[mike777]

If nothing else this entire forum discussion and real world discussion shows just how difficult it is to destroy and replace a government program with something else or several somethings. So many forces come together to protect an existing program.


fwiw I suggested extending medicare to people under 65 years and years ago....not that I have a solution for paying for it, how to not stifle innovation, and fixing the many problems that come along with that suggestion.

[ldrews]

PassedOut, on 2017-March-13, 19:07, said:

He can't do that. Trump has said that health care is broken and that he will fix it. He has control of the executive, legislative, and judicial branches of government, and the democrats are powerless to prevent him from implementing his solution -- one that will give better health care to all at lower prices. He's chosen the most talented cabinet in US history to help him do it.

Blaming the democrats won't work.

What makes you think he has control of the legislative branch of government? Have you talked to McCain, Shumer, Pelosi, Ryan about this? And you have forgotten that non-budgetary reconciliation legislation requires 60 votes in the Senate, allowing Democrats to filibuster?

I am glad you approve of his cabinet.

[PassedOut]

ldrews, on 2017-March-13, 21:04, said:

What makes you think he has control of the legislative branch of government? Have you talked to McCain, Shumer, Pelosi, Ryan about this? And you have forgotten that non-budgetary reconciliation legislation requires 60 votes in the Senate, allowing Democrats to filibuster?

Trump's party controls both the house and the senate, and can avoid a legislative filibuster on health care via reconciliation, as they've announced they'll do.

Trump knows the composition of the legislature and has proclaimed that health care will be fixed quickly, and fixed so that everyone is covered and costs are down. A plan like that will have no trouble passing quickly, as soon as Trump reveals what it is. Legislators in both parties will be embarrassed to have missed figuring it out for themselves. It will be fascinating television to see Trump let that cat out of the bag.

After that, he'll tell the military how to get rid of ISIS.

[Zelandakh]

cherdano, on 2017-March-13, 17:36, said:

You misread the CBO report (if you did, in fact, read it). CBO didn't claim 24 millions would lose insurance compared to now. CBO claims 24 millions would lose health insurance compared to status quo, i.e. Obamacare.

The CBO also says:

In other words, Obamacare is not, in fact, imploding. ldrews knows better than the CBO, of course. Who is more likely to make a well-educate guess, CBO or ldrews?

The CBO is clearly fake news. The "real truth" is obviously that Trumpocare is a shining beacon of goodness that will heal all Americans and be paid for by the Chinese, or the tooth fairy, or perhaps just the next Democrat administration that has to pick up the pieces.

[Zelandakh]

mike777, on 2017-March-13, 20:20, said:

fwiw I suggested extending medicare to people under 65 years and years ago....not that I have a solution for paying for it, how to not stifle innovation, and fixing the many problems that come along with that suggestion.

I might suggest extending Medicare to all Americans, calling it the National Health Service, and paying for it by taxing the rich by at least as much as the poor. But obviously that would have me labelled as a Communist terrorist and an enemy of the Free World.

[ldrews]

PassedOut, on 2017-March-13, 22:04, said:

Trump's party controls both the house and the senate, and can avoid a legislative filibuster on health care via reconciliation, as they've announced they'll do.

Trump knows the composition of the legislature and has proclaimed that health care will be fixed quickly, and fixed so that everyone is covered and costs are down. A plan like that will have no trouble passing quickly, as soon as Trump reveals what it is. Legislators in both parties will be embarrassed to have missed figuring it out for themselves. It will be fascinating television to see Trump let that cat out of the bag.

After that, he'll tell the military how to get rid of ISIS.

Trump is a Republican in name only. He is a populist that executed a hostile takeover of the Republican Party. Do you not remember the campaign? The Republican Party leadership hated Trump almost as much as did Clinton. Trump won the election by appealing directly to the Republican voters and bypassing the Republican establishment. I think you are having a "senior" moment!

[ldrews]

Zelandakh, on 2017-March-14, 07:01, said:

I might suggest extending Medicare to all Americans, calling it the National Health Service, and paying for it by taxing the rich by at least as much as the poor. But obviously that would have me labelled as a Communist terrorist and an enemy of the Free World.

If you think the rich would end up paying a significant portion, you are ignorant of history or are incredibly naive.

[Zelandakh]

ldrews, on 2017-March-14, 07:30, said:

If you think the rich would end up paying a significant portion, you are ignorant of history or are incredibly naive.

It is naive to point out that a fairer system could be implemented? Since you wanted change, I would have thought that this would appeal to you as it is certainly a bigger change from the status quo than anything being proposed by the current administration.

[PassedOut]

No Magic in How G.O.P. Plan Lowers Premiums: It Penalizes Older People

Quote

According to the C.B.O. report, the bill would make health insurance so unaffordable for many older Americans that they would simply leave the market and join the ranks of the uninsured.

