What is the next Healthcare fix step?

Discussion in 'Politics, Religion, Social Issues' started by Rhonindk, Jul 29, 2017.

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What will be the next Healthcare fix step

  1. GOP will try Repeal / Replace again

    10 vote(s)
    24.4%
  2. The Democrats will propose a fix to the ACA

    3 vote(s)
    7.3%
  3. We will see a bipartisan attempt

    8 vote(s)
    19.5%
  4. A Single Payer proposal

    1 vote(s)
    2.4%
  5. Nothing but a bunch of talk

    19 vote(s)
    46.3%
  1. Rhonindk macrumors 68020

    Rhonindk

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    #1
    Was watching a bit on the "next steps" for a healthcare solution (CBS / FOX) and there was some commentary on n"wonder what is next" that was triggered by Trump still pushing for a fix, is bipartisan a real possibility, and growing commentary that McConnell should step aside.

    So I decided to see what are esteemed members here thought.

    Personally, I think we will see another GOP try.
     
  2. MadeTheSwitch macrumors 6502a

    MadeTheSwitch

    Joined:
    Apr 20, 2009
    #2
    I don't know how many times the GOP will keep getting on a sinking ship. It's embarrassing. I think what will happen next is first the Dems will propose some fixes to the ACA. That will be rejected by republicans. After that, perhaps both sides will realize they can't do this alone and start writing something together. Of course the fringes of each party will complain about that, but that is how legislation used to get done. Time to return to those days and start getting some things accomplished.
     
  3. fitshaced macrumors 68000

    fitshaced

    Joined:
    Jul 2, 2011
    #3
    I can't imagine anyone who believes that the poor should just be poor and stuff their unaffordable health care will ever start reasoning after losing an argument. The only way it will get through is if the voters threaten to kick them out of their cushy seat. It will take another election before the ACA gets another look I think.
     
  4. WarHeadz macrumors 6502a

    WarHeadz

    Joined:
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    Location:
    Los Angeles
    #4
    Agreed. Fixing healthcare requires starting with a common goal. When one side has a main goal of covering everybody, and the other side doesn't share that goal, you won't come to an agreement.
     
  5. BoxerGT2.5 macrumors 68000

    BoxerGT2.5

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    Jun 4, 2008
    #5
    Nothing will be fixed until the bottom falls out.
     
  6. mrkramer macrumors 603

    mrkramer

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    Somewhere
    #6
    With half the country not believing that you have a right to life after you are born there is no way anything substantial will be passed until the entire insurance market collapses and they start losing access to their care.

    On the bright side if doctors start defaulting on student loans due to a lack of patients who can afford to pay them without insurance we may get healthcare and education fixed as a result.
     
  7. Rhonindk thread starter macrumors 68020

    Rhonindk

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    Bloom County: Meadow Party
    #7
    That is the scary likely course.
    --- Post Merged, Jul 31, 2017 ---
    A couple of clarifications:
    • Loan deferment is a postponement of a loan's repayment. ...
    • Loan delinquency is a failure to make loan payments when they are due. ...
    • Loan default is the failure to repay a loan according to the terms agreed to in the promissory note.
    They will get their money. Not even bankruptcy will get you away from them.

    As a footnote: most newer doctors do not go into private practice until after the loans are paid off. Cost prohibitive.
     
  8. VulchR macrumors 68020

    VulchR

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    Scotland
    #8
    I think eventually enough people in the US will wake up and smell the coffee when they start having to take care of the baby boomer's in the final stages of their lives. I would expect quite backlash against any party not trying to provide basic health coverage as a safety net. If you think the VA medical system is a scandal now, just you wait and see what happens when middle class people realise how much it costs to care for elderly relative they care about, how much confusing pointless paperwork is involved, how much profiteering (and indeed outright fraud) goes on, and how horrible that care becomes once somebody can no longer pay.

    The US private health care system has delivered exactly what it was designed to do: profits, not health.
     
  9. BoxerGT2.5 macrumors 68000

    BoxerGT2.5

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    Jun 4, 2008
    #9
    Let's put it this way, politicians can't touch SS or Medicare as they are political 3rd rails. The ACA is another political 3rd rail. Couple this with the fact that both political parties would rather do nothing and wait to win seats in the house or Senate so they can pass a bill or a fix that resembles more of what they want, then to compromise with the other party. It's ****ed either way. Unless the premium increases rise so much that those who don't receive a subsidy (the majority) start to get extremely pissed. But then all I suspect would happen is Washington will raise the ceiling on who qualifies for a subsidy because it's better to get more people on the government tit.
     
