We know what happened here. Republicans demonized Obamacare solely because it carried President Obama's identity. Their strategy was always to demonize the black President. Had the plan carried the imprimatur of another, it would simply be fixed of its flaws, but certainly not the target of scorn and vitriol. After all, it was originally the plan as conceived by the conservative Heritage Foundation, and crafted to fit Massachusetts under the leadership of that state's Republican Gov. Mitt Romney who adopted it. Now the Republicans are stuck. They must act as if they have re-fashioned it and made it harsh and uncaring, because promising to do so over the past eight years or so served their political purposes -- to minimize venomously any possible Obama achievement -- even if they knew (and now know) deep down its salutary results for millions of Americans.
313
One more time: The American people get the government they vote for. They elected Donald Trump who though he promised to insure everyone, provide better healthcare, repeal mandates and lower premiums is delivering none of the above. In fact those who voted for Trumpcare and most benefited from Obamacare will be left without insurance and with "access" only to plans that they cannot possibly afford.
Until those who fell for this conman and continue to let the Koch Brothers and Pal Ryan impose their Radical Republican Terrorism on the American people vote them out of office nothing will change. And this is just the beginning. Fasten your seat belts the worst is yet to come.
Until those who fell for this conman and continue to let the Koch Brothers and Pal Ryan impose their Radical Republican Terrorism on the American people vote them out of office nothing will change. And this is just the beginning. Fasten your seat belts the worst is yet to come.
332
The repeal is motivated by nothing more than pure spite from a morally bankrupt party.
They would rather take people's health care away than live in a world where our first black president provided it to them.
It's a despicable and irredeemable act.
They would rather take people's health care away than live in a world where our first black president provided it to them.
It's a despicable and irredeemable act.
462
What is the root cause of this callousness and indifference to the value of human life and suffering, particularly in this land of abundance and well-intentioned Christian values? Why do we cling so desperately to the value of human self-sufficiency and independence when we are all so interdependent on one another? Why do we allow one's "dollar valuation" to trump all other values in a land with inestimable riches (dollars and otherwise)? Why can we not acknowledge the vast disparities in human capacities that we all share and the dignity of our humanness? I submit that our (American) legacy of slavery and oppression feeds our inflated superiority of a White, Christian master-race and the denigration of all others. This, I believe, is the core of inflated individuality and our American disease. The intention to deny medical care on the basis of dollar renumeration is an antiquated notion from an earlier society in which resources were scarce and truly rare which is not the case today. The greed of insurance companies is no different that that of individuals who would not contribute (and participate) in the greater good. I suggest that we/one look very deeply into our beliefs of self-reliance and personal independence and discover, perhaps, that our fellow-man is both worthy and fragile, like ourselves.
149
What is the essence of the free market? If you want something or need it, you can have it, if you can pay for it. If what you want is in short supply it is rationed by your having to pay more. This is the creed of the White Christian Republicans in our government. How very White of them but not at all Christian; but oh so Republican. The GOP is the party of profits over people and money over people.
To Republicans health care, just like liberty, is a zero sum game of winners and losers. To Republicans one person’s liberty is another person’s slavery, because to them, freedom, like health care is not infinite and there is just not enough to go around.
With Republicans there is an abiding belief that when Republicans are in control, elections have consequences and it is winner take all. They represent their donors and their base in that order. If they do not have the whip hand it is a question of minority rights to stifle all progress for those for those who cannot pay for health care, shelter, food, and liberty.
The dual purpose of Republican controlled government is establish a ruling class based upon great wealth and to make Republicans rich. They have become an internal enemy and a political cancer and seek to overthrow our system of government. They are giving us taste of full blown fascism with a neo-facist as a de facto president, but it is the GOP itself that is the most dangerous and the most at risk because they fear the voters - for now.
To Republicans health care, just like liberty, is a zero sum game of winners and losers. To Republicans one person’s liberty is another person’s slavery, because to them, freedom, like health care is not infinite and there is just not enough to go around.
With Republicans there is an abiding belief that when Republicans are in control, elections have consequences and it is winner take all. They represent their donors and their base in that order. If they do not have the whip hand it is a question of minority rights to stifle all progress for those for those who cannot pay for health care, shelter, food, and liberty.
The dual purpose of Republican controlled government is establish a ruling class based upon great wealth and to make Republicans rich. They have become an internal enemy and a political cancer and seek to overthrow our system of government. They are giving us taste of full blown fascism with a neo-facist as a de facto president, but it is the GOP itself that is the most dangerous and the most at risk because they fear the voters - for now.
210
ObamaCare to be replaced with TrumpCareless. Utterly Careless.
I am more afraid for this country every day.
I am more afraid for this country every day.
202
The New Testament I read talked about healing the sick and feeding the hungry, no market based solution was mentioned. If you want to worship Capitalism be my guest, it is free country, but the fact is that you are not a Christian, stop pretending to be one.
214
According to one of the accompanying articles on this issue, Mr. Trump asserted on Friday that 2017 would be “a disaster” for the health law. “That’s the year it was meant to explode, because Obama won’t be here,” he said, adding that “as bad as it is now, it’ll get even worse.”
Explain to me what it meant by "It was meant to explode"? I hadn't realized that the Democrats had placed a time bomb in a bill they had themselves passed. Where exactly is that part in the bill, though I do realize it is quite lengthy. Trump's accusations show incredible breadth, which I guess is one of the reasons he applies them but that vastness covering so my parties is the reason they are so incoherent. I guess we haven't gotten any further than his attacks on Obama's birth certificate his followers don't care about truth. Trump is the mercury bullet (and mercurial) President and 'purge them all' when we really need a more silver bullet type of leader.
Explain to me what it meant by "It was meant to explode"? I hadn't realized that the Democrats had placed a time bomb in a bill they had themselves passed. Where exactly is that part in the bill, though I do realize it is quite lengthy. Trump's accusations show incredible breadth, which I guess is one of the reasons he applies them but that vastness covering so my parties is the reason they are so incoherent. I guess we haven't gotten any further than his attacks on Obama's birth certificate his followers don't care about truth. Trump is the mercury bullet (and mercurial) President and 'purge them all' when we really need a more silver bullet type of leader.
54
As a trauma instructor and emergency doc I quit reading after the fifth paragraph.
The author may be a hospice nurse but she knows NOTHING about the legal standard of “duty to act.”
Once a person passes certification and is licensed whether as an EMT, paramedic, registered nurse, or physician we are BOUND BY LAW to care for patients in an emergency.
You, the civilian can walk away from an emergency OR if you choose to get involved each state has a Good Samaritan Act that prevents your being sued if in good faith you try to help an injured or ill person out in public.
But we professionals are duty-bound to help people in life or limb threatening emergencies. Yes we run TO the scene... not away.
So Theresa Brown? Make your statement another way--but do NOT write something this illegal and against every fiber of our being in emergency medicine. Otherwise we’d be in a “safer” profession.
The author may be a hospice nurse but she knows NOTHING about the legal standard of “duty to act.”
Once a person passes certification and is licensed whether as an EMT, paramedic, registered nurse, or physician we are BOUND BY LAW to care for patients in an emergency.
You, the civilian can walk away from an emergency OR if you choose to get involved each state has a Good Samaritan Act that prevents your being sued if in good faith you try to help an injured or ill person out in public.
But we professionals are duty-bound to help people in life or limb threatening emergencies. Yes we run TO the scene... not away.
So Theresa Brown? Make your statement another way--but do NOT write something this illegal and against every fiber of our being in emergency medicine. Otherwise we’d be in a “safer” profession.
What has become clear and sadly obvious is the fact that large segments of the American society don’t see that they are being played, shamelessly and ruthlessly. They still cling to the notion that anybody striving for social equity, health insurance for all, a better life for the middle class must be a shill for a socialist take-over. For too many years the Republicans have fueled such fears and have hidden behind a veil of patriotism their incompetence and unwillingness to lessen the vulgarity of the two class system – rich and poor – this society has turned into.
When in 2010 the electorate galloped with great speed over the lemming cliff of the tea party one would have hoped that 6 years were enough to see its error and correct it. Far from it. The talent of the Republican party to pull the wool over the nations eyes was at its height during the Obama years in the White House. There is a reason why their budget proposals always cut education first. An informed voter would hardly fall for their lies and deceptions.
The bootlickers and sycophants have now been swarming out into the Trump kraal incongruously populating cabinet positions for which most are not qualified. One can only hope that even the most naive voter will ultimately realize that he is viewed as election-booth-fodder by the Republican party in order to be able to serve its master, the 1 % crowd.
When in 2010 the electorate galloped with great speed over the lemming cliff of the tea party one would have hoped that 6 years were enough to see its error and correct it. Far from it. The talent of the Republican party to pull the wool over the nations eyes was at its height during the Obama years in the White House. There is a reason why their budget proposals always cut education first. An informed voter would hardly fall for their lies and deceptions.
The bootlickers and sycophants have now been swarming out into the Trump kraal incongruously populating cabinet positions for which most are not qualified. One can only hope that even the most naive voter will ultimately realize that he is viewed as election-booth-fodder by the Republican party in order to be able to serve its master, the 1 % crowd.
90
For those who decry the ACA as too expensive, imagine how the costs would come down with a single payer system. See Canada, see Taiwan, see Germany. Should I go on.
A lot of the cost of the current systems, as was reported in this paper only yesterday is in "administrative costs" and profit to insurance companies.
Another is the lack of a moral sense in the Pharmaceutical industry which spends more money on advertising ( and much of that on direct to consumer advertising) than it does on research.
And finally, many, not all Doctors buy into the system which profits them to over treat, over medicate over refer.
There are systems around the world that do much better, better care for less cost. But our Repubs are blinded by their own ideologies and the Religion of a "Free Market".
A lot of the cost of the current systems, as was reported in this paper only yesterday is in "administrative costs" and profit to insurance companies.
Another is the lack of a moral sense in the Pharmaceutical industry which spends more money on advertising ( and much of that on direct to consumer advertising) than it does on research.
And finally, many, not all Doctors buy into the system which profits them to over treat, over medicate over refer.
There are systems around the world that do much better, better care for less cost. But our Repubs are blinded by their own ideologies and the Religion of a "Free Market".
89
Greatest group of con men in history. Liars, thieves, cheats. Hopefully their greed will be their rapid downfall. People are probably going to have to fill the streets by the millions to stop this craziness.
156
The only reason Republicans have formulated this "health care" legislation is that they think you, the American people, will put up with their stiffing you.
Why would they? Because in the past you have.
Why do they want to stiff you? Because their donors want the tax cut that repealing the ACA brings with it.
It's can't be any simpler.
It is more than a moral failing to have people dying in the streets because they can't afford care. It's an evil.
I live in a country where a world class single payer system has been in place for decades. It's just a part of the social fabric. It's not kinder or gentler. It's just the right thing to do. It says we're all in this together.
That's not true in America, and hasn't been for a long time.
It's why I'm glad I don't live there anymore.
You want to talk about American exceptionalism? I'll define it for you.
The Marshall Plan.
The Peace Corps.
The Gates Foundation.
That's what American exceptionalism looks like. Trump? He's its antithesis.
And he's the President of your country.
My advice to you? Do something about it. That would be the country's first step toward becoming exceptional again. Not great again. Exceptional again.
When and if you do decide to do it let me know. I'll drive south and join you in the streets. Because that's what it's going to take for America to remember who it was and want it wants to be.
Again.
Why would they? Because in the past you have.
Why do they want to stiff you? Because their donors want the tax cut that repealing the ACA brings with it.
It's can't be any simpler.
It is more than a moral failing to have people dying in the streets because they can't afford care. It's an evil.
I live in a country where a world class single payer system has been in place for decades. It's just a part of the social fabric. It's not kinder or gentler. It's just the right thing to do. It says we're all in this together.
That's not true in America, and hasn't been for a long time.
It's why I'm glad I don't live there anymore.
You want to talk about American exceptionalism? I'll define it for you.
The Marshall Plan.
The Peace Corps.
The Gates Foundation.
That's what American exceptionalism looks like. Trump? He's its antithesis.
And he's the President of your country.
My advice to you? Do something about it. That would be the country's first step toward becoming exceptional again. Not great again. Exceptional again.
When and if you do decide to do it let me know. I'll drive south and join you in the streets. Because that's what it's going to take for America to remember who it was and want it wants to be.
Again.
281
Thank you, Ms. Brown, for this! I constantly think about how health care in this country could be designed to be fair for all. I want to play devil's advocate for only one minute in the following scenario:
This happened to 2 different friends of mine while both in their 20's:
1. "Artist", uninsured, no job is diagnosed with ovarian cancer. Goes to the state hospital, and the surgery, chemo, recovery costs all paid for. Thank goodness she survived, but owes no money to the hospital.
2. Manager of Starbucks, working 60 plus hours a week discovers the same. After insurance pays what it will, this woman owes 10's of thousands of dollars out of pocket.
There are so many stories as this, so many variables. We want to think that all patients are equal.... but it seems that some patients are always more equal than others.
This happened to 2 different friends of mine while both in their 20's:
1. "Artist", uninsured, no job is diagnosed with ovarian cancer. Goes to the state hospital, and the surgery, chemo, recovery costs all paid for. Thank goodness she survived, but owes no money to the hospital.
2. Manager of Starbucks, working 60 plus hours a week discovers the same. After insurance pays what it will, this woman owes 10's of thousands of dollars out of pocket.
There are so many stories as this, so many variables. We want to think that all patients are equal.... but it seems that some patients are always more equal than others.
47
Twisted minds create twisted morals....
These twisted minds are those who represent....only themselves and
no one else: included in the US Congress are minds like Speaker of the House
Ryan; and in the Senate Mitch McConnell.....selfish narrow minded zealots
espousing only one cause....their own self interests.
Universal Health Care is practice in our counterparts in the world of nations.
The selfishness of those who would inflict ill health and death on others are
those nations whose leaders or governments ...would allow preventable
sickness and death on their citizens....and the cowards in our US Congress
are those who belong in this group of immoral dictators of death...
that is really what this new legislation represents ...the work of immoral
men and woman in the Republican Congress...
this is what the foul and stinking swamp of immorality consists of
disgusting selfish and deceptive elected representatives of ....themselves only.
These twisted minds are those who represent....only themselves and
no one else: included in the US Congress are minds like Speaker of the House
Ryan; and in the Senate Mitch McConnell.....selfish narrow minded zealots
espousing only one cause....their own self interests.
Universal Health Care is practice in our counterparts in the world of nations.
The selfishness of those who would inflict ill health and death on others are
those nations whose leaders or governments ...would allow preventable
sickness and death on their citizens....and the cowards in our US Congress
are those who belong in this group of immoral dictators of death...
that is really what this new legislation represents ...the work of immoral
men and woman in the Republican Congress...
this is what the foul and stinking swamp of immorality consists of
disgusting selfish and deceptive elected representatives of ....themselves only.
65
Morality- meet Trump, Farage, LePen, Erdogan, Orban, and our brave new 2.0 world.
And those are just the names that come to mind.
There are so many more...
How to turn this ship around?
That is the question of our time.
And those are just the names that come to mind.
There are so many more...
How to turn this ship around?
That is the question of our time.
37
The Right tells us to our faces they don't care and americans vote for them in larger numbers.
America and americans are not right.
Sorry we do some things right, but when it comes to caring...bzzzt! americans don't care.
America and americans are not right.
Sorry we do some things right, but when it comes to caring...bzzzt! americans don't care.
The issue that nobody seems willing to discuss in all of this is why does healthcare cost as much as it does? At what point is the cost of healthcare just as usurious as 100% loansharking?
Ms Brown is completely right in both her moral indignation about the impact of the republican plan on the less fortunate as well as her observation that the emergency rooms of this country will once again be the defacto medical centers for the poor. The republican plan is both un-Christian as well as economically ... dumb.
But the crux of the matter is that healthcare services cost more in this country than anywhere else in the civilized world. We have an industry rampant with conflicts of interest, rampant with crony capitalism, and rampant with lack of accountability for good outcomes. People live unhealthy lives, doctors prescribe tests and medications in knee-jerk 5 minute "diagnoses," hospital bills are indecipherable with hidden fees, pharmaceutical firms squelch competition via buyouts and patent extensions, politicians wink and blink according to what lobbyist is stroking their wallet.
Healthcare should be like education. Supported by taxpayers. Free and available to all Americans.
Just as free public education transformed the US from a nation of illiterate farmers to a nation of literate innovators across a range of industries, so too will a healthy nation transform our quality of life.
As a people, we are beyond dumb to elect politicians like Ryan or Trump.
Ms Brown is completely right in both her moral indignation about the impact of the republican plan on the less fortunate as well as her observation that the emergency rooms of this country will once again be the defacto medical centers for the poor. The republican plan is both un-Christian as well as economically ... dumb.
But the crux of the matter is that healthcare services cost more in this country than anywhere else in the civilized world. We have an industry rampant with conflicts of interest, rampant with crony capitalism, and rampant with lack of accountability for good outcomes. People live unhealthy lives, doctors prescribe tests and medications in knee-jerk 5 minute "diagnoses," hospital bills are indecipherable with hidden fees, pharmaceutical firms squelch competition via buyouts and patent extensions, politicians wink and blink according to what lobbyist is stroking their wallet.
Healthcare should be like education. Supported by taxpayers. Free and available to all Americans.
