Trump's healthcare policy
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Trump's healthcare policy

By anotheraccount following x   2016 Mar 2, 4:17pm 10,834 views   42 comments   watch   sfw   quote     share    


https://www.donaldjtrump.com/positions/healthcare-reform

Point #5: Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.

Does Hillary have anything like that on her website? Nope.

https://www.hillaryclinton.com/issues/health-care/

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3   iwog   ignore (3)   2016 Mar 2, 4:29pm   ↑ like (5)   ↓ dislike (2)     quote      

tr6 says

His formula is really simple. Switch everyone to HSAs, allow deduction of healthcare premiums for individuals, let everyone find out true prices. I think it will work. (and repeal ObamaCare)

How is that different from now other than the fact HSAs will become mandatory and HMOs and other health insurance would be outlawed?

This doesn't fix the fundamental problem of the health care mafia being legally allowed to run up a million dollars worth of hospital bills without giving you a quote or an estimate, which in itself is disingenuous as hell because hospitals ROUTINELY (and I know this from negotiating hospital bills for decades) decide how much they are going to charge for a procedure on the basis of ability to pay and nothing else.

4   anotheraccount   ignore (1)   2016 Mar 2, 4:55pm   ↑ like (3)   ↓ dislike (0)     quote      

iwog says

ow is that different from now other than the fact HSAs will become mandatory and HMOs and other health insurance would be outlawed?

Not really that different. It's been talked about for a long time and never fully implemented.

iwog says

This doesn't fix the fundamental problem of the health care mafia being legally allowed to run up a million dollars worth of hospital bills

Well, at least prices will be transparent. Things like Sutter ultrasound billed as four different procedure codes for $2000 will become more visible.

The point is that Hillary thinks that ObamaCare as it exists right now is ok.

5   anotheraccount   ignore (1)   2016 Mar 2, 4:58pm   ↑ like (2)   ↓ dislike (0)     quote      

I saw a Sutter affiliated doctor last year. Just in case, he send me to get an x-ray at the Sutter hospital nearby. I wonder what's his kick back. I did not do it even though it would not cost me anything. I knew it would be a difference between $50-70 at another facility or $1500 at Sutter for the insurance company.

6   FNWGMOBDVZXDNW   ignore (2)   2016 Mar 2, 7:23pm   ↑ like (0)   ↓ dislike (0)     quote      

If true, this is the best idea to come out of the Donald's campaign. It does contradict the idea that he would negotiate great prices for Medicare, but it's s good idea.

7   anotheraccount   ignore (1)   2016 Mar 2, 7:32pm   ↑ like (0)   ↓ dislike (0)     quote      

YesYNot says

It does contradict the idea that he would negotiate great prices for Medicare, but it's s good idea.

Actually, it does not. Medicare is a separate thing all together. Because of Medicare Part D passed under Bush and ACA passed under Obama, the government can't negotiate drug prices.

8   FNWGMOBDVZXDNW   ignore (2)   2016 Mar 2, 7:38pm   ↑ like (0)   ↓ dislike (1)     quote      

Using group buying power to negotiate prices is precisely why hospitals don't have clear billing. They charge everybody a different amount. You can't argue that you would be the best negotiator one day and then say you will make prices transparent the next day.

9   anotheraccount   ignore (1)   2016 Mar 2, 7:45pm   ↑ like (2)   ↓ dislike (0)     quote      

YesYNot says

Using group buying power to negotiate prices is precisely why hospitals don't have clear billing.

That's BS. In Northern Cal, Sutter is a monopoly in many areas. Part of Sutter's contract negotiations with insurance companies is that prices can't be made public. That has nothing to do with group buying power.

10   FNWGMOBDVZXDNW   ignore (2)   2016 Mar 3, 4:41am   ↑ like (0)   ↓ dislike (0)     quote      

Group buying power is why people are negotiating on prices instead of using market principles in the first place.

