Goodbye and Good Riddance, AHCA

The Republicans have pulled their American Health Care Act bill from consideration and are moving on. So … who are the winners and losers?

Gotta say, one big winner is me. I’m sooooo tired of hearing about health care. I wasn’t looking forward to the fight in the Senate. I’m overjoyed that we’re done with that issue and moved on. Healthcare was about number 10 on my list of important things to get done. If it doesn’t happen until next year I’m perfectly fine with that.

Next big winner? Supreme Court Nominee Neal Gorsuch. Now, the Senate will not be totally consumed with a health-care fight. They can move directly to his up-or-down vote.

Who is next on the winners list? In the short run, Ex-President Obama. His namesake legislation is untouched. However, it is tottering. So in the long run, depending on how bad Obamacare gets, he may be a loser. This way, Obamacare is still in place and it is all still on his shoulders, for better or worse.

The Senate won in general. The fight over this bill would not have been pretty on either side. Lots of bitterness avoided.

The final winner was President Trump. Despite the loss, he got praise from both the conservative and moderate wings of the party for putting his shoulder to the wheel and giving it his all. Everyone knows it’s not a dictatorship, he doesn’t get to tell the House of Representatives how to vote. Sure, he’d have loved to win, but now he gets to forget about health care entirely and talk tax reform.

ahca 2

Guess which one a businessman would rather talk about?

Losers? Paul Ryan and the House Republican leadership. They put the bill together in secret. It was clear they were in deep trouble when Congressman Rand Paul was walking around the basement of the Capitol with the media in tow, to the door of the secret room, where the other Republicans said he couldn’t come in to see the bill. Very effective theater, to be sure, but it highlighted a very real problem.

However, given the blowback I suspect that will be the very last time Speaker Ryan makes that mistake … he was already talking today about wanting everyone to be involved in the writing of the tax reform proposal.

Finally, the American people both won and lost. Today’s polls showed that only 14% of the public supported the Republican plan. I certainly was not among the supporters. To me, it was poorly thought out and poorly written, obviously done in a hasty manner. So we won by not having this bill pass … but we lost because we’re still under Obamacare. Thirty percent of the counties in the US only have one insurance company. Premiums and deductibles have been climbing steadily. Not pretty.

My only comment on all of this is that the inability to pass this legislation is nowhere near as important as the politicians and the media would like us to think. People keep yammering on about how the Administration is “wounded” and the like … nonsense. Trump knows that not every deal gets to yes, and you simply move on to the next deal. The breathless analysis by both the right and the left is way overblown. Both sides of the media have exaggerated the importance of this. Yes, it’s a loss, and it looks big because it is the first loss, but it’s a four-year term. I just wish all the media would get a grip, and dial down the level of the rhetoric.

Onwards to the next political madness,

w.

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55 thoughts on “Goodbye and Good Riddance, AHCA

  1. What a difference an election makes!

    The Republicans now control the White House, Senate, and Congress. They fought the obummer-care replacement to a standstill, because they want to get it right. It’s called “deliberation”.

    The Democrats bonded in lockstep to rush through obummer-care, irresponsibly. “We have to pass it to know what’s in it!”

    It’s nice to have adults in charge, for a CHANGE!

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    • Republicans control the Senate IFF they have 60 reliable votes. The Dems invoked the nuclear filibuster option for approval appointees other than Supremes, but not for anything else. Those rules have been in place over 100 years now for a good reason.

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      • Once the Dems let the camel’s nose under the tent by eliminating 200 years of tradition and eliminating the filibuster when it was inconvienient for them, that’s notice that they will do so again when the filibuster is inconvienient, so the 60 vote requirement for anything is only going to last until the Dems want to do away with it and are in power.

        So why should the Republicans stick to a rule that hurts them that they know the Dems will not be restrained by?

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  2. I did not support it but neither did I oppose it. I have medicare as primary and employer based insurance as a secondary. I wonder how many of us were polled and what the question was. I never understood Obama Care and I did not understand this one.

