Content That herring_RN Likes

Content That herring_RN Likes

herring_RN Guide 47,632 Views

Joined Mar 14, '04 - from 'California, USA'. herring_RN is a retired registered nurse. She has '>40 years' year(s) of experience and specializes in 'Critical care, tele, Medical-Surgical'. Posts: 15,926 (72% Liked) Likes: 30,247

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  • Aug 24

    Quote from AndyB
    The most important thing is to control the cost of healthcare services, but in terms of how we pay the costs, it's far more efficient (cheaper) to recognize from the start in general the same healthcare services are going to be provided no matter what, so the most efficient way to do it is to collect and pay our costs out of a single account.

    The Average ObamaCare premium is $408 per month. This is a 9% increase from 2015.

    The cost of health insurance has actually been rising sharply since long before obamacare.

    Pre-obamacare premium increases were typically around 6%, with premiums going up by double digits in certain markets. A number of private insurers in some markets failed to properly calculate the ratio of healthy to chronically ill consumers that would purchase their insurance, and as a result are now having to adjust with increases around 9%. Obamacare just gives is a way to pay more of the cost of healthcare.

    Quote from AndyB
    Insurance was cheaper before Obamacare. Obama decided to add mandatory "qualified health plans" to the mix which requires unnecessary item coverage to people who have no use for these items. One example is men are for to buy new plans that include prenatal care, maternity coverage, and newborn care coverage. This includes women past childbearing age. Children’s visits to doctors, dentists, and eye doctors even if you have no children. Obamacare policies also must include mental health and substance abuse services.

    Yes, these added provisions increase the cost of medical insurance to people who do need or do not want these provisions.
    That's not how insurance works, if you're a man and therefore unlikely to use maternity coverage for instance, that potential amount is not calculated into the cost, at least by reasonably competent insurance adjustors. Premiums are based on the amount of claims they predict they will pay out, if they are predicting they will pay out maternity coverage on a male and raising premium costs as a result then they are violating the actuarial value requirements of the ACA.

    If the cost of insurance through the exchanges is wildly over-estimated, why are so many insurers barely breaking even or even losing money?

    Prior to the ACA, individual insurance certainly was cheap, but that's because it didn't really function as insurance. I went from paying about $600 a year for an individual market plan to more than $7000 through an employer, and was happy to do so.

    Previously, the individual market was allowed to essentially decide they just didn't want to pay claims anymore on someone, the rate of claim denials was 1 in 7, with 6 digit claims almost guaranteed to result in plan cancellation. The ACA makes individual market plans pay their claims, which compared to not paying out claims is very expensive..

    Quote from AndyB
    As for your statement of "The CBO said that there will be a reduction in demand for hours amounting to about 2 million FTE's, not that it would "cost" 2 million jobs."

    I guess you failed to see the link I posted clearly that said: "CBO: 2 million jobs' worth of hours lost under ObamaCare" Since you did not see it last time I put it in bold for you.

    I did read it, did you? Because what it said was that the 2 million full time job equivalent reduction in hours was "almost completely due to decreased demand for hours" and cited the availability of quality insurance outside of employer-sponsored insurance as being a major factor.

    Quote from AndyB
    "Prior to the ACA, adequate insurance was only available through the employer-sponsored group markets, which led many people to work "just for the benefits" ie access to quality health insurance."

    That is not true. As a previous travel nurse it was easy to obtain coverage independently. You used to be able to simply go to a Blue Cross Blue Shield site, check out what you needed or wanted, and get the quote along with getting the insurance if so desired. This coverage was available for families also so I don't understand how you are trying to pain the picture that medical insurance was unavailable to small business owners also.

    You trying to say that new grads from nursing schools can't get jobs? How bizarre. Last I knew we already have a nursing shortage and it is expected to get even worse:

    The U.S. Is on the Verge of a Major Nursing Shortage - The Atlantic

    The only people cutting hours are those who do not want to lose subsides. But other peoples hours are being cut by employers so they won't have to be forced to offer them medical insurance. Garden's link: Fed Survey: Obamacare Causing Companies to Cut Jobs - CFO Journal. - WSJ

    Obamacare has not saved money. It has increased medicaid sign-ups by 9 million to 10 million. This is paid for by taxpayers. In a recent report to Congress, the Centers for Medicare and Medicaid Services said the cost of expansion was $6,366 per person for 2015, about 49 percent higher than previously estimated.

    Medicaid estimate renews cost concerns over '''Obamacare'''

    Where is the money coming from to pay for Obamacare subsides? This is paid for by taxpayers.

    As for your statement of "(the first year of the ACA cost containment measures was the first time in 50 years that healthcare inflation didn't rise faster than general inflation)".

    Another falsehood. The last time this happened was in 2008 which is 2 years before Obamacare.

