Tuesday, March 7, 2017

Peter Radford — RyanCare! Or is it TrumpCare?


It's a tweak of Obamacare. and it is already looking like it cannot get enough GOP votes to pass as it is written.

The Radford Free Press
RyanCare! Or is it TrumpCare?
Peter Radford

25 comments:

Dan Lynch said...

Only the president has enough clout to push through a new health care plan. Hence I take the GOP's proposals with a grain of salt. The only plan that matters is Trump's.

Ideological issues aside, Trump has an political incentive to take health care reform seriously, because regardless of whose idea it was, it will be called TrumpCare and Trump will own it, just as Obama owned O-Care.

Andrew said...

Aren't you supposed to have all that stuff figured out BEFOREHAND?

The only plan that matters is Trump's.

This is the man who said that health insurance is more complicated than he thought. He knows nothing about pretty much everything. Don't hold your breath.

Ryan Harris said...

The Dems need to be an opposition party and propose changes that would make it palatable for their globalist elite base. Or they can be the party of NO! and follow the GOP template.

The GOP wasted years making little progress and shaping less policy.

Matt Franko said...

"health insurance is more complicated than he thought."

That was his sarcasm...

Noah Way said...

^ Translation: there are a lot more fingers in the pie than he originally thought.

Ryan Harris said...

Politically complicated.

Scary for politicians because no matter what they do, they get screamed at by someone.

1/4 of GDP goes down the healthcare toilet and the people in the medi-pharma machine aren't going to let that number fall without a fight.

Highly charged claims over Granny and Cute Kids croaking at the hands of evil politicos has become standard practice.

Matt Franko said...

To me the current system is dominated by he academe Ryan.... just as the govt institution for the last 8 years at least was dominated by the academe....

Trump is trying to convert that over to rule by business people....with healthcare he is trying to concentrate financial resources into a collective mass of personal accounts and then get scale in purchasing by the group...

Noah Way said...

Scale purchasing by group is how medicare functions. All we need to do is increase the size of the group to include all US citizens instead of dividing it up between dozens of insurers (not providers!), their anti-trust non-competitive "networks", and thousands of different "plans" (all of which require specialized administration on the part of providers).

Matt Franko said...

Medicare doesnt function by scale purchasing... HCFA (govt price setter) sets the price for individual procedures.. IF, and I repeat, IF (ie no guaranty they will...) a Medicare patient shows up and is treated, then the providers have to submit a claim totaling up all of the HCFA prices for indivdual itemized procedures the patient received and then wait to get paid...

That is VERY different from a business perspective than getting paid UP FRONT (premium) and GUARANTEED (govt tax credits are 'money good'...) for complete care for all of the patients you have signed up...

Trump doesnt buy his bars of soap for his hotels one bar at a time by negotiating the best price of ONE bar of soap...

Matt Franko said...

If you prefund an MSA every month which the plan does with the refundable credit, then the providers can go get people to sign up and debit the MSA and then they will have a GUARANTEED revenue stream to work from (as govt is going to put it there every month guaranteed) and they can get scale by signing more and more people up...

Look for a household the credit can be about $1200/mo if your state has 1M households that would be $14B/yr going in to provider systems... its a lot of $$$$

Matt Franko said...

Business works best by achieving scale AND guarantees...

these two things are what Trump is going after... he's not an academic...

Noah Way said...

Semantics, HCFA administers Medicare, it's all the same system. Congress banned Medicare from negotiating drug prices.

Dan Lynch said...

Trump has come out in favor of RyanCare. Trump promises to help pass Ryan care.

If RyanCare passes (unlikely) with Trump's endorsement, then Trump will be a one term president. RyanCare is awful, even conservatives don't like it, nor will it make insurance companies happy.

A conservative, pro-business takedown of RyanCare

Republican's guarantee issue scheme of buy it whenever you need it will make the Republican program just as financially unsustainable––too many won't buy it and those who do will be disproportionately sick.