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    • My understanding is that ACA was done to insure 10k to 15k not insured by government, work or private policies.
      Why did Obama, Pelosi and company need a 2000 page bill to insure 4% of the US population?

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  3. It’s my thought that the reason why health care costs are so high to require insurance (actually a prepayment plan) is due to the very existence of health insurance. Costs will only go up when the actual consumer is divorced from seeing the bill. Additionally employees don’t actually see how much their employer pays for health insurance that could actually be going out in wages. People clamoring for health insurance don’t get that they are compounding the problem.

    And if attorneys general would actually enforce consumer protection laws against Big Medicine and throw a few folks in jail I believe would also make costs drop like a stone.

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    • The real problem is that there is no real “list price” for health care. When “discounts” are routinely 90% or more, you know the un-discounted price is bogus. But people can’t just bypass insurance and pay directly without getting hit with the bogus price.

      If people could pay the “insured” price, most people could do away with “insurance” for the routine stuff and let it be real insurance, a bet against the odds, you betting you will have a major medical issue, and the insurance company betting that you won’t.

      the tax break of a HSA (paying health care costs with pre-tax money) and the encouragement it provides to save for a medical “rainy day” are nice to have, but would not be nearly as critical if it wasn’t for the pricing problem.

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      • It’s called a Chargemaster list. From Wiki:
        “Chargemasters include thousands of hospital services, medical procedures, equipment fees, drugs, supplies, and diagnostic evaluations such as imaging and blood tests.” “…is a comprehensive listing of items billable to a hospital patient or a patient’s health insurance provider. In practice, it usually contains highly inflated prices at several times that of actual costs to the hospital. The chargemaster typically serves as the starting point for negotiations with patients and health insurance providers of what amount of money will actually be paid to the hospital.”
        The so called “negotiations” obviously only occur with insurance companies if at all: “The impact of the chargemaster is such that those with good insurance or better access to means to afford quality healthcare pay the least for that care, whereas conversely uninsured, and others who pay out-of-pocket for healthcare pay the full chargemaster listed price for the same services.” However “In California, a regulation known as the “Payers’ Bill of Rights” (which is unique to the state) requires all hospitals to provide their chargemaster to the state, which then posts them online for the public.” Of course the probable result of overcharges to those without any ability to pay are additional costs to other’s insurance or the taxpayer (Medicare/Medicaid).
        A part of the Trump reform requirement:
        “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.”
        Obviously didn’t make it into the Ryan Care bill.

        https://en.wikipedia.org/wiki/Chargemaster
        https://web.archive.org/web/20161110004206/https://www.donaldjtrump.com/positions/healthcare-reform

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        • > Obviously didn’t make it into the Ryan Care bill.

          since that bill was an end run around the fact that they didn’t have enough votes to break a filibuster, they were limited in what they could put in it (thus the need for the phase2 and phase3)

          I suspect that price transparency is a two-part issue.

          First, Price can change the regulations to require that the prices be made available.

          But I suspect that it will take legislation to end the “discounting” and force medical providers to set real prices in their chargemaster lists.

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    • When you never see the “real” pricing of something, especially something structured as oddly as healthcare, you lose all sense of its value. In my mind, the only good way to fix health insurance is to make those costs both transparent and real. We should simply get rid of “group” healthcare plans and (like medicare) put each and every person on a personal plan that they themselves choose and pay for. I don’t want to get rid of employers contributions for healthcare plans, but would like to do it through personal healthcare “savings” accounts that the individual himself controls. And that HSA becomes the “property” of the individual, portable from one job to another.

      Next, I would level out the taxation imbalance on healthcare plans. Any money spent on a healthcare plan, or placed into a HSA would be completely untaxed, no matter the source of those funds (insert reasonable caveats here).

