Thursday, August 15, 2019

Another reason Health Care-for-All is the solution to problems below...

The stories about health care on spinning out fast and furious, so it's hard to cover every nightmarish situation that screams for universal health care, now.

Trump's Junk Insurance Plan Wastes Money, Doesn't Pay for Health Care: Here's one thing almost everyone said would happen...except Trump and his drooling mod of deplorable's:
BREAKING: Trump’s junk insurance plans are spending an average of 39% of your premium on actual medical care. ACA requires 75% minimum. Short-term health plans spend little on medical care.
No, really? This is what happened before the ACA became law, and why the ACA was so desperately needed.

Uninsured Rise, Again: Excluding Trump and his panting cult, almost everyone predicted an increase in the uninsured rate thanks to Trump's attack on Obama's one big political and social success:
ModernHealthcare: The Obamacare exchanges last year lost 1.2 million of its unsubsidized enrollment last year, the CMS found in a report released Monday.

From 2016 to 2018, 2.5 million people who were paying their entire Affordable Care Act premiums dropped out of the individual market.

The Trump administration's latest enrollment snapshot doesn't bring many surprises given the high price tag for premiums, but the numbers are stark. The exchanges saw a 40% drop in unsubsidized enrollment from 2016 to 2018, and the declines hit almost every state.
Check out this down-the-rabbit-hole perspective:
In a statement, CMS Administrator Seema Verma characterized the report as another sign that the ACA isn't working. "The ongoing exodus of the unsubsidized population from the market proves that Obamacare's sky-high premiums are unaffordable."
Uh, that "unaffordable" and "unsubsidized" market Verma is talking about is...the existing insurance market without government subsidies, which is what Republicans call the free market and want to return to. Doh?
The high premiums (are) attributed to "sabotage" by the Trump administration and GOP lawmakers in Congress.
Medicare-for-All includes all coverage, all doctors, and all hospitals!!! Democrats continue to repeat absolute nonsensical talking points pushed by Republicans:
Joe Biden and other moderate Democratic candidates opposed to “Medicare for All” have cast the plan as anti-labor, arguing that it would leave union members worse off by stripping them of the health care benefits they painstakingly negotiated. But not all labor unions agree. Many others unions remain undecided. 

Some of the biggest labor groups in the country have embraced the plan. Those supporting Medicare for All say health care increasingly dominates contract battles, consuming bargaining power that could instead be directed toward raising wages and improving working conditions.
Sara Nelson, president of the Association of Flight Attendants: “When we’re able to hang on to the health plan we have, that’s considered a massive win. But it’s a huge drag on our bargaining. So our message is: Get it off the table.”
It's true that union workers are wary of giving up hard-won benefits, even when promised a plan that covers more services for less money.
Eliminate International Medical Vacations: Lower Hospital Costs Dramatically, Pay Doctors Well Instead in Medicare-for-All: Bet you didn't know a major Wisconsin manufacturer is saving huge amounts of medical payouts with this in foreign countries: 
Donna Ferguson awoke in the resort city of Cancun. She walked down a short hallway from her Sheraton hotel and into Galenia Hospital. A surgeon, Dr. Thomas Parisi, who had flown in from Wisconsin the day before, stood by Ferguson’s hospital bed and used a black marker to note which knee needed repair. For this surgery, she would not only receive free care but would receive a check when she got home.

The hospital costs of the American medical system are so high that it made financial sense for both a highly trained orthopedist from Milwaukee and a patient from Mississippi to leave the country and meet at an upscale private Mexican hospital for the surgery.

Ferguson gets her health coverage through her husband’s employer, Ashley Furniture Industries. The cost to Ashley was less than half of what a knee replacement in the United States would have been. That’s why its employees and dependents who use this option have no out-of-pocket copayments or deductibles for the procedure; in fact, they receive a $5,000 payment from the company, and all their travel costs are covered. Parisi, who spent less than 24 hours in Cancun, was paid $2,700, or three times what he would get from Medicare, the largest single payer of hospital costs in the United States. Private health plans and hospitals often negotiate payment schedules using the Medicare reimbursement rate as a floor.

The high prices charged at American hospitals make it relatively easy to offer surgical bargains in Mexico: In the United States, knee replacement surgery costs an average of about $30,000 — sometimes double or triple that — but at Galenia, it is only $12,000, said Dr. Gabriela Flores Teón, medical director of the facility.

The standard charge for a night in the hospital is $300 at Galenia, Flores said, compared with $2,000 on average at hospitals in the United States. The other big savings is the cost of the medical device — made by a subsidiary of the New Jersey-based Johnson & Johnson — used in Ferguson’s knee replacement surgery. The very same implant she would have received at home costs $3,500 at Galenia, compared with nearly $8,000 in the United States, Flores said.
Medicare Needs Major Changes Too: Here's a story I personally experienced with own mom that ended up costing our family a lot of needless out-of-pocket spending.

NOTE: Every bad thing in the blog post would not be an issue with universal health care. Think about that: 
Medicare paid for Betty Gordon’s knee replacement surgery in March, but the 72-year-old former high school teacher needed a nursing home stay and care at home to recover.

Yet Medicare wouldn’t pay for that. So Gordon is stuck with a $7,000 bill she can’t afford — and, as if that were not bad enough, she can’t appeal. The reasons Medicare won’t pay have frustrated the Rhode Island woman and many others trapped in the maze of regulations surrounding something called “observation care.”

Patients, like Gordon, receive observation care in the hospital when their doctors think they are too sick to go home but not sick enough to be admitted. They stay overnight or longer, usually in regular hospital rooms, getting some of the same services and treatment (often for the same problems) as an admitted patient — intravenous fluids, medications and other treatment, diagnostic tests and round-the-clock care they can get only in a hospital.

But observation care is considered an outpatient service under Medicare rules, like a doctor’s appointment or a lab test. Observation patients may have to pay a larger share of the hospital bill than if they were officially admitted to the hospital. Plus, they have to pick up the tab for any nursing home care. Medicare’s nursing home benefit is available only to those admitted to the hospital for three consecutive days. Gordon spent three days in the hospital after her surgery, but because she was getting observation care, that time didn’t count.

There’s another twist: Patients might want to file an appeal, as they can with many other Medicare decisions. But that is not allowed if the dispute involves observation care.

Monday, a trial begins in federal court in Hartford, Conn., where patients who were denied Medicare’s nursing home benefit are hoping to force the government to eliminate that exception. A victory would clear the way for appeals from hundreds of thousands of people. The class-action lawsuit was filed in 2011 by seven Medicare observation patients and their families against the Department of Health and Human Services. Seven more plaintiffs later joined the case.

“This is about whether the government can take away health care coverage you may be entitled to and leave you no opportunity to fight for it,” said Alice Bers, litigation director at the Center for Medicare Advocacy, one of the groups representing the plaintiffs. If they win, people with traditional Medicare who received observation care services for three days or longer since Jan. 1, 2009, could file appeals seeking reimbursement for bills Medicare would have paid had they been admitted to the hospital. More than 1.3 million observation claims meet these criteria for the 10-year period through 2017, according to the most recently available government data.

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