Just as free public education transformed the US from a nation of illiterate farmers to a nation of literate innovators across a range of industries, so too will a healthy nation transform our quality of life.
As a people, we are beyond dumb to elect politicians like Ryan or Trump.
92
Survival of the fittest. Unfortunately, the GOP will determine that " fitness".
And, I'm guessing, white males will get the advantage. Because, America. Women, minority's and children: you get the dregs, the leftovers. And you can bet the rich and their congressional lackeys won't leave many crumbs.
Welcome to Trumpcare, you get only what you pay for, preferably in CASH.
And, I'm guessing, white males will get the advantage. Because, America. Women, minority's and children: you get the dregs, the leftovers. And you can bet the rich and their congressional lackeys won't leave many crumbs.
Welcome to Trumpcare, you get only what you pay for, preferably in CASH.
43
To borrow from Dickens,
"Are there no prisons?"
"Plenty of prisons..."
"And the Union workhouses." demanded Scrooge. "Are they still in operation?"
"Both very busy, sir..."
"Those who are badly off must go there."
"Many can't go there; and many would rather die."
"If they would rather die," said Scrooge, "they had better do it, and decrease the surplus population."
Every Republican member of Congress (with two exceptions), along with Trump, Pence and Price, all call themselves "Christian" -- which claim is not merely a vulgar obscenity, but out-and-out BLASPHEMY: for the word means "Christ-like" -- a quality NONE of these sociopaths, misanthropes and sadists even remotely possess. Indeed, they are anti-Christs.
"Are there no prisons?"
"Plenty of prisons..."
"And the Union workhouses." demanded Scrooge. "Are they still in operation?"
"Both very busy, sir..."
"Those who are badly off must go there."
"Many can't go there; and many would rather die."
"If they would rather die," said Scrooge, "they had better do it, and decrease the surplus population."
Every Republican member of Congress (with two exceptions), along with Trump, Pence and Price, all call themselves "Christian" -- which claim is not merely a vulgar obscenity, but out-and-out BLASPHEMY: for the word means "Christ-like" -- a quality NONE of these sociopaths, misanthropes and sadists even remotely possess. Indeed, they are anti-Christs.
108
During the 2008 GOP primaries, Senator John McCain was asked "should we just let the uninsured die?" I will never forget the prolonged burst of cheering and applause from the galleries. To his credit, McCain gave them a rotten look.
Back to the routine health care provided by hospital Emergency Rooms. Now that they have restructured themselves to the ACA - where they got paid - to potentially bankrupting not just the ER but the hospital itself. Republicans, how is that going to increase access and choice?
Too bad we can't restrict the repeal of the ACA to Republicans and those who voted for Trump. See how they like having their healthcare trumped to enrich millionaires.
Republicans are all for stealing from the poor and giving to the rich - it is socialism for the wealthiest who get all the breaks - tax breaks, "free" markets that costs everyone else, freedom from punishment or prison for wrongdoing, etc.
This is the oppression by the have everything against the have nothing - with the have nothing being squeezed even more into debt slavery.
"We the People ... promote the general Welfare ... to ourselves and our Posterity ...."
"We the Republican People ... promote the wealthfare of the rich ... to them and their descendants ...."
Lets face it. In America some people are worth more than others - based on the value of their bank account (here and overseas). These people hate the idea of government rationed healthcare (how does that apply to the wealthy?) instead of the more efficient market based healthcare rationing that leaves those with few resources to die on the street more efficiently. How much are you willing to pay to live?
Too bad we can't restrict the repeal of the ACA to Republicans and those who voted for Trump. See how they like having their healthcare trumped to enrich millionaires.
Republicans are all for stealing from the poor and giving to the rich - it is socialism for the wealthiest who get all the breaks - tax breaks, "free" markets that costs everyone else, freedom from punishment or prison for wrongdoing, etc.
This is the oppression by the have everything against the have nothing - with the have nothing being squeezed even more into debt slavery.
"We the People ... promote the general Welfare ... to ourselves and our Posterity ...."
"We the Republican People ... promote the wealthfare of the rich ... to them and their descendants ...."
Lets face it. In America some people are worth more than others - based on the value of their bank account (here and overseas). These people hate the idea of government rationed healthcare (how does that apply to the wealthy?) instead of the more efficient market based healthcare rationing that leaves those with few resources to die on the street more efficiently. How much are you willing to pay to live?
39
What do "moral" objectives have to do with the GOP's objectives? Why in the world would anyone think these people are motivated by any high moral calling?
Remember, the leader of the GOP - Donald Trump - got up in front of thousands of people at one of his rallies and, after saying "Now, the poor guy, you've got to see this guy" launched into a grotesque mocking of a reporter who suffers from arthrogryposis - a highly disfiguring joint condition.
Think about it. A grown man (actually...an old man) running for President of the United States of America actually thought it would a good idea to make fun of a disabled person in front of thousands of people.
That...is how much this President cares about the less fortunate among us. That is how this President views the worth of people who suffer from severe medical conditions.
Remember, the leader of the GOP - Donald Trump - got up in front of thousands of people at one of his rallies and, after saying "Now, the poor guy, you've got to see this guy" launched into a grotesque mocking of a reporter who suffers from arthrogryposis - a highly disfiguring joint condition.
Think about it. A grown man (actually...an old man) running for President of the United States of America actually thought it would a good idea to make fun of a disabled person in front of thousands of people.
That...is how much this President cares about the less fortunate among us. That is how this President views the worth of people who suffer from severe medical conditions.
80
The Republicans are not championing a free market. You give them too much credit. The insurance market was created in the 1940s by a government hand-out to corporations, the right to offer health care benefits without income tax. The entire industry is government subsidized and now they (insurance companies) want to be able to continue to collect pure economic rent (upward wealth distribution) even though it destroys value for everyone (by using private insurers in lieu of the US government as the insurer). Doctors and suppliers (drug and device cos) like the current un-free market too because the biggest player in the market, the one which could negotiate on behalf of veterans and the elderly is prevented from doing so by these purveyors of "free" markets. Stop saying that what Republicans and conservatives want to do is make markets free. It's a huge lie. They want to keep them un-free so that they can keep distributing wealth upwards.
63
Why wouldn't they take it one step further.....paying a fee for police/fire/EMS response. You can't afford it.....you don't get it. The magic of the free market! Is this a great country, or what?
22
Charlotte Rampell in the WAPO explains tax cuts are the ONLY reason the GOP is pushing this bill. If they can lower taxes below a certain threshold now, in a few months, when their tax plan comes up for vote, they can use reconciliation, and avoid the 60 vote requirement. Neato, huh?
The Republicans attacked "death panels" to criticize Obamacare. But the real death panels are the Republicans in Congress who refuse to recognize that "market economics" do not work with healthcare. Every civilized society reached this conclusion quickly and long ago. The result? Longer lifespans for their citizens at half the cost of American healthcare. Republicans refuse on principle to seek a proven lower cost option--just expand Medicare to cover everyone and let Medicare negotiate drug and other medical prices. Meanwhile, conservatives seek to kill the poor, except for the unborn, who must be saved even if it requires intrusive GOVERNMENT INTERFERENCE in people's lives. Meanwhile, Trump voters will soon see just how much Trumpcare cares about them and their health. Not! What they care about is cutting the tax in Obamacare on the 1% that funds the care of the poor--a fair bargain that will soon be undone.
23
The Republican Party are unwilling to undertake serious, win-win solutions, for all Americans. Their inability to manage complex solutions will become more obvious each day as this administration wears on, even with Russia's plodding interference. This is not fun anymore, and Obama and Democratic hatred is fading. This nation is theirs to uplift or not. The Republican exuberance for personal upheavals, beginning with the deportations, coal ash dumping in red state rivers and streams, border walls, and cuts to the Coast Guard and the State Department are easy. Tax breaks for the wealthy and subsidies for Carrier corporations are easy. Russia has identified our intellectual laziness in spades. Destroying institutional reputations and your own nation's security is one thing, but believing that jeering at poverty works for our nation's future is the Republican's most searing and honest work of all. True Americans owe their lives to the job creators. True Americans must bathe the rich over and over again in oil and pearls. Healthcare is a nuisance for worker bees.
Ignore the element of good fortune - so crucial to those chest-thumpers here, bellowing today but not knowing what illness or injury may befall them or their families tomorrow. My question to Michael and the others here: Do ya feel lucky? ... Well, do ya?
14
The moral and ethical bankruptcy of Ryan's "Swampcare" is obvious. But, to me, just as important, long-term, is that there's NOTHING in this proposal that does ANYTHING to control health care costs nationwide. Unless or until we (plural--GOP, DEM, Independents) do something to address the outrageously-high costs of health care delivery (uh, like every other developed country in the world) this problem ain't going away, ACA or Swampcare be damned.
The Koch brothers seethe at the words, "Single Payer." Yet, show me an economic model that effectively controls costs without it, then.
The Koch brothers seethe at the words, "Single Payer." Yet, show me an economic model that effectively controls costs without it, then.
15
[My comment disappeared before I'd finished writing, so I'm posting another one.]
One phrase in this op-ed covers everything in the GOP's revamp of America First: "equity in a you-get-what-you-pay-for model."
That sentiment embodies the entire Republican idea of
fairness: "If you cannot pay for it (food, housing, healthcare, or whatever), you cannot have it."
And the flip-side is, "No taxes needed to give you any 'free' stuff, so I get to keep all the money the stuff would have cost."
Immoral? It's a killer!
One phrase in this op-ed covers everything in the GOP's revamp of America First: "equity in a you-get-what-you-pay-for model."
That sentiment embodies the entire Republican idea of
fairness: "If you cannot pay for it (food, housing, healthcare, or whatever), you cannot have it."
And the flip-side is, "No taxes needed to give you any 'free' stuff, so I get to keep all the money the stuff would have cost."
Immoral? It's a killer!
12
Republican leaders are truly 'Human Diablos on Earth.'
13
We should not overlook the part of the Republican plan that includes significant tax cuts for the wealthy. That money has to come from somewhere and their proposals essentially take funds away from those in need of medical care and transfer that largesse to wealthier individuals. It is a simple matter of greed and Congress feeding the appetites of their immensely wealthy benefactors. Thus, this is one of the several "feeding tubes" through which these American Oligarchs, aided and abetted by Trump's billionaire club members, slowly drain the economy at the expense of those citizens most in need. Shame!
18
If democrats really are the party of liberal moral compassion, ask all those who are of that 1% tax bracket AND who REALLY don't need their ANTI-ACA GOP tax cut to put that money aside.
I mean the 1% people like, Warren Buffet, the Clintons, the Obamas, other famous and not so famous extremely well off people.
What if they could put their huge refunded tax cut into a trust fund to help out those who are much less fortunate who did not vote REPUBLICAN and yet will suffer as a result of the GOP plan?
Democrats take care of their own.
It would shame the GOP, help those who didn't vote for the REPUBLICAN repeal of the ACA and most importantly really make a difference in the lives of those less fortunate.
Tough on republican voters those in red states. Let them see just how much their congress people and fellow republicans feel about them.
Stupid gets as stupid votes.
Let Faux news try to spin this.
I mean the 1% people like, Warren Buffet, the Clintons, the Obamas, other famous and not so famous extremely well off people.
What if they could put their huge refunded tax cut into a trust fund to help out those who are much less fortunate who did not vote REPUBLICAN and yet will suffer as a result of the GOP plan?
Democrats take care of their own.
It would shame the GOP, help those who didn't vote for the REPUBLICAN repeal of the ACA and most importantly really make a difference in the lives of those less fortunate.
Tough on republican voters those in red states. Let them see just how much their congress people and fellow republicans feel about them.
Stupid gets as stupid votes.
Let Faux news try to spin this.
17
The 'real' GOP: Only members of our political party get medical care.
If the Democrat Party were as mean and evil as the GOP, their policy would be 'those who didn't vote for Hillary don't get medical care. But, the Democrats aren't mean and evil. The GOP who voted for Trump are the spawn of Satan - every one of them. There is no middle ground when fighting Satan - it is war.
If the Democrat Party were as mean and evil as the GOP, their policy would be 'those who didn't vote for Hillary don't get medical care. But, the Democrats aren't mean and evil. The GOP who voted for Trump are the spawn of Satan - every one of them. There is no middle ground when fighting Satan - it is war.
14
Paul Ryan's dad died when he was 16.
Paul Ryan's family received Social Security survivor benefits some of which paid for Lyin' Paul Ryan to go to college.
Now Ayn Rand Lovin' Lyin' Paul Ryan does not want YOU to collect any of Social Security in any form, Medicare or Medicaid, because "you should stand on your own two feet and not leach off the system."
The present AHCA is just a MONUMENTAL TAX CUT FOR FAT CATS (hundreds of BILLIONS of dollars) and not a health care bill, because many people will never get any health care at all under this bill.
Remember to VOTE on November 3, 2018. Remember who tried to screw you over. Vote the bums out.
Paul Ryan's family received Social Security survivor benefits some of which paid for Lyin' Paul Ryan to go to college.
Now Ayn Rand Lovin' Lyin' Paul Ryan does not want YOU to collect any of Social Security in any form, Medicare or Medicaid, because "you should stand on your own two feet and not leach off the system."
The present AHCA is just a MONUMENTAL TAX CUT FOR FAT CATS (hundreds of BILLIONS of dollars) and not a health care bill, because many people will never get any health care at all under this bill.
Remember to VOTE on November 3, 2018. Remember who tried to screw you over. Vote the bums out.
79
Is it a greater moral duty to help the sick, or to keep your paycheck?
When you define "earn" as "deserve" and believe that material wealth is the God-given right to living a righteous life, keeping that paycheck is God's reward. We have fallen away from social justice and into a belief in prosperity gospel.
But really, how do we stand back and tell people that their kids will go blind in one eye, because we won't cover the cost of the exam that determines that they have a lazy eye? How do we tell people that really good treatments for asthma exist, but they can't have them, and better yet, we decided that the repackaging of a cheap and readily available emergency inhaler should make that cost prohibitive too? How do we tell a diabetic that it is too bad he cannot come up with the $400-$500 a month he needs for insulin? Do we ask the person who cuts her thumb while on vacation to duct tape it together because the out of pocket cost for the stitches is $1000?
We, as a nation, have "earned" contempt, and "deserve" nothing less.
When you define "earn" as "deserve" and believe that material wealth is the God-given right to living a righteous life, keeping that paycheck is God's reward. We have fallen away from social justice and into a belief in prosperity gospel.
But really, how do we stand back and tell people that their kids will go blind in one eye, because we won't cover the cost of the exam that determines that they have a lazy eye? How do we tell people that really good treatments for asthma exist, but they can't have them, and better yet, we decided that the repackaging of a cheap and readily available emergency inhaler should make that cost prohibitive too? How do we tell a diabetic that it is too bad he cannot come up with the $400-$500 a month he needs for insulin? Do we ask the person who cuts her thumb while on vacation to duct tape it together because the out of pocket cost for the stitches is $1000?
We, as a nation, have "earned" contempt, and "deserve" nothing less.
35
Republicans are going back to First Principles with their "Repeal and Replace" scampaign; strip away anything that might benefit the working poor or the Middle Class and give any savings to the 1%! Some 11 million Americans will lose their health insurance under Trump Care. Over $800 billion in tax breaks will go the the super rich.
It's the same old GOP plan from way back when; don't get sick, die quickly unless you have the money already to not have to worry.
It's the same old GOP plan from way back when; don't get sick, die quickly unless you have the money already to not have to worry.
20
One approach which might force a Republican response beyond simple repeal would be to amend the Emergency Treatment Act of 1985, so that beyond treating all comers, hospitals could bill the government for unpaid costs. Rather than pass those costs onto the insured, via rising hospital fees and the resultant pass through via insurance premiums, spread the cost over all citizens via the government. One possible outcome would be that the government would decide this is too expensive, and reverse the 1985 Act, which in turn would lead to a national health system, since most Americans will not simply let the uninsured die. Alternatively, by making the cost a government problem, rather than "invisible" as it currently is, the government would be forced to find a health care alternative that concentrated on patient care (not E.R. visits) rather than the current emphasis which treats insurance premiums and actual care as the same thing.
15
The soul of today's Republican Party is constituted by punitive greed wrapped in soulless individualism.
20
Lets eliminate free healthcare for the House and SenTe and see if they develop a better feel for what freedom means to the rest of us.
26
Well said, but lets also look at the cold, hard business side. The cost of healthcare is not limited to monies flowing through the healthcare system and insurance. There is a societal cost of not having quality care. There are frictional costs of a dysfunctional administration of care and its funding. Every major employer self-insures the healthcare they offer and limits the plans much like single payer structures because that Is the most cost effective manner of delivering quality care and insuring a healthy productive work force. A cost benefit analysis taking into account the risk cost to society proves the efficiency and efficacy of quality healthcare for all delivered through a carefully managed single payer (efficient) system. This Is further evidenced by comparing both ACA and AHCA to countries with these systems. The U.S. comes in last among comparable nations. It isn't socialism, it's good business practice. The moral argument and the cold hard facts align.
14
What really sickens me to see Paul Ryan talk about how the ACA is imploding and a failed policy. The ACA is "imploding" because the Republicans refused to do the necessary fixes. The real truth is that the ACA is not imploding it is in fact sustainable with minimal changes. The Republicans would have you believe that they are saving Americans from the ACA by this ridiculous unworkable plan. Of course their plan would cost millions to lose insurance millions more to be underinsured and the insurance marketplaces to collapse. Premiums wil skyrocket and people will not get the care that they need and deserve. The cynicism of the Republicans in Congress is nauseating. I wish I could afford to see a doctor. Unless the Republican sign on for the same insurance for themselves that they are forcing upon the rest of us I have no respect.
