I also don't get it. SC won't hear the "mandate" issue again. Not that it matters. Ramming something so controversial through congress totally backfired. It gave us a completely Republican controlled govt. It gave us "Hitler". Hopefully people learned their lesson...
Congress repealing the mandate is what changed since Roberts and the SC weighed in. That's the basis on which the judge claimed to take it up again. The whole law, without the mandate which underpinned the whole law itself.
Agree. Do we really think the American public is going to support being taxed up to 60% to pay for single payor though? I know the projection is somewhere along the lines of upto a 40% reduction in physician salary to help pay for it. I think the mandate being eliminated will not destroy the whole bill unless they really link overall lack of constitutionality to the entire thing.
I don't think the law changed enough so that it now violates our constitutional rights. I think it's more constitutional now, without the mandate, workable or not.
It does seem more likely by the day that the purpose of the ACA was to push the country into single payer. The vitriol that I hear on a daily basis from patients from all walks of life towards private insurance companies is telling. I think the current system is on its last legs.
Or they will just fiscally stimulate and take on more government debt.
Medicare advantage will not be tenable politically IF there’s a big increase in taxes. These plans are basically catastrophic coverage where there’s high co-insurance for most health care services. It’s great if you’re healthy, but it doesn’t cover jack s***. Without drastic decrease in the actual cost of care, none of these payment models are viable long term.
That's... that's not at all what Medicare Advantage plans are.
This plan is better than what is offered in my county (which covers a lot less), but still isn't great. A lot of the cost is still pushed onto older individuals on fixed income.
You and I must be reading this very differently.
I'm a specialist, so that's probably why our patients are affected differently. $40 (it's 50 in my county) for each specialist visit adds up quickly when one is on fixed income, and many seniors with health problems see multiple specialists. I literally have patients tell me every week that they can't come in because they can't afford the $50 copay.
Any changes to the system will result in apocalyptic outcry. If you killed off the Advantage plans, everyone who is happy with Kaiser would go bonkers also.
There’s outcry with the status quo right now. The easiest political route for the policy makers is to go universal coverage while forcing down prices and running up public debt.
Medicare part B is little better - its 20% with no maximum. For some testing that's less, for some it will be more.
I agree but isn't that what Medicaid is supposed to be?
No because everyone does not qualify for Medicaid
Is this plan going to replace Medicare?
It sounds like Medicaid For All.
Sadly it seems like my Medicaid patients actually get some of the best overall care, especially considering the comorbidities. Probably unique to my area as Medicaid contracted out management to a private company, but I have less hassle than private insurance getting things authorized, it pays better than Medicare, and when I do need to do a peer to peer the call goes directly to an actual doctor, who I’ve generally found reasonable.
I do think we'll end up in a UK-type system.
Actually I think most people would be ok with it if it's executed well. But any conflicts or issues will be magnified 10000% by the opposing party/media.
Depends on how bare bones the coverage is
there is a difference between providing care for the indigent/poor and providing care for the elderly and disabled.
Do you think this would be better than VA Care for All (obviously with a less toxic name)?. That is, the govt has clinics and hospitals with employed docs/pharmacy/labs/imaging to provide basic, free care for all. Within this system, no pre-auths, no insurance, no profit motivations. If you want better, you pay for it on the outside...
