Socialist Commie Health Care Thread

[andydp]

I noticed we didn't have a thread devoted to the "Socialist, Commie" health care that Biden and his liberal woke fascists are propping up.  Feel free to add any ACA related info here.

My favorite quote is from the old days of "Obamacare":

Obamacare took away my guns and put me in a FEMA re education camp.

Random musing:  I have noticed very few attacks against "ACA type" medical coverage.  I think Kansas voted NOT to expand Medicaid.  Nothing of the kind of mass attack against Obamacare.  I didn't notice any "screaming" about extending the enrollment time for ACA coverage either.

[pnwguy]

Apr 10, 2021 14:05:01 GMT andydp said:

I noticed we didn't have a thread devoted to the "Socialist, Commie" health care that Biden and his liberal woke fascists are propping up.  Feel free to add any ACA related info here.

My favorite quote is from the old days of "Obamacare":

Obamacare took away my guns and put me in a FEMA re education camp.

Random musing:  I have noticed very few attacks against "ACA type" medical coverage.  I think Kansas voted NOT to expand Medicaid.  Nothing of the kind of mass attack against Obamacare.  I didn't notice any "screaming" about extending the enrollment time for ACA coverage either.

"But Bidencare put a tracking and thought chip in my arm with their socialist vaccine..."

[goldenvalley]

Apr 10, 2021 16:06:55 GMT pnwguy said:

Apr 10, 2021 14:05:01 GMT andydp said:

"But Bidencare put a tracking and thought chip in my arm with their socialist vaccine..."

 How many people saying that have a cell phone in their pocket?

[andydp]

Has anyone noticed the complete lack of ANY mention by "them" of the ACA enrollment extension ?  

I may have missed it, did the stimulus package have a provision for extra funding of the ACA ?

[LFC]

Nevada is pushing towards a public health insurance option. Health care providers are, as expected, squawking because they don't want to do anything that reduces profits or even requires them to put in a real effort to cut costs.

Joe Biden’s election brought a new optimism that a public health insurance option could become a reality. But while the public option, a government-run insurance plan that competes with private insurers, seems to be off the table at the federal level, Nevada lawmakers are pushing to pass their own version before the end of their legislative session.

Nevada would become just the second state with a public option, after Washington implemented its own version of the proposal this year. The Democrat-controlled legislature is racing against the clock — the legislative session ends on June 1 — but the legislation is already moving through Senate committees.

“Now is the time to act,” Nevada Senate Majority Leader Nicole Cannizzaro told me in a recent interview. “This really is designed to be a very reasonable approach to developing another option for folks. It’s not looking to upend the entire system. There are people who are unserved by this system. How do we serve those individuals?”

Here are the basics of the Nevada proposal, Senate Bill 420:

- The “public option” plan would be sold on the state insurance marketplace created under the Affordable Care Act, available to the individuals and small businesses that are already eligible to purchase plans there, starting in 2026.
- Health insurers that participate in the state’s Medicaid managed care program would be required to submit a public option proposal; other insurers could also submit a bid.
- The public option plan would offer silver-level (covering 70 percent of medical costs) or gold-level (80 percent) coverage.
- Premiums for the public option would initially be set 5 percent lower than a “benchmark” plan from the private insurance plans already sold on the marketplace; over time, the goal would be to bring the premiums down to 15 percent lower than the benchmark plan.
- Health care providers that accept the state’s Medicaid patients or the state employees’ health insurance plan would be required to accept patients on the public option plan.

The proposal is drawing backlash from health care providers, as Megan Messerly has covered for the Nevada Independent. And some experts contend that, considering most uninsured people already qualify for Medicaid or ACA subsidies, the public option may not be the most effective vehicle for expanding coverage — but could put downward pressure on health care costs.

I suspect that we'll eventually end up with a two-tier nation, much as already exists in terms of wealth and income. Residents of the blue states will have guaranteed access to health care and those in the red states will not. It will be interesting to see if the blue states create regional healthcare districts to provide them with more leverage. Both the Northeast and the Pacific Coast regions would have massive clout in forming how health insurance is administered. If it were up to me there would be strict eligibility rules on people coming from out of state / region. The last thing I'd want to see is the sick who didn't put into the systems moving in to take advantage. Damn red state healthcare queens.