30
All members of congress need to have the same health insurance choices as most other Americans. If this were the case, they would not be working so hard to limit access to healthcare. I cannot understand why their positions of relative wealth make them unable to understand that we all need medical care when we need it without having to worry about how we will be able to afford it. Maybe their good fortune of having good coverage for their healthcare is one of the reasons they are so averse to meeting their constituents face to face at town halls. Perhaps they do have a good conscience and they feel strong shame for not having to worry about their health care and how to pay for it while most of us would be bankrupt by even one injury or serious illness. They occupy a fantasy world where no one is ever in need of healthcare but in the rare instance when they do need healthcare, it will be accessible without bankruptcy. Too bad that that is a pleasant dream and not reality.
17
"For a large number of Congressional Republicans, any effort to cover the costs of care for the poor and uninsured smacks of socialism and unwelcome government interference in the market."
Can that be true? A "large number of Congressional Republicans" would deny others healthcare simply because of belief in some abstraction called the "free market", which is a euphemism for an entity run according to rules set by corporations strictly for corporate (not human) advantage?
The power of ideas is great, but not so great as this. The real source of this resistance is simply money: money for the rich, but more unfortunately, money for Congressional delegates who would rather serve their corporate sponsors than their human constituents.
Can that be true? A "large number of Congressional Republicans" would deny others healthcare simply because of belief in some abstraction called the "free market", which is a euphemism for an entity run according to rules set by corporations strictly for corporate (not human) advantage?
The power of ideas is great, but not so great as this. The real source of this resistance is simply money: money for the rich, but more unfortunately, money for Congressional delegates who would rather serve their corporate sponsors than their human constituents.
13
To truly have a fair market, EMTLA should be repealed.
Asking the medical system to treat everyone without regard to their ability to pay, yet even a cursory amount of tax penalty to those who should have insurance is very unfair to all the people who use health care or work in one.
The irony is, simple thing like driving, you need a liability insurance or else you cannot drive.
The maximum harm they can do, cause an accident and destroy a car or injure costing 100 to 300 thousand. But some can just not carry health insurance and expect a million dollar treatment and not pay a dime
Obama care was the most reasonable approach that was feasible with do no harm mantra as its basis.
Asking the medical system to treat everyone without regard to their ability to pay, yet even a cursory amount of tax penalty to those who should have insurance is very unfair to all the people who use health care or work in one.
The irony is, simple thing like driving, you need a liability insurance or else you cannot drive.
The maximum harm they can do, cause an accident and destroy a car or injure costing 100 to 300 thousand. But some can just not carry health insurance and expect a million dollar treatment and not pay a dime
Obama care was the most reasonable approach that was feasible with do no harm mantra as its basis.
8
I know of a similar case. Two construction workers who were brothers were sent unconscious to the emergency room, having breathed toxic fumes.
One brother had his wallet and health insurance card. The other brother had left his in the truck back at the construction site.
My friend was married to the guy without the insurance card. She said he laid on the gurney for hours while the other brother was being treated. And yes, this happened in Pittsburgh, back in the 1990's.
One brother had his wallet and health insurance card. The other brother had left his in the truck back at the construction site.
My friend was married to the guy without the insurance card. She said he laid on the gurney for hours while the other brother was being treated. And yes, this happened in Pittsburgh, back in the 1990's.
15
We get to vote for members of Congress, but we don't get the chance to vote on what they are planning to impose on us. The issue of health insurance is so important that a special election should be held for ordinary citizens to say "yes" or "no" to what they come up with. It can literally be a question of life or death for some of us or our loved ones.
Congress people earn a minimum of $174,000 a year (not counting stipends and monies for their offices, employees, etc. We ordinary folks like Obama care because it's affordable and reliable. They can afford whatever comes down the track after they kill the ACA, but very few of the people we know earn over $50,000 a year.
Health care is crucial to every American. We deserve the right to vote on this issue.
Congress people earn a minimum of $174,000 a year (not counting stipends and monies for their offices, employees, etc. We ordinary folks like Obama care because it's affordable and reliable. They can afford whatever comes down the track after they kill the ACA, but very few of the people we know earn over $50,000 a year.
Health care is crucial to every American. We deserve the right to vote on this issue.
14
Somehow the words mock and Paul Ryan appear very comfortable in such close proximity. More often than not I see him with a smirk on his face. I think he finds this, all of it, amusing. I believe that will change someday.
The republicans appear to have little concern that their plan will not serve the needs of their constituency. They are getting what they want in this role of the dice with Trump. They are, again, putting money in the pockets of the only people they serve; corporate interests. evangelical interests, the NRA and their own personal interests. They don't like appearing in town halls. They have a lot to answer for. Will the electorate wake up to these dangerous, insulated elites? How long will it take?
The republicans appear to have little concern that their plan will not serve the needs of their constituency. They are getting what they want in this role of the dice with Trump. They are, again, putting money in the pockets of the only people they serve; corporate interests. evangelical interests, the NRA and their own personal interests. They don't like appearing in town halls. They have a lot to answer for. Will the electorate wake up to these dangerous, insulated elites? How long will it take?
15
Imagine for-profit ambulance services and for-profit hospitals. It is a very easy step then to understand the decisions people will make at the scene of a nasty accident. And it is a decision that makes perfectly good sense if the Almighty God is the dollar.
What are we becoming?
What are we becoming?
12
Ryan knows, of course, exactly what he is doing to millions of people who have remained mostly voiceless and powerless since the enactment of ACA (absent video from recent town halls). The case of AML cited by the good nurse is only the tip of the tip of the problem. People will suffer quite publicly now since the arousal of the great mass of Americans ready to listen to them. Ryan is prepared to take the heat. Insensitivity to the suffering of others is a great asset for a man like him. Ryan may think of himself as a pious and God fearing man, but what he is doing is diabolical. The election of someone so ill suited to public service and many others could only have occurred with the rampant gerrymandering we all know occurred under our noses.
17
Truth be said, not all medical care, in fact a small percentage of medical care is emergent.
So, people who have "disease processes" will still not be able to get healthcare treatment. Their health problems are not those that can be treated in an ER, maybe symptoms, but not their disease on the whole.
This is one of the issues of youth versus seniors, and thus a reason youth did not buy into purchasing the ACA.
Youth sees themselves getting treated in an ER, not on an oncology unit or an ICU. Who needs insurance, youth says.
Seniors see the opposite. They have lived their families, friends, themselves, being treated in the oncology units, cardiac units, the ICU's. They say, we need insurance.
So there you have it: the "failure of Obamacare" sayeth Donald Trump.
Pick your policy? The new Republican plans? What young person, unfamiliar with health issues, believes in health processes that yes, even young people get cancer, young people do end up in ICU's, and will make the Republican's proposal workable? Some, maybe, but not enough to have made the ACA lucrative for healthcare insurance companies.
Talk about affordable? Who is going to make this affordable? That is the challenge. And Paul Ryan has it wrong, wrong, wrong!
So, people who have "disease processes" will still not be able to get healthcare treatment. Their health problems are not those that can be treated in an ER, maybe symptoms, but not their disease on the whole.
This is one of the issues of youth versus seniors, and thus a reason youth did not buy into purchasing the ACA.
Youth sees themselves getting treated in an ER, not on an oncology unit or an ICU. Who needs insurance, youth says.
Seniors see the opposite. They have lived their families, friends, themselves, being treated in the oncology units, cardiac units, the ICU's. They say, we need insurance.
So there you have it: the "failure of Obamacare" sayeth Donald Trump.
Pick your policy? The new Republican plans? What young person, unfamiliar with health issues, believes in health processes that yes, even young people get cancer, young people do end up in ICU's, and will make the Republican's proposal workable? Some, maybe, but not enough to have made the ACA lucrative for healthcare insurance companies.
Talk about affordable? Who is going to make this affordable? That is the challenge. And Paul Ryan has it wrong, wrong, wrong!
12
There is no "free market" for health care. As nurse Brown explains, the Emergency Medical Treatment and Labor Act precludes hospitals from negotiating whether to treat or not treat the sick and injured.
Paul Ryan has taken Ayn Rand's philosophy as his own: unfettered self-interest is good and altruism is bad. Never mind the moral chasm that results. It's all about money.
Paul Ryan has taken Ayn Rand's philosophy as his own: unfettered self-interest is good and altruism is bad. Never mind the moral chasm that results. It's all about money.
16
The repeal of the ACA engineered by the compassionate conservatives will result in 157 BILLION dollars in tax cuts for the wealthy. If you want moral failure, you don't have to go beyond this appalling sentence.
14
How will history judge this regime that prioritizes a border wall that squanders the common wealth, denies climate change and slashes the EPA, and moves backward on health care rather than forward to a single payer universal coverage? With dissent and resistance, maybe that history won't get written.
16
I could live with with severe cutbacks in mental health, opioid addiction programs and other vitally needed services like these, if I could be assured that they will continue to be available whenever needed by President Trump, Mike Pence, Steve Bannon, Jared Kushner, Kellyanne Conway, Sean Spicer, Stephen Miller, Speaker Ryan and other afflicted members of the White House staff and Congress.
Here we are just 50 days into Trump’s grotesque clown college of a Presidency and the damage he has done to this nation’s reputation in the world already seems irreparable.
Here we are just 50 days into Trump’s grotesque clown college of a Presidency and the damage he has done to this nation’s reputation in the world already seems irreparable.
So let's just let the ACA self destruct? Let's review its promises: you can keep your doctor ( LIE), you can keep your plan ( LIE), it will reduce costs by an average of $1500/ yr ( LIE), poor folks will have a plan they can afford, like the Bronze plan ( LIE). The problem is that when you separate the provider of a service from the payer, market forces to control costs are reduced and costs go out of control. Nothing reinforced this more for me than when my wife needed an MRI of her shoulder. I paid cash and instantly received a 45% discount because the burden of the paperwork was gone. A concierge doctor with unlimited visits cost $1500/yr and a young person only needs to add catastrophic insurance. Of course, this makes too much sense for the ACA which bans this type of service. The ACA is a total failure just as everybody was told it would be and Democrats were hoping that Hillary would just tell people that single payer was the only option. The ACA was the trojan horse to Socialized medicine but it has failed.....thank goodness.
3
Anyone paying attention-most especially those responsible for voting for Trump and his GOP henchmen-had to know they were supporting someone who would abrogate their own best interests in a kind of masochistic denial.
They will reap what they have sown.
They will reap what they have sown.
6
The right hates the idea of government paying yet another entitlement - and I understand that.
But hospitals are legally obligated to treat people - because you can't just let them die. Which means higher bills for the insured and for people who can afford it.
In other words, we're gonna pay one way or another. The "free market" isn't free.
But hospitals are legally obligated to treat people - because you can't just let them die. Which means higher bills for the insured and for people who can afford it.
In other words, we're gonna pay one way or another. The "free market" isn't free.
8
Republicans dodge questions today about the increased cost of their plan (such as it is) to low and middle class citizens with the idea of "choice." They will have choice.
In other words, what will happen is that no matter what plan you chose (and can afford), when you get sick, you will end up saying "No. I chose the wrong insurance company" to quote a Liberty Auto Insurance ad, when the health insurance company rep tells you you are not covered for the Cancer you did not think you would get. At least you had choice.
In other words, what will happen is that no matter what plan you chose (and can afford), when you get sick, you will end up saying "No. I chose the wrong insurance company" to quote a Liberty Auto Insurance ad, when the health insurance company rep tells you you are not covered for the Cancer you did not think you would get. At least you had choice.
6
Do people have amnesia? We have had this extended debate in the past. If you lack insurance and need expensive care, you go to the ER which is the most expensive venue in the system. At the end of this expensive treatment the hospital "eats the cost" and patients have had to declare medical bankruptcy. There is no free lunch for the patient or for the society. All this talk of medical savings accounts and access is a bad joke. We are talking about families that usually don't have a lot of extra cas to stash into such an account, and access is most certainly not the same as ability to attain care. I just don't get it.
10
Thank you for putting a human, and humane, face to what it means not to have healthcare insurance; the republican's cruel and incompetent trial to repeal Obamacare has no virtues. They have nothing near the Affordable Care Act's providence for the least among us. That lying Trump says the A.C.A. is a 'disaster' is preposterous, as most of his vulgar bullying attests. And Paul Ryan, the driver of the repeal, is another 'Ayn Rand' hypocrite whose own health care is taken for granted. Although a private market approach can be successful if there is sensible regulation to avoid gouging, its costs are never going to be lower than a governmental single payer universal healthcare coverage, as evidenced in any other civilized country on this Earth. Our problem stems from a system mandated since WWII, an employer-paid healthcare insurance...and no control on the private market (Big Pharma, the medical devices' industry, hospitals, healthcare insurance companies), able and willing to charge astronomical or unexplained high fees to a captive audience, and where the profit motive seems the main objective, no doubt to appease a jealous god, greed. The republicans, in a most coward fashion, claim the A.C.A. smacks of 'socialism'; of course it does, and that is a good thing, as proven by the enormous benefit, and popularity, of Medicare, Medicaid and Social Security. And to add insult to injury, fraudsters Trump and Ryan want to cut health care from the poor so to lower taxes on the rich.
9
In my lifetime, advances in medical care have been fabulous: insulin, antibiotics, treatments for arthritis of various kinds, replacement of arteries, joints and organs, cancer treatments. Some of these have enabled me to live a painfree active life, longer than my parents.
It is expensive. THAT is the challenge. Fraud is negligible. Overuse fractional. Advertising that drives us to the latest (and hence) more expensive option is significant. But when you look at it squarely, the issue we face as a people is whether health care - as symbolized though not fulfilled totally by the ACA - is a right, or only available to those with money.
We tried the old way for decades. The ACA is an effort to fulfill the promise, and looks encouraging, including efforts to pay only for proven treatments. After we try every thing else to paraphrase Winston (Churchill, not Smith), we can do the right thing and go for single payer, which will make health care affordable for all, truly.
It is expensive. THAT is the challenge. Fraud is negligible. Overuse fractional. Advertising that drives us to the latest (and hence) more expensive option is significant. But when you look at it squarely, the issue we face as a people is whether health care - as symbolized though not fulfilled totally by the ACA - is a right, or only available to those with money.
We tried the old way for decades. The ACA is an effort to fulfill the promise, and looks encouraging, including efforts to pay only for proven treatments. After we try every thing else to paraphrase Winston (Churchill, not Smith), we can do the right thing and go for single payer, which will make health care affordable for all, truly.
9
As a retired health care provider, I can tell you, Trump, Ryan, etc. do not have a clue as to what they are talking about. The republican premise is based on an abstraction of the right to choose a plan that is best for the individual. There is no freedom inherent in a private insurance marketplace. You may get to choose a plan, but that and every plan has some form of limitations associated with it. And good luck to the average citizen trying to make sense of numerous plans with tons of fine print. Insurance companies do what is best for the insurance company.
If Obama was a white man and a republican ( or democrat for that matter ) we would not be having this discussion.
If Obama was a white man and a republican ( or democrat for that matter ) we would not be having this discussion.
24
spot on – but some additional points
1) The majority of people without medical coverage will not experience a dire medical emergency. However most people even with insurance will spend their days worrying about what will happen if they lose their job or for whatever reason& can’t afford insurance. This will become a baseline of fear in the daily lives of the majority of Americans – even the healthy.
2) Your patient was young. An older patient could still be relatively poor but managed over a lifetime to have acquired a little equity in a home and car. That would all be wiped out to qualify for Medicaid.
3) Most people treated in emergency rooms receive poor care beyond the immediate treatment. Your patient was lucky.
4) 1 OUT OF EVERY 2 BABIES BORN ARE PAID FOR WITH MEDICAID. THIS IS NEVER EVER DISCUSSED. The implications mean an inexorable death spiral for insurance, as those brought up on welfare tend to perpetuate it and consume enormous social services. $$$$$ www.whijournal.com Medicaid Covered Births 2008 through 2010 in the context of the Implementation of Health Reform.
5) And just how long in this day of linked communication do the rich & their spokespeople think they will be able to deny 21st century medical care to the poor before it becomes impossible for them to appear in public.
The worlds population explodes, pillaging and destroying the earth. The rich have a duty but so do the poor. We need Politically incorrect honest discussions.
1) The majority of people without medical coverage will not experience a dire medical emergency. However most people even with insurance will spend their days worrying about what will happen if they lose their job or for whatever reason& can’t afford insurance. This will become a baseline of fear in the daily lives of the majority of Americans – even the healthy.
2) Your patient was young. An older patient could still be relatively poor but managed over a lifetime to have acquired a little equity in a home and car. That would all be wiped out to qualify for Medicaid.
3) Most people treated in emergency rooms receive poor care beyond the immediate treatment. Your patient was lucky.
4) 1 OUT OF EVERY 2 BABIES BORN ARE PAID FOR WITH MEDICAID. THIS IS NEVER EVER DISCUSSED. The implications mean an inexorable death spiral for insurance, as those brought up on welfare tend to perpetuate it and consume enormous social services. $$$$$ www.whijournal.com Medicaid Covered Births 2008 through 2010 in the context of the Implementation of Health Reform.
