mandated to include certain features, it will drive premiums up.

However, it seems that the argument being presented is one that is a bit arse-about-face.

The reason it is a little bit arse about face; is that what you're talking about doesn't really have much to do with Monopolies.

After all, if a state mandates X features in the provided insurance, then any company should be able to provide insurance that has those features.

While it would be true that NY health insurance maybe more expensive than, say, Nebraska insurance; there shouldn't be any logical reason why multiple companies can compete in NY that would drive the costs down.

Obviously, it would be true that your premiums would be higher than someone in another state; but what you're talking about doesn't seem to be particularly related to the preventing a state-wide monopoly, does it?

As I said, the barrier to entry isn't the regulation; and this seems to still be true here. If a relatively large company operating in a different state wants to compete in NY; even though there are more mandates, those mandates themselves aren't the problem, it's the ability to get cheaper deals with the doctors and hospitals that provide them.

As I said, while the insurance would be higher cost in NY vs NE, you should still be able to have competition and drive costs down; after all, everyone is playing by the same rules.

Now what you're actually suggesting is, I suspect, actually rather sneaky. Lets take a hypothetical example of Mental Health; i don't know what the state and federal mandates are but lets say, for the sake of example, that NY mandates mental health coverage, and NE doesn't.

Ignoring the personal opinions of many people here, I'm sure; you decide that you don't need coverage for Mental Health, and decide to buy a policy from Nebraska from a different company that doesn't operate in NY.

In that case, there most certainly needs to be some sort of agreement, or regulation to allow that other company to pay doctors and hospitals the same amount as an insurance company has negotiated in NY; which in itself would be the solution that allows for competition.

So you pay less for your insurance in NY; but people who are living in NY and have a NY policy have to then pay more; because the people who use mental health facilities in NY paid for by NY insurance (and presumably other states that mandate it to) now have fewer people paying their premiums, so that increases the cost of NY insurance premiums.

So, it would seem on the face of it, that if enough people did that; the cost of insurance for people who need or want Mental Health insurance now becomes prohibitive.

The only real solution is to make federal level mandates that everyone can agree on to ensure that the cost is spread around all policy holders; which seems to undermine the very argument you are making to decrease prices by allowing insurance policies to cross state.

But, I suspect that isn't what you mean; what you really mean, and hence the sneaky part; is to roll back the mandates at a federal level.

While I'm sure there are some mandates I'm sure you and I would agree on, there are some that I won't for the reasons I've outlined above.

In reality, I think the whole system is pretty insane; because it's a system that incentivizes providers providing health care that is justifiable but not strictly speaking necessary, and incentivizes insurance companies to not insure people who need health care; neither of which are in the best interests of the people who need healthcare.

A couple of things:

*every plan offered in a state is reviewed by that states DOI for several things (including premiums... and their increases) BEFORE it can be offered. Meaning every health plan has gov approval
* the whole 'across state lines' is a canard. Companies can already do that
* premiums are based off risk and risk pool. That's based off utilization. It is called pmpm (per member per month) that's why the Medicaid expansion has resulted in fewer companies participating now. State numbers were faulty resulting in lower pmpm by MCO's. Once MCO's had their own data, they had to raise prices. Subsidies decreased every year. MCO's would operate at a loss. Hence pull out of market
* individual plans: see above

There are multiple things I could list but politicians don't understand this stuff. Most practitioners don't understand their contracts. Many if not most in the payer portion of the industry may know their piece but not understand how everything fits together: individual/government/employer based, claims, transactions, regulations, coding, reimbursemement methodolgies...

Listening to people in office or running for office is a recipe for misinformation. Why? They just don't know how it works.
kevin24018
Posts: 1,804
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10/17/2016 1:23:53 PM
Posted: 1 month ago
At 10/15/2016 5:19:57 PM, Stymie13 wrote:
At 10/15/2016 4:25:01 PM, slo1 wrote:
At 10/15/2016 4:10:44 PM, Stymie13 wrote:
Question for you smart folk: what is a sic? Why is it important?

I'm not smart so I don't know. What is a sic?

You and tree: sic means service industry code. Analytics, Ge, gender determines premium. It's not the only factor but primary driver. Everything is based on numbers and analytic predictive modeling. Don't know the diff between icd 9 -10? Listen don't talk. Those clowns in DC have no clue, neither does your hr rep. Please humor me: what's a cert?

and the rest of the world is up to what? icd 15 or something, none of that crap really matters, for example, you can no longer put "tick bite" as a dx code, you need a specific location, but why? what does it matter if it was on the arm or leg? most of this crap doesn't change or effect treatment, just more bs
Stymie13
Posts: 2,162
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10/17/2016 1:50:54 PM
Posted: 1 month ago
At 10/17/2016 1:23:53 PM, kevin24018 wrote:
At 10/15/2016 5:19:57 PM, Stymie13 wrote:
At 10/15/2016 4:25:01 PM, slo1 wrote:
At 10/15/2016 4:10:44 PM, Stymie13 wrote:
Question for you smart folk: what is a sic? Why is it important?

I'm not smart so I don't know. What is a sic?

You and tree: sic means service industry code. Analytics, Ge, gender determines premium. It's not the only factor but primary driver. Everything is based on numbers and analytic predictive modeling. Don't know the diff between icd 9 -10? Listen don't talk. Those clowns in DC have no clue, neither does your hr rep. Please humor me: what's a cert?

and the rest of the world is up to what? icd 15 or something, none of that crap really matters, for example, you can no longer put "tick bite" as a dx code, you need a specific location, but why? what does it matter if it was on the arm or leg? most of this crap doesn't change or effect treatment, just more bs

Actually the rest of the world has been on icd 10 since the late 90's. We didn't change until cams could upgrade what's called FISS. There is no higher that icd10. It expanded dings from 15000 to 75000. No plan worldwide to expan icd 10 but cpt 6 is being worked on.