[Deleted]

May 5, 2021 20:02:53 GMT andydp said:

Has anyone noticed the complete lack of ANY mention by "them" of the ACA enrollment extension ?  

I may have missed it, did the stimulus package have a provision for extra funding of the ACA ?

Since, I don't have to follow the issue, this is my cursory understanding. The Covid stimulus extended subsidy coverage to a larger group of people: previously, subsidy for those who earned over 400% of poverty line income precipitously dropped to zero; now the subsidy decrement is gradual.

[LFC]

Now THIS is how Republican healthcare is meant to work.

As the coronavirus spiked in Missouri last fall, a wave of cases hit a nursing home in the state's rural heartland. Robin Bull, a part-time nurse, remembered an ambulance "coming and going constantly" on one especially scary morning, rushing residents to Moberly Regional Medical Center, the local hospital.

But even as Bull was helping send patients to Moberly Regional, the hospital was in the process of suing her and at least one other former employee at the nursing home. They were two of more than 600 former patients that the hospital has sued over medical bills during the coronavirus pandemic, according to a CNN analysis of court records.
Moberly Regional sued Bull last May for $9,281, costs that Bull said came from an emergency room visit for food poisoning several years ago. After a judge ruled in the hospital's favor late last year, the company filed a motion to start garnishing part of her roughly $850-per-month salary.

Bull, who also receives disability payments, said she and her husband both contracted Covid-19 last summer, and they've struggled to pay their bills each month.

"I tried to reason with the lawyers and tell them there's no way I can pay for this, but nothing worked," Bull said. "Having this huge bill looming over my head -- it's been stressful, it's been heart-sickening."

Bull's experience is hardly unique. Hospitals owned by Community Health Systems, Inc., one of America's largest hospital chains, have filed at least 19,000 lawsuits against their patients over allegedly unpaid medical bills since March 2020, even as other hospitals around the country have moved to curtail similar lawsuits during the coronavirus pandemic, a CNN investigation found.

The company's 84 hospitals, which are concentrated in the South and stretch from Alaska to Key West, Florida, have taken their patients to court for as little as $201 and as much as $162,000. They say litigation is a last resort.

CNN's review of court filings across 16 states the company operates in found that most of the patients sued by CHS -- like Bull -- didn't hire a lawyer or fight the lawsuits, and judges often ruled in the company's favor by default. In some states, defendants' debts piled on with attorney's fees and interest. Elsewhere, the hospital chain's subsidiaries quickly moved to garnish defendants' paychecks after a judgment.

Advocates say those hardball collection tactics can leave low-income patients in financial ruin -- especially considering the lawsuits were filed in the middle of the Covid-fueled economic collapse.

"I can't think of a worse thing a hospital system can be doing than suing patients for medical bills during a pandemic and a recession," said Caitlin Donovan, the spokeswoman for the National Patient Advocate Foundation, a patients' rights group.

[LFC]

The criminal enterprise known as United Healthcare has decided to, once again, play doctor and decide what is and isn't an emergency after the fact.

Doctors and hospitals are condemning plans by UnitedHealthcare—the country’s largest health insurance company—to retroactively deny emergency medical care coverage to members if UHC decides the reason for the emergency medical care wasn’t actually an emergency.

In the future, if one of UHC's 70 million members submits a claim for an emergency department visit, UHC will carefully review what health problems led to the visit, the “intensity of diagnostic services performed” at the emergency department (ED), and some context for the visit, like the member’s underlying health conditions and outside circumstances. If UHC decides the medical situation didn’t constitute an emergency, it will provide “no coverage or limited coverage,” depending on the member’s specific insurance plan.

Emergency medical doctors and hospitals were quick to rebuke the plan. They say it sets a dangerous precedent of requiring patients to assess their own medical problems before seeking emergency care, which could end up delaying or preventing critical and even lifesaving treatment.

Some of you may remember from the old board that I wrote at length on the issues I had with this company when I was stuck with them. They are everything that is wrong with American health insurance all rolled into one steaming pile of shit. They should have been shut down ages ago.

[HockeyDon]

Fantastic. We have United through my employer.