11   errc   ignore (2)   2016 Mar 3, 5:26am   ↑ like (0)   ↓ dislike (1)     quote      

The whole reason insurance supposedly exists is to pool funds

The notion of group buying power is very dumb

12   FNWGMOBDVZXDNW   ignore (2)   2016 Mar 3, 5:45am   ↑ like (2)   ↓ dislike (0)     quote      

IMO, the fact that hospitals can charge different people different amounts of money is dumb. As long as it is legal to charge different people different prices, the idea that insurance companies or the government would negotiate and use group buying power to do so is not dumb.
But wholesale prices are always negotiable and based on the size of orders in our society, so health care is not special in that sense.

13   errc   ignore (2)   2016 Mar 3, 5:58am   ↑ like (1)   ↓ dislike (1)     quote      

Whats really dumb is the idiots that voted for, or supported, Ppaca, the law requiring everyone to fork over very large sums of money to these worthless corporations

14   FNWGMOBDVZXDNW   ignore (2)   2016 Mar 3, 7:32am   ↑ like (2)   ↓ dislike (0)     quote      

I've never been told that I could not find out the cost of a car until after I bought it and signed something stating that I would pay for any charges that the seller saw fit to add on. I was told that prior to my last surgery, which was a fairly simple procedure.

The issue with health care is that an insurance company is allowed to negotiate a group rate, but the retail consumer who needs health care on a time-sensitive basis is picked up, laid across the desk, and asked to sign away rights to be raped in a not yet disclosed fashion.

15   zzyzzx   ignore (1)   2016 Mar 3, 7:45am   ↑ like (3)   ↓ dislike (0)     quote      

iwog says

This doesn't fix the fundamental problem of the health care mafia being legally allowed to run up a million dollars worth of hospital bills without giving you a quote or an estimate, which in itself is disingenuous as hell because hospitals ROUTINELY (and I know this from negotiating hospital bills for decades) decide how much they are going to charge for a procedure on the basis of ability to pay and nothing else.

There is no one thing that is going to fix all healthcare issues. Transparent pricing and HSA's are a big improvement, since it should make routine medical care less expensive. The other stuff like what you mention (presumably you are referring to emergency care) about what hospitals do can be addressed separately.

16   FNWGMOBDVZXDNW   ignore (2)   2016 Mar 3, 7:53am   ↑ like (0)   ↓ dislike (0)     quote      

Ironman says

So you want to compare buying a car, an inanimate object just sitting there, to going in and having surgery in a hospital?

Do you really think that everyone reading this is too stupid to notice that you are the one who made the comparison in the first place? Did you notice that yourself?

Are you in favor of the current situation where patients have to sign something stating that they will pay whatever charges are deemed appropriate after service?

17   mell   ignore (1)   2016 Mar 3, 8:09am   ↑ like (3)   ↓ dislike (0)     quote      

Best plan ever suggested.

zzyzzx says

iwog says

This doesn't fix the fundamental problem of the health care mafia being legally allowed to run up a million dollars worth of hospital bills without giving you a quote or an estimate, which in itself is disingenuous as hell because hospitals ROUTINELY (and I know this from negotiating hospital bills for decades) decide how much they are going to charge for a procedure on the basis of ability to pay and nothing else.

There is no one thing that is going to fix all healthcare issues. Transparent pricing and HSA's are a big improvement, since it should make routine medical care less expensive. The other stuff like what you mention (presumably you are referring to emergency care) about what hospitals do can be addressed separately.

Agreed. Actually Transparent pricing and HSA's with allowed accumulation and passing on do fix quite a bit of it. It's obvious that a lot of people are let by their emotions and convictions when they try to rip apart Trumps proposals. On taxes, healthcare and immigration he is a clear winner so far.

18   bob2356   ignore (1)   2016 Mar 3, 8:44am   ↑ like (0)   ↓ dislike (1)     quote      

mell says

Agreed. Actually Transparent pricing and HSA's with allowed accumulation and passing on do fix quite a bit of it.

No it doesn't fix quite a bit of it. It fixes a little bit of the symptoms without doing anything about the underlying disease.