5) And just how long in this day of linked communication do the rich & their spokespeople think they will be able to deny 21st century medical care to the poor before it becomes impossible for them to appear in public.
The worlds population explodes, pillaging and destroying the earth. The rich have a duty but so do the poor. We need Politically incorrect honest discussions.
7
What free market Republicans don't understand, or willfully ignore, is that healthcare is not a free market. If it were people like this young woman would not be struck by a disease when she was unprepared to pay for treatment by being insured. I'm totally dismayed by the cynicism and lack of care these politicians display.
13
Listening to Paul Ryan's Powerpoint presentation about the new health plan (as much as I could stand), I kept thinking that every problem he presented would so easily be solved by a Single Payer plan. It's also important to notice that they keep stressing "access" but never guaranteeing "coverage."
25
when a political party anoints itself with the authority to determine which citizens will be afforded basic health care and which we can not afford to cover, we are no longer a whole country.
there are people we all know who have enjoyed hundreds of thousands, if not millions of dollars of taxpayer health care coverage who would deny even basic coverage to their fellow citizens. and they proudly wave our flag. sleep well!
there are people we all know who have enjoyed hundreds of thousands, if not millions of dollars of taxpayer health care coverage who would deny even basic coverage to their fellow citizens. and they proudly wave our flag. sleep well!
16
It is becoming ever more clear that this is not a health care bill but a tax cut plan for the wealthiest Americans.
Just another facet of the evolving oligarchy, one supported ironically by the working poor and lower middle class.
Just another facet of the evolving oligarchy, one supported ironically by the working poor and lower middle class.
24
The dreadful scenario Mrs Brown describes (car accident) is a bit misleading, since injuries resulting from a motor vehicle accident fall under no fault insurance, the same as work related injuries fall under worker compensation.
To my knowledge there is no mention of reforms to no fault and workers comp insurance (yet).
Mrs Brown (and maybe some doctors and hospital administrators) could provide us with "data" on how hospitals and physicians have benefited financially from the expansion of Medicaid> since the ACA took effect, in NYC visits are often reimbursed at a rate higher than commercial insurance; free metrocards are given to medicaid recipients every time they go to a hospital clinic for a "medical service" or a test; the hospital charges for both the "facility" and the doctor's fee, etc.
A lot of us, in the medical profession, have been willing participants in the chaos that practicing medicine has become
To my knowledge there is no mention of reforms to no fault and workers comp insurance (yet).
Mrs Brown (and maybe some doctors and hospital administrators) could provide us with "data" on how hospitals and physicians have benefited financially from the expansion of Medicaid> since the ACA took effect, in NYC visits are often reimbursed at a rate higher than commercial insurance; free metrocards are given to medicaid recipients every time they go to a hospital clinic for a "medical service" or a test; the hospital charges for both the "facility" and the doctor's fee, etc.
A lot of us, in the medical profession, have been willing participants in the chaos that practicing medicine has become
3
If our legislators had to have the same coverage as what the least of any of their constituents can afford, the problem would be solved. Instead, the GOP sees that good card should only be available to the wealthy who can afford it.
18
If you never need or use it, insurance can be thought of as unfair. But because of that, insurance is actually fair to everyone. This in turn is why everyone must have it and pay what they can afford for it even if that is nothing.
15
Difficult times in America are about to get dangerous and deadly if this GOP healthcare plan passes and is enacted--which it probably will be given the ugly zealotry of the "Freedom Caucus" and Paul Ryan. Once enacted, this fiasco will take generations to fix. I just got enrolled in Medicare, but I have a feeling that I may not have it long--if the GOP has their way.
9
Too much of media coverage of the GOP health care effort is focused on the strategies of passage, on Trump's "art of deal" prowess. We need more coverage (like provided by this article), of the moral dimension of the proposed bill's effect on American society.
9
It is the height of hypocrisy for Congressmen and women, who themselves are covered by a robust government insurance program, turning around and denying a less than robust program to the citizens they represent. Ryan and McConnell would be more credible if instead of standing in front of whiteboards and Powerpoint presentations, they took out their government insurance policy, ribbed it up in front of the media and stated, that they and their families were enrolling in Trumpcare.
10
The right, despite efforts to falsely appear otherwise, has proven time and again where their priorities lie. They are without a doubt absolutely not in line with the needs or welfare of the vast majority of American citizenry. Freedom of choice and free markets are not worth squat in the face of serious illness and potential death. In essence their idea of these concepts serves to greatly limit potentially life sustaining choices to the millions who will lose access to long term quality care as a result of their efforts. In their vision the only really important aspect us that profiteers have maximum advantage.
Freedom of choice and free market health care amounts to little more than freedom from choice because millions will not be able afford the so called free market price gouging.
Freedom of choice and free market health care amounts to little more than freedom from choice because millions will not be able afford the so called free market price gouging.
5
Solving healthcare is a lot easier than the complexities introduced everyday. Increase the number of doctors that are purposely controlled to ensure high salaries for specialists. When an Orthopedic Surgeon makes $600k per year, it is easy to justify a lot of paperwork thus increased the cost over and over. Apply free market to supply of doctors and see the prices tumble, most routine visits would be cash only and insurance kicks in for high costs treatments only.
As for large student debt and years of study as justification for high salary, I know of no other profession where such guarantee exists, not lawyers, not MBA, not PHD, not professors or teachers. Why the special treatment for doctors.
As for large student debt and years of study as justification for high salary, I know of no other profession where such guarantee exists, not lawyers, not MBA, not PHD, not professors or teachers. Why the special treatment for doctors.
7
The whole idea of a free market in health care is absurd. We haven't had one since LBJ. Cars and cellphones and food and entertaiment and toys and jewelry and clothes and most things can be bought in a free market. Consumers can decide what they need or want and educate themselves about the products to the extent they want. Reading articles on the internet about health care problems, many of them life-threatening, is not going to make you a Tom Price or a Ben Carson or any competent physician. You won't know if you have a life threatening condition or one that can easily be cured with antibiotics or some similar treatment.
So what Republicans mean when they talk about removing people from the health care rolls because they don't want insurance is "free market" in only one sense-if you can't afford health care you can't have it. Next to go will be food stamps, an even more vital necessity of life. And they are working towards eliminating water (by polluting rivers and streams) for all who cannnot afford bottled purified water (it's Flint all over again on a national scale). Abortion and contraception restrictions are meant to deny sex to those at the lower end of the income scale. In other words, their attack on the ACA, far from creating a free market for health care, is meant to deny the basic necessities of life for those least fortunate. Let's tell it as it is. And Trump, of course, is fully complicit in this attack on the less fortunate and the disabled.
So what Republicans mean when they talk about removing people from the health care rolls because they don't want insurance is "free market" in only one sense-if you can't afford health care you can't have it. Next to go will be food stamps, an even more vital necessity of life. And they are working towards eliminating water (by polluting rivers and streams) for all who cannnot afford bottled purified water (it's Flint all over again on a national scale). Abortion and contraception restrictions are meant to deny sex to those at the lower end of the income scale. In other words, their attack on the ACA, far from creating a free market for health care, is meant to deny the basic necessities of life for those least fortunate. Let's tell it as it is. And Trump, of course, is fully complicit in this attack on the less fortunate and the disabled.
10
Look to Scandinavia and you will see civilized countries in contrast to our winner take all way of thinking.
8
A consequence of the Republican replacement for Obamacare will be many employers not providing insurance. In addition to the obvious savings of not paying for employee insurance, there will be another competitive reason to drop health insurance coverage after both employer and individual mandates are gone. Consider two fast food firms trying to hire minimum wage workers. One employer offers the minimum wage plus some (probably meager) health insurance, that requires some partial payments from the employee. The other employer offers the minimum wage and can tell the prospective employee that since there is no health insurance the employee will receive a monthly refundable tax credit, that will significantly increase their take-home pay.
The employee can get the monthly refundable tax credit and choose not to use it to buy health insurance. This will probably be the choice made by many low wage workers. In this way the employer not providing health insurance actually has an easier time attracting low wage workers.
"..In the USA we have attempted to deal with the combination of inelastic demand and unregulated medical care prices in various ways. One method of keeping medical care expense as a percent of GDP to "only" double that of other developed countries was to have a significant portion of the population uninsured and denied medical care in some circumstances. The uninsured (conscripts in the war against rising medical costs) ..."
http://seekingalpha.com/article/1647632
The employee can get the monthly refundable tax credit and choose not to use it to buy health insurance. This will probably be the choice made by many low wage workers. In this way the employer not providing health insurance actually has an easier time attracting low wage workers.
"..In the USA we have attempted to deal with the combination of inelastic demand and unregulated medical care prices in various ways. One method of keeping medical care expense as a percent of GDP to "only" double that of other developed countries was to have a significant portion of the population uninsured and denied medical care in some circumstances. The uninsured (conscripts in the war against rising medical costs) ..."
http://seekingalpha.com/article/1647632
7
As a Canadian comforted by our universal health care I am obviously biased as I read screeds on health care (or the lack of) in the USA. Please, I need some answers: as various “perfect” plans are rolled out they all appear impervious to the trials and tribulations that will be the destiny of so many ordinary (i.e. not rich) citizens and others . Does nobody care, do those in government all sleep soundly at night as they visit their perfect health plans on the “forgotten people”?
6
The question is why Republicans put honoring their word to repeal the ACA, or Obamacare, ahead of providing for the healthcare needs of Americans. The answer is, I think, not hard to understand. Taken in the context of its policies across the board, the GOP wants favors a straight, white, Christian society of the rich, the educated, and the healthy; and relegates all others to the dystopia of the opposite. To this end, in the name of free markets--how ironic that government is creating or sustaining the market--the GOP is sponsoring a risky, inefficient, exploitive private-sector heath care system to extract as much money as possible from those is and below the middle class.
5
Every other civilized country has free universal health care for their citizens and so should we. The failure to put that in place is the cause of this absurd and cruel situation. As usual, the right has succeeded into confusing the issue in the minds of voters who have been conditioned to fear the word "socialism".
3
With all the health care talk, how come there is so little discussion of actual numbers. In 2015, health care consumed 17.8 % of GDP ($30 trillion) or 3.2 trillion dollars. Other industrialized countries, save Switzerland, had GDP costs of less than 10% GDP. Despite the high costs, the U.S. system ranks very poorly (not even in the top 30 by the World Health Organization). What if we were to adopt a medical care system similar to the rest of First World countries. Could we save half the difference between expenditures, say 630 billion dollars a year? That's more than all our yearly military costs. What if we were to use American ingenuity and match other countries expenditures? What could we accomplish with that $1.2 trillion a year? Finally, what's stopping us from even trying to achieve these savings? How about a Republican party whose leadership has the Ayn Randian concept that government can do no good and as a consequence allows millions to suffer.
6
Forget compassion for the poor who are afflicted by disease.
They're expendable in the scheme of things when you're one of the Koch Brothers and the health and welfare of Americans is just a tiny blip on the radar compared with the larger goal of amassing even more wealth and power.
In any case, we all know the poor will pass up health insurance in a heartbeat in order to buy gadgets. Sad!
They're expendable in the scheme of things when you're one of the Koch Brothers and the health and welfare of Americans is just a tiny blip on the radar compared with the larger goal of amassing even more wealth and power.
In any case, we all know the poor will pass up health insurance in a heartbeat in order to buy gadgets. Sad!
5
I am shocked and baffled by these lawmakers. Most of them grew up in an American cultural surround where charity and human decency are stressed. Yet many in Congress are actually slavering at their chance to commit millions of their fellow Americans to lives without dignity. How can this be happening in our country?
10
Seems like the Republicans are purposely creating a healthcare law that fails . It may be their only chance of destroying the dream of afforable health for all, without outright repeal.
4
A fact that can not be denied. The larger the pool of insured, the lower the cost for those within the pool. If every citizen of the U.S. were covered under a universal all inclusive plan the average price of healthcare would be lower for everyone. One plan, everyone covered, no exceptions.
How is that different from the way national security or police protection is designed to work? Aren't they supposed to provide universal coverage?
How is that different from the way national security or police protection is designed to work? Aren't they supposed to provide universal coverage?
7
The simple goal of trumpcare is to lower the standard of living for low income people, in order to raise the standard of living of the already well off.
6
Is the goal of health care reform to lower the overall cost of health care and insurance for as many people as possible, or is it a social program designed to subsidize poor people? I hope everyone realizes that it cannot be both. As a matter of fact, they are diametrically opposed objectives, as we learned with Obamacare. Therefore we should separate them into 2 programs.
Ms. Brown describes what is known in hospitals as a "wallet biopsy", generally the first diagnostic test conducted on entry to the ER. Gratefully, EMTs and paramedics are not equipped to administer this test.
If you arrive at the ER with a chronic condition (perhaps diabetes) which has spun out of control (in thus example - diabetic coma) your wallet biopsy determines your hospital path. Fail the test and you'll receive emergency treatment followed by discharge (and a primer on accessing Medicaid.) Pass the test and you'll also receive emergency care and then be admitted for ongoing treatment of the underlying disease.
When Medicaid no longer exists there will be no options for care of chronic diseases if you fail the current gold standard first line diagnostic: the wallet biopsy.
If you arrive at the ER with a chronic condition (perhaps diabetes) which has spun out of control (in thus example - diabetic coma) your wallet biopsy determines your hospital path. Fail the test and you'll receive emergency treatment followed by discharge (and a primer on accessing Medicaid.) Pass the test and you'll also receive emergency care and then be admitted for ongoing treatment of the underlying disease.
When Medicaid no longer exists there will be no options for care of chronic diseases if you fail the current gold standard first line diagnostic: the wallet biopsy.
It's beyond ironic that the political party most associated with self-reliance and personal responsibility would undo legislation that demands those things. The ACA mandates insurance coverage, demanding that citizens be responsible for their own part in the vast pool of healthcare costs. Yet republicans dismiss this mandate as 'socialism.' When citizens access the healthcare system without insurance, the rest of us pay for it: That's socialism.
4
There's a moral failing with all complexities that don't work properly. And that covers all complexities. No one seemed concerned about the failing of the ACA signed by the caring Obama, and puzzled over by Pelosi.
There is no good answer to a faulted law that taxes those who will not comply.
There is no good answer to a faulted law that taxes those who will not comply.
1
Sadly, Emile - another poster - says, "For my whole life--from my childhood through my adulthood (one that's marked by extensive travels abroad), I've casually bought into the idea that Americans are a friendly, open, generous, and freedom-loving people. But with the presidency of Donald Trump, and with what the Republicans are doing with medical care, along with everything else, it's clear I've been a fool. We're really a very small-minded, selfish and cruel people."
Emile, I must disagree and would call your attention to the nationwide protests against this administration and their destructive plans for America. The real problem is that BIG money masters behind republican operatives have taken over OUR systems in the last 40+ years and convinced too many that "government is the problem" and "your vote doesn't count."
Truth is OUR governments are social constructs to protect us from people like the Robber Barons, mafia and other crooks that want to destroy us and the only thing that really counts in America is OUR individual vote.
All it takes is for Good People to Do Nothing and the real story is that America's Silent Majority is Roaring. The Sleeping Giant has Awakened and SHE is furious, along with socially conscious men. OUR actions is what will restore your lifelong vision of America, which reflects the values of the vast majority of us.
It is all good.
Emile, I must disagree and would call your attention to the nationwide protests against this administration and their destructive plans for America. The real problem is that BIG money masters behind republican operatives have taken over OUR systems in the last 40+ years and convinced too many that "government is the problem" and "your vote doesn't count."
Truth is OUR governments are social constructs to protect us from people like the Robber Barons, mafia and other crooks that want to destroy us and the only thing that really counts in America is OUR individual vote.
All it takes is for Good People to Do Nothing and the real story is that America's Silent Majority is Roaring. The Sleeping Giant has Awakened and SHE is furious, along with socially conscious men. OUR actions is what will restore your lifelong vision of America, which reflects the values of the vast majority of us.
It is all good.
4
Across the Whites R Us Baptist, Evangelical and fraudulent Bible Belt, America's Christian Shariah Crusaders replaced the "Amazing Grace" hymn in every one of their churches with "Amazing Spite" a long time ago.
Nobody champions Christian ill will toward others better than the Confederate Republic of Republistan.
"Amazing spite! How sweet the glee
That deadened a heart like mine.
I once was blind, but now I see,
God's giant rainbow of hateful brine."
Drop dead, America - and Praise the Hateful Lord !
Nobody champions Christian ill will toward others better than the Confederate Republic of Republistan.
"Amazing spite! How sweet the glee
That deadened a heart like mine.
I once was blind, but now I see,
God's giant rainbow of hateful brine."
Drop dead, America - and Praise the Hateful Lord !
13
TWO PRAYERS
A PRAYER OF THANKS FOR TODAY
Thank God I am White
Thank God I am Male
Thank God I am on Medicare
A PRAYER OF THANKS FOR TOMORROW
Thank you Lord for these 68 years
And thank you Lord for giving me cancer and high blood pressure
So I likely will be called to the bosom of the Heavenly Host
Before Republicans make
The water too tainted to drink
The air too polluted to breathe
... and before Wall Street cheats me out of every penny I have.