      Finally, I would put any healthcare subsidies on a true sliding scale, based on income, but getting rid of the terrible “cliffs” that actually discourage people from earning even a little more money. With Obamacare as it currently exists, a person can literally lose thousands of dollars of subsidy by increasing their income by just a single dollar (yes, an extreme case, but it is truly possible).

      Lots of other changes I’d make, but those get to the heart of it I think.

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      • If there is real pricing, most people won’t need a health care plan for routine things, they will need an insurance plan for major things, and something like a HSA (with company contributions) makes a huge amount of sense.

        Some companies would want to offer additional things, like covering 100% of routine preventitive care and I see no problem in their offering that sort of thing.

        But the key to gettng things under control is to get read of the fake pricing, and with it the care ‘networks’. Let the health care plans declare the most that they will pay for a procedure, and the health care providers declare what they will charge for the procedure, and let people decide who to use.

        I agree with the need to eliminate cliffs in subsidies, we need to eliminate cliffs in all benefits. I’ve seen people who avoid doing things that would probably help them in the long run because it would cost them so much from lost benefits in the short run.

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    • Bob Johnson,
      I agree with you about insurance being the major problem with healthcare costs. It has totally removed the relationship between cost and benefit. When I was a kid dad had his own business and we lived outside a small town in North Carolina. There was no insurance a far as I know so we paid cash for everything, drugs, tests, procedures, etc. Hospital bills you could pay on time. The doctors earned middle class incomes but still had time to devote 25% to 30% of their time to providing free or bartered healthcare for the poor. They did not have to have 3 to 5 employees solely dedicated to processing insurance claims.

      Recently I have decided that the best solution might be to eliminate health insurance all together with the exception of catastrophic (possibly provided by the government) and with the government providing for the healthcare needs of the actual destitute. Of course this appears to be where Obamacare is headed on its path toward oblivion.

      I cannot agree with the Progressive’s call for a single-payer system. All you have to do is look at how the government has run most of its healthcare programs (e.g., Medicare Part D, Medicaid, & VA/CHAMPVA) to see that a single-payer system could never be. or at least remain efficient enough for us to afford.

      Re davidelang and DaveK,
      Personally, I thing the government should immediately require that all drug advertisements contain a standard price (e.g., for a one month standard dose) and all medical providers must publish the price for each procedure they perform on both their website and in their office. All healthcare providers should also be required to inform the customer, in advance, of the price of any test, drug, or procedure they prescribe or recommend. All multi-tiered pricing of drugs, tests and procedures should be eliminated where at all possible, and the cash price to the consumer must always be less that or equal to the lowest billing price. At least to me these changes would slot right into an HSA type system.

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  4. One certainly hopes that Mr. Ryan has learned a lesson here. I will say that I am disappointed, however — after 7 years, the best they can do is a bill crafted in secret ignoring the rest of the party (and any potentially sympathetic independents and/or Democrats)? And then we have another representative on the eve of the vote doing his best Nancy Pelosi impression! They employed precisely the approach that they hated when the Democrats did it, only to find that the Republicans weren’t as easily cowed as the Dems were, and didn’t fall in line because they didn’t want to break the promises they made during the election. AND the mainstream Republicans pretty much ignored what the people said during the last election — we want to GET RID of Obamacare and its expense and regulatory burden, and get back to the free market. Is that to hard to understand?

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    • If you haven’t watched the press conference that Ryan gave after pulling the bill, you should.

      He talked about how easy it is for the minority party, they don’t have to actually have a plan, they can just be against something when they know that the majority is never going to let them kill it. Becoming the majority party and actually having to do something is hard.

      I found the honesty in his statement refreshing and I think that he will be trying very hard to avoid making the same mistake again. Unfortunately, I think that a lot of others have failed to learn the same lesson.

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    • I don’t believe Rand Paul and the US Senate get an input to the House bill until it is passed and sent to the Senate for their chance to fix the House bill.
      Rand Paul knows that so, running around like a cartoon chicken demanding something that wasn’t his was childish and disrupting to the process.

