The unofficial Obamacare thread...

[jvlgato]

Oh, one more thing about Primary Care Doc's and overprescribing antidepressants. The very typical and extremely common scenario is this: you are the PCP. You have 10 minutes to see your patient. You have to deal with severe hypertension, diabetes, and the cold they came in for. Oh, by the way, can you fill out my kid's school physical? Oh, and can you look at this weird growth on my skin? It's been growing for 6 months now. Now at 20 minutes for the visit, 10 minutes late. Add that to the 30 minutes from the last 2 patients. Nurse tells you your next patient is getting pissed. Patient in front of you doesn't want to leave. What's the matter, you look upset? Why are you crying? 'I'm sorry. I can't take it any more. My job is terrible, I don't make enough money, and I'm about to get fired, my husband is cheating on me, my son is in jail. I'm just so depressed' (starts crying and won't stop). Now 40 minutes late and you need 10 minutes to document the visit. I know a good therapist, let me give you his card. 'I can't afford that, doctor. It's too expensive, I have no money, and my insurance won't cover it. ' Isn't there something you can give me to help?'




What do you do? Honestly.

 

[billmac91]

Is there a way for me to stop paying 25% more for health insurance every year? Is Trump gonna fix that?

Fuck everyone else. My wife and I are getting shit on every which way here in PA. Every year our insurance has gone up since this was instituted.

No...we're all fucked.

Which is the point....many think a minority group within the Republican Party were hellbent on letting Obamacare continue to tank which will force democrats to come to the table ready to negotiate just to put a stop to a democratic bill that has been an unmitigated disaster...

 

[Sebastian]

Is there a way for me to stop paying 25% more for health insurance every year? Is Trump gonna fix that?

Fuck everyone else. My wife and I are getting shit on every which way here in PA. Every year our insurance has gone up since this was instituted.

The problem always has been, since the GOP took the House, is that they have tried to kill the ACA any way they could. And when you are trying to kill something you are not looking to improve it. There was never a nation-wide good-faith implementation of the plan as many states opted out, and yes, it didn't work as envisioned because it was being sabotaged from the beginning.

Now that the GOP realizes they cannot pass a bill, for numerous reasons, one would hope that both sides can now come to the table and fix some of the problems with the ACA. Because that is what legislators are supposed do and a lot of people in this thread have explained several ways to fix certain issues. Considering how vital healthcare is to people, it should be a top priority and a bi-partisan issue.

But, let's face it. Based off what Trump said today, other than once again demonstrating he doesn't know how our government works (blaming Democrats for not voting for the bill... no shit, moron), it appears the GOP may not do a single thing, or entertain any proposals, to fix some of the issues with Obamacare. In other words, they may be perfectly content to do nothing, watch people get fucked over so they can blame the Democrats, and hope it keeps them in power in 2018 so that they can try again with another bill (that will fail because no one wants to lose coverage). This is likely if Ryan is booted as Speaker by the Freedom Caucus who, having no problem seeing 24 million people lose coverage, obviously would have no problem watching people wither on the vine.

The GOP is in the driver's seat. If things don't get fixed, that is on them. They control the House, Senate and White House. To claim that they can't do anything to tweak the ACA, if they actually tried (like with the intent of creating good policy) is not really believable.

 

[billmac91]

The problem always has been, since the GOP took the House, is that they have tried to kill the ACA any way they could. And when you are trying to kill something you are not looking to improve it. There was never a nation-wide good-faith implementation of the plan as many states opted out, and yes, it didn't work as envisioned because it was being sabotaged from the beginning.

Now that the GOP realizes they cannot pass a bill, for numerous reasons, one would hope that both sides can now come to the table and fix some of the problems with the ACA. Because that is what legislators are supposed do and a lot of people in this thread have explained several ways to fix certain issues. Considering how vital healthcare is to people, it should be a top priority and a bi-partisan issue.