A PRAYER OF THANKS FOR TODAY
Thank God I am White
Thank God I am Male
Thank God I am on Medicare
A PRAYER OF THANKS FOR TOMORROW
Thank you Lord for these 68 years
And thank you Lord for giving me cancer and high blood pressure
So I likely will be called to the bosom of the Heavenly Host
Before Republicans make
The water too tainted to drink
The air too polluted to breathe
... and before Wall Street cheats me out of every penny I have.
284
The ACA has been screamed at, beaten down, lied about and has evoked far right rage since its founding. When the new face of its replacement is down right giddy over cutting taxes on the rich that helped pay for it and you realize all along that Ayn Rand is his guiding light, I for one would like to rub his face in the misery and grief soon to be unleashed. Maybe I can catch him at mass tomorrow when he is in the communion line or exchanging the sign of peace with his fellow henchmen.
48
Today's GOP willingly writes blank checks for war and tax cuts for the wealthy yet when the debt comes up it's Social Security, Medicare & Medicaid to blame. It should come as no surprise that they reject the ACA in spite of the fact that it is the creation of Conservatives. What can you expect from someone who's economic worldview comes from Ayn Rand?
47
Exactly. Some 18 million LEGAL American citizens stand to lose their insurance coverage, AND the deficit may actually rise if Trumpcare is enacted in its current form. The rural, poor areas that suffer from the opioid epidemic and that voted overwhelmingly for Trump will be hit the hardest by the cuts. Even the Koch brothers have instructed their organizations to repudiate the Republican "replacement" plan. It would appear it's only supporters are congressional Republicans and our president himself, all of whom hope to push it though Congress before anyone realizes how ugly the pig is that they're frantically trying to lather with lipstick.
Conservative pundit, Avik Roy has called attention to an especially brazen bit of hypocrisy in the proposed bill: it takes away insurance subsidies from the poor. . .and gives them to the rich. https://www.washingtonpost.com/opinions/gop-hard-liners-obamacare-incohe...?
Conservative pundit, Avik Roy has called attention to an especially brazen bit of hypocrisy in the proposed bill: it takes away insurance subsidies from the poor. . .and gives them to the rich. https://www.washingtonpost.com/opinions/gop-hard-liners-obamacare-incohe...?
27
Health care should be a right, not a market driven privilege.
42
The Republicans are making me sick.
50
ACA is half a loaf and the soon to be fought and mis named AHCA is a slice taken from that loaf, but neither are satisfactory.
We need universal health care and anything short of this is a continuing slap in our face delivered by men and women who, thanks to the generosity of the American public, have no concern for such trivial matters.
Absolute hypocrisy.
We need universal health care and anything short of this is a continuing slap in our face delivered by men and women who, thanks to the generosity of the American public, have no concern for such trivial matters.
Absolute hypocrisy.
22
Please make Paul Ryan, and politicians of all stripes, buy their insurance on the free market. Problem solved.
41
No matter what side of the debate you're on, It's amazing to me that the American people don't insist upon receiving the same insurance as our members of Congress have. Notice that neither Republican nor Democrat mention their own gold-plated plans and what they receive in any of these discussions, they manage to keep it way under the radar. And it's payed for by the American taxpayer.
1
David. Not solved at all.
They all have ample funds to buy on the free market.
They can always tap their campaign funds if needed. The latter may not be "legal" but then who will go after them? A congressional investigation? The ethics folks? Nope.
They all have ample funds to buy on the free market.
They can always tap their campaign funds if needed. The latter may not be "legal" but then who will go after them? A congressional investigation? The ethics folks? Nope.
1
Maybe the loss of healthcare coverage will be the kick in the teeth Americans need.When children and loved ones die because of "hey you can't afford it,so it's your fault" will hit home. After all Republicans are always against something until it affects them . Say Nancy Reagan's reversal on stem cell research because of Ronnie.Or gay rights when their children come out. Hopefully single payer will come of this.Most likely kicking and screaming at the top of it's lungs.That is,if it's got a healthcare card.
32
Scrooge couldn't have devised a better way to "decrease the surplus population."
46
"House Speaker Paul Ryan and others would take mock offense at the idea that they’re willing to let people go without care, but it’s the unavoidable logic of their drive to undo Obamacare."
Mr. Ryan knows people are going to die. He also knows that his Republican Congress can't be charged with murder for any of it.
Mr. Ryan knows people are going to die. He also knows that his Republican Congress can't be charged with murder for any of it.
52
The Republicans/Conservatives shouted "Death Panel" and their constituents took it up, thought it was a good argument or at least a good sounding argument. Why now do Democrats not say the same? Why always is the Left so weak in language?
36
Because some entrenched Democrats are also taking money from the 1 percent that will be the only beneficiary of this new bill.
1
Paul Ryan will read this story and say that your compassion is touching, but is it right for society to impose those moral views on everyone? According to him, requiring health care and supporting that requirement with public dollars is a collective moral judgement. While we need health care the government should not impose it.
Ryan argues that morality is an individual choice. Government programs like the ACA or even Medicaid take away our freedom by taking away our choice. The best venue for real choice, and thereby individual freedom is the marketplace. There you buy what you want and reject what you don't want. If you can't afford something you work hard and save for it. These are all choices and expressions of freedom. Government simply gets in the way our freedom.
So despite the last 200 years of history in industrialized societies Ryan and his fellows in the GOP think that we should go back to the mid nineteenth century. Of course when it comes to his corporate fiends big government is not such a bad thing.
For them government should manipulate markets, build infrastructure for businesses at no cost, clean up the environment that they spoil and treat the injuries and diseases that they cause, all without taxing corporations for this malevolence behavior and indemnify them from law suits.
This view reflects impaired empathy or remorse, they lack feeling for others and have an inability to act morally. Simply put the leaders in Washington have become sociopaths.
Ryan argues that morality is an individual choice. Government programs like the ACA or even Medicaid take away our freedom by taking away our choice. The best venue for real choice, and thereby individual freedom is the marketplace. There you buy what you want and reject what you don't want. If you can't afford something you work hard and save for it. These are all choices and expressions of freedom. Government simply gets in the way our freedom.
So despite the last 200 years of history in industrialized societies Ryan and his fellows in the GOP think that we should go back to the mid nineteenth century. Of course when it comes to his corporate fiends big government is not such a bad thing.
For them government should manipulate markets, build infrastructure for businesses at no cost, clean up the environment that they spoil and treat the injuries and diseases that they cause, all without taxing corporations for this malevolence behavior and indemnify them from law suits.
This view reflects impaired empathy or remorse, they lack feeling for others and have an inability to act morally. Simply put the leaders in Washington have become sociopaths.
119
In some respects, free-market capitalism mixes with medical care almost as badly socialism mixes with agriculture. The economic failures of communism are well known, particularly the inability of state-run agriculture to provide even basic staples. In free markets "consumer sovereignty" directs the producers of goods and services to follow the dictates of supply and demand. As Adam Smith explained in 1776, no central authority coordinates the delivery of food and the plethora of goods that a major city like London needs every day. Rather, the "invisible hand" of competitive free markets results in an abundance of goods and services being provided to consumers in the most efficient manner. The "consumption" of medical care overturns many of the economic assumptions that underlie free-market efficiency. Usually, the conditions under which medical care is provided are the exact opposite of consumer sovereignty. In most cases the "sellers" i.e. the doctors, tell you, the "buyer" what and how much you need and set the price. The prevalence of third-party payers further removes medicine from the purview of the normal supply and demand market economics that prevails for goods and services whose sellers do not face inelastic demand.
The price inelasticity of health care is also a consequence of the success of the medical science. Two hundred years ago, consultation with a physician did not significantly alter the outcomes of most medical. ..."
http://seekingalpha.com/article/1647632
The price inelasticity of health care is also a consequence of the success of the medical science. Two hundred years ago, consultation with a physician did not significantly alter the outcomes of most medical. ..."
http://seekingalpha.com/article/1647632
2
You have answered my question. I still can't fathom how people get this way to begin with and not have moral breakdowns.
3
The woman with A.M.L. was very lucky that she either lived in a State with expanded Medicaid (probably because there was not a Republican Governor) or the disease made her completely unable to work. Otherwise she could not have received medicaid because she was not categorically eligible. In order to qualify for medicaid in states that do not have the ACA expanded provision (going down the tubes with the Republican replacement) you have to be someone with dependent children and meet a very low income requirement or be totally disabled, eligible to receive SSI. I was neither when facing prostate cancer that could and would have killed me if left untreated. The treatment cost was in the $200K range, money which I did not have growing on a money tree out behind my modest home. LUCKILY a for profit company gave me the care for free and I am well and able to contribute back to this wonderful world by helping others, paying it backwards and forwards.
30
The best and only health care solution is a single payer-tax supported national health care plan. Those on the right are too callous and greedy to consider that fact. Too many on the left are stuck in the shibboleth that it is politically impossible Why can't we dream big and get it right?
81
Japan's explicit price controls are roughly emulated in other countries via the use monopsonistic systems. Monopsony, meaning "single buyer" is the flip side of monopoly. A monopolist sets prices above free market equilibrium. A monopsonist sets prices below free market equilibrium. It does not matter if there is an actual single payer or many buyers (or payers) whose prices are set by the government or by insurance companies in collusion with each other.
More competition among sellers generally leads to lower prices. However, more competition among buyers leads to higher prices. In the health insurance industry the beneficial effects of more insurance companies competing for patients are far outweighed by the adverse effects of insurance companies competing for doctors and hospitals in their HMO plans. This was completely misunderstood during the recent debate on health care reform. With health care, more competition among insurance companies on balance results in higher prices.
Focusing attention on the insurance companies, which are simply intermediaries between the doctors and the patients, was a tragic error. It would like trying to solve a problem of high energy prices by focusing on gasoline stations. Only if the government sets prices can health care prices be controlled. Controlling prices does not automatically result in longer waiting times. Japan generally has shorter waiting times to see doctors than does the USA..."
http://seekingalpha.com/article/1647632
More competition among sellers generally leads to lower prices. However, more competition among buyers leads to higher prices. In the health insurance industry the beneficial effects of more insurance companies competing for patients are far outweighed by the adverse effects of insurance companies competing for doctors and hospitals in their HMO plans. This was completely misunderstood during the recent debate on health care reform. With health care, more competition among insurance companies on balance results in higher prices.
Focusing attention on the insurance companies, which are simply intermediaries between the doctors and the patients, was a tragic error. It would like trying to solve a problem of high energy prices by focusing on gasoline stations. Only if the government sets prices can health care prices be controlled. Controlling prices does not automatically result in longer waiting times. Japan generally has shorter waiting times to see doctors than does the USA..."
http://seekingalpha.com/article/1647632
I would like someone to tell me why conservative Republicans hate Federal intervention meant to help people. Is it greed, contempt for those without a lot of money, pull yourself up by your bootstraps, or just protecting their own riche? I find this ideology so out of joint with how to run a country that is helpful and fair to all. Perhaps we are just living on different planets. I prefer mine.
2
The answer, from this side of the border, is, of course, some form of single-payer system, like the rest of what Mr Trump calls the "civilized world." What I have never quite understood is the deep fear of government among so many Americans, all in the name of freedom. Freedom is a fine-sounding word, but as Isaiah Berlin famously said, "freedom for the pike is death for the minnow."
The only way I get a sense of the American system in Canada is when I pay my dog's veterinary bills. The invisible hand is never benign.
The only way I get a sense of the American system in Canada is when I pay my dog's veterinary bills. The invisible hand is never benign.
73
Hah! We Americans have freedom from being healthy! Take that Canadamunism! We get the freedom to be sick and dying!
Mission accomplished!
Mission accomplished!
4
Hear! Hear! I might add that what is equally mystifying is why Republican lawmakers who profess to hate government campaign so hard to be part of it.
3
Health insurance isn't the only thing we're losing. We're going to be losing clean air and water, wait till those health risks start piling up. We're losing an effective educational system. We're losing the ability to protect ourselves from the greed of financial institutions.
Most important is we're losing truth. A small group of people are shoveling false news, hate and fear all over the land. They're not doing to improve your health or well-being. They think you're too stupid to catch on. They may be right, after all you elected Trump, Ryan, McConnell and a host of others as bad or worse.
Millions of Americans are still shaking their heads wondering how this all happened. It happened because of ignorance and fear and hate and Republicans willingness to sell their souls.
Save the country and yourself. Repeal and replace them.
Most important is we're losing truth. A small group of people are shoveling false news, hate and fear all over the land. They're not doing to improve your health or well-being. They think you're too stupid to catch on. They may be right, after all you elected Trump, Ryan, McConnell and a host of others as bad or worse.
Millions of Americans are still shaking their heads wondering how this all happened. It happened because of ignorance and fear and hate and Republicans willingness to sell their souls.
Save the country and yourself. Repeal and replace them.
307
I remember reading a news article in 2010 about how a fire department in a small town in Tennessee actually let a family's house burn down even though it could have been saved.
Why? Because the town, South Fulton, made people who lived outside of town pay a $75 annual fee to get fire service. This family hadn't paid the fee, and the fire department watched while their home burned, killing three dogs and a cat. Oh, the fire department did spray down the house next door when embers threatened it. That guy had paid the fee.
The town of South Fulton is in Obion County, which is Republican to the core. Incidentally, it is now suffering from a severe opioid addiction crisis. Many of the people in the county are affected, but voted Republican anyway. They made their bed, and now they have to lie in it.
These are the people who are running the country now. In my opinion, they are hateful and beneath contempt.
Why? Because the town, South Fulton, made people who lived outside of town pay a $75 annual fee to get fire service. This family hadn't paid the fee, and the fire department watched while their home burned, killing three dogs and a cat. Oh, the fire department did spray down the house next door when embers threatened it. That guy had paid the fee.
The town of South Fulton is in Obion County, which is Republican to the core. Incidentally, it is now suffering from a severe opioid addiction crisis. Many of the people in the county are affected, but voted Republican anyway. They made their bed, and now they have to lie in it.
These are the people who are running the country now. In my opinion, they are hateful and beneath contempt.
364
Perhaps if the town had the opt-in 30 percent surcharge option that the Republicans are touting for health insurance, the poor family could have saved the house for just under $100.
3
Having been a parish pastor for over 40 years and living in a highly Republican area, I sometimes wonder if I pretty much wasted my career preaching Jesus' love for all manner of people. The Republicans of today care only for themselves and the wealthy and the rest of us can go to you know where. Four years of Trump? Tell me it can't be so!
10
As my physician/hospital administrator father used to say, "Diseases don't discriminate," which is why he continued to volunteer in clinics until his mid 80's when he felt he couldn't keep up with all of the medical advances he thought he needed. Throughout he railed against the designer drug prices, doctors who crammed their waiting rooms over prescribing and unnecessarily testing and the dunning of patients who clearly could not afford care, but if left to suffer would end up in emergency rooms.
All of the above were considered when ACA was crafted with input from every one of the organizations currently protesting the GOP's rushed and frankly unconscionable bill. Watching Paul Ryan's flop sweat as he tries to sell this bill is telling; it appears he knows that the more the public understands the consequence of this legislation, the less they will support. In short, he and his colleagues would like to stretch out the bad news until they are safely back in office. Give the tea party credit, they are open about their desire to just run us over, simple, clean, done.
All of the above were considered when ACA was crafted with input from every one of the organizations currently protesting the GOP's rushed and frankly unconscionable bill. Watching Paul Ryan's flop sweat as he tries to sell this bill is telling; it appears he knows that the more the public understands the consequence of this legislation, the less they will support. In short, he and his colleagues would like to stretch out the bad news until they are safely back in office. Give the tea party credit, they are open about their desire to just run us over, simple, clean, done.
132
For my whole life--from my childhood through my adulthood (one that's marked by extensive travels abroad), I've casually bought into the idea that Americans are a friendly, open, generous, and freedom-loving people. But with the presidency of Donald Trump, and with what the Republicans are doing with medical care, along with everything else, it's clear I've been a fool. We're really a very small-minded, selfish and cruel people.
499
What you describe is a reflection of a people made small and fearful. We are not longer the country that dreams big, or sees the future as anything but threatening. It is inconceivable to think that this country today would ever invest in something as bold as the Marshal Plan.
We are encouraged to ignore fact-based reasoning, embrace short term patchwork fixes, never to dream big, be bold or embrace challenges. We cannot long survive when our primary motivations are self-protection and "getting mIne" before it is too late. We have lost faith in ourselves and in our future.
We are encouraged to ignore fact-based reasoning, embrace short term patchwork fixes, never to dream big, be bold or embrace challenges. We cannot long survive when our primary motivations are self-protection and "getting mIne" before it is too late. We have lost faith in ourselves and in our future.
3
Not all of us. Not even a large minority of us. What has happened -- what will happen -- is representative only of a mean-spirited, anti-freedom segment of our population who, having gained power, is determined to hurt as many people as possible in pursuit of their version of perfection. I am convinced Americans as a whole won't stand for it.
9
You are absolutely correct. The current iteration of the republican party, and the cadre of trump supporters cheering for their arrogant self-interests, demonstrate that the majority of Americans are small minded, selfish and cruel.
Fine. You worry about a seriously ill patient who won't be able to pay for her medical treatment. Leave aside the fact that that's what charity is for. Where is your concern for how we're going to pay for the ACA? $1T in deficits? Indeed, if you favor government of the size BHO bequeathed us, where do you propose to come up with the $600B in annual deficits, projected to increase every single year?