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  5. Scott Adams agrees:
    http://blog.dilbert.com/post/158812654486/trump-and-healthcare

    Speaking of healthcare, I predicted on Periscope here several days ago that the only way to get a bill passed was to let Ryan fail hard on the first attempt while scaring the left at the same time. That softens both sides to the middle. There was literally no other path to the middle. You couldn’t get there without the first step being a major failure by the majority party. This necessary step toward success is, of course, being reported as total failure.

    My non-mainstream view is that the biggest problem with health care is how expensive it is, not how the insurance is provided, and fixing the cost problem is hard because life is priceless.

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    • It’s hard because we spend about $4T per year health care.
      With a population near 350M that’s about $11.5K per person per year.
      Everybody knows that not everybody can afford it.
      How we pay for it is the current discussion.

      My question is whatever happened to hospitalization insurance?

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  6. Obamacare (Patient Protection and Affordable Care Act) is still unfolding and can only cause results to get worse. Trump and the GOP can just let this happen, while moving on to other things. Trump can say “I tried.” and his base can see and accept that. I think, also, this is a good thing, for now.
    At some point changes to Obamacare will happen but, until then, society will deal as best it can all the flaws.

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    • The dems have an answer to fix health care…
      Change to government single payer with price controls on all medical procedures and devices and then just throw more money at it.
      The progressive answer is always more taxpayer money.
      The only reason progressive programs fail is we didn’t spend enough taxpayer money.

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  7. I’d love to see Trump call a press conference and say these words: “Well, you know, I acted as I said I would, I immediately complied with a campaign promise within the first few weeks of my presidency, and within 90 days from assuming office we had a replacement ready for the AHCA disaster. My fellow Americans, you need to realize your elected representatives saw to it that this effort was shot down. Period. No other excuses. I tried my best to put out something that would replace the worst mess we have ever had that is sinking like a rock. When it implodes, please keep in mind that there was another option to watching the premiums and deductibles skyrocket as most major insurers pulled out of the exchanges and got out of Dodge. We can now move on to the other many areas that need some serious fixing that were either ignored or weakened by eight years of Obama’s ineptness..”

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  8. The conservative House Freedom Caucus members refused to support the RyanCare bill, because it was not healthcare legislation that would serve US citizens well going forward. Letting Obamacare continue to stumble on towards its ultimate failure will further embarrass the socialist democrats who oppose ‘repeal and replace’. They forced Obamacare on America. They own it! As Obamacare fails, so will the resolve of the socialist democrats.

    We can hope that America will get much better healthcare legislation when Paul Ryan and his minions have learned to craft legislation in a more transparent fashion and Nancy Pelosi and her socialist democrat cadres have been shamed into fractured cooperation.

    It’s Another Great Day for America!

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  9. Obama care tottering.
    No. More imploding than anything else.
    “Only 14% of the public supported the Republican plan.”
    Heck. I’ll bet less than 1% read it and fewer still understood it.
    The Dems have gone off the vacuous Pelosi deep end and the Ryan Reps are clueless.

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    • Technically, Senators and Representatives are both ‘Congressmen’, but you’re right, in common US parlance ‘Congressman’ usually refers to members of the House of Representative. /Mr Lynn

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      • Not to split hairs – In the U.S., the proper term for both is “legislators”…the house of Representatives member is a Congressman(or woman), and the Senate members are Senators. 🙂

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      • You are correct, WE. At least according to what I was taught in ninth grade Civics (I don’t think they have a course called “Civics” anymore…).
        Congress is one the three branches of government and is “bicameral”- composed of the Senate and the House of Representatives.

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  10. The Democrats crafted the “affordable” Care Act behind closed doors and had to pass it to see what was in it, while the Republicans are attempting to correct it, essentially in the sunshine for all to see. I believe it, the “Affordable” Care Act needs repair/replace and many folks have said it does, including Hillary nad Bill Clinton. I believe the current Congress will.