[LFC]

Jun 15, 2021 14:21:46 GMT HockeyDon said:

Fantastic. We have United through my employer.

Ugh. I hope you don't have any major need to use it. My worst experience was having a bill rejected as "subscriber unknown." The provider gave them my correct first name, correct last name, correct plan number, and correct member ID. Why the rejection? They didn't provide my middle initial.

Oh, yeah. And I received a notification from United that the bill had been rejected. Sooooo ... subscriber was only unknown when it came to paying the bill?

Plenty of other refusals to pay and general f***ing with my providers. It took one over 6 months to collect.

[goldenvalley]

ACA still stands. The Supreme Court just issued ruling that the plaintiffs lacked standing to sue...no cognizable injury alleged.

[indy]

Jun 17, 2021 14:38:48 GMT goldenvalley said:

ACA still stands. The Supreme Court just issued ruling that the plaintiffs lacked standing to sue...no cognizable injury alleged.

And in a nod to the law of unintended consequences, they basically said that as a result of the mandate provision being successfully removed by a previous lawsuit, the plaintiffs weren't required to pay anything, so no injury could be 'fairly traced' to the law.

[LFC]

Vox has a good summary of what Obamacare has and has not accomplished. BTW have you heard any right-wing screeching about the costs on the exchanges lately? Nope, because they've generally stabilized as expected. Of course any large insurance price increases will be blamed on Obamacare, never mind that they'd been occurring for decades before the ACA was passed.

The Affordable Care Act’s achievements are clear. People who buy insurance in the individual and small-group markets no longer face discrimination for preexisting conditions. Preventive services for Americans with all types of insurance are free. Combine the marketplaces that provide tax subsidies for private coverage and the Medicaid expansions adopted by 38 states (along with a handful of smaller provisions), and the ACA has provided coverage to about 31 million Americans, according to a new estimate from the Biden administration.

After the rocky rollout of HealthCare.gov in 2014 and a few years of soaring premiums, the law’s private marketplaces have stabilized; now Democrats are trying to expand access to them. Premiums are flat. More health insurers are offering plans. Congress approved an expansion of the law’s tax subsidies to higher-income earners and the Biden administration opened a special Covid-19 enrollment period during which 1 million people have signed up for insurance. States are now starting to set their own public options, giving the idea a new life after it was scuttled during the legislative debate over the ACA.

[Deleted]

[goldenvalley]

We can laugh at it via the above editorial cartoon, but lots of people got elected and re-elected based on the Wile E Coyote plots. Some of those folks had no other platform than getting rid of ACA and no interest in actual governance of this country. It's part of why we're in the mess are in.

[LFC]

Jun 18, 2021 19:41:00 GMT goldenvalley said:

We can laugh at it via the above editorial cartoon, but lots of people got elected and re-elected based on the Wile E Coyote plots. Some of those folks had no other platform than getting rid of ACA and no interest in actual governance of this country. It's part of why we're in the mess are in.

And let's not forget that the Trump administration pulled multiple maneuvers to weaken it, all with GOP backing.

[LFC]

United Healthcare, the largest criminal organization in the entire health insurance industry, is looking to steal people's money yet again. If you can't raise their premiums then cut their benefits. Their model has always been lower premiums, which companies love, coupled with intentionally shitty reimbursement and god awful customer service for both subscribers and providers. I had several providers tell me that they had more trouble getting reimbursed by UHC than all of the other insurers combined.

United Healthcare, the largest insurer in the US, recently announced a new policy it said would help hold down health care costs: It would review claims for emergency department care, opening up the possibility that the company might deny coverage if a patient’s medical needs were not actually an emergency.

After outcry from doctors and patients, the insurer said it would delay implementation until the Covid-19 pandemic has passed — but it still plans to institute the policy eventually.

United Healthcare framed the maneuver as a way to contain costs, as the New York Times reported. But there are problems with that idea, according to the half dozen health policy experts I spoke to. It’s not clear emergency room misuse is actually a rampant problem. And even if some patients do unnecessarily visit the ER, United’s new policy risks discouraging people from seeking necessary care without any guarantee that it will actually bring down costs.