19   FNWGMOBDVZXDNW   ignore (2)   2016 Mar 3, 9:11am   ↑ like (0)   ↓ dislike (0)     quote      

Ironman says

Have you ever sat down with a billing person and actually ASKED for a breakdown on charges BEFORE your medical treatment?

Of course you haven't.... it's because you have insurance, so you don't ASK.

This is not true. I broke my collarbone, and the surgery was elective, but it was time sensitive, because there is a window of opportunity when bones stitch back together. In the end, my expenses were around $3500, which was my deductible.

The day after I had my initial doctors appointment, I called the hospital and my insurance company to find out what the costs would be. I was not able to get a lick of information from either party. I didn't have a choice of hospital, because my doctor has a relationship with a particular hospital (as they generally do). I called the hospital four times as a matter of principal. They gave me nothing. I couldn't delay, because of the time window.

The bill was a joke. The original bill was over $30,000 for this approximately less than 1 hr procedure. The negotiated cost was something like $6,000, of which I may have paid $2000 or $2500 or something. The insurance paid the rest. I had other costs including PT. Out of pocket on the year it was about $3500.

The overall cost was annoying, but wasn't a huge deal for me. But this system is crap. There are unknowns when you go into a surgery, but they give you no information ahead of time, and it is not a free market for the consumer. On the transparency part of Trump's plan I give him an A+. On the other hand, this is one part that is obvious, but will get into a law. Anyone who didn't have an insurance company to 'negotiate' the ridiculous $30K fee down to $6K would be screwed.

20   bob2356   ignore (1)   2016 Mar 3, 9:58am   ↑ like (0)   ↓ dislike (0)     quote      

YesYNot says

The day after I had my initial doctors appointment, I called the hospital and my insurance company to find out what the costs would be. I was not able to get a lick of information from either party. I didn't have a choice of hospital, because my doctor has a relationship with a particular hospital (as they generally do). I called the hospital four times as a matter of principal. They gave me nothing. I couldn't delay, because of the time window.

Next time go to medicare's database. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/index.html It's in excel format but you can dig through it easy enough.

The obvious question is why would you care since you had no choice anyway?

21   FNWGMOBDVZXDNW   ignore (2)   2016 Mar 3, 10:03am   ↑ like (0)   ↓ dislike (0)     quote      

bob2356 says

Next time go to medicare's database.

Thanks. That's useful. I did have a choice, because it was an elective surgery with benefits and drawbacks. At some point, I decided I would pay up to my deductible anyway. At that point, it was a matter of principle.

23   bob2356   ignore (1)   2016 Mar 3, 10:21am   ↑ like (0)   ↓ dislike (0)     quote      

YesYNot says

bob2356 says

Next time go to medicare's database.

Thanks. That's useful. I did have a choice, because it was an elective surgery with benefits and drawbacks. At some point, I decided I would pay up to my deductible anyway. At that point, it was a matter of principle.

For a lot less than 3500 you could have gone to costa rica for the surgery. So you had the choice of shopping for a cheaper procedure and didn't. Just like millions of people every year don't bother. and won't bother now matter what happens with transparent pricing.

That is not to say I'm against transparent pricing. I'm all in favour, but it won't make anything more than minimal difference if it happens.

24   anotheraccount   ignore (1)   2016 Mar 3, 10:24am   ↑ like (0)   ↓ dislike (0)     quote      

bob2356 says

That is not to say I'm against transparent pricing. I'm all in favour, but it won't make anything more than minimal difference if it happens.

If everyone has a 13K deductible I think it will make some difference.

25   bob2356   ignore (1)   2016 Mar 3, 10:34am   ↑ like (0)   ↓ dislike (0)     quote      

tr6 says

bob2356 says

That is not to say I'm against transparent pricing. I'm all in favour, but it won't make anything more than minimal difference if it happens.

If everyone has a 13K deductible I think it will make some difference.

If wishes were fishes. Average deductible 13k, that will happen how? Average deductible is something like 1500 last time I looked. What will be driving it up by a factor of almost 10 in the foreseeable future?

People aren't going price shopping on a $1500 deductible. You didn't do it for $3500.