But, let's face it. Based off what Trump said today, other than once again demonstrating he doesn't know how our government works (blaming Democrats for not voting for the bill... no shit, moron), it appears the GOP may not do a single thing, or entertain any proposals, to fix some of the issues with Obamacare. In other words, they may be perfectly content to do nothing, watch people get fucked over so they can blame the Democrats, and hope it keeps them in power in 2018 so that they can try again with another bill (that will fail because no one wants to lose coverage). This is likely if Ryan is booted as Speaker by the Freedom Caucus who, having no problem seeing 24 million people lose coverage, obviously would have no problem watching people wither on the vine.

The GOP is in the driver's seat. If things don't get fixed, that is on them. They control the House, Senate and White House. To claim that they can't do anything to tweak the ACA, if they actually tried (like with the intent of creating good policy) is not really believable.

This isn't entirely true.....again, the Freedom Caucus in fact didn't want to sign off on the new bill because they felt there was too much leftover from Obamacare in the new bill drafted by Paul Ryan. While "repeal and replace" became the slogan as they pitched the new healthcare plan, they weren't actually repealing the entire program. Many parts were being left in place.

But beyond the fact those within the Freedom Caucus wanted to outright repeal Obamacare and create an entirely new system, the 3 phased approach Trump and Ryan wanted, also didn't get enough support by those dissenting within the party.

I just think it's important to point out that Trump and Ryan were actually pushing a new healthcare plan that left many of the pillars from Obamacare. Trump and Ryan were both for coverage for those with pre-existing conditions (they just wanted a separate risk pool so those otherwise healthy wouldn't be on the hook for added costs) and they wanted to gradually change the healthcare system in 3 waves.

I'm not sure how effective their healthcare plan ultimately would've been, but the entire goal was to decrease costs for the average American after watching insurance costs damn near increase 25% year over year....it's been absurd. I guess we can argue who looks the worst as we're all now stuck with an insanely expensive Obamacare option that has insurers running for the hills leaving constituents with 1 or 2 options, and soon to be zero insurers in some states. Which is why I said earlier, all Americans lose on this deal.

Hopefully each party recognizes their faults in this situation and something "bi-partisan" can get worked out. Because the current system created by democrats and jammed through without any republican support has truly been a shitty option......

 

[The Human Q-Tip]

I have known the kid since 3rd grade. Top student, always wanted to be a doctor. Spent a year post grad applying to schools, no go.

But forget his situation, statistically, what are the odds? I can't see this as coincidence so I am wondering what driving that..

He may have done shitty on the MCAT.

Is there a way for me to stop paying 25% more for health insurance every year? Is Trump gonna fix that?

Fuck everyone else. My wife and I are getting shit on every which way here in PA. Every year our insurance has gone up since this was instituted.

Drop mandated essential coverages, drop guaranteed issue, and drop things like 26 year olds remaining on policies, which you're generally subsidizing even if you don't have an adult child of your own.

It stands to reason that the more things government mandates that insurance cover, the more expensive policies will be.

 

[CommD]

Its worth noting that the Republicans are still operating under the "Hastert" Rule, which limits their actions to a majority of the Republican caucus. This is their choice, and is what empowers the "Freedom" Caucus to control legislative action in the House. Its ultimately why Boehner resigned.

Its also why Trump's blaming of the Democrats for the Republican failure is so utterly ridiculous and insincere. After all, the McConnel's refusnik approach to anything brought forth by Obama is what made the ACA a Democrat-only bill in the first place.

Trump and Ryan could choose to abandon that approach tomorrow if they so choose, and do the right thing by the American people and address problems with the ACA on a bi-partisan basis.

Of course, they may have to come to Jesus about the BS the have been selling their own constituents about the ACA before the Dems will work with them, but so be it. Ryan may not survive as speaker, but ultimately he may wind up going the Boehner route anyway as he is obviouly in a no-win situation.

 

[CleveRocks]

Revising the ACA is not in Trump's best interest. This is purely a Republican party move and certainly not driven by the voters. Paul Ryan said he could get it done as the first agenda item, but failed to get the votes he needed.. Now they want to hang it on Trump.. If he smart he walks to the exit and goes to work on the next thing..