@Matt, your comments suggest that you are completely out of touch with the poor and working class. The poor and working class have no disposable income to set aside for MSA's. They have no disposable income for deductibles and co-pays. They have no cash up front to buy insurance while they are waiting for a tax refund that they may or may not get.

Noah Way said...

+++ Dan

Tom Hickey said...

Government doesn't negotiate the price they pay for Medicare. I get the statements. The provider submits a charge, which is shown on the statement. The Medicare payment is along side of it. The discount is usually pretty hefty, much more than the private insurance companies negotiate for themselves, where the discount is only about 30%.

Under the present system in the US, there is no competition among providers and only among insurance cos for premiums on non-Medicare claims.

To get costs down there would have to be competition among providers, and people are generally unable or unwilling to negotiate among providers to get the "best" deal on medical services.

BTW, some providers do not accept the Medicare assessment and the client is responsible for the difference in those cases.

Tom Hickey said...

The way it works from the providers side is that they submit a CMS 1500 (formerly HFCA 1500) with the billing code and then get paid.

Billing codes are the basis of billing.

If the provider submits the wrong code, then Medicare will turn it down. Then you have to call Medicare to find out why they didn't pay. They tell you that they don't cover that code. You tell them the procedure. They tell you the provider submitted the wrong code. You tell the provider's billing office they submitted the wrong code. They tell you they can't change the code without the physician submitting it. You contact the physician and get them to change the code. If all goes well it takes about an hour.

Noah Way said...

Competition does not exist in narrow "networks" that function as virtual monopolies. Or when huge powerful corps manipulate the "market" politically and economically.

And once again the value system is inverted - the only measure being cost. I'd like to see competition for quality and outcomes instead of prices and profits.

The purpose of government is to protect us - from each other.

Matthew Franko said...

"Competition does not exist in narrow "networks" that function as virtual monopolies."

Yes and in my state, that monopoly is held by the UNIVERSITY of Maryland Medical System for ANY cardiac operation... ie the academe...

So where are your "huge powerful corporations" ????? Where are they????

Name me ONE...

Michelle O. and Valerie Jarrett were taking $1M annual out of the UNIVERSITY of Chicago Medical System... not some "corporation!"...

mmcosker said...

Good lord just expand Medicare to all. Remember there is a private component to Medicare - Advantage plans or Part C. This allows the private insurance industry to still exist via part C. Use the current premium schedule for the portion individuals pay, then figure out the employer portion. Of course, there will need to be some way to waive premiums for poorer people. By God what is this so hard.

mmcosker said...

Also if one chooses traditional Medicare you probably want a medigap policy, another private insurance option.

Dan Lynch said...

@mmcosker, it's hard because capitalism.

The whole purpose of the ACA was to preclude the expansion of Medicare, which conservatives would like to phase out all together.

There would be no need for any sort of insurance if we had free public clinics & free public hospitals. Then not only would all the people in the private insurance industry have to find new jobs, but also all the government employees associated with Medicare and all the people in the health care industry who do billing for Medicare.

Private insurance adds no value. Single payer insurance adds no value. They're all parasites, some parasites are just worse than others.

Noah Way said...

@Matt

Unitedhealth Group.
Wellpoint Inc. Group.
Kaiser Foundation Group.
Humana Group.
Aetna Group.
Etc.
You're welcome.

Ryan Harris said...

My Senator said expanding Medicare is a non-starter. I told him that I don't know the exact circumstances, but he will lose his job for that position to a candidate to whom that position is a possibility.

Matt Franko said...

Those are insurers ... not providers...... middlemen.

All they do is help firms aggregate or get more scale with providers....

Who are the big providers?

Noah Way said...

@Matt

More semantic quibbling. The insurers are the gatekeepers and the price setters. Insurance has been substituted for and equated to "care" when in fact it is not. Medical costs are still the majority of bankruptcies.