“Too blunt and the wrong problem” is how Tom Tsai, a health policy researcher at Harvard University and a surgeon at Brigham and Women’s Hospital, succinctly put it to me.

“We shouldn’t reduce emergency department visits because we expect to save money,” Laura Burke, a physician at Beth Israel Deaconess Medical Center in Boston who has studied emergency room use, told me. “Because there is no evidence that’ll actually happen.”

The problem is not that patients overuse or misuse the emergency room, said Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation. Emergency department visits have actually been stable for years and, after a drop during the Covid-19 pandemic, have not yet recovered to previous levels.

If anything, the problem is the prices that hospitals charge for ER services, experts said. Those have been rising in recent years. United may be trying to send a warning on prices to providers with its new policy — “a shot across the bow,” as Hempstead put it — but in doing so, patients are being put at risk of facing huge medical bills they may struggle to pay.

“It’s not fair to patients,” she said. “It puts the patients in the middle.”

But it's easier to f*** over the patients than large hospital chains.

[LFC]

A rule that's part of the ACA plus an additional rule by the Trump administration (Holy crap! Something actually decent from the Mango Moron!) are forcing hospitals to post prices. Compliance is less than uniform.

A colonoscopy might cost you or your insurer a few hundred dollars — or several thousand, depending on which hospital or insurer you use.

Long hidden, such price variations are supposed to be available in stark black and white under a Trump administration price transparency rule that took effect at the start of this year. It requires hospitals to post a range of actual prices — everything from the rates they offer cash-paying customers to costs negotiated with insurers.

Many have complied.

But some hospitals bury the data deep on their websites or have not included all the categories of prices required, according to industry analysts. A sizable minority of hospitals have not disclosed the information at all.

While imperfect and potentially of limited use right now to the average consumer, the disclosures that are available illustrate the huge differences in prices — nationally, regionally and within the same hospital. But they're challenging for consumers and employers to use, giving a boost to a cottage industry that analyzes the data.

While it's still an unanswered question about whether price transparency will lead to overall lower prices, KHN took a dive into the initial trove of data to see what it reveals. Here are five takeaways from the newly public data and tips for how you might be able to use it to your benefit.

[LFC]

Kaiser is seeing the health care systems of other countries improved faster relative to the U.S. We've had some improvements but we were already sucking wind compared to so many other nations. COVID put a spotlight on the inferiority of our system.

Take a long enough lens — say, 25 years — and it seems as though health care in America is inarguably getting better.

People are living longer than they did a quarter century ago. The burden of disease, a metric that includes premature deaths and disability, has dropped. The number of avoidable hospitalizations and hospital errors is lower.

But below those rosy numbers is the truth: American health care has been falling behind other countries in the developed world for decades.

Life expectancy has increased, but by less in the US than in the wealthy nations of Europe and Asia. The improvement in disease burden has likewise been less impressive than that of comparable countries. Meanwhile, to achieve those mediocre results, the United States continues to spend more money on medical care than any other country in the world; while health spending in the US isn’t going up faster than in other countries, it was higher to begin with and continues to increase. We’ve maintained a sizable lead in health care spending while getting outcomes that are worse than countries that spend less.

And all of that was true even before the United States experienced one of the worst Covid-19 outbreaks in the world.

Kaiser Family Foundation researchers recently warned of a “further widening of the gap” between the US and other countries as a result of the pandemic. Life expectancy in the US had already stagnated in the last few years, driven by a rise in drug overdoses and suicides; now Covid-19 will shorten it further. Disease burden had been trending upward in the US while dropping elsewhere; the Covid-19 pandemic is likely to widen that disparity too.

You could say the trajectory of American health care before, during, and after the pandemic is like that of an individual vulnerable patient: It was sicker to begin with, hit hard by Covid-19, and will be dealing with the lingering effects for a long time.

[jackd]

And what does Kaiser recommend we do? They observe that we spend more on medical and less on social services than the other countries they discuss. Are they willing to give up some of their revenue to accommodate social welfare spending?

[LFC]

The so-called greatest healthcare system in the world (if you ask Republicans) is collapsing in the face of the pandemic.

During the current delta-driven Covid-19 wave, Americans are being transported hundreds of miles from their homes because no nearby hospital has room for them. Some of them have even died waiting for medical attention.

