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The PPACA Thread Part IV - Repeal & Replace, or Something...

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Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

WisconsinWildcard said:
Much of the MRI cost is in the interpretation. I would also add that many MRIs from the outside "low cost" centers can often be near worthless. They are cheaper for one because they are often done on less powerful machines. Another aspect is the protocol. An MRI at an academic center usually has a well experienced radiologist look over the order (who has access to the complete medical record), deem which sequences are best and make sure they are performed correctly. I am able to consult with the radiologist and get the most bang for our buck on a single MRI.

I think it is important to provide choice but a patient needs to know the downsides. I end up repeating most "MRI in a box" MRIs because they are done so **** poorly that one cannot tell much from them. Sure, some cases you can get by with that (I think ortho questions are generally better answered as they have a much simpler set of sequences) but for the most part in my field, it is a waste of time and money.

And do not get me started on open MRIs ;)
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The good news for me is that mine was for ortho purpose - left glenoid labrum check (torn - again).
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

Well, now with the major fallout from Comey coming, we at least see that little is going to happen which will overturn the ACA anytime soon.
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

bronconick said:
Senate Majority Leader Mitch McConnell (Ky.). Score: +25. "Once the Senate receives a nomination, we look forward to a full, fair and timely confirmation process to fill the Director position."

They'll be back on the ACA in two weeks, tops.
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May be back on it, but given that it takes so few R's to muddle things up- even if they get back on subject in two weeks, I can't see them making any real progress.

Too much boiling about Russia to actually do anything for the president.
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

bronconick said:
Senate Majority Leader Mitch McConnell (Ky.). Score: +25. "Once the Senate receives a nomination, we look forward to a full, fair and timely confirmation process to fill the Director position."

They'll be back on the ACA in two weeks, tops.
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Before then. Although they'll go nuclear to get the new FBI director confirmed. The Democrats won't confirm anyone without a Russia Special Prosecutor and that won't happen. So, all Mitch has to do is go nuclear, rubber stamp the new FBI director and BANG, Health Care is back on the docket.
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

Yeah...remember the Senate isnt exactly happy they have to deal with this crap anyways. They can stall as long as they want and wait until the CBO numbers come out. It isnt like Trump or the ACHA is polling high right now they have no reason to hitch their wagons to it.

Trump will appoint someone fast (I am sure we can look at his donor list and take some guesses) but they arent going to rubber stamp them in this climate.
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

ScoobyDoo said:
Before then. Although they'll go nuclear to get the new FBI director confirmed. The Democrats won't confirm anyone without a Russia Special Prosecutor and that won't happen. So, all Mitch has to do is go nuclear, rubber stamp the new FBI director and BANG, Health Care is back on the docket.
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They can do that but they wont...not yet at least.
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

Handyman said:
They can do that but they wont...not yet at least.
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I think they will. Mitch is on the 13 man health care team and the Republicans want to get to Tax Reform. They need that 880 Billion dollar tax cut from the Health Care bill badly and nothing is going to stop them from getting it.
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

ScoobyDoo said:
I think they will. Mitch is on the 13 man health care team and the Republicans want to get to Tax Reform. They need that 880 Billion dollar tax cut from the Health Care bill badly and nothing is going to stop them from getting it.
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Besides angry constituents who are already lashing out at the House members. Nice to see that, BTW.

Especially the morons who admitted not reading the bill. Some of the same morons who complained that a year of working on the ACA wasn't long enough.
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

ScoobyDoo said:
I think they will. Mitch is on the 13 man health care team and the Republicans want to get to Tax Reform. They need that 880 Billion dollar tax cut from the Health Care bill badly and nothing is going to stop them from getting it.
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Mitch is evil but he isnt stupid. They wont pass the bill as is anyways (even in Reconciliation it doesnt have the votes yet) and with Trump now all over the place doing his best Tricky Dick impression they will stall. They arent in the hurry the House was. Ryan promised this and it crapped the bed twice making him look like an ineffective Leader. (cause he is one) Mitch doesnt have to do anything he doesnt want to.

The Senate never wanted this and the Russia deal gives them the perfect cover to sit on it and do what they do best. (i.e. nothing)
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

Handyman said:
Mitch is evil but he isnt stupid. They wont pass the bill as is anyways (even in Reconciliation it doesnt have the votes yet) and with Trump now all over the place doing his best Tricky Dick impression they will stall. They arent in the hurry the House was. Ryan promised this and it crapped the bed twice making him look like an ineffective Leader. (cause he is one) Mitch doesnt have to do anything he doesnt want to.

The Senate never wanted this and the Russia deal gives them the perfect cover to sit on it and do what they do best. (i.e. nothing)
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The pull of a near trillion dollar tax cut is a huge want. If they could slip it into a "Drill every ounce of public land in Wyoming Bill" they would do it.
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

The part that may be irreconcilable is the Medicaid expansion. House FreeDumb Caucus isn't going to accept that in a compromise bill, while Senate can't pass a bill with that eliminated.
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

Rover said:
The part that may be irreconcilable is the Medicaid expansion. House FreeDumb Caucus isn't going to accept that in a compromise bill, while Senate can't pass a bill with that eliminated.
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They have to because that's where the 880 billion comes from. They'll pass it.
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

They dont have the votes to do it. And if they dont get them soon then the CBO report will put a serious hitch into them passing it in Reconciliation. If they cant force it through that way they have zero chance. (they dont have the 60 votes needed) Mitch cant go Nuclear to pass it either because of the way the bill was filed. (IIRC)
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

Handyman said:
They dont have the votes to do it. And if they dont get them soon then the CBO report will put a serious hitch into them passing it in Reconciliation. If they cant force it through that way they have zero chance. (they dont have the 60 votes needed) Mitch cant go Nuclear to pass it either because of the way the bill was filed. (IIRC)
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He doesn't need 60 if it goes through reconciliation and as far as I know that's been the plan all along.
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

ScoobyDoo said:
He doesn't need 60 if it goes through reconciliation and as far as I know that's been the plan all along.
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Yeah I know...the problem is if the CBO report comes out and isnt a vast improvement I am not sure they can pass it through Reconciliation because of the debt issue. (The Byrd Rule) That is what I am saying...they either pass it now or they probably dont pass it at all.

As of now they dont have the 51 votes to pass it anyways. Too many defections.
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

Handyman said:
Yeah I know...the problem is if the CBO report comes out and isnt a vast improvement I am not sure they can pass it through Reconciliation because of the debt issue. (The Byrd Rule) That is what I am saying...they either pass it now or they probably dont pass it at all.

As of now they dont have the 51 votes to pass it anyways. Too many defections.
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The Turtle is the one Troll that could make it happen.
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

Handyman said:
I dunno...if any Senator is up for re-election they are signing their own death warrant.
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They're all Democrats.There's a Republican senator in Nevada but the rest are in states that are blood red. The upcoming midterm is so bad for Democratic control of the Senate that an absolute best case would be a 50-50 split. They crapped themselves last November in the Senate.
 
Re: The PPACA Thread Part IV - Repeal & Replace, or Something...

Handyman said:
Yeah I know...the problem is if the CBO report comes out and isnt a vast improvement I am not sure they can pass it through Reconciliation because of the debt issue. (The Byrd Rule)
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The Byrd Rule is only a rule. Mitch can change it if he wants. It would be a terrible idea for the GOP to do that, but he could and this is a Brave New World.
 
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