Rand Paul's Healthcare Proposal

Discussion in 'Health Care' started by RedDirtWalker, Jul 13, 2017.

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Would you be in favor of Rand Paul's Medical Bill..and why?

  1. Yes

  2. No

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  1. RedDirtWalker

    RedDirtWalker Well-Known Member

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    This has been out for some months, but I'm just now looking at it. If there is a thread already on this topic I was not able to locate it.

    Earlier this year Rand Paul came out with a proposed bill to reform the US healthcare system. Here is the summary of it in PDF and a video of him explaining portions of it. https://www.paul.senate.gov/imo/media/doc/ObamacareReplacementActSections.pdf


    On the surface it seems like a good plan.

    • Allows a person to tailor insurance to their needs, instead of a 60 year old having to carry pregnancy coverage.
    • It allows a 2 year window for people with preexisting conditions to get enrolled and once enrolled they can't be refused again.
    • It changes the tax code so that a person can get individual insurance as well as businesses.
    • It drastically (in a very good way in my opinion) overhauls the Health Savings Account system, making for unlimited donations, 5K tax deductible, and broader definition of "medical" to include weight loss, and general health items and programs. Just to name a few.
    • Promotes doctors to do charity work through tax incentives.
    • Allows IHPs (Independent Health Pools) which allows individuals to pool together for lower costs.
    • Allows insurers to sell in any state.
    • Allows small business operations to pool together based upon being a member of an organization. (Plumbers as an example)
    I'm not sure why this has not received any traction, but on it's surface it seems to have all of the qualities to lower insurance costs, thus making it more affordable for all.
     
  2. Lil Mike

    Lil Mike Well-Known Member

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    It hasn't gotten a lot of traction because there really isn't that much to it. Most of these are not bad ideas, but they are small ideas and won't really do much.

    • It allows a 2 year window for people with preexisting conditions to get enrolled and once enrolled they can't be refused again.

    I'm not really clear how that would work.
     
  3. RedDirtWalker

    RedDirtWalker Well-Known Member

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    How will it not do much? It changes the way the insurance sells to the people. It changes the way people can get insurance and make their own groups to help reduce the cost. It changes a lot.

    What exactly are you looking for in a Healthcare bill.
     
  4. Deckel

    Deckel Well-Known Member Past Donor

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    Some of this already exists. For instance many professional organizations allow members to buy health insurance as a group. It was cheaper for me to do it on my own instead of being part of a group. It is the one thing that in reality is different than it sounds--you get a high risk person or two in your group and you are the one paying a higher premium for that person as opposed to someone outside that group.
     
  5. Lil Mike

    Lil Mike Well-Known Member

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    I'm unclear what you mean by "it changes the way insurance sells to the people?" Honestly from those bullet point descriptions I didn't get a clear idea as to how this works. That's why I noted the pre-existing conditions bullet. What does that mean? Since pre-existing conditions has been one of the most vexing healthcare problems, that description doesn't tell me anything on how that would work.
     
  6. Ndividual

    Ndividual Well-Known Member

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    I voted 'yes', but in reality I would prefer to see the Federal government completely eliminated from providing any spending on health care.
    I would have voted 'no' only if that would result in complete repeal of Obamacare.
     
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  7. CourtJester

    CourtJester Well-Known Member

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    What an intelligent healthcare bill should do is control or reduce total healthcare spending in the United States. This bill does not do that. All it does is transfer cost to older and poorer Americans and save younger and healthier Americans some money.
     
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  8. RedDirtWalker

    RedDirtWalker Well-Known Member

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    The government shouldn't control costs. It should give the opportunities for the people and insurers to control cost. If a person doesn't like the cost of their insurance they can switch to a new company. This is done all of the time in many other markets and the people get cheaper rates. Not being locked into whatever your employer has or the government offers, gives people that option and makes insurers complete for business. His plan gives people that freedom. Using HSAs also allows a person to pick their hospital of choice in a non-emergency situation. This means that now the hospitals are competing for business also and thus what to be competitive to get business. This would happen at the doctor office level also. Right now people pick doctors based upon who's in their companies network. If theirs not a network then people can pick the doctors they want, thus making doctors compete for business. His plan seems to offer all of these possibilities.

    According to history, anytime the government tries to regulate it messes the system up, not improves it.
     