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    • Why do people still believe that the government should dictate what insurance coverage we must have and how much we must pay for it? There is no need to replace this boondoggle. Let the private insurance companies go back to offering a variety of plans and let the free market dictate the coverages and prices.

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  11. I go to see the outlaws in Switzerland quite often from the UK, where the NHS is a killer. The Swiss have an insurance based health care system and the government in the region screws the price down by using monopoly power against big insurance. Then the consumer is king and can choose from a number of private hospitals and diagnostic clinics. They make sure that there is plenty of competition. They pay a bit more than the Brits and less than the Yanks, but everyone gets quick and competent medical treatment and don’t die waiting or unable to pay.The French and German system are much better than the UK or US shambles too. Take care to get it right next time. Last but most important, get claims lawyers out of the picture.

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  12. The problem is that Obamacare created entitlements, namely subsidies for insurance premiums, and notably the proscription against pre-existing conditions, which essentially undermines the basis of insurance: you can’t insure your home after the fire has burned it down. Has the 20th-21st century USA ever rescinded an entitlement?

    In all likelihood the Obammunists expected from the start that the ‘Obamacare’ public/private patchwork was bound to fail, whence it would be replaced with ‘Medicare for all’, i.e. a form of socialized medicine. They are doubtless encouraged that the jerry-rigged Ryan bill has failed, since their path now looks clear.

    We have to hope that President Trump and those in the White House are actually in favor of free enterprise and limited government, so they will come back with a way of extricating the Federal government from medicine, and returning it to the States and the People (per the 10th Amendment). To that end, I have written a brief manual, which I invite readers of this estimable blog to peruse, “The Principles of Freedom and Medical Care”:

    https://walkingcreekworld.wordpress.com/2017/01/09/the-principles-of-freedom-and-medical-care/

    “How to to make free choice and free markets work in the increasingly complex world of contemporary healthcare.”

    /Mr Lynn

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  13. I am ecstatic with the outcome. Process is important regardless of the outcome. One of the reasons O’BamaCare is hated is because it was a cramdown – crafted in the dark and shoved down the collective throats of 330 million Americans. Ryan makes that same mistake.

    How to do this? Chunk it up. Put together 8 – 10 Bills and pass those that have enough support. Blame democrats for those that don’t. How to proceed? If it were me I’d ….

    – Bill 1 – Complete O’BamaCare repeal
    – Bill 2 – Block grant Medicare to the states. Remove all federal regs on it,
    – Bill 3 – Block grant Medicaid to the states. Remove all federal regs on it.
    – Bill 4 – Allow health insurance sales across state lines
    – Bill 5 – Allow private entities to set up pools for pre-existing conditions. If the insurance companies can figure out how to make money from smokers, they can bloody well do the same thing with pre-existing folks. Note for the record: My 31-year old is one of the pre-exisitng folks,
    – Bill 6 – Allow HSA’s / MSA’s – no limit on contributions / no limit on what the money is spent for / complete transferrability

    That’s a start, but it demonstrates where to go and how. Cheers –

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  14. “Healthcare was about number 10 on my list of important things to get done.”

    Perhaps for you but many like my wife need to have the private insurance companies get back in control of what they offer at what price. In order to do that, the ACA must first be repealed without replacement and the sooner the better. Personally I use the VA as a disabled vet but my wife has to go without. Prior to the ACA she had a plan for $205/month with a $1500 annual deductible. With the ACA her premiums would be over $500/month with over $7000 as an annual deductible.
    So what we need done is to repeal the ACA now but effective Dec 31, 2017. That would be plenty of time for private insurance to roll out their new policies. Have open enrollment for those new policies from Jan 1, 2018 through March 31, 2018. That would be plenty of time for people and companies to make the appropriate changes with regard to the new insurance available. But again, that needs to be done now.

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    • I concur.