What is the human cost of endless deficits? Where is the morality in proposing to fund handouts, freebies, and giveaways, without the slightest suggestion of how to pay for them? Yeah, freedom is problematic; maybe that woman's MDs won't step up to the plate and work for free, as they should. But where is the morality of bankrupting the entire country, because you're too dishonest to pay for the things you contend we need?
VT showed what happens when a government which actually has to pay its bills considers single payer. So, consider a modest proposal:
Pick a few states, impose single payer, and PROVE that you can make it work while actually paying the bills. Be moral enough to propose paying for the things you want, rather than sending the bills to our kids.
Good luck.
What is the human cost of endless deficits? Where is the morality in proposing to fund handouts, freebies, and giveaways, without the slightest suggestion of how to pay for them? Yeah, freedom is problematic; maybe that woman's MDs won't step up to the plate and work for free, as they should. But where is the morality of bankrupting the entire country, because you're too dishonest to pay for the things you contend we need?
VT showed what happens when a government which actually has to pay its bills considers single payer. So, consider a modest proposal:
Pick a few states, impose single payer, and PROVE that you can make it work while actually paying the bills. Be moral enough to propose paying for the things you want, rather than sending the bills to our kids.
Good luck.
12
I think you have bought into the falsehood that ACA is making us go down the tubes. The wall would do that just fine. You call freedom problematic. 'that p word covers a multitude of sins. How about stopping corporate welfare first? I need to stop reading these comments and responding before my blood pressure soars.
"Your kids" won't have to worry about paying bills. They will worry about breathing and drinking and eating because there will not be any clear air or water after this current administration is through.
I too would like to see some states experiment with single payer.
Here's a quote from the article which should interest you when you suggest that the woman's doctors should "work for free."
"The first round of curative treatment required a six-week hospital stay, multiple infusions of chemotherapy and intensive round-the-clock nursing. And that was just the start."
So, it is not just the doctor but nurses, hospitals, and staff members who should "work for free" in this woman's and many other such cases. You do mention "charity" which could help but, again, there are many such cases all around us.
Perhaps the Republican plan will bring better and cheaper health care to all Americans. As promised time and again.
We shall see but so far I do not expect those things to happen.
Here's a quote from the article which should interest you when you suggest that the woman's doctors should "work for free."
"The first round of curative treatment required a six-week hospital stay, multiple infusions of chemotherapy and intensive round-the-clock nursing. And that was just the start."
So, it is not just the doctor but nurses, hospitals, and staff members who should "work for free" in this woman's and many other such cases. You do mention "charity" which could help but, again, there are many such cases all around us.
Perhaps the Republican plan will bring better and cheaper health care to all Americans. As promised time and again.
We shall see but so far I do not expect those things to happen.
3
Great article. Of course the poor, being poor by choice?, don't get or deserve health care under this new plan, do they? Since from what I read this new plan will give enormous tax breaks to the wealthy who don't really the money anyway. We have long ago stopped being a caring country, despite what the so-called Christians like Paul Ryan say. Give the poor iPhones and let them eat cake, if they can afford it.
I'm currently reading 1984. Sounds a lot like 2017, substitute Donald Trump for Big Brother.
I'm currently reading 1984. Sounds a lot like 2017, substitute Donald Trump for Big Brother.
25
The Republican's preferred approach to health care remains what it has always been: "Be rich enough to either afford good insurance or to not need it at all. If you are too poor to buy insurance, stay healthy. If you are poor and get sick, die quickly and cheaply."
The problem for Republicans now is that they have not been able to find the right words to make this approach sound good to enough of their low-information voters. But never fear - the search for obfuscating language will continue unabated.
Moreover, with their irrational and immoral approach to health care, the Republicans would kill far more Americans than either al Qaeda or ISIS ever imagined in their wildest dreams. As it is, Republican controlled legislatures and governors in the states that refused the offered Medicaid expansion are needlessly killing about 22,000 Americans every year.
Republican politicians warned us that "Obamacare" would give us "death panels," but I am sure they never thought the term would be an accurate description of many GOP-controlled state legislatures.
The problem for Republicans now is that they have not been able to find the right words to make this approach sound good to enough of their low-information voters. But never fear - the search for obfuscating language will continue unabated.
Moreover, with their irrational and immoral approach to health care, the Republicans would kill far more Americans than either al Qaeda or ISIS ever imagined in their wildest dreams. As it is, Republican controlled legislatures and governors in the states that refused the offered Medicaid expansion are needlessly killing about 22,000 Americans every year.
Republican politicians warned us that "Obamacare" would give us "death panels," but I am sure they never thought the term would be an accurate description of many GOP-controlled state legislatures.
13
A nonsensical example. We all know that the wounded driver would be taken to the hospital, treated, then billed and forced into bankruptcy, thus requiring his unpaid medical costs to be covered by surcharges against the dwindling few who have insurance.
3
It is generally useful to read the entire article before commenting on it. the author makes her metaphor clear in the third paragraph from the end.
"Abandoning this patient to her terrible disease simply because she couldn’t pay for the cure feels sad and wrong. Just as sad and wrong as abandoning an injured patient at a crash site."
Happy to clear that up for you.
"Abandoning this patient to her terrible disease simply because she couldn’t pay for the cure feels sad and wrong. Just as sad and wrong as abandoning an injured patient at a crash site."
Happy to clear that up for you.
1
Thanks for this very important article. The moral dimensions of policies by governments and corporations requires much more of such coverage.
The article and the comments are both useful to building a better society.
The article and the comments are both useful to building a better society.
10
Paul Ryan and the rest of the GOP Congressfolk are flogging their plan just to save their supporters a few bucks in taxes, it's the main criteria for any Republican legislation. Ryan never talks about the government help (Social Security benefits after his father died) that put him through college. If he did, his plans to cut government benefits would expose him for the heartless hypocrite he is. I can't imagine why he isn't confronted with this every time he steps in front of a microphone, and his cronies enjoy tax-paid insurance at our expense. Why not this cover this, reporters? You might save a few lives.
33
I have always wondered about something. We go to war for good reasons or bad and many people die, but there is relatively very little political protest (at least in the past 40 years). We live in country where roughly 12,000 people a year die from guns (I think that's the number) and again very little protest. We see horrible examples or racism and hatred all the time and most of us don't complain. Then President Obama comes along and passes a bill that saves lives and attempts to improve a truly horrible health care system -- and this causes more backlash than anything since the Vietnam War. How can that be? We abide silently with wars, gun violence, racism, global warming -- and yet it's a health care bill that riles people up. How can insurance cause such anger? I honestly and sincerely don't get it.
69
It is linked to the idea that being poor is a result of being a bad person--lazy, stupid, incompetent--and therefore not deserving of sympathy or even of help to break the cycle of poverty. Poor people, the thinking goes,have made their bed, and they must lie in it. So must their children, who even if they didn't create the poor household they live in, must suffer the consequences of being born to poor people.
Yes, it's dumb and ruthless. But that is the thinking involved here.
Yes, it's dumb and ruthless. But that is the thinking involved here.
2
you couldn't have put it any better. Well if this law passes there will be something to add to Trump's America First list. First in the number of citizens who die from inadequate medical care. That certainly will be something to tweet about.
6
Perhaps special benefit productions of Dickens's "A Christmas Carol" could be arranged where Republicans are prompted to stand up and cheer where Scrooge advocates "decrease the surplus population"?
(Nahhh--Republicans would simply use such productions as campaign fundraisers)
Perhaps the Republican healthcare plan needs a more generic name accurately describing its benefits.
The great cartoonist Tom Batiuk (Funky Winkerbean, Crankshaft) already came up with the moniker "DenialCare" years ago to describe the severe shortcomings of pre-Obamacare health insurance, so we can't use that.
How about "NihilCare"?
(Nahhh--Republicans would simply use such productions as campaign fundraisers)
Perhaps the Republican healthcare plan needs a more generic name accurately describing its benefits.
The great cartoonist Tom Batiuk (Funky Winkerbean, Crankshaft) already came up with the moniker "DenialCare" years ago to describe the severe shortcomings of pre-Obamacare health insurance, so we can't use that.
How about "NihilCare"?
3
How sad with such a rich country, that many people will die because rich people are too cheap and selfish to contribute. We are all going to hell with the so called president and his merry men.
14
Freedom's price is risk: to others as well as to oneself. One pays it whenever crossing the street. Even staying home is not an option. The house can burn down. Then where are you?
2
If the Republicans really believe in the evils of government-sponsored health care, they'd give up their own insurance.
10
The Republican proposals are not market based; they are cruelty based.
18
I cannot at all comprehend or fathom the GOP. All they want to do is cut entitlements like Social Security and Medicaid, and instead of trying to work on solutions to the few glitches with Obamacare they simply want to throw out the baby with the bath water. Is anyone able to make sense of this?
7
it wasn't taken, it was given away. I understand poverty - I grew up in a ghetto where we had 4 pupils to every textbook and my mother had a 6th grade education. I read and I educated myself. I understand how difficult that is, but it's not like anybody had to read to between the lines. Donald Trump told everyone what he was planning to do and now they are astonished he is doing it??? That doesn't make sense. I think that we call it magical thinking, the idea that a crooked billionaire would represent working/poor people. Hillary Clinton may not have been the most appealing candidate, but she was the most on our side. Trump voters gave the country away to the wealthy, the Russians, and the corporations.
20
We have spent more on veterinarian bills for our cats than the anti-health insurance crowd are willing to spend on taking care of their less fortunate human neighbors.
8
Moral failure is a nice way of describing the deplorable disgusting basket of trump and his merry republican followers. Watching the glee in their eyes is pathological. Trying to understand the desire to cause suffering is illogical. To say that their brains and hearts are hard wired for coldness and disregard for anyone but themselves is blindness of the human condition. Watching them profess to be good Christians defies any logic. We have truly entered a dark time in American history.
18
2 degrees of réflexion, pretty much 1 degree too far to think for the average Trump voter.
5
...and it's not clear to me that voters will punish the Republicans for the abandonment of the poor, the sick and the old. We saw Kentucky, ground zero of Appalacian poverty, elect a governor who explicitly vowed to block Medicare expansion. I am just not sure when or if the rubber hits the road here. DT and the Republicans are very good at obfuscation, distracting and bamboozling enough people, and the red states have ergot in their rye...
10
Kim Davis, the county clerk who wouldn't sign a marriage license for a same-sex couple, put Blevin over the top. She refused to do her job as a government employee (in a job she inherited from her mother) because of her religious opposition to same-sex marriage. She could have honorably resigned, but instead fought tooth-and-nail to keep her $75K paycheck without doing her duty. Blevin stepped in to support her, casting her as a victim of religious persecution, which attracted the votes many of the religious people in the rural areas. Democrat Jim Grey tried to explain to them that the end of Obamacare meant the end of the widely popular and successful Kynect system, but the emotional appeal of a persecuted Christian, stoked by Blevin, drowned him out.
3
This is Republicanism in a nutshell: "Equity in a you-get-what-you-pay-for model."
That hard-boiled sentiment - that the only fair policy demands that every person pay for what he or she receives - drives everything the G.O.P. wants to institute throughout America. From taxes to schooling to housiing and healthcare, the Haves are telling the Have-Nots
That hard-boiled sentiment - that the only fair policy demands that every person pay for what he or she receives - drives everything the G.O.P. wants to institute throughout America. From taxes to schooling to housiing and healthcare, the Haves are telling the Have-Nots
5
First of all, I was an EMT/Paramedic and we would never ignore someone in distress.
But, I've seen hospitals do it. (We bring in a junkie with an infected AC, and they treat the guy like dirt.) Another time, a guy put a four-inch gash in his leg and told us he didn't want to go to the hospital because he didn't have insurance. So, we put a butterfly bandage on it. Problem solved. In that case, it would have been nice if we could have had access to a suture kit and a TD injection.
Let me put it to you simply; medics will do what they can to help people. However, the GOP is setting up a system to refuse treatment, yet at the same time deny us access to simple medical tools and procedures we need to help. You just can't have it both ways. To do so is inhumane.
But, I've seen hospitals do it. (We bring in a junkie with an infected AC, and they treat the guy like dirt.) Another time, a guy put a four-inch gash in his leg and told us he didn't want to go to the hospital because he didn't have insurance. So, we put a butterfly bandage on it. Problem solved. In that case, it would have been nice if we could have had access to a suture kit and a TD injection.
Let me put it to you simply; medics will do what they can to help people. However, the GOP is setting up a system to refuse treatment, yet at the same time deny us access to simple medical tools and procedures we need to help. You just can't have it both ways. To do so is inhumane.
239
One of the worst features of Trump care is that it replaces subsidies paid as you go with tax breaks paid at the end of the year. How many less than well-off people will be able to come up with the full cost of insurance and wait until the end of the year to paid. Very few indeed.
This is just one more reason Trump care is callous and cruel to all but the wealthy.
This is just one more reason Trump care is callous and cruel to all but the wealthy.
2
The whole idea of a safety net is anathema to the Republican, er, reptilian brain. Republicans insist success depends on your own hard work. If you achieved success, you and you alone deserve the rewards of that achievement. Your factory workers make a good product because of their skills (universal public education). Your products move to market freely (public transportation infrastructure). Your ideas are disseminated with the speed of light (ARPAnet begat the internet). Until we can break through this carapace of ignorance and shortsightedness, we will have programs created for our "benefit" by people most grounded in selfishness.
We are all in this together. My neighbor's illness diminishes me as well.
We are all in this together. My neighbor's illness diminishes me as well.
5
One of the major obstacles to health care reform, or any other real reform (not the right-wing euphemism for downgrade), is the pledge that all republican legislators are required to sign by anti-tax activist Grover Norquist. Grover was never elected to anything by anybody, but he is one of the most influential forces in right-wing politics today. The hypocrisy of these so-called Christians is nauseating.
3
What is most regrettable is that the Trump administration does not approach the issue of health care as a matter of policy; for them it's a purely a political, PR issue. Trump is more concerned with who takes the blame rather than with making things better. This is the way Trump approaches every problem, everything is PR, there is no reality, it's all perception.
There is nothing more dangerous than approaching things in that way. But I guess you get what you voted for (oops, I forgot, most people didn't vote for it, most people voted to keep and expand Obamacare).
There is nothing more dangerous than approaching things in that way. But I guess you get what you voted for (oops, I forgot, most people didn't vote for it, most people voted to keep and expand Obamacare).
2
Death panels
Rationing
Steal from the poor to give to the rich
Predatory of Seniors
These should be the mantra for this bill. These are the points that will motivate people who moved from Obama to trump because they were left out of the recovery, and correctly so.
I don't know why dems are insisting on arguing this along tax lines. That's the least of it. People are going to die. Lots of people are going to die.
That's the lead line on this one.
Everyone must hammer their congress reps that they are afraid they are going to die over this one. Knock those smug mocking smiles off republican voices.
Threaten them with trump care for all, including them.
Rationing
Steal from the poor to give to the rich
Predatory of Seniors
These should be the mantra for this bill. These are the points that will motivate people who moved from Obama to trump because they were left out of the recovery, and correctly so.
I don't know why dems are insisting on arguing this along tax lines. That's the least of it. People are going to die. Lots of people are going to die.
That's the lead line on this one.
Everyone must hammer their congress reps that they are afraid they are going to die over this one. Knock those smug mocking smiles off republican voices.
Threaten them with trump care for all, including them.
6
We must make sure everyone understands the difference between the proposed Trumpcare and Obamacare. Only then will we be truly be positioned to make a rationale decision on who to support now and in the future. Ignorance of these oftentimes complicated policies is the bane of true American Patriots and America. We Will be served best by a simple explanation of the factual details of this proposal and its impact on our national budget. This will allow us to carry on an intelligent and factual conversations in the kitchen and the street. Please prepare us for these discussions and the appropriate questions to seek the truth.
All people deserve the best health care available at a reasonable cost for all, and those who can't afford it we must lift them up, that's the American values I learned from my parents, church, school, and truly honorable politicians. Please help us get there ...
All people deserve the best health care available at a reasonable cost for all, and those who can't afford it we must lift them up, that's the American values I learned from my parents, church, school, and truly honorable politicians. Please help us get there ...
3
The republicans should have the courage of their convictions and repeal the emergency care act at the same time. After all, is the act not a form of "taking" without the reimbursement that accompanies a normal taking. If not, perhaps they should pass a law that gun manufactures should provide a free gun for those too poor to purchase a gun. After all they are adamant about second amendment "rights." Are the poor not being denied the exercise of that right because of their poverty.
Image a party that lied about "death panels" taking away insurance from millions.
Image a party that lied about "death panels" taking away insurance from millions.
9
Anne from Minnesota uses the word "giddy," to describe Republicans and their satisfaction to have power, especially the long-sought repeal mantra. It is exactly the word that came to my mind when Paul Ryan has been describing the dream-come-true of what he and Republicans can do. It is our nightmare.
16
People have to actually care what happens to their fellow man to create policy and laws that benefit the general population. It's been years and years since the Republicans have paid even lip service to that notion. And now they're in the process of taking away all personal dignity for ordinary citizens, all chance at an American dream future where opportunities existed and reducing anyone not rich to a sort of fearful and horrific future of uncertainty and misery.