The remaining pool of people would be comparatively younger and healthier and, thus, less expensive to cover. Other changes would help make health insurance skimpier — cheaper, but with deductibles that are higher than those criticized by Republicans under Obamacare.

Under the G.O.P. bill, the C.B.O. finds that insurance premiums would first spike, by 15 percent to 20 percent more than under Obamacare over the next two years. But by the end of a decade, the average plan would cost 10 percent less than it would under the Affordable Care Act. (Over all, though, 24 million fewer people would have insurance, it found.)

...

The combined difference in how much extra the older customer would have to pay for health insurance is enormous. The C.B.O. estimates that the price an average 64-year-old earning $26,500 would need to pay after using a subsidy would increase from $1,700 under Obamacare to $14,600 under the Republican plan.

In 1985, Congress passed the Emergency Medical Treatment and Active Labor Act, which made medical treatment a right for everyone, citizen and non-citizen. Under that law, all hospitals that accept Medicare or Medicaid must provide treatment to anyone needing care -- even those not covered by Medicare, Medicaid, or private insurance -- regardless of the patient's ability to pay.

Before the ACA, those treatments were paid for by those of us who did buy health insurance, and that freeloading was one of the factors causing our insurance rates to increase dramatically year after year. To put an end to that freeloading, the ACA instituted the Individual Shared Responsibility Fee, the "insurance mandate."

In 2010, the Attorneys General of 14 states asked the Supreme Court to find a new constitutional right to freeloading, thereby invalidating the Individual Shared Responsibility Fee. The Supreme Court ruled 5-4 that there was no such constitutional right to freeloading, with Chief Justice Roberts in the majority -- much to the displeasure of the freeloading advocates.

Now Paul Ryan and the other freeloading advocates propose to restore freeloading legislatively, while forcing many older folks out of insurance coverage altogether. Those older folks will need a disproportionate amount of the care that congress has declared to be their right. The financial burden for that care will fall largely on older folks who do pay the much higher premiums envisioned by Ryan and his freeloaders.

I'm not surprised to see that the AARP opposes this return to freeloading.

[jogs]

y66, on 2017-March-13, 20:04, said:

Trumpcare is what we got when Paul Ryan decided to f*ck people who need health care the most.

You're free to pay for the poor who cannot afford to pay for their healthcare.

Obama was unable to provide healthcare to military vets.

[jogs]

mike777, on 2017-March-13, 20:20, said:

fwiw I suggested extending medicare to people under 65 years and years ago....not that I have a solution for paying for it, how to not stifle innovation, and fixing the many problems that come along with that suggestion.

By 2030 the US taxpayer wont be able to afford medicare to people over 65.

[jogs]

awm, on 2017-March-12, 09:56, said:

His promise to "drain the swamp" has pretty much gone by the wayside, as he appointed a cabinet full of billionaires and Goldman-Sachs execs.

Billionaires are not the swamp. 1776-1787. The wealthiest colonists were among the delegates who formed the nation and wrote the constitution. The career politicians are the swamp. This group starts with Chuck Schumer and Nancy Pelosi. Unfortunately Paul Ryan seems to be joining them. Many career bureaucrats are part of the swamp. These are the people who must be drained.

[ldrews]

Zelandakh, on 2017-March-14, 07:57, said:

It is naive to point out that a fairer system could be implemented? Since you wanted change, I would have thought that this would appeal to you as it is certainly a bigger change from the status quo than anything being proposed by the current administration.

First of all, "fairness" is in the eye of the beholder. What is fair to you may not be seen as fair by other people.

Second, as has been pointed out by others, all change is not necessarily good. Change without respect to agreed upon goals is irresponsible and potentially damaging. The Democrats/liberals have their set of goals, the Republicans/conservatives have a different set of goals. Since the control of government has changed from one set of hands to another, many of the changes being proposed are an attempt to march to the new set of goals. In this context change that moves toward the Republican/conservative goals is "good" and changes that move away are "bad".

Your idea of "fairer" is not in accord with the Republican/conservative goals, so your suggestion for change is "bad".

You may not like it, but the only way to move in your preferred direction is to persuade the Republicans/conservatives that your ideas further their goals, or outvote them at the next election.

Until a social consensus is achieved regarding an appropriate solution to the health care problem we will undoubtedly continue to see contentious behavior.

[Zelandakh]

ldrews, on 2017-March-14, 09:00, said:

First of all, "fairness" is in the eye of the beholder. What is fair to you may not be seen as fair by other people.

Second, as has been pointed out by others, all change is not necessarily good. Change without respect to agreed upon goals is irresponsible and potentially damaging.