  9. CourtJester

    CourtJester Well-Known Member

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    That is pure nonsense. Allowing a choice of less coverage and a cheaper plan isn't competition it is a race to destruction of the health insurance system whoch s Rand apauls basic objective.

    And there has never been and never will be effective competition for medical services except perhaps for elective proceedures. Anyone who has ever been hospitalized for a major problem knows this is just a simple fact. You are in a bed and tests are ordered, and tests are run. What are you going to do, threaten to leave and go to a cheaper facility. Competition works really well where there are multiple options, time to make a decision, and the ability to not purchase the service. Those criteria will never exist for the most expensive medical situations.
     
  10. RedDirtWalker

    RedDirtWalker Well-Known Member

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    How is it a race to the destruction of the health insurance system. A person picks what they want and the insurance company provides it at a cost. Insurance "system" gets it's money and the person gets their desired coverage.

    Most medical procedures give you time to "shop". You have cancer and want treatment from this particular medical institution...done. You need your tonsils out, and from this medical facility......done, Bone spur removed.....done, Knee replacement....done......I can go on and on with examples. Yes you would have emergency services that you have no choice in, but most people over their life time are NOT dealing with emergency surgeries regularly. I had to have my Appendix remove that was on the verge of rupture. My doctor that examined me at his office looked at me and said......I'll meet you at the hospital.....NOW. While I didn't have time to shop around I could have determined prior to the need, what hospital I would want to go to and told the doctor.....I'll meet you at this Specific hospital.

    I was unable to locate a stat for the percentage of medical visits a person has in a life time that are emergency (if there is an available stat), but I would wager it's in the single percentile....like 2%. People keep harping on this EMERGENCY...EMERGENCY, but most medical services are NOT emergency's and people can and should have the choice of where and at what cost.
     
  11. squidward

    squidward Well-Known Member

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    They just want free ****
     
  12. Seth Bullock

    Seth Bullock Well-Known Member Past Donor

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    I don't always agree with Rand Paul on all things, but I admire him in many ways.

    The part I put in red concerns me, and I'll try to explain why. On its face it sounds logical. If you're a man why should your insurance include childbirth costs? If you're a woman, why should your insurance cover prostate problems? If you're young and healthy, why should your insurance premiums subsidize the premiums of older folks who have more ailments? Shouldn't older people pay more for insurance since they have more ailments? And if you're 50, and you've never been addicted to illegal or legal drugs, why should your insurance cover drug addiction treatment? I'm 62, and I am at almost zero risk of getting diabetes. Why should I have to pay for insurance that covers diabetes? I also have a long history of being a safe driver. Young people do not. Why should my insurance premiums be subsidizing the increased risk that younger people pose for the treatment for serious car crash injuries? Don't all these examples mean that we're all paying more for insurance that we don't need to subsidize others?

    Here are my concerns about tailoring insurance to your own needs ...

    Does it really save us money? By "us" I mean all of us - men and women, old and young. For example, if you have a million random people enrolled into a plan by an insurance company, and 50% are men, and 50% are women, we are spreading the risk of childbirth costs by including a group that will never have childbirth costs - the men. What this means is that an insurance company can offer insurance that covers childbirth to a young couple that plans to start a family that is affordable because of the premiums paid by the 50% who will never have children.

    The problem I see is that if we're allowed to tailor our insurance to our needs, no man will buy insurance that covers childbirth. No women beyond child-bearing age will buy it. And no woman who does not plan to have children will buy it. The only people who will buy insurance that covers childbirth will be women who plan to have children. The cost of their insurance will have to reflect the almost 100% chance that the insurance will have to cover one or more births.

    Let's talk about men ...

    If we can tailor our insurance to our needs, this means that all women and all young men will purchase insurance that does not cover treatment/surgery for prostate enlargement or prostate cancer. The only people who will buy it will be men in the high-risk category of being over 50. There will be no one in that group to mitigate that risk, and so the insurance will be very costly.

    Continuing ...

    If you are not and never will be addicted to drugs, you will not choose a plan that covers drug addiction treatment. Only people who are addicted to drugs will, and, most likely, it will be too costly to buy because there will be no drug-free people in the group.

    And what about the unexpected? What if you opt out of coverage for something you think you have little chance of getting, but then you get it. Like cancer while your young, for example. Now what are you going to do? Buy insurance just for people who have cancer? Good luck with that! It's going to cost a fortune, if you can even get it.