2
"Personal Responsibility" "Access" "Freedom of Choice" and all the other phrases the Republicans use to justify a market-based approach to health care disguise a tax cut for the rich and what is essentially a death warrant for the poor and many in the middle class. The Affordable Care Act was not perfect but the unaffordable Tryancare is a travesty that exposes Trump's great lie of "cheaper, better health care for all." We have to buy auto insurance. We have to pay taxes. Those of us who work have to pay into Medicare. I wish the GOP would stop trying to reinvent the wheel and acknowledge that the only realistic approach to affordable health care for all is a single-payer system that every other civilized nation except ours adopted long ago. Why this obsession with "free markets" that aren't free to all but the very rich?
11
Does no one understand that the goal of the Republicans in Congress is simply to enrich the richest (white) folks and to ensure an army of underpaid, underfed, underhoused, and undercared-for working poor who will be expected to work at all the menial jobs (including maids for Groper in Chief's hotels) until they die? That this has been the goal and strategy all along--to build a rich white paradise with some token rich non-white people who will populate professional sports and music for their entertainment?
The party of Lincoln..........
The party of Lincoln..........
7
Congress seems to operate on the same plan retailing companies do, "Charge what the market will bear." Only they've gone far further than that and now nobody can bear the cost. I don't know how anyone could question what's plain as the noses on our faces, Congress is only interested in providing for the rich and either becoming rich with them or growing their own already existing wealth.
A good friend's first 3-day hospitalization bill for AML for $60,000, so I disagree with this article except the $100,000 cost for treatment of AML. Without insurance, many people will either die or their treatment cost will be absorbed in other ways, often by those conservative Republicans.
2
A government that allows its citizens to suffer and die simply because they can't afford health care is an inhumane government. There is far more to life than the bottom line.
13
A government who creates an expensive health care system by carving out special treatment for insurance companies, Big Pharma and all the other rapidly escalating costs of health care in any form is a cruel and sinister government interested only in raising campaign funds from well heeled corporations and individuals and lining their own pockets while in office and greater lining when they join their campaign financiers after they leave office, not to mention all that private, high-paying employment for the family members of Congress Critters. When the same pharmaceuticals are available in the rest of the world for a pittance compared to what's required of people with or without insurance in the U.S. and then Congress makes it illegal to buy those medications outside the U.S., there's something far more than Rotten in Denmark. One wonders whether conscience no longer exists in Washington.
2
The premise of this passionate appeal is, unfortunately, wrong. The GOP health insurance replacement plan isn't about health care or insurance. Rather, it is a tax cut for upper income families and individuals.
But the column is right in one very real sense: there is not internal logic to the plan, other than the ultimate denial of needed health care, or, alternatively, the return of the system in which middle income families are forced to underwrite emergency health care for the poor or uninsured.
The proposal is devoid of common sense, a knowledge of how insurance works, and compassion. Our nation's only hope is that passage of it will destroy the Republican Party and lead the way to a single payer plan via expansion of Medicare.
But the column is right in one very real sense: there is not internal logic to the plan, other than the ultimate denial of needed health care, or, alternatively, the return of the system in which middle income families are forced to underwrite emergency health care for the poor or uninsured.
The proposal is devoid of common sense, a knowledge of how insurance works, and compassion. Our nation's only hope is that passage of it will destroy the Republican Party and lead the way to a single payer plan via expansion of Medicare.
16
An excellent, pointed commentary about the reality of denying affordable healthcare to all. Where are our morals about caring about fellow human beings? I thought the United States stood for "justice for all", I guess only until they're ill or injured.
6
But, but, but, (deep sigh) Mr Trump said he is really smart, and, and, and (another deep sigh) he said he would fix Obamacare. Medicaid will be better. Medicare will be better. Everybody will have better healthcare. Trump will fix it. One more deep sigh for all the Trump voters who thought this man had a plan.
17
If Obamacare was so great, and more than half of those insured by the plan (10 million ) then why have many fine hospitals and doctors refused to take them as patients? The government has set payment reimbursement caps for virtually all patient ailments the medical community is expected to treat. Unfortunately the government and Obamacare have forced many physicians to create "conceirge" services, where individuals pay a set annual fee for the privilege of being treated by a doctor of their choice... a service and fee that only the wealthy can afford. The medical community might be up in arms about the proposed repeal, they hate Obamacare even more. The government imposed unfair and inadequate reimbursement fees to doctors and hospitals has caused a staffing crises all across our country. We are all suffering.
10
The answer is inhuman greed and the high cost of medical school. In civilized countries, med students attend school tuition-free, and in some countries they are paid to attend. We are now lower than 31st in the world in life expectancy, and in health-care costs per capita. And those "socialist" countries above us have a higher per-capita ownership of small businesses and family farms.
not so sure of your comments, "fine hospitals and doctors refused to take them as patients..." which states where those ? I've only lived in a handful of states (never Florida) - didn't realize it was so bad down there. My doctor friends and hospital administration friends (currently Pres of large health care system) has't seen those remarks to be true for them... hum ?
1
Pvbeachbum:
No responsible analyst I have seen has implied that the ACA is not in need of repair. As for the medical community as a whole, the major organizations are overwhelmingly in favor of repair, not blanket repeal: http://thehill.com/blogs/pundits-blog/healthcare/323490-republican-healt... . The AMA, American College of Physicians, most specialty societies, American Nursing Assn, American Hospital Assn--all favor repair, not repeal. Although not a medical association, AARP has come out strongly against repeal: http://www.aarp.org/politics-society/advocacy/info-2017/aarp-opposes-hea... .
Physicians (I am one of them) have not been "forced" into creating concierge practices. Sometimes they can provide less expensive and more accessible care than available insurance plans. Sometimes they are cherry-picking the most affluent patients.
I know that Secretary Price says that his physician "friends" talk with hi about all the ACA problems. Do not think--not for a moment--that those friends represent the majority of US physicians. There is no major evidence for your comment that the "medical community might be up in arms about the proposed repeal, they hate Obamacare even more." If you have that evidence, beyond a personal assertion or a favorite op-ed, please cite it.
No responsible analyst I have seen has implied that the ACA is not in need of repair. As for the medical community as a whole, the major organizations are overwhelmingly in favor of repair, not blanket repeal: http://thehill.com/blogs/pundits-blog/healthcare/323490-republican-healt... . The AMA, American College of Physicians, most specialty societies, American Nursing Assn, American Hospital Assn--all favor repair, not repeal. Although not a medical association, AARP has come out strongly against repeal: http://www.aarp.org/politics-society/advocacy/info-2017/aarp-opposes-hea... .
Physicians (I am one of them) have not been "forced" into creating concierge practices. Sometimes they can provide less expensive and more accessible care than available insurance plans. Sometimes they are cherry-picking the most affluent patients.
I know that Secretary Price says that his physician "friends" talk with hi about all the ACA problems. Do not think--not for a moment--that those friends represent the majority of US physicians. There is no major evidence for your comment that the "medical community might be up in arms about the proposed repeal, they hate Obamacare even more." If you have that evidence, beyond a personal assertion or a favorite op-ed, please cite it.
2
Call this what it is. 'Stupid care', 'dumb care', ' we don't care' or better 'gimme the money-you're on your own' care act. The republicans are mot responsible for the well being of the bottom 99% in any way, shape or form.
56
"We don't csre" just about sums it up. Ryan, who is married to a Mellon heiress and has an utterly undeserved reputation for being smarter than a post, gave us his contemptuous take on it last week when he said that Ryancare wouldn't win any beauty contests for keeping Americans insured. Who cares about Americans dying unnecessarily? Not the Republicans who have spent the last eight years in their extended freakout and their lies about death panels. Their words to us are now and have always been, "Die already. If you aren't rich our God of Greed thinks you are lazy and worthless---but vote for us anyway." And the deplorables did.
4
Yes, there is great fallacy in the idea that "healthy" folks, young or not, don't need insurance. My niece was a healthy almost 18 year old when she started having headaches. The pediatrician found nothing, but sent her to a neurologist 'just in case.' The neurologist initially didn't see anything, but got an MRI 'just in case.' There was a giant brain tumor, which turned out to be cancer. She is, thankfully, 'stable' 10 years later, but the family lives MRI to MRI - initial chemo, if paid for out of pocket, would have been around $8000/mo.
No one knows what his/her health will be tomorrow or next week. Insurance is for the 'just in case.' Any one of us can be the picture of health one moment and struggling for life the next. Life is capricious. We play with fire when we think that anyone doesn't need health insurance. Giving folks the choice to opt out is a disservice both to them and to the rest of us. To them because it may cost them their lives; to the rest of us because if they do get any care we will pay the bill.
No one knows what his/her health will be tomorrow or next week. Insurance is for the 'just in case.' Any one of us can be the picture of health one moment and struggling for life the next. Life is capricious. We play with fire when we think that anyone doesn't need health insurance. Giving folks the choice to opt out is a disservice both to them and to the rest of us. To them because it may cost them their lives; to the rest of us because if they do get any care we will pay the bill.
174
Truer words were never spoken. The entire point of insurance is insurance for what you may not need now, but will inevitably need at some future time. And the most foolish are those who believe "it" could never happen to them, whether it's an accident on the ski slopes, a car wreck, or a sudden diagnosis of a serious illness. But the Republicans have convinced too many people that paying for health insurance when you think you won't need it is a gamble worth taking. It's not. Your niece knows it and a close relative of mine currently recovering from surgery knows it. A youngish man I know also knows it now--as he struggles to pay for the very extensive surgery that was the result of a motorcycle accident. He didn't believe he could afford insurance but he could have had twenty years of insurance for what the surgery is costing him.
5
Reason and decency are irrelevant to those Republicans whose salaries and health care are covered by our tax dollars, and to those ALEC members who inherited fortunes that generate an annual income far greater than 90% of Americans can possibly earn.
2
My daughter (who also has Down syndrome was diagnosed with ALL leukemia (better to have than AML) at age 18. The treatment was painful and long (2/12 years).She recovered fully and is now healthy and happy. It was costly but our family had employer based health insurance. If I have to pay a little more in taxes so Medicaid could pay for a young woman's treatment for leukemia , then count me in. Medical crises can happen to anyone, young or old.
3
The only American that will benefit from the Donald’s brief time in office is that former president who is currently considered the worst president in US history. That gentleman, who shall remain nameless, may now confidently slip away to the tranquil ineptitude of being number 2.
6
It is not hard to imagine that the law requiring hospitals to provide care will be repealed as another restrictive regulation. Hospitals will of course continue to provide some care, at least until they go out of business. The Republicans in Congress seem to be living in an alternate reality, with their President, where truth is fiction and saying something over and over makes it true. "We are not pulling the rug out from under anyone, coverage will be better and cheaper, people will have the freedom to choose, the ACA is collapsing, everyone will be covered, it is going to be so terrific..."
Why do I have a headache and feel so depressed?
Why do I have a headache and feel so depressed?
10
The truest test of Trump opinion of the GOP health care plan is refusal to put his name on it. (This from the man who labels buildings he doesn't build and even water!)
Trumpcare is a botched tax cut for the wealthy disguised as a pastiche of the ACA. It includes incentives for insurance companies--but not for citizens.
In other words, Congress is uninterested in good health care for the US electorate; the GOP Congress is completely focussed on fooling the GOP voters into believing their plan is equivalent to the ACA (it's not).
---The GOP now refers to "access" to health care and no longer to health care. Access is NOT health care; it is only the opportunity to buy it.
---We are one of the few nations that does not consider health care a basic human right--and we pay double for what we do have than other countries. Medicare spends just under 2 % on overhead, private insurance is closer to 12-14%.
---Ryan is posing the vote for Trumpcare as a test of Party loyalty. Conservatives are against it because they are against gov. health care at all.
--But WHERE are those few GOP Congressmen who are willing to vote their conscience, who are willing to truly represent their constituents rather than their donors?
--Why worry about terrorists when the GOP is projected to kill millions of Americans through a lack of health care than Bin Laden could have possibly dreamt?
Trumpcare is a botched tax cut for the wealthy disguised as a pastiche of the ACA. It includes incentives for insurance companies--but not for citizens.
In other words, Congress is uninterested in good health care for the US electorate; the GOP Congress is completely focussed on fooling the GOP voters into believing their plan is equivalent to the ACA (it's not).
---The GOP now refers to "access" to health care and no longer to health care. Access is NOT health care; it is only the opportunity to buy it.
---We are one of the few nations that does not consider health care a basic human right--and we pay double for what we do have than other countries. Medicare spends just under 2 % on overhead, private insurance is closer to 12-14%.
---Ryan is posing the vote for Trumpcare as a test of Party loyalty. Conservatives are against it because they are against gov. health care at all.
--But WHERE are those few GOP Congressmen who are willing to vote their conscience, who are willing to truly represent their constituents rather than their donors?
--Why worry about terrorists when the GOP is projected to kill millions of Americans through a lack of health care than Bin Laden could have possibly dreamt?
27
In America the debate on health care can be boiled to two contrasting views. 1) Health is a basic right 2)Access to care is a right
Supporters of view 1 need to understand those who favor 2 are operating off of a different fundamental principle. Supporters of view 1 must realize it is necessary to engage and defeat the 2nd view, an appeal to 'rightness' will not secure the desired outcome.
Supporters of view 1 need to understand those who favor 2 are operating off of a different fundamental principle. Supporters of view 1 must realize it is necessary to engage and defeat the 2nd view, an appeal to 'rightness' will not secure the desired outcome.
4
Ms Brown is at last describing the brutal truth that underlies the drive to dismantle Obamacare--get rid of the sick, infirm and aged who no longer contribute to the capitalist economy while bloating even further the great fortunes of the Mercers, Kochs, etc. who now, with the Republican ascendency, hold the reins to all political American power. This is no longer a great moral brave nation with leaders who will speak truth to power but a country run by a cadre of right wing sniveling cowards who are only in the game to fatten their own purses and keep playing the game. I am disturbed and actually sickened by their greed, hypocrisy, and most of all, their belief in their own superiority to other human beings.
29
There will be no source of care. Rural hospitals and clinics will be forced to close. In some areas there will be no place to go to get any care without going hundreds of miles. As long as it doesn't happen before Trump country can vote in the 2018 elections and enough time has passed to transfer any meager assets to the healthcare system, the GOP will be thrilled.
9
It would be easy to improve Obamacare if your goal was to improve it - make it simpler, easier to obtain or pay for, cover more people, encourage better medicine.
It's only hard when your goal is something else - a tax cut for the rich, injection of political agenda or ideology, punishing someone you've been told to not like, etc.
It's only hard when your goal is something else - a tax cut for the rich, injection of political agenda or ideology, punishing someone you've been told to not like, etc.
54
Spot on Bruce. Yours is a simple and straightforward analysis and one that Democrats would be wise to adopt.
No, we’re not going to leave someone on the side of the road with a serious head injury because they didn’t have an insurance card. But we’ll get damn close to it as the Republicans continue down the free market path and the lovely idea of tax credits. Which is just another way of saying; let’s keep the subsidies off the federal budget and we’ll look great, then we can give the super wealthy more tax breaks. Then we’ll look even greater. Then Trump can go around the country and tell all those poor souls that voted for him how great he is. And then…………..
I’ve been on Medicare now for 9 years and it is a blessing. It’s single payer healthcare for seniors and it really does work. Someday, maybe not in my lifetime, we’ll have something like Medicare for all Americans.
For the time being though we all need to fight for those that may be negatively affected by what the Republicans are about to legislate. Particularly those on Medicaid and with serious health issues.
I’ve been on Medicare now for 9 years and it is a blessing. It’s single payer healthcare for seniors and it really does work. Someday, maybe not in my lifetime, we’ll have something like Medicare for all Americans.
For the time being though we all need to fight for those that may be negatively affected by what the Republicans are about to legislate. Particularly those on Medicaid and with serious health issues.
52
The Republicans would tell you that Medicare is "bankrupt" and they're not going to fix it. Instead, they are going to provide "vouchers" to you so you can go to the health insurance "marketplace" and purchase the health insurance that fits your needs. Everyone I know that is about to turn 65 is so looking forward to their upcoming birthday. Medicare - I've been on it for 8 years myself. It doesn't cover everything (I have secondary through my former employer and catastrophic through my union - a term that Republicans abhor)
3
The whole of this argument and the logic behind it is so crystal clear to anyone who can read, yet Republicans are peddling a market-based fantasy to what end, I'll never know. Clearly if the market is not serving everyone who needs a certain something, the market has failed. That this is the case with healthcare could not be more clear. Yet, Ryan et al peddle nonsense. Part of me wants those who voted for Republicans to get sick and die impoverished because of their folly. The other part of me wishes these Republicans had no insurance so they too could get sick and die impoverished. I would much prefer the latter over the former.
11
I suspect we are already there. When I called an ENT to be seen for a chronic sinus infection, before I was able to describe my symptoms, the receptionist asked if I had insurance. What if I had said 'no, but I'm willing to pay off my bill over the next few months'? I have no doubt that I would have heard a click and a dial tone.
2
The CBO report is due out next week and will put a number on how many people could lose insurance coverage if Trump and Ryan's plan are adopted. The Republicans will ignore the report, claim the numbers are fixed, and won't lose a wink of sleep even it it turns out to be right
Personal responsibility and freedom are the phrases they hide behind to justify their callous behavior.
For all the preaching and talk. both Evangelicals and conservative Republicans have never been their brothers' keepers.
Personal responsibility and freedom are the phrases they hide behind to justify their callous behavior.
For all the preaching and talk. both Evangelicals and conservative Republicans have never been their brothers' keepers.