    Quote from AndyB
    U.S. Health Care Costs Rise Faster Than Inflation Forbes Welcome

    You're correct that subsidies are funded by tax credits and tax deductions, which varies based on the persons ability to pay. Trump's plan greatly expands the amount taxpayers are contributing to health insurance for those who need insurance. The amount taxpayers contribute should be the minimum required, I don't agree with Trump's view that if we're going to contribute part of the cost that we should just go ahead and pay all of it.

  • Aug 24

    Quote from AndyB
    Oh Really?

    Only an extremely small portion of administrative costs are related to the dollar value of health care benefit claims. Expressing these costs as a percentage of benefit claims gives a misleading picture of the relative efficiency of government and private health plans.Medicare beneficiaries are by definition elderly, disabled, or patients with end-stage renal disease. Private insurance beneficiaries may include a small percentage of people in those categories, but they consist primarily of people are who under age 65 and not disabled. Naturally, Medicare beneficiaries need, on average, more health care services than those who are privately insured. Yet the bulk of administrative costs are incurred on a fixed program-level or a per-beneficiary basis. Expressing administrative costs as a percentage of total costs makes Medicare's administrative costs appear lower not because Medicare is necessarily more efficient but merely because its administrative costs are spread over a larger base of actual health care costs. When administrative costs are compared on a per-person basis, the picture changes. In 2005, Medicare's administrative costs were $509 per primary beneficiary, compared to private-sector administrative costs of $453.

    -Greg Mankiw Professor of Economics at Harvard University

    N. Gregory Mankiw

    Medicare Administrative Costs Are Higher, Not Lower, Than for Private Insurance
    By Robert A. Book, Ph.D.

    Medicare Administrative Costs Are Higher, Not Lower, Than for Private Insurance

    The Myth of Medicare's 'Low Administrative Costs'

    Forbes Welcome

    Hope you are not going to tell us the VA and Post Office are experts in efficiency because they are government.
    I'm familiar with Mankiw's piece on private vs public administration costs, as well as the various articles in response that pointed out his rationale was exactly backwards which he seemed to agree with.
    It is true that the typical medicare beneficiary uses far more healthcare services than the typical under-65 private insurance recipient. As a result there are far more claims to process per beneficiary in medicare, which is why the per-beneficiary cost is higher for medicare. So while we're paying medicare slightly more per person, the volume of work per person is much higher, which means for the same amount of work, medicare does that work for less.

  • Aug 24

    Quote from AndyB
    At the beginning of the healthcare reform debate in 2009, Obama and most Congressional Democrats said private insurers would be less able to gouge consumers with unreasonably high premiums and deductibles if they had to compete with a government-run plan. That’s because even though such a plan would have to abide by all the same rules as private insurers, the Public Option health plan would not be run by Wall Street and consequently would not need to allocate a substantial portion of premium revenue to reward shareholders (and, of course, insurance company CEOs).

    You do realize that Hillary's campaign has gotten over $41 million from from Wall Street don't you:

    Top Industries data for Hillary Clinton, 216 Cycle | OpenSecrets

    While they were saying that publicly, behind closed doors Obama administration officials were in constant communication with insurance industry lobbyists, and those lobbyists made it abundantly clear to the White House that while the industry could go along with most of the reform proposals Democrats were considering, they would not tolerate a Public Option.

    Why are you lying about Trump having a plan identical to Obamacare?

    Trumps's plan:

    1. Completely repeal Obamacare. Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to.

    2. Modify existing law that inhibits the sale of health insurance across state lines. As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.

    3. Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.

    4. Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.

    5. 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.

    6. Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources.

    7. Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers.
    Free market principles and having no requirement to buy insurance is far from Obamacare:

    Healthcare Reform | Donald J Trump for President
    I went through is plan in the forum dedicated to that topic, but again;

    #2 The ACA already allows for insurers to sell plans across state lines, it actually encourages this through the use of multi-state compacts which facilitate insurers in offering multi-state plans.

    #3 Helping people afford insurance through offsetting taxes is a good idea, that's what the subsidies are. The difference in what Trump is proposing is that it would help a very small window of consumers go from not being able to afford insurance to being able to afford it since it would be a broad tax break. What makes more sense is to focus those tax incentives where they are really needed, otherwise we're just wasting money while at the same time doing less to fix the problem.

    The biggest problem with this part of his plan is what he plans to do for those where a straight insurance deduction won't help, which is to put them on all fully government paid medicaid.

    #4 HSA based are already not only an option but are more popular than ever. And you can already pass HSA's on to heirs tax free.

    #5 The fees hospitals and other providers charge are already available, either through the CMS online database, various private groups that collect and share this data, and from the hospitals and providers themselves. Shopping around can be very useful, but only for a relatively small portion of the healthcare services we use. When you roll into the ER with a stroke, MI, etc, you don't have much leverage to bargain at that point, what makes far more sense is to utilize a service that can pre-negotiate all possible care you might need and use the leverage of a large block of consumers to negotiate for lower prices.

