Interesting People mailing list archives

Re What the Republican Health Plan Gets Right


From: "Dave Farber" <dave () farber net>
Date: Sat, 06 May 2017 20:13:50 +0000

---------- Forwarded message ---------
From: John Day <jeanjour () comcast net>
Date: Sat, May 6, 2017 at 3:24 PM
Subject: Re: [IP] Re What the Republican Health Plan Gets Right
To: <mb () blacknell net>
Cc: Dave Farber <farber () gmail com>


Totally agree, but I can’t help adding a couple of points.

On May 6, 2017, at 14:38, Dave Farber <dave () farber net> wrote:


---------- Forwarded message ---------
From: Mark Blacknell <mb () blacknell net>
Date: Sat, May 6, 2017 at 2:37 PM
Subject: Re: [IP] What the Republican Health Plan Gets Right
To: Dave Farber <dave () farber net>


Jesus.  I was wondering who could come out to defend this plan, and . . .
well.  It's not the brightest and best.

The doctor that wrote the op-ed complained about a patient that saw him too
often for ailments she didn't have.  And whose fault was that?  Obama's,
apparently.  Not the patient's for making poor decisions, or even
(especially) his for failing to educate his patient.  Simple solution?  He
could have declined to see her.  My kids' pediatrician refuses to see
non-vaccinated children.  He could have done the same.


Even if he had tried to educate his patient, part of the doctor’s
responsibility is to care for his patient’s mental health. As we get older
some of us worry more than others. ;-)  And we always hear tales of that
long debilitating illness that is part of old age. She wants reassurance.
It is his job to provide it. (And I have to agree with her that this time
of year when the temperature is going up and down, it *is* hard to tell
allergies from a cold or the flu.) ;-)


This reminds me a bit of my banker friends, who insisted that they only
behaved so poorly in the run-up to the 2008 meltdown because the government
let them.  They were simply chasing profits, you see, and that's what they
were supposed to do.  It was the government's fault that they weren't
restrained.  (Also, could they have a bailout, please?)


But when there is talk of the kind of regulation to stop this. They
complain that the industry can self-regulate. They don’t need regulation,
because they are so much smarter than those guys wrecked the economy before.


As to his pre-existing conditions claptrap, it strikes me as coming from
someone who has never had job/economic insecurity.  Aside from 22 year olds
who haven't yet figured out that they're not, in fact, immortal, no one
*chooses* to go without some sort of access to health care.


Yes, he completely does not understand how insurance works. The whole idea
is that you pay less than it would cost to cover the worst case and few
people ever have the worst case. At the same time, young people are helping
cover old people, just as they covered old people when they were young and
young people will be helping cover old people when these 20-somethings are
old.  Insurance isn’t about a 2 year ROI.


The AHCA is a terrible failure of American government/politics/society.  I
can't imagine defending this particular piece of legislation.


The AHCA is the cruelest act of government to kill its own citizens that we
possibly have ever seen in the US.  I have seen other countries wage war on
their citizens, but I never thought I would see it here.

Take care,
John


Mark Blacknell




mb () blacknell net
+1.202.270.5909
Washington, DC

On Sat, May 6, 2017 at 1:20 PM, Dave Farber <farber () gmail com> wrote:




Begin forwarded message:

*From:* Dewayne Hendricks <dewayne () warpspeed com>
*Date:* May 6, 2017 at 10:19:22 AM EDT
*To:* Multiple recipients of Dewayne-Net <dewayne-net () warpspeed com>
*Subject:* *[Dewayne-Net] What the Republican Health Plan Gets Right*
*Reply-To:* dewayne-net () warpspeed com

[Note:  This item comes from friend Bob Frankston.  Bob’s comment:'The
author blithely offers a "let them eat cake" piece of advice by saying that
people with preexisting conditions can just get a job and get coverage via
their employer. Totally out of step with a gig and entrepreneurial economy.
Or for that matter, any rational economy that doesn't try to hide the true
costs of healthcare.’.  DLH]

What the Republican Health Plan Gets Right
By MARC K. SIEGEL
May 5 2017
<
https://www.nytimes.com/2017/05/05/opinion/what-the-republican-health-plan-gets-right.html


Now that the Obamacare replacement bill has passed the House and is moving
on to the more centrist Senate, the real debate begins. What is the true
purpose of health insurance, and what is our government’s goal in ensuring
we have it?

I learn from my patients every day about the benefits, limitations and
contradictions of their health insurance. One charming 60-year-old with
severe seasonal allergies insists on seeing me every few weeks this time of
year, even though I tell her she doesn’t need to — her antihistamines and
nasal spray treatment rarely changes. But she worries that her allergies
could be hiding an infection, so I investigate her sinuses, throat, lungs
and ears. I reassure her, and her insurance (which she buys through New
York’s Obamacare exchange) covers the bill.

If she was responsible for more than a small co-payment for these visits,
I’m sure I would see her less often.

We pride ourselves on being a compassionate society, and insurance
companies use this to manipulate us into sharing the costs of other
people’s excessive health care. Meanwhile, 5 percent of Americans generate
more than 50 percent of health care expenses. Why shouldn’t a patient who
continues to see me unnecessarily pay more?

The government’s job is to maintain public health and safety. It should
ensure that insurance plans include mandatory benefits like emergency,
epidemic, vaccine and addiction coverage. The Republican bill would let
states apply for waivers to define these benefits differently; it would be
a big mistake to drop such coverage entirely. But Obamacare went well
beyond these essentials, by mandating an overstuffed prix fixe meal filled
with benefits like maternity and mental health coverage that drove smaller
insurers with fewer options out of the market. The few that remain often
have a monopoly, and premiums rise.

Speaking of compassion, how about some for the 20-something construction
worker who can’t afford to pay his rent because his premiums help subsidize
overusers like my allergy sufferer? Why shouldn’t a patient who is
risk-averse pay more for coverage she might never need, while that
construction worker be allowed to choose a cheaper insurance plan that
might cover only the essentials?

In addition to limiting the menu of essential benefits, the House bill
would let states create high-risk pools for patients with pre-existing
conditions who had let their insurance coverage lapse, and who could then
be charged premiums more in keeping with their health care needs. This is
the only way to make insurance affordable for most consumers; pre-existing
conditions will continue to drive up premiums if everyone is compelled to
pay the same price.

These risk-pool premiums can and should be subsidized by the government. A
recent report from the Kaiser Family Foundation found that high-risk pools
can work, but have been historically underfunded. Trumpcare should change
that — though it will cost more than the House bill’s $8 billion in
additional funding. Drastic cuts to Medicaid should also be reversed, which
could help the bill pass the Senate.

[snip]

Dewayne-Net RSS Feed: <http://dewaynenet.wordpress.com/feed/>



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