    And about the older folks, let's say aged 50-65. Yes, they have more ailments than younger people, and so they use their medical insurance more. So why shouldn't they pay more for insurance and younger people pay less? My answer to the 25 year old is that, I know this won't seem real to you, but you are the elderly ... just not yet, but inevitably. And when you're that age, you're going to be thinking about putting your kids through college, paying off the mortgage, and saving for retirement. You will probably be reaching your best earnings of your lifetime, and some of the financial struggles of your younger years will be abating. Do you really want your medical insurance premiums to be eating up your success and derailing your plans at that time? You see, what I'm saying is that if you pay a little more when you're young and healthy to pay for the insurance costs of older folks, you're really just "paying it forward". You are going to reap the benefit of that at a time in your life when you are really going to appreciate it.

    So, to summarize, what I'm saying is that spreading the risk (and that's what insurance is all about) is good for all of us. The more you spread the risk over all people, male and female, old and young, the more your insurance can cover and the less it costs for the coverage that you need when you need it.

    Almost all of my adult life (I'm 62), I have been covered by insurance that pretty much covers everything, male or female, young and old. Sure, it costs money, but whenever anything has happened to me, my wife, or my kids, I didn't have to wonder if it was covered. It was covered. And I shudder to think what would have happened if I had bought some cheap insurance that didn't cover this or that, and then this or that happened. And I will add that I was a part of a very large pool of insured people - young and old, male and female, and this worked out well for me and my family.

    My two cents ... Seth :oldman:
     
  13. Ndividual

    Ndividual Well-Known Member

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    Excellent point.
    Perhaps the best solution is to allow market to determine what health/medical coverage will be provided and at what cost, leaving individuals and NGO's within our societies to provide any excess funding as they needed and best spent. Of course government has a responsibility to intervene and act in cases where a highly communicable disease threatens our societies collectively.
     
  14. Deckel

    Deckel Well-Known Member Past Donor

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    Basically Obamacare Lite would allow people with preexisting conditions to enroll for the first two years but after that they couldn't. More or less it seems like a way to mandate those people to have insurance while removing the mandate for others.
     
  15. Deckel

    Deckel Well-Known Member Past Donor

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    Insurance companies would likely not tailor policies to such a degree. "Well I have had my tonsils out, so I can save money by having a policy that does not cover tonsillectomies now." doesn't seem realistic
     
  16. mak2

    mak2 Active Member

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    I thought the idea of insurance was spreading the costs over lots of people. That is why groups of people that work for big companies get better rates etc. So I think we should have one really, really big group health insurance policy. All American citizens should be the group. To figure out how much to charge you take all the healthcare we pay for in a year and divide it by how many Americans there are, charge that much. Easy huh?
     
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  17. RedDirtWalker

    RedDirtWalker Well-Known Member

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    Seth, I wasn't going to respond line by line so I shorten it so would know I responded.

    I believe you're taking the selective a bit to far. As @Deckel pointed out it seems impractical to get so selective as to not be covered for tonsillectomies. I have had my Appendix removed so that will never happen again; should I have a reduction in my insurance cost.....probably not. I also believe you're taking the way things are paid wrong, but to be fair I do not work in insurance I could be wrong. I believe the way it works is a person paying for pregnancy coverage, but not using it doesn't offset the pregnancy cost of a person using it. The person paying for prostate coverage pays into a large pool that the pregnancy cost pulls from, thus the person paying for prostate coverage does in fact pay for the pregnancy coverage. People are still paying into the pool like they always have, men just don't have to pay for pregnancy cover and women don't have to pay for prostate. If they want to though I don't see why they can't. A husband covers the wife's pregnancy or the wife covers the husband's prostate.
     
  18. RedDirtWalker

    RedDirtWalker Well-Known Member

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    Slick move on vying for National Healthcare.
     
  19. Deckel

    Deckel Well-Known Member Past Donor

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    Large employers are required by law to provide pregnancy coverage to employees as part of their mandated insurance. That alone would be a driver of keeping that aspect in most policies. That has been the law since before I was born. Really the large employer mandates are going to be the pool drivers here anyway. Interesting wrinkle though is apparently Obamacare didn't mandate the coverage for dependents so twenty somethings on mom's policies may not have their labor and delivery covered the way they think they would.
     
  20. Lil Mike

    Lil Mike Well-Known Member

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    That doesn't do anything about the costs of those people with pre-existing conditions in each group. If that really is Paul's plan as you describe it, it doesn't make sense.
     

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