FT 10-05: Medical Care Act 2.0 (Debating)

[Lumine]

I move that this deeply flawed bill be tabled.

Seconded.

[ON Progressive]

I will open a vote for tabling.

[AustralianSwingVoter]

Aye

[KoopaDaQuick 🇵🇸]

Abstain

[Lumine]

Aye.

[The world will shine with light in our nightmare]

Abstain.

[YE]

Any reason the sudden urge to abstain after previous support?

Especially given there are zero bills in the danm quene. This isn’t the cancer pay act, people.

[The world will shine with light in our nightmare]

Any reason the sudden urge to abstain after previous support?

Especially given there are zero bills in the danm quene. This isn’t the cancer pay act, people.

Because the main criticism of this bill wasn't addressed - namely that price-gouging is mainly the fault of healthcare providers and not insurers.  Until that is addressed, I am uneasy about banning private insurance outright.  We should at least address either cost transparency or the price-gouging itself before making such a drastic change to the existing system, but I'm not sure what would be the best way to go about it.

[YE]

Any reason the sudden urge to abstain after previous support?

Especially given there are zero bills in the danm quene. This isn’t the cancer pay act, people.

Because the main criticism of this bill wasn't addressed - namely that price-gouging is mainly the fault of healthcare providers and not insurers.  Until that is addressed, I am uneasy about banning private insurance outright.  We should at least address either cost transparency or the price-gouging itself before making such a drastic change to the existing system, but I'm not sure what would be the best way to go about it.

Fair enough, though tabling this bill makes no sense given the lack of queue we have.

I'll look into this further soonish once I'm all caught up on schoolwork. Seeing as for once I'm not running a campaign, I'll have the time this weekend hopefully.

[ON Progressive]

The tabling motion has failed to break the two-thirds supermajority as required by the standing orders.

[Esteemed Jimmy]

Does anyone have anything to add?

[YE]

I’ll get around to fixing this.

[AustralianSwingVoter]

The fact remains that this bill is absolutely horrendous. Banning private insurance will do nothing to help people, and will do nothing to fix the problems found in the American health care system.

[AustralianSwingVoter]

I move for a final vote so we can get it over with and vote this bill down.

[Esteemed Jimmy]

I move for a final vote so we can get it over with and vote this bill down.

Members have 24 hours for objections.

[YE]

What's the status of IRL supplemental Medicare plans post-Atlas Care? Because to be clear I don't think those should be banned but also find the entire profit health care industry IRL in the US to be problematic and I don't want rich guys using private insurance while the poor stays on the government plan.

[The world will shine with light in our nightmare]

I am objecting to a final vote until we figure out a way to address cost transparency/reduction for healthcare providers.

What's the status of IRL supplemental Medicare plans post-Atlas Care? Because to be clear I don't think those should be banned but also find the entire profit health care industry IRL in the US to be problematic and I don't want rich guys using private insurance while the poor stays on the government plan.

That's a good question.  The RRPHA absorbed all current Medicare beneficiaries (along with Medicaid recipients) into AtlasCare.  I would think that Medicare enrollees keep their supplemental plans, but I'll confer with NCYankee just to be sure.

[AustralianSwingVoter]

1 week has now passed with no debate. No amendment is forthcoming, so I once again motion for a final vote. 24 hours for objections.

[YE]

I am objecting to a final vote until we figure out a way to address cost transparency/reduction for healthcare providers.

What's the status of IRL supplemental Medicare plans post-Atlas Care? Because to be clear I don't think those should be banned but also find the entire profit health care industry IRL in the US to be problematic and I don't want rich guys using private insurance while the poor stays on the government plan.

That's a good question.  The RRPHA absorbed all current Medicare beneficiaries (along with Medicaid recipients) into AtlasCare.  I would think that Medicare enrollees keep their supplemental plans, but I'll confer with NCYankee just to be sure.

there's been no debate because this remains unresolved.

[Southern Senator North Carolina Yankee]

I am objecting to a final vote until we figure out a way to address cost transparency/reduction for healthcare providers.

What's the status of IRL supplemental Medicare plans post-Atlas Care? Because to be clear I don't think those should be banned but also find the entire profit health care industry IRL in the US to be problematic and I don't want rich guys using private insurance while the poor stays on the government plan.