The point of the whole thing is this: neither candidate nor anyone in gov and most in the industry have a clue on how to bring cost down. And they can't because it is Americans utilization.

They aren't analogous but they are synonymous. What happens with too many car claims or home owners claims? What does State Farm, geico, progressive do? Either your premium goes through the roof or you are dropped.

In my world, I tell people to go negotiate your own rate with your doc. Take away the protection of the evil hmo. Negotiate your own heart rate med with Pfizer.
kevin24018
Posts: 1,804
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10/17/2016 1:56:33 PM
Posted: 1 month ago
At 10/17/2016 1:50:54 PM, Stymie13 wrote:
At 10/17/2016 1:23:53 PM, kevin24018 wrote:
At 10/15/2016 5:19:57 PM, Stymie13 wrote:
At 10/15/2016 4:25:01 PM, slo1 wrote:
At 10/15/2016 4:10:44 PM, Stymie13 wrote:
Question for you smart folk: what is a sic? Why is it important?

I'm not smart so I don't know. What is a sic?

You and tree: sic means service industry code. Analytics, Ge, gender determines premium. It's not the only factor but primary driver. Everything is based on numbers and analytic predictive modeling. Don't know the diff between icd 9 -10? Listen don't talk. Those clowns in DC have no clue, neither does your hr rep. Please humor me: what's a cert?

and the rest of the world is up to what? icd 15 or something, none of that crap really matters, for example, you can no longer put "tick bite" as a dx code, you need a specific location, but why? what does it matter if it was on the arm or leg? most of this crap doesn't change or effect treatment, just more bs

Actually the rest of the world has been on icd 10 since the late 90's. We didn't change until cams could upgrade what's called FISS. There is no higher that icd10. It expanded dings from 15000 to 75000. No plan worldwide to expan icd 10 but cpt 6 is being worked on.

The point of the whole thing is this: neither candidate nor anyone in gov and most in the industry have a clue on how to bring cost down. And they can't because it is Americans utilization.

They aren't analogous but they are synonymous. What happens with too many car claims or home owners claims? What does State Farm, geico, progressive do? Either your premium goes through the roof or you are dropped.

In my world, I tell people to go negotiate your own rate with your doc. Take away the protection of the evil hmo. Negotiate your own heart rate med with Pfizer.

yes and I think lowering monthly payment and increasing some co-pays will help with over utilization, though I think most who are covered by private tend to only use it when needed, unlike the constant flow of medicaid patients into e.r.s with none emergent problems, I can remember before they gave taxi vouchers people calling ambulances for regular simple none emergency illness or problems. Health care is another resource that shouldn't be wasted.
Stymie13
Posts: 2,162
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10/17/2016 2:32:31 PM
Posted: 1 month ago
At 10/17/2016 1:56:33 PM, kevin24018 wrote:
At 10/17/2016 1:50:54 PM, Stymie13 wrote:
At 10/17/2016 1:23:53 PM, kevin24018 wrote:
At 10/15/2016 5:19:57 PM, Stymie13 wrote:
At 10/15/2016 4:25:01 PM, slo1 wrote:
At 10/15/2016 4:10:44 PM, Stymie13 wrote:
Question for you smart folk: what is a sic? Why is it important?

I'm not smart so I don't know. What is a sic?

You and tree: sic means service industry code. Analytics, Ge, gender determines premium. It's not the only factor but primary driver. Everything is based on numbers and analytic predictive modeling. Don't know the diff between icd 9 -10? Listen don't talk. Those clowns in DC have no clue, neither does your hr rep. Please humor me: what's a cert?

and the rest of the world is up to what? icd 15 or something, none of that crap really matters, for example, you can no longer put "tick bite" as a dx code, you need a specific location, but why? what does it matter if it was on the arm or leg? most of this crap doesn't change or effect treatment, just more bs

Actually the rest of the world has been on icd 10 since the late 90's. We didn't change until cams could upgrade what's called FISS. There is no higher that icd10. It expanded dings from 15000 to 75000. No plan worldwide to expan icd 10 but cpt 6 is being worked on.

The point of the whole thing is this: neither candidate nor anyone in gov and most in the industry have a clue on how to bring cost down. And they can't because it is Americans utilization.

They aren't analogous but they are synonymous. What happens with too many car claims or home owners claims? What does State Farm, geico, progressive do? Either your premium goes through the roof or you are dropped.

In my world, I tell people to go negotiate your own rate with your doc. Take away the protection of the evil hmo. Negotiate your own heart rate med with Pfizer.

yes and I think lowering monthly payment and increasing some co-pays will help with over utilization, though I think most who are covered by private tend to only use it when needed, unlike the constant flow of medicaid patients into e.r.s with none emergent problems, I can remember before they gave taxi vouchers people calling ambulances for regular simple none emergency illness or problems. Health care is another resource that shouldn't be wasted.

Utilization per 1000 (to adjust trends) was within 4% for employer/Medicaid but higher for Medicare (expected, aged population). There is no way for me to condense 30% of the economy into a snippet. Hell the fed numbers put out per year is a 400 page manual. And that doesn't address history, finances,states, etc...

My basic point is simple: increasing utilization over decades has driven cost, all parties are guilty in the current mess (payers, drug companies, government both state and fed, practitioners, facilities, and yes, the 320 million wonderful citizens). There is not 1 thing that will do much of anything, block grants are flat stupid, and single payer is in no way a serious notion for so many reasons I won't even start listing (including Medicare for all).