Your turn for a senior moment? May I remind you:-

ldrews, on 2017-March-12, 18:14, said:

barmar, on 2017-March-12, 14:15, said:

So all that matters is that he's replacing a system you don't like? It doesn't matter that the proposed replacement has extremely serious problems of its own, and doesn't actually fulfill his campaign promise of healthcare for everyone?

Is anything good as long as it's not Obamacare?

The current system seems to be imploding. The question becomes do you stick with the known but deteriorating system or do you take the gamble of trying a new system. The new system is not guaranteed to be "better" and given political realities can probably never be guaranteed to be "better".

To me it is similar to the recent election choice: stick with the status quo candidate or gamble with the change candidate. Depends on how much you think change is needed.

In other words, you wanted change regardless of whether it is better or worse. Can anyone really claim that the change that came with Trump during the election campaign was based on respect? Or indeed that it had any agreed upon goals. That electing Trump was irresponsible and potentially damaging is probably something many here would agree with you on though. I am glad to see that you have come to accept this.

[Winstonm]

ldrews, on 2017-March-14, 09:00, said:

First of all, "fairness" is in the eye of the beholder. What is fair to you may not be seen as fair by other people.

Second, as has been pointed out by others, all change is not necessarily good. Change without respect to agreed upon goals is irresponsible and potentially damaging. The Democrats/liberals have their set of goals, the Republicans/conservatives have a different set of goals. Since the control of government has changed from one set of hands to another, many of the changes being proposed are an attempt to march to the new set of goals. In this context change that moves toward the Republican/conservative goals is "good" and changes that move away are "bad".

Your idea of "fairer" is not in accord with the Republican/conservative goals, so your suggestion for change is "bad".

You may not like it, but the only way to move in your preferred direction is to persuade the Republicans/conservatives that your ideas further their goals, or outvote them at the next election.

Until a social consensus is achieved regarding an appropriate solution to the health care problem we will undoubtedly continue to see contentious behavior.

Cam you at least admit this much:

1) In a market based healthcare system, there is zero incentive for profit-based health insurers to offer coverage to people who are already sick.
2) In a pure market-based healthcare system, profits rather than health outcomes are the driving force for insurance company decision-making.

[y66]

From The Original Lie About Obamacare by David Leonhardt:

Quote

You hear it from Republicans, pundits and even some Democrats. It’s often said in a tone of regret: I wish Obama had done health reform in a bipartisan way, rather than jamming through a partisan bill.

The lament seems to have the ring of truth, given that not a single Republican in Congress voted for Obamacare. Yet it is false —demonstrably so.

That it’s nonetheless stuck helps explain how the Republicans have landed in such a mess on health care. The Congressional Budget Office released a jaw-dropping report Monday estimating that the Republican health plan would take insurance from 24 million people, many of them Republican voters, and raise medical costs for others. The bill effectively rescinds benefits for the elderly, poor, sick and middle class, and funnels the money to the rich, via tax cuts.

The AARP doesn’t like the bill, nor do groups representing doctors, nurses, hospitals, the disabled and people with cancer, diabetes and multiple sclerosis. Other than that, Mrs. Lincoln, it’s a great bill.

If Republicans still pass it, they will take political ownership of the flawed American health care system — after making it much more flawed. Tom Cotton, the Republican senator from Arkansas, has said the bill is so bad that it would “put the House majority at risk next year.” On the other hand, if Republicans fail to pass their own bill, they’ll look weak and incompetent, which is also not a good look to voters.

How did the party’s leaders put themselves in this position? The short answer is that they began believing their own hype and set out to solve a problem that doesn’t exist.

Obamacare obviously has flaws. Most important, some of its insurance markets — created to sell coverage to the uninsured — aren’t functioning well enough. Alas, Paul Ryan, Mitch McConnell and Donald Trump are not trying to fix that problem. They’re trying to fix a fictional one: saving America from a partisan, socialistic big-government takeover of health care.

To understand why that description is wrong, it helps to recall some history. Democratic attempts to cover the uninsured stretch back almost a century. But opposition to universal government-provided insurance was always too strong. Even Lyndon Johnson, with big congressional majorities, could pass programs only for the elderly and the poor — over intense opposition that equated Medicare with the death of capitalism.

So Democrats slowly moved their proposals to the right, relying more on private insurance rather than government programs. As they shifted, though, Republicans shifted even farther right. Bill Clinton’s plan was quite moderate but still couldn’t pass.

When Barack Obama ran for president, he faced a choice. He could continue moving the party to the center or tack back to the left. The second option would have focused on government programs, like expanding Medicare to start at age 55. But Obama and his team thought a plan that mixed government and markets — farther to the right of Clinton’s — could cover millions of people and had a realistic chance of passing.