      Healthcare is by far my largest monthly expense by a 2x+ margin. I maintain my legacy policy (4 individuals covered with no preexisting conditions) as any change would maintain the same pricing with significantly less coverage. It is by no means affordable for me, but I am trapped with no viable options so I continue to finance the Healthcare of others. Healthcare is a top 3 issue in my book and I greatly desire to get out of this force fed oppression from the democrat’s!

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  15. Thanks for the article Willis. I agree. I’m glad they pulled the bill rather than having another fiasco directly traceable to Republican leadership. I’d rather see Obama Care falter and then resolve the problems.

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  16. I have mixed feelings about the bill. It didn’t do anywhere close to everything that I want to have happen to ObamaCare, but I think it was about as much as it was possible to cram into the procedural trickery that is the budget reconciliation process. It would have made it easier for Price to gut the regulations, further backing off ObamaCare. But it would have made the Republicans responsible for the resulting mess. At this point they can keep pointing at the Health Care mess as being the responsibility of Obama and the Democrats.

    I will say that I have lost a lot of respect for quite a number of the hard-line right wing folks in both the House and the Senate over this bill. How can they ever expect to get a “perfect” bill created, let alone passed?? Perfection is not something that happens in legislation. It’s always a series of compromises between different interests and opinions.

    I hope some of them are uncomfortable with the fact that Pelosi is saying almost exactly the same thing that they are.

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  17. “Thirty percent of the counties in the US only have one insurance company. Premiums and deductibles have been climbing steadily. Not pretty.”
    I was always a bit bemused by the concept of Obahblah care which as I sort of understand it forces people to buy insurance from insurance brokers. The State of Victoria had a similar system for 3rd party auto accident injury cover. As above premiums climbed steadily eventually the number of insurers/competition fell to 1 so in the 1990s the State govt set up a no-fault scheme – an extra tax on motorists, but at least the super profits go to general revenue (sorry, road safety initiatives) rather than corporate and judicial lunches, and the question of who should pay seems to have been been replaced by “how much can we screw the system for”.

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  18. From the “I can dream files”.
    1 Make punitive lawsuits and “rewards” for malpractice non existent. Just have to know mistakes happen and live with it.
    2, Open up medical school to the masses, stop the AMA from limiting the production of new doctors.

    More doctors and lower overhead allows people to get medical procedures done for less. Insurance goes down.
    I believe the American public would vote for such a reform of the law.

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    • you do need punishment for doctors who are negligent.

      I have a friend who was in the hospital yesterday (4th trip this month) who has had 6 surgeons say that what she needs is beyond the expertise of anyone in the county, that she needs to see a specialist at USC, and a couple doctors scheduled her for surgery first thing monday morning and didn’t think that it was important enough to even bother talking to her first (they scheduled the surgery and told her the surgeon would stop by over the weekend and talk to her, then told her today that this seemed like such a trivial thing that he didn’t think it was necessary to talk to her first).

      Other (specialist) surgeons in the area heard what procedure she needed and didn’t even agree to have a consultation appointment with her, as it would just waste their time as it was far to complex for them to take on.

      They then sent her home. This after one of her doctors had said that he was reccommending to the insurance company that they send her by ambulance to USC for surgery, and scheduled the local surgery for first thing monday morning because of expected life-threatening complications that could hit any time.

      If they had gone ahead with the surgery and she had lost her entire stomach as a result (a common complication), “oops, mistakes happen” isn’t sufficient to cover the case.

      I fully agree that malpractice lawsuits are out of control, but there’s a good reason they exist in the first place.

      David Lang

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      • David, I agree stupid things happen, people make mistakes, it is real people who suffer. Maybe it’s time people realize they are dealing with actual humans and not some omnificent being. There are going to be terrible consequences for bad diagnoses. I suppose a person could refuse any treatment, that is the only safe way to avoid malpractice. Until science improves in this field there will be sad outcomes.
        This is all easy for me to say, being in good health and blessed with reasonable good genes. There are those who are not so lucky in the crap shoot of life. Nothing in life bares too close scrutiny without one having to turn away.