That's a good question.  The RRPHA absorbed all current Medicare beneficiaries (along with Medicaid recipients) into AtlasCare.  I would think that Medicare enrollees keep their supplemental plans, but I'll confer with NCYankee just to be sure.

Sorry for missing this and the PM sent a few days ago. Lot of PMs getting sent back and forth to start the Senate.

2. Medicare Recipients will be transitioned over in an orderly fashion, administered by the H&HS Sub-Department to the equivalent parts of Atlascare, from the equivalent parts of Medicare that they are presently enrolled.

I want to say yes, but the details of this transition were suppose to be handled by the SoIA and I don't think this happened with the level of detail that I had envisioned back when this was composed.

There are a lot of similarities in how Medicare and Atlascare works and both divided into Parts, though the details on the Parts I would refer back to Scott since he composed that aspect.

The thing I would note when I say Parts is that I refer to the internal Parts of the AtlasCare program and not Parts I, II, III of R&RPH itself. In hindsight once Parts were added to Atlascare I should have utilized different section divider names for the bill itself.

Both Atlascare and Medicare charge premiums, but for Seniors those premiums are "subsidized to Medicare levels" and the beyond that the Sliding scale subsidy kicks in to cover the difference in place of Medicaid, which we got rid of (along with most every other federal health care program). I think the subsidy is probably more generous than what Medicaid offered and with far less strings attached, though for exact numbers I would recommend PiT or Encke, because I still cannot read that formula:

a. Healthcare Insurance will be subsidized in accordance with a sliding scale subsidy based on age and income in relation to a maximum of $12,000 annually, indexed to Health care inflation.
b. The formula is as follows: y = 1 - (x - f(t))/2
where x is the multiple of $12,000 that their annual salary amounts to and f(t) is the formula for determining the max subsidy cutoff as a function of age t. (f(t) = 0.0022*(t-20)^2 - 0.0291*(t-20) +1.66))

It would be a hell of a tall order for the GM to pull off, but at some point we need to get a read on what healthcare inflation is like post all our drug cost/health cost bills passed subsequent to R&RPHA because that will allow us to know what Atlascare is charging for premiums and also what the max cut off for the formula is now. At 5% for instance, it is up to $13,230 now.

The thing that makes me unsure about this is that we pushed to move away from "sliding scale benefit" or partial benefit like Medicare IRL, in favor of a public option that covers the whole tab at the point of delivery and then a sliding scale subsidy (which is a separate program) based on age and income to help those who need it, to cover the public option's or its competitor's premiums. This aspect kind of makes me think that Atlascare would squeeze supplementals out, but in its place create an industry of Atlascare competiting plans (assuming a region allows competition to Atlascare) aimed at seniors. I don't think these would be many in number for various reasons though.

[Fmr. Representative Encke]

I think the subsidy is probably more generous than what Medicaid offered and with far less strings attached, though for exact numbers I would recommend PiT or Encke, because I still cannot read that formula:

Here's a visualization of the subsidy I whipped up in Mathematica:

[Southern Senator North Carolina Yankee]

And its still too steep a decline in subsidy for my liking lol.

[Southern Senator North Carolina Yankee]

Shua used to make a big deal about avoiding benefit cliffs. You make $1 over a threshold and you lose all your benefits, basically.


We spent what seemed like an eternity trying to get a formula that met all the criteria and had a slow rate of decline. Maybe the visual exaggerates the rate of decline in support because of how long its axis are.

[Fmr. Representative Encke]

Shua used to make a big deal about avoiding benefit cliffs. You make $1 over a threshold and you lose all your benefits, basically.


We spent what seemed like an eternity trying to get a formula that met all the criteria and had a slow rate of decline. Maybe the visual exaggerates the rate of decline in support because of how long its axis are.

The shape of the function means that the decline remains constant for all ages and occurs over an interval of $24,000. For instance, at age 20, the decline begins at $19920 and goes to zero at $43920.

[Southern Senator North Carolina Yankee]

Shua used to make a big deal about avoiding benefit cliffs. You make $1 over a threshold and you lose all your benefits, basically.


We spent what seemed like an eternity trying to get a formula that met all the criteria and had a slow rate of decline. Maybe the visual exaggerates the rate of decline in support because of how long its axis are.

The shape of the function means that the decline remains constant for all ages and occurs over an interval of $24,000. For instance, at age 20, the decline begins at $19920 and goes to zero at $43920.

I see.