In other words, US hospitals are being forced — in the middle of a public health emergency — to ration health care for their patients.

Rationing has long been a dirty word in US health policy, used as an attack on any socialized health program that more centrally determines which medical services will be covered and for whom. The US health system has always rationed care through cost: It’s de facto rationing when a patient doesn’t get the medical care they need because they can’t pay out-of-pocket costs or because they live in a rural community without a facility nearby.

“We’re so used to rationing by ability-to-pay in this country that classic capacity rationing feels a bit foreign,” Hannah Neprash, a health economist at the University of Minnesota, said in an email.

The states with the worst outbreaks in confirmed cases per capita right now — Tennessee, Kentucky, Alaska, Wyoming, and West Virginia, according to the New York Times’s tracker — have either set new hospitalization records in the last several weeks or are near their previous highs from the winter wave. All of them have vaccination rates below the national average. Throughout the South, hospitals are reporting they have more patients in need of ICU care than ICU beds available, as the Times reported on Tuesday.

America, the richest country in the world, is not supposed to be a place where patients are left at the door to die. Yet that is exactly what’s happening now — 18 months into the pandemic.

[goldenvalley]

Some comment on LGM said rationing is socialism; cutting off care is capitalism.

[LFC]

House Dems join Republicans to protect Big Pharma's obscene profits from Medicare. This is beyond disgusting.

Democrats had a neat plan for their health care agenda. As part of the $3.5 trillion spending bill they’re putting together as I type, they would finally, after years and years of pledges to do so, pass legislation to cut the costs of prescription drugs. This would have two wonderful benefits for the Democrats. First, the obvious: They would fulfill a campaign promise to cut the costs of prescription drugs. Fulfilling popular promises is good! Second, the Medicare drug negotiations—price negotiations between the government and pharmaceutical companies— would save the government hundreds of billions of dollars that Democrats could then use to pay for the rest of their health agenda: covering new services under Medicare, bringing the ACA’s Medicaid expansion to all 50 states, and making permanent the improvements Democrats made to Obamacare’s insurance exchanges in their COVID relief bill earlier this year.

Again, a neat plan on paper. In terms of actually shepherding this idea through Congress, though, there was always one problem that tended to be overlooked: Doing this would require punching the pharmaceutical industry, and its powerful lobby, squarely in the jaw. There’s a big reason such a popular idea—let the government negotiate drug prices!—hadn’t happened already, namely that the pharmaceutical sector wouldn’t take kindly to the threat of losing $500 billion. And now, they haven’t. Which means that, even in the early stages of Democrats in Congress trying to cobble together the Build Back Better Act, the plan is in deep trouble.

This week, the Energy and Commerce Committee met to discuss drug pricing. The legislation that House Democrats wanted to pass has an aggressive mechanism for making sure drug manufacturers complied with negotiated prices. And if they didn’t, the government would slap the companies with an escalating tax that would ultimately reach 95 percent of sales. The criticism from pharmaceutical companies, then, was that this wasn’t much of a negotiation at all, but instead the government setting rates at gunpoint. They further explained, as they often do, that these funds would severely hamper pharmaceutical innovation.

Their lobbying efforts got somewhere. Three moderate members of the committee—California Rep. Scott Peters, Oregon Rep. Kurt Schrader, and New York Rep. Kathleen Rice—announced that even though they had voted for this idea in 2019, they had since changed their minds, and now had grave concerns about pharmaceutical innovation. (It is also worth noting that Peters, in particular, has accumulated sizable donations from the pharmaceutical industry this year.)

The three members held strong, and all three voted against the drug-pricing proposal in a Wednesday committee vote. That was just enough to create a tie, and the drug-pricing plan failed to advance. PhRMA, the pharmaceutical lobby, crowed in a statement afterward that “the House markups on health care demonstrate there are real concerns with Speaker Pelosi’s extreme drug pricing plan and those concerns are shared by thoughtful lawmakers on both sides of the aisle.” (And themselves, they left out.)

Huffpo points out that a number of House Dems who are blocking party priorities are from safe districts.

From prescription drug prices to higher taxes on the rich, many of the Democrats in the House standing in the way of more progressive legislation hail from safe Democratic seats.