26   anotheraccount   ignore (1)   2016 Mar 3, 10:44am   ↑ like (0)   ↓ dislike (0)     quote      

bob2356 says

verage deductible is something like 1500 last time I looked.

That's not really true. If you look at California Exchange sliver plans with $1500 deductible and $5000 out of pocket maximum for a single person, you will see that the out of pocket is essentially the new deductible. co-pays and co-insurance between $1500 and $5000 only lessens the cost a bit. For a family on a bronze plan out of pocket max is 13K. Withing a three or four years it will be up to 15K, most likely.

27   FNWGMOBDVZXDNW   ignore (2)   2016 Mar 3, 11:00am   ↑ like (2)   ↓ dislike (0)     quote      

Ironman says

Just because you don't know how to get to the right people doesn't make it true.

I'm pretty sure that no one knows how to get the right people.

Ironman says

When I was in the industry, maybe 1% - 2% of people would actually ask how much it was.

Maybe that's why the hospital can get away with employing people who don't know how to or refuse to answer the question. When the hospital billing employees who are reachable by phone do research and come back to you empty handed, how is the average retail customer going to fare trying to get info from that same organization?

28   anotheraccount   ignore (1)   2016 Mar 3, 11:27am   ↑ like (0)   ↓ dislike (0)     quote      

Ironman says

They're all transparent.

Single ultrasound with a single tech billed as 4 different codes at Sutter. Talked to three different billing people and no one could explain to me why there were 4 charges.

29   someone else   ignore (0)   2016 Mar 3, 11:41am   ↑ like (3)   ↓ dislike (0)     quote      

Holy cow this position alone would get me to vote for Trump. Why can't any other candidate support something so obviously in the public interest?

OK that does it. I officially support Trump now. If he can get price transparency in medical care that alone would be a far greater accomplishment than anything in Obamacare.

30   TwoScoopsPlissken   ignore (0)   2016 Mar 3, 12:27pm   ↑ like (1)   ↓ dislike (0)     quote      

Don't forget negotiating Medicare Part D Drug Buys, which is a no-brainer.

The fact that the Gov't pays full retail is such an obnoxious mark of Big Donor Control of the Dems and Reps, it's really all you need to know.

Notice neither Cruz, Rubio, or Hillary have said jack shit about it.

31   anotheraccount   ignore (1)   2016 Mar 3, 12:30pm   ↑ like (2)   ↓ dislike (0)     quote      

thunderlips11 says

Notice neither Cruz, Rubio, or Hillary have said jack shit about it.

Cruz and Rubio - repeal ObamaCare with no solution.
Hillary - ObamaCare is great.

32   curious2   ignore (1)   2016 Mar 3, 2:39pm   ↑ like (2)   ↓ dislike (0)     quote      

Patrick says

Why can't any other candidate support something so obviously in the public interest?

The other candidates are run by special interest groups: usually the revenue recipients (e.g. hospital corporations) that finance the politicians, and sometimes the "heavy users" who are hostages of the existing system (e.g. SSRI addicts).

Price transparency would help a lot for chronic conditions and elective procedures, but not much with emergencies, which are what most people worry about. IMO, the only solution to emergencies is to fund federally EMTALA on a fee-for-diagnosis basis. (EMTALA requires hospitals that receive Medicare funds to treat true emergencies without regard to payment, although it lets them bill the patient on a fee-for-service basis for whatever they can collect as iwog wrote above. Results include over-pricing and over-utilization to maximize revenue.) Mayo Clinic negotiates with insurers on a fee-for-diagnosis basis, e.g. a broken leg costs $x adjusted for agreed aggravating factors (e.g. obese diabetics are inherently more difficult to treat). The Mayo method creates an environment where medical professionals cooperate as a team to solve medical problems as efficiently as possible, instead of overcharging via potentially injurious over-utilization. Currently, the AMA structures Medicare to overpay specialists and underpay GPs, all on a fee-for-service basis, and hospital corporations game the system to maximize revenue. Both major parties refuse to solve the problem, so they can "preserve the issue" for their own campaign purposes. As long as people are scared of emergencies, they can be manipulated by politicians who know how to exploit fear.

