So you think Trump is bad

[aerius]

While you're all losing your shit over Donald Trump, Rand Paul just introduced a bill on Congress that will fuck shit up worse than anything douchebag Donnie can do short of punching the big red button.

I present the Obamacare replacement bill
https://www.congress.gov/bill/115th-con ... l/222/text

Of particular interest is section 601 which reads as follows:

SEC. 601. QUALITY HEALTH CARE COALITION.

(a) Application of the Federal Antitrust Laws to Health Care
Professionals Negotiating With Health Plans.--
(1) In general.--Any health care professionals who are
engaged in negotiations with a health plan regarding the terms
of any contract under which the professionals provide health
care items or services for which benefits are provided under
such plan shall, in connection with such negotiations, be
exempt from the Federal antitrust laws.

Congratulations, if this bill passes, the entire medical industry is now exempt from antitrust laws and they're free to carry out open price fixing & collusion. They can charge you as much as they want for anything they want, and there won't be a damn thing you can do about it. If you thought the Epipen price gouging last year was bad, you ain't seen nothing yet. Take that same price gouging, apply it to everything from Aspirin & insulin to stitches, broken bones, and everything medical related and crank it up to 11. If you want to see millions of people die for profit, here it is.

[The Romulan Republic]

Trump is horrific.

So are these shits.

Basically... Republicans gonna Republican. The whole party (or at least the elected leadership) is a giant cesspit.

And yes, Republican economic policy increasingly amounts to "If you are poor, its your fault, and your sentence should be a slow death". All for the betterment of those who already have everything, of course.

[Dragon Angel]

I don't think it was a question the other Republicans could be just as bad, if not worse. They're just seeing Trump do his thing and now they feel much more emboldened to pass any insane law they can think of, screwing everyone in this country with the exception of their rich donors. It may take millions of families four years to realize that they or their relatives are in deep shit, but I guess it will turn around sooner or later.

[The Romulan Republic]

Maybe when it does, we'll finally get the political support for single payer, once people see what the Republican version of the American dream is really like for the average person.

I just hope it happens sooner rather than later, and with as little suffering as possible.

[FireNexus]

As I read that, it says that doctors will not be subject to antitrust laws in connection to negotiations with insurance companies. So... it appears that doctors or medical providers just can't be hit with an antitrust complaint for banding together to squeeze insurance companies.

It says health care professionals negotiating with health plans are exempt in connection with those negotiations.

What part of that am I missin that doesn't specifically restrict the exemption to negotiations with health insurance companies by doctors.

Googling it finds that doctors (health care professionals) are currently restricted from collective bargaining with insurance companies because they're technically businesses which are subject to antitrust. So doctors get shafted by insurance companies who have an asymmetric bargaining position. And the result is that insurance companies get a sweetheart deal while doctors are forced to charge any uninsured through the nose.

I'm no big fan of Rand Paul, but letting groups of small business owners squeeze big, powerful corporate interests seems fine by me if they aren't going to be removed from the field.

[FireNexus]

I suppose it hinges on whether this:

(5) Health care professional.--The term ``health care professional'' means any individual or entity that provides health care items or services, treatment, assistance with activities of daily living, or medications to patients and who, to the extent required by State or Federal law, possesses specialized training that confers expertise in the provision of such items or services, treatment, assistance, or medications.

Includes pharmacies or drug companies. My understanding is that insurers usually negotiate with pharmacies rather than manufacturers. But I may be wrong.

[Ziggy Stardust]

I'm with Nexus, here. There is nothing in that reading to me that supports aerius' interpretation (also, I find it super disingenuous on his part that he quoted only a single paragraph of that section without also quoting the rest of its provisions and limitations .... though I can excuse that as incidental rather than malicious), though I'll defer to someone with actual legal experience who is better equipped to interpret these sorts of things.

[aerius]

I'm with Nexus, here. There is nothing in that reading to me that supports aerius' interpretation (also, I find it super disingenuous on his part that he quoted only a single paragraph of that section without also quoting the rest of its provisions and limitations .... though I can excuse that as incidental rather than malicious), though I'll defer to someone with actual legal experience who is better equipped to interpret these sorts of things.

The limitations apply to Federal government programs such as Medicare, Medicaid, military & veterans, and of course federal employees. The medical industry still needs to follow antitrust laws when dealing with the above entities, for instance, a group of doctors working with people on Medicare can't get together to fix prices for those particular patients.

However, for everyone else that's not listed under subsection 3, my understanding is that healthcare providers are allowed to collude with their fellow professionals to set prices when negotiating payments with the insurers and health plan companies who are paying the patient's bills. So for example, every doctor that deals with Blue Cross can legally get together and set a price floor on their services, and then they can do the same to every party that's not covered under the limitations listed above. The health plan providers will of course pass the bill to the patient so if you're not on Medicare or Medicaid you're kinda fucked.

[FireNexus]

They can only do that to health plans. They can't, under the above, collude to fix prices elsewise. This is collective bargaining for doctors, or at least it seems clear that is its intended purpose when you read the definitions in that subsections and the general language of the law. I can see ways it's ambiguous enough to be a problem, but I can't see that it is designed to allow doctors to fuck everyone over rather than to be on an actual negotiating footing with insurance companies.

There are enough actual intentional big fucking problems without having to make them out of nothing.

[K. A. Pital]

If this applies to legal persons, then entire companies may refuse to provide the mentioned plans below a certain prices, no? Not to mention that medical professionals having the upper hand in bargaining with the insurance companies (as much as the thought is likeable) will lead to the costs being carried straight over to the consumer of said services.

[FireNexus]

The bill as written applies to "health care professionals" (defined above) in their negotiations with "health plans" and explicitly states that the exemption is only under those circumstances. So it doesn't give health insurers any additional price fixing authority, or providers any authority to collide outside their dealings with health insurers.

As far as the passing of the price, yeah. But the unintended side effect is that it might drive down the cost of services for the uninsured. Currently, insurers have all the bargaining power, so they negotiate bare minimum prices for any service. Uninsured customers often don't pay, so the prices have to be raised for them to make up for the losses in a vicious cycle. And insurance companies sure don't give a fuck about that. By allowing them to collectively bargain with knsurance companies so that they can force them to pay the cost of keeping the business open to provide the service all up, rather than paying an insurance-company calculated "reasonable rate", we might could get those prices down. The result being that the uninsured pay less and the insured pay more, with everyone's prices approaching something like the actual cost of providing those services writ large.

Anything that makes health care pricing more transparent is fine by me. But I'm probably kidding myself as much as Rand is if I think it'd work out like that in reality.

[General Zod]

The problem with Trump is that he's just going to give this a rubber stamp without even bothering to read it. So yeah, he is still terrible.

[Flagg]

Trump is the Wearers of The Decaying Skin of The GOP rubber stamp. So, he's the problem. Any fuckwit in congress can sponsor a bill, if the executive won't sign it, then it doesn't matter.