That’s not true in the Senate, where the most outspoken conservative voices represent swing states.

But the opposition of many electorally secure House Democrats to President Joe Biden’s agenda undermines the longstanding excuse that concerns about electorally risky votes are the greatest obstacle to advancing a progressive agenda.

“There is an argument to make in a purple district that there are Democrats who have trouble if they vote with leadership enough of the time,” said Rebecca Katz, a progressive strategist based in New York City. “We’re now seeing Democrats … in safe seats who continually mess with core Democratic priorities.”

[LFC]

Sinema appears to be wholly purchase by Big Pharma. The more she's pulled into the spotlight the more she looks like a self-serving piece of shit. There are no legitimate arguments for this, only lobbyist talking points that she's mechanically regurgitating.

The White House has a new headache as it struggles to get its multitrillion-dollar party-line spending bill passed: Sen. Kyrsten Sinema's objections to drug pricing reforms that are already struggling to make it through the House.

The Arizona Democrat is opposed to the current prescription drug pricing proposals in both the House and Senate bills, two sources familiar with her thinking said. They added that, at this point, she also doesn’t support a pared-back alternative being pitched by House Democratic centrists that would limit the drugs subject to Medicare negotiation.

Sinema met with President Joe Biden on Sept. 15 to discuss the social spending package, in which party leaders hope to include the Medicare prescription drug pricing proposal. Sinema has made her resistance to the current House prescription drug negotiation proposal clear to the White House, according to one of the sources, but it’s unclear if she’s completely immovable.

The drug price negotiation changes that Sinema is coming out against are a major component of the bill’s envisioned financing. Democrats are counting on them to raise as much as $700 billion over 10 years to pay for the party-line bill’s ambitious programs. Axing it could imperil the health care reform components in the social spending plan, such as a proposal from Sen. Bernie Sanders (I-Vt.), and supported by Biden, that would expand Medicare coverage to hearing, dental and vision.

The prescription-drug pricing measure is also one of the biggest elements championed by the White House. In speeches this summer, Biden highlighted the proposal as popular across the electorate.

And here's what following the money brings us to.

Sen. Kyrsten Sinema formed a congressional caucus to raise “awareness of the benefits of personalized medicine” in February. Soon after that, employees of pharmaceutical companies donated $35,000 to her campaign committee.

Amgen gave $5,000. So did Genentech and Merck. Sanofi, Pfizer and Eli Lilly all gave $2,500. Each of those companies has invested heavily in personalized medicine, which promises individually tailored drugs that can cost a patient hundreds of thousands of dollars.

Sinema is a first-term Democrat from Arizona but has nonetheless emerged as a pharma favorite in Congress as the industry steers through a new political and economic landscape formed by the coronavirus.

She is a leading recipient of pharma campaign cash even though she’s not up for reelection until 2024 and lacks major committee or subcommittee leadership posts. For the 2019-20 election cycle through March, political action committees run by employees of drug companies and their trade groups gave her $98,500 in campaign funds, Kaiser Health News’ Pharma Cash to Congress database shows.

That stands out in a Congress in which a third of the members got no pharma cash for the period and half of those who did got $10,000 or less. The contributions give companies a chance to cultivate Sinema as she restocks from a brutal 2018 election victory that cost nearly $25 million. Altogether, pharma PACs have so far given $9.2 million to congressional campaign chests in this cycle, compared with $9.4 million at this point in the 2017-18 period, a sustained surge as the industry has responded to complaints about soaring prices.

Sinema’s pharma haul was twice that of Sen. Susan Collins of Maine, considered one of the most vulnerable Republicans in November, and approached that of fellow Democrat Steny Hoyer, the powerful House majority leader from Maryland.

It all adds up to a bet by drug companies that the 43-year-old Sinema, first elected to the Senate in 2018, will gain influence in coming years and serve as an industry ally in a party that also includes many lawmakers harshly critical of high drug prices and the companies that set them.

[goldenvalley]

From the above post: "awareness of the benefits of personalized medicine." What is personalized medicine? Is it simply a phrase designed to somehow contrast with "socialized" medicine that otherwise has no real meaning?