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      • “You do need punishment for doctors who are negligent.” Sure. But the punishments should be reasonable, not like a Stella reward of $1,000,000.00 for a lady who bought a cup of hot coffee at McDonald’s and spilled it on her legs. It is the legal system which is out of control. The outrageous price of healthcare is only a consequence.

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        • I agree with you that many lawsuits are unreasonable. I was only disagreeing with the ide of eliminating them entirely with the statements “mistakes happen, doctors are human”

          Yes mistakes happen, but there is a category of problems beyond mere mistakes, whatever you want to call it, and there needs to be punishment for that sort of behavior.

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  19. IT just occurred to me, give a 200% tax credit to doctors and hospitals for the money they lose on nonpayment care. Might relieve the pressure on the Government to provide one payer healthcare.

    Liked by 1 person

    • Current tax code does not allow doctors to deduct pro bono work for taking care of poor people. Many doctors would gladly to so for free if they could deduct the cost of doing so. A win for everyone except the federal tax man.

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  20. What on earth makes Rand Paul, a Senato,feel he should be involved in the work of the House. I’d keep him out just for being a jackass.

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    • Bob, while Rand Paul may be all that you claim, he was doing the right thing by pointing out that the House Republicans had taken a very wrong turn by crafting legislation in private. Me, I don’t care who it is that tells me I’m driving the bus over the cliff …

      w.

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  21. Since I am Founder and CEO (being founder is easist way to become CEO) of a company devoted to controlling nosocomial (hospital acquired) infection, I have been following this, albeit not closely. Obama’s ACA did not address health care costs, it addressed health care insurance. Not close to the same thing. The Ryan bill was just Obamacare Lite.
    The core issue is that the US spends almost twice as much on healthcare as comparable countries like UK, Canada, Germany, France, yet produces worse results on almost all healthcare metrics from infant mortality to longevity. Data cited in the last health care example in the context chapter of ebook The Arts of Truth.

    The reasons are structural, and true reform must address it. The US system is essentially fee for service. The more services provided, the higher the fees (doctor/hospital income). Medical malpractice lawsuits guarantee maximal ‘CYA’ services. A startling contrast between 3 top tier fee for service institutions (Mass General/Harvard Med, Hopkins, UCLA) and two top tier group practice institutions (Mayo, Cleveland Clinic). Sample is total cost of last two years of life from mortality of all causes (heart disease, cancer, whatever) for all treated patients from 2001-2005 . Now that is a large and severe sample. These people were or became terminal. Health care costs rise with age, and the last two years of life are almost always the most expensive. For sure by a lot in both my parents cases.
    The group practice outcomes focussed Mayo and Cleveland had on average 60% the total cost of the fee for service sample. Neither Obamacare nor Ryancare addressed this fundamentally broken US system problem. Maybe Trump will eventually get around to it, as is obvious to any business person when given such facts.

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    • Couldn’t agree more, Rud. The problem is not in the insurance end. As you point out, it is in the cost end, where we not only can’t control costs … we can hardly find out what they are. How much is a hip replacement? Nobody knows …

      Best to you,

      w.

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      • “How much is a hip replacement?”

        Don’t know about that but my wife just had a colonoscopy and was self pay, no insurance.
        $400 for the Gastro doc including initial consult, procedure and follow up results. $1300 for the OR, anesthesiologist, recovery room and nurses.

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  22. I want O-care gone, specifically the mandate that is what I call health care slavery. I’ve written to my state Democratic senator Richard Durbin and Rep Randy Hultgren about by angst about that law several times. Obviously Durbin was one of the @#%& that shoved that crap down our throats. There is a guy who is as fake as the news…pure socialist… swamp gator. He’s another example of why we need term limits.

    Personally I wasn’t for the repo-care either. So I’m not sad. We’ll just get to watch that Obamanation implode. I also don’t want single payer and have the same crappy health care as our poor vets. I want repeal… no replacement. We don’t need government in our business. Government is the problem… not the answer.

    Like

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