The insurance and Healthcare lobbies want to kill Obamacare, they are going to have to come to some solution that does not scare the crap out of the big demographics, ie boomer seniors and millenials..

I think the XO on Obamacare is they only thing that gets done on the topic until it implodes of its own accord..

 

[Sebastian]

I have known the kid since 3rd grade. Top student, always wanted to be a doctor. Spent a year post grad applying to schools, no go.

But forget his situation, statistically, what are the odds? I can't see this as coincidence so I am wondering what driving that..

I have no problem with Country of origin.. my cardiologist for example is quite good. My regular doctor Bangladesh has a Nazi bedside manner.. the other two are ok, but Nigeria has very poor English. It takes some time to communicate..

I've done a lot of research lately on this. I am by no means an expert, but my recommendations would be:

My guess is his MCAT was middling. That is essentially the touch of death when the average US Med School has an acceptance rate of 4-7%. There are a lot of guys with 4.0s and 50% MCATs.

1. I would suggest he takes the MCAT over and over until he gets 85% or better. They don't penalize for retaking the test.

2. Apply to a shit-ton of schools. Like as many as humanly possible. And keep it doing it until he sticks somewhere. It is worth it if he really wants to practice medicine.

3. Did he apply to any D.O. schools? DOs are fine physicians that receive the same training. However, due to a historical stigma that has mostly faded, they aren't seen as being as prestigious as MDs. In reality they are mostly the same. DO School is as bit easier to get in to. In fact, if he had a 4.0 and decent MCAT I think he could get in right now.

4. While he is reapplying, retaking the MCAT, do something medical. Anything. Med Schools value life experiences. Intern somewhere, do research. Something. Also, he should look into the Armed Forces possibly getting him a spot in Med School in exchange for some years served as a military doctor after graduation.

Any thoughts @jvlgato?

 

[jvlgato]

Spot on, @kingstannis.

I was going to post something similar but you did a much better job. Sounds snotty, but 4.0 students are a dime a dozen. Need >95+th percentile MCATS and extracurriculars that make you stand out.

 

[Sebastian]

Spot on, @kingstannis.

I was going to post something similar but you did a much better job. Sounds snotty, but 4.0 students are a dime a dozen. Need >95+th percentile MCATS and extracurriculars that make you stand out.

@CleveRocks I looked at the rankings again and MCAT scores (old scale prior to 2017) break down:

Top Tier: 36+ 95%+

Mid-Tier: 34-36 90%+

Everyone Else: 30-32 80%-85%

DO Schools: 27-30 65%-80%

And people think Law School admissions are competitive.

 

[jvlgato]

I actually still find it weird that he got a 4.0 at Case and didn't get into ANY med schools in Ohio, which has many med schools. I agree there's something missing. A straight A student at Case ought to be able to do well in the MCATS.

I've heard the story so many times. When I sit down and talk to people who got 'straight A's' and didn't get in, they usually got straight A's in everything except their premed science courses. Or got straight A's at a community college and transferred their credits to their 4 year school. I'll bet if we could actually look at his med school application, which shows a full transcript, MCATS, extracurriculars, and an essay, there would be something missing.

 

[CleveRocks]

I asked.. 3.95 at case, 92 on third mcat

 

[Sebastian]

I asked.. 3.95 at case, 92 on third mcat

Did he only apply to schools in Ohio? Those numbers should be good enough to get him in somewhere.

Lots of schools where that is above the median.

He could get into any DO school with those numbers. The best program is at Michigan State.

 

[jvlgato]

3.95 is excellent. Grades on basic sciences? (Chemistry, Organic Chemistry, physics, biology?)
What was his major?

The MCAT scoring system keeps changing. 92 is what, his percentile?

If he got a 3.95 for classes, all taken at Case, with 3.95 grades in the basic sciences and 92nd percentile in the MCATs, he ought to get into medical school somewhere, certainly a DO school.

Did he apply to every medical school in Ohio? Some outside of Ohio? Is he a resident of Ohio? Any DO schools?

 

[jvlgato]

Serious question, does he interview well? Good social skills? Do anything outside of study a lot?