BTW, I think vaccines should also be funded federally and distributed freely. When you get vaccinated, you are really helping your neighbors more than yourself. It's like jury duty or voting: it's a civic duty or at least a public good. Instead, we tax vaccines and restrict them via overpricing and mandatory insurance, so more people get sick and generate more hospital revenues.

Lastly, Donald Trump proposing something does not mean it would actually happen if he gets elected. He says many opposite things, and his medical plan would require Congressional cooperation. The entrenched patronage networks make so much $$$ from the existing system that I doubt either major party would change it in a way that benefits the public interest. A president has more control over judicial nominees, and the Republicans have made a horrible pact with Pat Robertson, so a GOP President and Senate would be a dreadful combination.

33   Entitlemented   ignore (0)   2016 Mar 3, 2:52pm   ↑ like (1)   ↓ dislike (0)     quote      

tr6 says

transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals

Clintons = Transparency! America knows this is the case.

We need transparency and fair pricing in Medical and Legal field. Would argue that passing the Affordable Legal Reform is more important that the Obamacare.

34   curious2   ignore (1)   2016 Mar 3, 3:04pm   ↑ like (1)   ↓ dislike (0)     quote      

Entitlemented says

Affordable Legal Reform is more important that the Obamacare.

For once we agree. The U.S. Constitution, Amendment VI, says: "In all criminal prosecutions, the accused shall enjoy the right...to have the Assistance of Counsel for his defence." Yet, Republicans advocate funding only prosecutors, and Democrats advocate funding only indigent representation. (Republicans demand "tort reform," by which they mean preventing you from suing for injury or fraud, while Democrats demand "access to justice," by which they mean more funding to represent indigent criminals and vagrants.) Neither party protects middle class people, who risk bankruptcy if they or their kids are falsely accused. Instead, as with medical emergencies, both parties "preserve the issue" for their own campaign purposes instead of solving the problem in the public interest. In any criminal case, you have an express right to the assistance of counsel, yet they charge you for it if you can pay. The government pays the police, prosecutor, court staff, even the jury, but the hapless defendant stands to be wiped out even if he did nothing wrong. IMO, the same right should extend even to civil cases: homeowners should not need to fear "frivolous" lawsuits, instead they should have a right to expect that assistance of counsel will be provided by the court as part of the court budget. You don't hear either major party proposing that though, because both represent the revenue recipients from the existing system, and advocate policies designed to maximize revenues.

BTW, the Constitution does not specify any particular right to medical assistance. To the contrary, the founders had no access to modern medicine, and yet the first five Presidents lived a median 82 years. That median includes George Washington, the only one who didn't complete his threescore and ten: he died at 67 because he was bled (standard medical care at the tme) and "waived his usual objections to medicines, and took those which were prescribed without hesitation or remark." Too few people read the Constitution, and even fewer follow it; most politicians, after swearing to uphold it, tend instead to maximize patronage network opportunities.

35   anotheraccount   ignore (1)   2016 Mar 3, 6:52pm   ↑ like (2)   ↓ dislike (0)     quote      

curious2 says

Lastly, Donald Trump proposing something does not mean it would actually happen if he gets elected. He says many opposite things, and his medical plan would require Congressional cooperation. The entrenched patronage networks make so much $$$ from the existing system that I doubt either major party would change it in a way that benefits the public interest. A president has more control over judicial nominees, and the Republicans have made a horrible pact with Pat Robertson, so a GOP President and Senate would be a dreadful combination.

I know that he is full of BS. Unfortunately Hillary does not even bother addressing any of these issues.

36   FNWGMOBDVZXDNW   ignore (2)   2016 Mar 3, 7:29pm   ↑ like (0)   ↓ dislike (1)     quote      

Hillary was pushing single payer for at least 16 years. She lost the election and a compromise produced the ACA. She is too pragmatic to throw it out and try again before the first one has time to be tested.