  10. AsherN macrumors 6502

    Joined:
    May 11, 2016
    Location:
    Canada
    #10
    The flaw in that argument is that the older generation will be under MediWathever. It will be heralded as a failure of single payer and an excuse to do away with it altogether.
     
  11. BoxerGT2.5 macrumors 68000

    BoxerGT2.5

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    #11
    The baby boomers are on Medicare, they've reached the finish line. This is about the ACA.
     
  12. VulchR macrumors 68020

    VulchR

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    Scotland
    #12
    I think it more likely that people will want it supported better rather than abolished. Helping an elderly relative wipe their backside in the middle of the night, day in, day out, with no government help whatsoever gets old very quick. Trust me on this....
     
  13. AsherN macrumors 6502

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    Canada
    #13
    I know. Not arguing against the reality, rather on how it be be spun as an example of the failure of government provided healthcare.
     
  14. VulchR macrumors 68020

    VulchR

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    Scotland
    #14
    This is the delusion I am talking about. If you think Medicare sustains decent health care standards as currently funded and administered, you have a very rude awakening coming your way. I say this after taking care of my grandfather (multiple strokes), mother (cancer) and father (vascular dementia) at the terminal stages of their lives. All them were professional and upper middle class, but were broken by the costs of health care. My mother fared OK, but only because she died swiftly after being incapacitated, but my grandfather and father died not quite penniless - but with just enough to cover a basic funeral (not enough for a marker though). Wait until you see, wait until you see....
     
  15. BoxerGT2.5 macrumors 68000

    BoxerGT2.5

    Joined:
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    #15
    Merely pointing out that the Baby Boomers are on another program, not the ACA. I'm well aware of the pitfalls and shortcomings of medicare. Which really makes you question why the left advocates for a "medicare for all" when you yourself just painted such a glorious picture from you own personal accounts.
     
  16. Rhonindk thread starter macrumors 68020

    Rhonindk

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    Bloom County: Meadow Party
    #16
    Medicare does not. Medicaid does. Getting them onto Medicaid is the challenge. (Have a mom in that situation - heart/dementia).
    Biggest issue: the rules and qualifications keep changing.

    Medicare is okay as long as your health issues are minor or seldom.
     
  17. VulchR macrumors 68020

    VulchR

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    Scotland
    #17
    In understand your point about Medicare, but surely the experiences that people will have taking care of the boomer's will impact on their judgement of the ACA. Besides repealing the ACA has been linked to issues around Medicare, specifically how well it is funded. No underfunded government programme will work well.

    I am not a fan of the ACA because it still allows the private sector to profiteer. Having had experience with both the US and UK systems, I prefer a national health service, paid for out of progressive taxes, providing universal health care according to need. The care I have witnessed in the UK NHS has been far more humane than anything I have seen in the US under Medicare/Medicaid. The UK system is far from perfect, and it is suffering strain as well due to the demographics and poor social services (stripped of funding by UK Conservatives). However, as imperfect as the UK NHS is, it is a better solution than the mish-mash of public and private systems in the US.
    --- Post Merged, Jul 31, 2017 ---
    Sorry - you're right in a way - I think of Medicare/Medicaid because usually they both tend to be invoked toward the end. The combination of the two still falls short of providing good care. The combination does allow warehousing of people until they die though.
     
  18. BoxerGT2.5 macrumors 68000

    BoxerGT2.5

    Joined:
    Jun 4, 2008
    #18
    Which is why people have an issue with single payer or UHC in the US. Our government has shown an inability to deal with tough issues regarding Medicare and SS, handing them another program is the definition of insanity. Especially in a country of 300+ million and less than have pay income tax.
     
  19. VulchR macrumors 68020

    VulchR

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    Scotland
    #19
    And yet we manage a huge, complex military; comprehensive emergency services; education; roads and airports; elections; etc. All run by the government. :eek:

    This a matter of priorities, not capabilities. Why does the US can-do attitude evaporate when we talk about providing a national health service? It's a mystery to me, but I suspect lobbying by people getting rich from the system offers a clue.
     
  20. Zenithal macrumors 68040

    Joined:
    Sep 10, 2009
    #20
    My proposal is simple.

    Single Payer
    Additional or private insurance can be bought in lieu of the deduction from pay of the aforementioned
    Additional services like dental can be bought
    Rewriting or rather standardizing billing costs via codes throughout the medical industry that average Joe can look up; fixed costs
    Children will stay on until 25, this allows 18 YOs to not incur debt without a job and focus on their college years without worrying about breaking something or getting sick
    Possible government investment into drug companies

    We spend a lot of money on superfluous junk. If states were to legalize something like cannabis, that tax money could be directed to schools and healthcare, taking some of the burden off the federal government. Though this does mean legalizing something I don't see the point in. Can't have your cake and eat it, too.
     