    #6 Putting more people into medicaid while simultaneously cutting medicaid funding only makes the basic problem of medicaid worse. This will either result in these costs just getting shifted back to private insurance plans (which makes fewer people able to afford private insurance pushing them into medicaid which creates an ever-worsening death spiral of healthcare underfunding) or some portion of the population will just have to be removed from access to medical care.

    #7 This one I agree with.

  • Aug 24

    Quote from PinayUSA
    Well it appears as if Huma worked at a radical muslim journal for 12 years.

    Huma Abedin worked at a radical Muslim journal for a dozen years | Fox News
    Huma worked for her mother's Journal on Muslim issues, this was a peer reviewed research journal which was an open forum for Muslims to discuss Muslim issues, this of course included conservative views. This was not a journal sponsored by or otherwise promoting extremist or terrorist groups.

  • Aug 23

    All the news "networks" have replaced the highest principles of journalism - honest, unbiased news - for whatever will get them the highest ratings. Hate watching the news. FOX, CNN, MSNBC, they're all the same, just a different slant on the bias....

  • Aug 23

    Quote from herring_RN
    Simple Definition of desperation
    1. a strong feeling of sadness, fear, and loss of hope
    2. a state of hopelessness leading to rashness

    Desperation | Definition of Desperation by Merriam-Webster

    noun: desperation

    • a state of despair, typically one that results in rash or extreme behavior.
      "she wrote to him in desperation"
      synonyms: hopelessness, despair, distress; anguish, agony, torment, misery, wretchedness;
      discouragement, disheartenment
      "her family failed to see her state of desperation"


    late Middle English: from Old French, from Latin desperatio(n-), from the verb desperare (see despair).

    Used in a sentence: The desperation of Hillary supporters is getting very amusing.

  • Aug 23

    Don't know that "desperate" exactly describes the Clinton campaign, though. So far, she's winning.

    Seems like over-confidence would be more likely.

  • Aug 23

    Quote from RobtheORNurse
    You almost had me. I clicked on the link expecting to see information such as date, location, and audience, just as I would in any evidence-based citation. But noooo, what I see is a reiteration of rumors that appeared on an anonymous discussion board. If a student submitted this, it would get a big red strikeout!

  • Aug 23

    Quote from RobtheORNurse
    What "speech"? The article says that there is a rumor going around since the 1990s that Clinton made negative comments about nurses, but no one has ever been able to find any documentation that that actually occurred. We all know that. Nothing new, no "speech," no documentation of her making any kind of negative statement about nurses.

  • Aug 23

    Quote from MassED
    He does what he wants, he says it like it is, which bothers many in our unfortunate P.C. society. He is the change that will bring the change. Everyone is relieved that someone finally had the nerve to light this fire. Love it and so do MILLIONS.
    Trump is the most PC candidate out there, spouting any alt-right meme he thinks the current audience wants to hear, regardless of whether he believes it. Witness his pronouncements to the religious right.

    The only truly new thing about his campaign is that he doesn't bother with dogwhistle coding, except when he's retweeting truly marginal nut-jobbery. "It was a sheriff's star!"

    ETA: "Millions" may love it, but so far he's still losing, which gives me hope for the fundamental decency and common sense of the American people.

  • Aug 23

    Quote from MassED
    Why WOULDN'T the POTUS want an amiable relationship to another superpower?

    That's just ridiculous to not want to work with Russia. Reagan worked with the Soviet Union. Treading softly is the answer. Maintaining friendly ties and good business relations is smart. Doubt that, then I doubt you.
    Ooookay ... Trump's business record is a little too spotty for you, so let's change the subject to national security and foreign policy.

    I submit that "maintaining friendly ties" has more to do with his personal financial goals in Russia than in protecting US interests. He's willing to sell out the Crimea to get under Putin's skirt, even going so far as to insist that the Republican Party change it's own platform position against Russian annexation. As his business record shows, he puts his own interests before anything else. Why should I believe he would take better care of the American citizenry than he has of his own investors, employees or vendors?

    Obviously, I'm not the only one wondering, since he's ditched Manafort so he doesn't have to answer any mor questions about that, either.

    I think it's conceivable that a Trump presidency could well lead to the US becoming just another client state.

    Then there's his bewilderment over nuclear weapons and the possible consequences of using them. I note with interest he's suddenly silent about that, too.

  • Aug 22
  • Aug 22

    All I know is I heard him say he was going to put his daughter Ivanka, and other experts in charge of "turning around healthcare because Obamacare doesn't "

  • Aug 22

    Well, there was that American-born dentist and his immigrant wife who supposedly seduced him into it. Maybe we should ban dentists?

  • Aug 22

    The 15 Rules of Web Disruption

    ... 6. Coordinate with a couple of others to “shout down” reasonable comments. This is especially effective when the posters launch an avalanche of comments in quick succession … the original, reasonable comment gets lost or attacked so much that it is largely lost.

    How to Spot - and Defeat - Disruption on the Internet