37   FortWayne   ignore (0)   2016 Mar 3, 7:45pm   ↑ like (1)   ↓ dislike (0)     quote      

This is an excellent plan, but establishment will hate it. It's gonna give folks more freedom and reduce prices.

Now I like Trump even more

38   curious2   ignore (1)   2016 Mar 3, 8:17pm   ↑ like (3)   ↓ dislike (0)     quote      

YesYNot says

Hillary was pushing

LOL - I try not to respond to lying trolls, but your comment went beyond even your own abysmal standards. Hillary Clinton in her own words, in 2008, when surveys showed majority support for single payer:

"You know, I have thought about this, as you might guess, for 15 years and I never seriously considered a single payer system."

Even prior to that, I can't recall her ever proposing single payer; to the contrary, she and Bill were among the first to propose HeritageFoundationCare, when she called it ClintonCare. It went on to become Romneycare, then "Hillary's Plan," and now Obamneycare.

I won't get sucked into another of your pointless trolling exchanges, where you have lied about what was on the screen in front of you, but this particular issue is so well documented that it illustrates perfectly the often 180 degree opposition between your comments and observable reality.

39   bob2356   ignore (1)   2016 Mar 3, 9:03pm   ↑ like (0)   ↓ dislike (0)     quote      

tr6 says

bob2356 says

verage deductible is something like 1500 last time I looked.

That's not really true. If you look at California Exchange sliver plans with $1500 deductible and $5000 out of pocket maximum for a single person, you will see that the out of pocket is essentially the new deductible. co-pays and co-insurance between $1500 and $5000 only lessens the cost a bit. For a family on a bronze plan out of pocket max is 13K. Withing a three or four years it will be up to 15K, most likely.

There are 35 million people in CA with health insurance outside of the California Exchange. There are 1.5 million people that used the California exchange in 2016. So your theoretical (but not actual) 13k affects 4,2% of people with health insurance and that's assuming the entire exchange is families on the bronze plan. Obviously the number is considerably lower.

My question stands. By what means do you see that the average deductible will increase by 1000% in the foreseeable future?

40   marcus   ignore (0)   2016 Mar 4, 1:12am   ↑ like (0)   ↓ dislike (0)     quote      

Patrick says

Holy cow this position alone would get me to vote for Trump.

In his case I think calling it a position might be a stretch. It's what he's saying to get votes.

And admit it, he had you with his Muslim hate.

41   FNWGMOBDVZXDNW   ignore (2)   2016 Mar 4, 3:19am   ↑ like (0)   ↓ dislike (0)     quote      

curious2 says

but your comment went beyond even your own abysmal standards

I see I was wrong about Hillary care from the 1990s. See. I'm happy to admit I was wrong when it is clear. curious2 says

I won't get sucked into another of your pointless trolling exchanges,

Lol. You love bringing up old threads, usually with a series of links where you selectively quote me out of context. Your getting sicker in, huh?

42   Entitlemented   ignore (0)   2016 Mar 4, 12:26pm   ↑ like (0)   ↓ dislike (0)     quote      

tr6 says

Point #5: Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.

Summary:

A new hospital was contstructed in the last few years next to my office in Goleta. Medical finance/planners/equipment/contruction gobbled up over 100 offices in 6 buildings at the local tech location next door.

They have consultants. They fly in Monday, and work Tues - Thurday morning. They place is a ghost town on Mondays and Fridays (lets me work). The other firms have been commenting on "now we have an idea why health care costs are skyrocking" They rent the office space and spend funds like only a law firm could do. When I asked the supervisor where are the People on Monday and Friday, she said that "well they work at home on Mondays/Fridays" and then said many are consultants and travel etc.

We need to have transparency on every private and public enterprize. I have accountants and lawyers charging rates that are unjustified, and they are always at long lunches and go home early.

America has been scammed by non productive, paper pushing workforces. There appears to be legions of Chiefs, oversee-ers, consultants, but the number of people creating or manufacturing thing is at an all time low.

Sometimes, by observation I believe that the Malproductivity and the fraud, makework and waste that exists in this country makes the Scam that Madoff did look like a minor accounting error.

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