They embarked on a bipartisan approach. They borrowed from Mitt Romney’s plan in Massachusetts, gave a big role to a bipartisan Senate working group, incorporated conservative ideas and won initial support from some Republicans. The bill also won over groups that had long blocked reform, like the American Medical Association.

But congressional Republicans ultimately decided that opposing any bill, regardless of its substance, was in their political interest. The consultant Frank Luntz wrote an influential memo in 2009 advising Republicans to talk positively about “reform” while also opposing actual solutions. McConnell, the Senate leader, persuaded his colleagues that they could make Obama look bad by denying him bipartisan cover.

At that point, Obama faced a second choice – between forging ahead with a substantively bipartisan bill and forgetting about covering the uninsured. The kumbaya plan for which pundits now wax nostalgic was not an option.

The reason is simple enough: Obamacare is the bipartisan version of health reform. It accomplishes a liberal end through conservative means and is much closer to the plan conservatives favored a few decades ago than the one liberals did. “It was the ultimate troll,” as Michael Anne Kyle of Harvard Business School put it, “for Obama to pass Republican health reform.”

Today’s Republican Party has moved so far to the right that it no longer supports any plan that covers the uninsured. Of course, Republican leaders are not willing to say as much, because they know how unpopular that position is. Having run out of political ground, Ryan, McConnell and Trump have had to invent the notion of a socialistic Obamacare that they will repeal and replace with … something great! This morning they were also left to pretend that the Budget Office report was something less than a disaster.

Their approach to Obamacare has worked quite nicely for them, until now. Lying can be an effective political tactic. Believing your own alternative facts, however, is usually not so smart.

[ldrews]

Zelandakh, on 2017-March-14, 09:31, said:

Your turn for a senior moment? May I remind you:-

In other words, you wanted change regardless of whether it is better or worse. Can anyone really claim that the change that came with Trump during the election campaign was based on respect? Or indeed that it had any agreed upon goals. That electing Trump was irresponsible and potentially damaging is probably something many here would agree with you on though. I am glad to see that you have come to accept this.

So, by opposing the Republicans current attempt at change you are asserting that the current situation is acceptable? That rather than try the Republican change we should do nothing? If not, what is your proposed solution?

I personally think that the current ACA program is deteriorating rapidly and if nothing is done millions of people will be signed up but with no effective health care at all. Stories are already surfacing of people who cannot use their health care because they cannot afford the deductible, effectively leaving them with no health care at all. But they do have access, right?

[blackshoe]

y66, on 2017-March-07, 09:38, said:

Adam Schiff is indeed a wise man and an effective Congressman for his district in LA which is one of the most diverse districts in the country. Probably to the left of you and slightly more libertarian on the political compass which is not an indication of wisdom or rationality.

It's not an indication of lack of those things either.

[Zelandakh]

ldrews, on 2017-March-14, 09:45, said:

So, by opposing the Republicans current attempt at change you are asserting that the current situation is acceptable? That rather than try the Republican change we should do nothing? If not, what is your proposed solution?

I personally think that the current ACA program is deteriorating rapidly and if nothing is done millions of people will be signed up but with no effective health care at all. Stories are already surfacing of people who cannot use their health care because they cannot afford the deductible, effectively leaving them with no health care at all. But they do have access, right?

I am opposing nothing. As a non-American it has zero effect on me if the government over there thinks that killing off its poorer citizens is a good idea. On the other hand, I feel a certain sadness that such a rich country chooses to act that way. I have already mentioned several possible models that might be of interest. A single-payer model like the UK's NHS; a universal multi-payer system such as in Germany; or a government-funded universal Medicare system such as in Australia. The problem is not coming up with a universal healthcare system that works better than any currently on the table, the difficulty is in getting it past the healthcare lobby when they are willing to pay billions of dollars to avoid the USA moving over to a system that would curtail their profits.

As far as the ACA goes, I have seen no evidence outside of your posts that it is deteriorating in the way you suggest. All of the audits of it have reported that it is stable despite the attempts of Republicans to undermine it. Indeed, the last report seems to suggest that deductibles under the Republican proposal will be considerably higher than under the ACA. Would you not consider implementing a scheme that is more expensive, less effective and had lower coverage to be just as irresponsible and potentially damaging as electing Trump was?

[Winstonm]

I just watched a Republican Congressman from Florida argue that the right to "access" healthcare is all that should be guaranteed because the government should not interfere with free markets and free choice, then he went on to say that the government should do something about the way insurance companies and pharmaceutical companies gouge the public. WHAT?

Let them eat cake - and oh, by the way, they don't seem to want their piece so I'll have that one, too.