  21. vrDrew macrumors 65816

    Joined:
    Jan 31, 2010
    Location:
    Midlife, Midwest
    #21
    US readers have probably seen those TV ads for a prescription drug called Humira. It's a medication used to treat a variety of unpleasant conditions such as Crohns Disease, ulcerative colitis, rheumatoid arthritis, and chronic psoriasis.

    Because Humira works by suppressing parts of the human immune system, there are all sorts of warnings of side-effects: which include fatal blood infections, cancers, tuberculosis, and death.

    Provided Humira doesn't kill you, there is another lesser known side-effect: It costs $3000 a month. There are generic equivalents, (technically known as "biosimilars") - but if you ask your doctor for Humira, your health insurance will end up paying $36,000 a year for this medication. Less whatever co-pays or deductibles you end up on the hook for.

    Humira has been off-patent since 2016. But it still accounted for $16 billion in global sales, the vast majority here in the US.

    Want to fix health care? Find a way to treat the tens of thousands of people with Crohns, colitis, and psoriasis without spending the best part of $40,000 a year for it. Rinse and repeat for the other top fifty- or one hundred most-prescribed medications, and you'll have made a good start.
     
  22. Rhonindk thread starter macrumors 68020

    Rhonindk

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    #22
    Items like this always come to light and are used to decry "the cost!!!". Some of them do take advantage of the consumer. Other don't. Politicians and other groups always grab the few abuses to support their pharma revision agenda.

    Couple items to think about: It costs up to $3Billion (with a B) to develop a new Rx in the US. You may need additional R&D for further studies as indicated by regulatory (local or global). More for longer term studies. Even more for legal (someone always sues.) We need to walk a fine line between abuse of the public trust and what is needed for new or reformulated drugs. If we blatantly cross over this line and just condemn, you will see a crash of the global Rx industry.
    Some say "Generic!". These are less audited at present than main brand pharma but the FDA (Federal and State) is trying to address this gap.

    We need to balance realistic cost/profit vs. abuse of the system if we want to "control" prescription drug prices.

    Sobering thought: under today's regulatory guidelines and legal environment we would not be able to develop a vaccine like polio in anywhere near the time-frame as the original or even the translated costs. It would likely never come to market.
     
  23. Zenithal macrumors 68040

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    Sep 10, 2009
    #23
    My understanding is most people hate generics and assume they're bunk medicine, whereas the namebrand is the real deal. I'm sure our local pharmacist can shed some light on this phenomenon of stupidity.
     
  24. vrDrew macrumors 65816

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    Jan 31, 2010
    Location:
    Midlife, Midwest
    #24
    Humira is an interesting, and enlightening, case.

    The drug itself was actually developed in the UK, by a company called Cambridge Antibody Technology, which was a partnership between some Cambridge University doctors, and the (UK Govt.) Medical Research Council. CAT worked with a US-based unit of a German biotech company to develop the drug. The rights to the drug were ultimately sold to Abbot Laboratories to manufacture and sell the drug here in the US. Abbott assumed the costs of testing and FDA approval (which were expensive) - but the actual development of the drug itself was largely funded by the UK taxpayer.

    The argument that US drug companies need to make huge profits to pay for the development of new drugs is getting a little timeworn.

    The other thing is that the Federal Government is legally prohibited from negotiating with drug companies on the prices of drugs like Humira. So, having been developed courtesy of the largesse of the UK taxpayer, it is turned around and used to soak the US taxpayer to the tune of a few billion a year for a decade or more.

    Why can't Medicare negotiate drug prices? Politics.

     
  25. rjohnstone macrumors 68040

    rjohnstone

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    Dec 28, 2007
    Location:
    PHX, AZ.
    #25
    There is some truth to it.
    While most generics are equal to their brand name counterparts, some simply fail to match efficacy of the original.
    Ask a pharmacists who's been in the business for more than 30 years. They know.

    I'll use Synthroid as an example, mainly because I use it and had a nightmare of a time managing my condition while on generic versions.
    The issue is generics can have an FDA set deviation of +/- 7% from the original on quantities of active ingredients.
    In the case of Synthroid, the dosages are done in micro grams. A +/- 7% deviation is close to two steps in dosage either way.
    My doctor and I couldn't get my levels stabilized on generics. Medco would only cover my meds if I went mail order on 3 mo supplies and they would alternate out between whichever Pharma company had the best deal on the generics. Some brands would send me too high (bad for the heart), some would keep me too low (numb fingers, slurred speech).
    I went brand name (DAW) and haven't had an issue since. Their dosages are dead on accurate.
    I pay full retail since Medco doesn't cover it even if the prescribing doctor say it must be DAW (dispense as written).
     

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