81
Evangelicals seem unfamiliar with passages from the Bible they enjoy thumping, mainly the book of Matthew that contains the compassionate words of Jesus himself.
3
True but what I can't understand is that if personal responsibility is a phrase that the Republicans hide behind then why don't they support the mandate that everyone needs to buy insurance and opt in? After all the ACA was modeled after a Republican plan constructed at a time when the party was actually rational.
It's a purely political issue now. They dubbed the ACA as Obama care and if you hate Obama then you're going to hate anything he touches. Purely political but clever marketing on their part. Really tragic that a good portion of Americans can't see this. And why have the Democrats gone silent once again.
It's a purely political issue now. They dubbed the ACA as Obama care and if you hate Obama then you're going to hate anything he touches. Purely political but clever marketing on their part. Really tragic that a good portion of Americans can't see this. And why have the Democrats gone silent once again.
2
Not only are the repealing it, but they appear to be quite giddy about the suffering it will cause. It is very difficult to wrap ones brain around the utter lack of compassion.
156
God has a way of remembering.
1
The GOP wants its tax cuts. They don't think poor people deserve
health care or health insurance, or food or clothing or shelter.
The rest is just commentary.
health care or health insurance, or food or clothing or shelter.
The rest is just commentary.
99
Republican plan -
Take 2 tax cuts and call me from the morgue.
Take 2 tax cuts and call me from the morgue.
2
It seems to me that since the members of Congress and their families have a great health care insurance plan that if the rest of us die and go away because we cannot afford medical care, that would just be fine with them. Do they have any idea at all, or do they even care, about the untold suffering, worry, pain, loss of sleep and yes, even loss of life that will happen to the rest of us. I just cannot believe the tragedy that is unfolding with the potential adoption of this health care plan
43
If you can't afford health care, you can still probably afford a gun. If you buy that gun and shoot a Republican politician who has voted against affordable health care, you will get free room, board, health care, euthanasia and funeral services. Pretty good tradeoff, I'd say.
1
Behavioral economics has demonstrated the pitiful limits of market economics, or rational efficiency reasoning. It's mainly hogwash.
We must be the only so called developed country that still buys the market swill, which is trotted out selectively to batter ordinary citizens. Market economics works when lobbyists con the legislative process, write the laws to suit their masters, and make a big bundle for their efforts. You can't have a health care system deserving the name if its anchored in market economics. And a mandate is the price we pay for a humane society. Shame shame on the GOP>
We must be the only so called developed country that still buys the market swill, which is trotted out selectively to batter ordinary citizens. Market economics works when lobbyists con the legislative process, write the laws to suit their masters, and make a big bundle for their efforts. You can't have a health care system deserving the name if its anchored in market economics. And a mandate is the price we pay for a humane society. Shame shame on the GOP>
45
Republicans don't hate socialism. What Republicans hate is the very idea of workers who can afford to stand up for their rights ... a thing they'll never be able to do effectively so long as their own health and the health of their family members is left to chance, market forces, and the insatiable greed of the last vultures in in the great game of exploit thy neighbor from generation unto generation; the insurance industry.
37
Trumpcare isn't a plan, it's a death warrant. There should be no illusion about the outcome. People who receive life-saving care under the Affordable Care Act will lose their coverage and be unable to afford treatment. Many will die. Trump, Ryan, McConnell and the rest of the despicable Republican crew will have blood on their hands. This is not an academic exercise.
As Alan Grayson said, the Republican plan is "Don't get sick. If you do get sick, die quickly."
As Alan Grayson said, the Republican plan is "Don't get sick. If you do get sick, die quickly."
146
The great pretense of George W. Bush's "compassionate conservativism" is now a long a thing of the past. In its place Donald Trump has shown us the real face of conservatism as built on lies, ignorance, hate, and hypocrisy.
You can not have a moral argument over healthcare or anything else for that matter when that is the morality of those you are arguing with and truth or basic decency has no meaning. Even their supposed regard for the unborn is an obvious sham as they consistently demonstrate a compete disregard for the living as well as the life of a newborn child.
You can not have a moral argument over healthcare or anything else for that matter when that is the morality of those you are arguing with and truth or basic decency has no meaning. Even their supposed regard for the unborn is an obvious sham as they consistently demonstrate a compete disregard for the living as well as the life of a newborn child.
54
Morally bankrupt indeed, that these highly successful and fortunate people, these white collar Senators and Congressmen, should feel justified in withholding basic healthcare from those less fortunate because they hadn't paid their share? It sounds like the Protestant Work Ethic beat out Christian charity but good. Or maybe it's just a pragmatic Republican way to "decrease the surplus population" since they usually vote Democratic anyway.
And by the way, has our own President paid his fair share?
And by the way, has our own President paid his fair share?
91
I am sure if every working person wanted to donate $100 to the fund through payroll deduction, they would be able to pay for it. Otherwise there will never be a program to satisfy everyone.
3
If you think the case you mention will this make supporter of repeal and replace pause, you are wrong. It is simple murder for hire, and the pay is fabulous,. The object of repeal and replace is, as much as possible, to let the working poor, disabled, pre-SS low-income seniors and non-whites in general die faster so we don't have to pay the cost of treating them, insuring them, jailing them or raising the minimum wage. The results will be booty by the bag for the most wealthy, who will reap millions a year in tax benefits. So they have sponsored a dog-whistle attack that fools enough ignorant racists into believing they are helping themselves just a little by letting tens of thousands die. Hitler would have been impressed at how fascism has evolved into such a respectable-lookng movement. Good Germans have become Good Americans. History won't be fooled.
160
Consider this. If you take free market healthcare to its logical conclusion then hospitals would demand to be paid up front for services rendered. No insurance and no money - no service. Of course the conservatives are depending on healthcare professionals and their institutions to do the moral thing. Naturally they don't speak of the hidden tax on everyone that subsidizes those who can't pay their bill.
92
If everybody paid the bill without insurance,costs would tumble at least 50% maybe more. This is why a health savings account has the ability to maximize the healthcare dollar. I have personally received a 45% discount on an MRI when I told the provider that I was paying cash so these estimates in price reductions are real. If people consider medical payments just like any other item they shop for, costs will come down. Right now, it is "free" or covered by " MEdicare" or "the insurance company pays". All formulas for zero cost control.
2
Indeed. And don't forget the often insurmountable additional cost to the patient who fails to pay the bill in the form of loss of financial credit, or ultimate bankruptcy.
3
Shame on the Democrats in Congress for failing to insist that the issues of health care costs both overall and for the people be discussed with respect to the real experiences of people. The ACA and most health plans in this country do not bring health care that people need to live healthy lives that they can afford. People find that few kinds of care are covered in proportions that allow people to receive the care that they need without taking extraordinary means to find the money to pay for it. The problems with high premiums are well publicized but the inability of people to get care that they need because of high copays and deductibles is barely discussed. The ACA definitely was an improvement over the previous situation but without bringing the costs down to people it's not going to address the ability of this country to provide needed care.
48
"Shame on the Democrats in Congress for failing to insist that the issues of health care costs both overall and for the people be discussed with respect to the real experiences of people. "
Oh really, you mean in the same way that Republicans are having discussions and debate over their plan.....NOT.
Obamacare' s limitations are due to GOP intransigence, versus a sincere and impactful effort by Democrats to help our most vulnerable citizens
Oh really, you mean in the same way that Republicans are having discussions and debate over their plan.....NOT.
Obamacare' s limitations are due to GOP intransigence, versus a sincere and impactful effort by Democrats to help our most vulnerable citizens
1
Yes, high out of pocket costs generated most of the complaints about the ACA, including from so many who voted for Trump and his promise to provide better health care at lower cost to all Americans. Yet, the Unaffordable Health Care Act (Trumpcare) does nothing to reduce out of pocket costs. It might be that ending the mandated package of health services for a qualifying insurance policy means that some people can buy cheaper insurance (you know, the kind that is sold by a duck on TV), but when inevitably major medical expenses hit some of those folks, their out of pocket costs will be astronomical.
One way to fix the ACA would have been to increase the subsidies. But the GOP health care 'reform' is intended to reduce federal spending on health services, so as to free up a big part of the budget for tax cuts on corporations and the top 1%. So increasing ACA subsidies was off the table. Another approach, one that would fulfill Trump's promises, is single-payer. But the GOP is adamantly opposed to any kind of public program that actually works, so that's off the table too. And that leaves this monstrosity of a tax cut bill disguised as health care 'reform' that Paul Ryan has handed us.
One way to fix the ACA would have been to increase the subsidies. But the GOP health care 'reform' is intended to reduce federal spending on health services, so as to free up a big part of the budget for tax cuts on corporations and the top 1%. So increasing ACA subsidies was off the table. Another approach, one that would fulfill Trump's promises, is single-payer. But the GOP is adamantly opposed to any kind of public program that actually works, so that's off the table too. And that leaves this monstrosity of a tax cut bill disguised as health care 'reform' that Paul Ryan has handed us.
5
Beyond a moral failing, the reprehensibility of opposition to universal healthcare with anecdotal "evidence" of its failure "wherever it has been tried," as occurred in a recent debate with Senator Bernie Sanders, is shameful. That voters actually believe such nonsense in the face of well-established statistics to the contrary, is also a profound intellectual failing that severely erodes the moral underpinnings of our culture.
7
Republican politcal leaders are irrepressible idealists and overwhelmingly rich, white, and elitist. They shun people who do not fit their image of an "American"; who elected to be poor or underemployed. They don't grasp the idea that there are lots of Americans that live off every paycheck. Rep. Chaffetz is just sure they can just scrounge into their piggy bank to find an extra $10K per year for health insurance.
Republicans unworkable, ideals include "free markets" and freedom of choice. If they were anything but elitist hypocrites, they would see that their ideals really should apply to all Americans. Everyone should be able to grasp the "freedom of choice."
The Republican Plan that would fit their holy ideals is to give everyone that freedom to choose whatever insurance they want and the "freedom" to figure out how to pay for it (sarcasm intended). Cut the elitist hypocrisy. Eliminate all tax supported health insurance, not just for the poor. That means Congress, the President, and all government employees become totally "free", and not forced to use the plans paid for by our taxes.
Republicans unworkable, ideals include "free markets" and freedom of choice. If they were anything but elitist hypocrites, they would see that their ideals really should apply to all Americans. Everyone should be able to grasp the "freedom of choice."
The Republican Plan that would fit their holy ideals is to give everyone that freedom to choose whatever insurance they want and the "freedom" to figure out how to pay for it (sarcasm intended). Cut the elitist hypocrisy. Eliminate all tax supported health insurance, not just for the poor. That means Congress, the President, and all government employees become totally "free", and not forced to use the plans paid for by our taxes.
5
There is also the moral failure of threats, fines, and governmental coercion. There is something called freedom, which it should be death to violate. There are the moral failures of premia exploding out of control, and of forcing people into something they don't want, and of denying them free choices about what *they* want.
Leave others alone. Mind your own business. Don't interfere!
Leave others alone. Mind your own business. Don't interfere!
You want to celebrate freedom, which you define as freedom from government mandates.
I ask: Do you have employer-provided health insurance? What if you lose your job?
I ask: Are you healthy and young? What if you are seriously injured in a car accident? I'm sure that if you drive a vehicle on the public roads you have car insurance which means you are a member of a risk pool even with a low probability of needing that insurance.
I ask: do you have lots of extra money to buy health care or health insurance?
Humans do not thrive alone: you are not alone. You are part of a community and a nation. Communities take care of their members. Insurance risk pools are part of community membership.
I ask: Do you have employer-provided health insurance? What if you lose your job?
I ask: Are you healthy and young? What if you are seriously injured in a car accident? I'm sure that if you drive a vehicle on the public roads you have car insurance which means you are a member of a risk pool even with a low probability of needing that insurance.
I ask: do you have lots of extra money to buy health care or health insurance?
Humans do not thrive alone: you are not alone. You are part of a community and a nation. Communities take care of their members. Insurance risk pools are part of community membership.
Thank you for this, and for reminding us that the ACA and the healthcare debate are about lives and well being, not just premium hikes and tax breaks.
I, like the woman you describe, would likely be very ill if not dead without ACA. This fall I was diagnosed with cancer after I checked with my doctor about something I found annoying but not necessarily worrisome. If I had catastrophic insurance with a high deductible, a policy with higher co-pays, or no insurance at all (all situations I've had in the past) I would have likely waited to check with my doctor, and that would have likely meant waiting until the cancer had spread and metastasized.
Now, with better and more affordable insurance, I am cancer free and am under close observation of my oncologist. But if I still had the policy I had before the ACA, I would likely be riddled with cancer and soon to be six feet under ground.
It is so clear that those writing and promoting the Republican plan have not had to deal with serious or chronic illness, or deal with inadequate insurance.
I know some folks had their premiums soar. But please remember that for many of us it isn't a matter of money, it truly is a matter of life and death.
Would you really choose a lower premium or a lower taxes over my life? Or that of the woman in this essay?
I'm hoping not, but we shall see.
I, like the woman you describe, would likely be very ill if not dead without ACA. This fall I was diagnosed with cancer after I checked with my doctor about something I found annoying but not necessarily worrisome. If I had catastrophic insurance with a high deductible, a policy with higher co-pays, or no insurance at all (all situations I've had in the past) I would have likely waited to check with my doctor, and that would have likely meant waiting until the cancer had spread and metastasized.
Now, with better and more affordable insurance, I am cancer free and am under close observation of my oncologist. But if I still had the policy I had before the ACA, I would likely be riddled with cancer and soon to be six feet under ground.
It is so clear that those writing and promoting the Republican plan have not had to deal with serious or chronic illness, or deal with inadequate insurance.
I know some folks had their premiums soar. But please remember that for many of us it isn't a matter of money, it truly is a matter of life and death.
Would you really choose a lower premium or a lower taxes over my life? Or that of the woman in this essay?
I'm hoping not, but we shall see.
7
Are we as a people going together into the future where medical care is a human right, cutting edge, efficient, and something we achieve with personal participation, a clean environment, improved safety and research for better treatment and cures? Obamacare or the ACA was an intermediate step. The Republicans are taking us backward to give their wealthy supporters an obscene tax break that they don't need and will never use. Stop playing in the garbage dump. Our country used to go to the moon. It is time to work together for a bright future.
7
Ive always wondered as to why someone doesn't say to these republicans "well if health care for all is socialism, then why isn't the fire department and police department socialist ? " no one would want fire personal or police personal not assisting us or our loved ones because we couldn't pay for the relevant insurance . Living as I do in the UK I don't claim our health service is perfect, but I've seen treatment for friends and family alike that really helped them recover. The idea that you could be declared bankrupt due to medical bills astonishes me.
9
You underestimate our dear Republicans. More than a few would indeed allow your house to burn to the ground if you had not purchased fire department services before the event. And don't overlook the degree to which the US criminal justice and law enforcement system is already privatized.
4
The points that this author raises are exactly on point. Prior to the ACA, people were routinely excluded from insurance if they had even the hint of a pre-existing condition. I was denied an individual Blue Cross Blue Shield policy because I was being treated for depression and was on "more than two drugs" (I was actually on 3 drugs, one of which was for sleep). I am also a psychiatrist & I routinely agonized over what to write in patient records & which code to use for billing. For a few brief years I didn't have to worry as much about all of that. I am appalled at what Trump & the GOP are about to do. Truly appalled.
10
What is shocking to me is that the debate over the provision of health insurance among our more conservative brethren has devolved into a heart-less discussion that masks the fact that their 'solutions' will lead to the deaths of tens of thousands of Americans (http://www.vox.com/policy-and-politics/2017/2/7/14500430/repealing-affor....
Even if estimates are wrong by a factor of four there will still be thousands of Americans dying needlenssly on an annual basis. On what ethical grounds would such carnage ever be acceptable?
Even if estimates are wrong by a factor of four there will still be thousands of Americans dying needlenssly on an annual basis. On what ethical grounds would such carnage ever be acceptable?
6
Why is no one bring up in the repeal and even in the current version of the GOP a repeal and replace their will be a massive cut to the Medicare part D drug benefit. Everyone is forgetting that the ACA aka Obamacare has gradually closed the donut hole in Part D of the Medicare prescription drug program. The seniors will be up in arms when they find out they will have to pay an extra $1,000 plus in prescription drug costs. That is pretty hard to do when most of them are living on $12,000 per year in Social Security.
9
I remember this. My father was involved in a 3 car crash in Kansas. It was 1951. When the ambulance arrived at the hospital his gurney was parked in a corridor for hours while the financial office tried to verify his health insurance coverage. The fact that he was a member of President Harry S Truman's "little" cabinet and on official business didn't help him one bit. Fortunately, his coverage was verified but the hours of untreated pain were a part of his memory until the day he died.
8
Where and How are those in need supposed to drum up $2000 medical savings accounts to pay for their medical needs. Most can not afford the current co-pays. Perhaps all Republicans will shed some of their health benefits to extend to the needy. Why is it that we never hear a word as to the cost of health care for the President, Senators,Congressmen, and all others attached to glorious health benefits paid for by those who now are losing all hope of decent health care. How do these Politicians sleep at night?
9
The horrific American state of health care, not to mention all levels education and income mobility is what in so many ways defines our Canada as USA Today wrote as the country that provides the American Dream. Both of your political parties need to attract young educated non ideologues to their leaderships if I may say so.
4
Why doesn't Nurse Brown get it? Those falling off OCare's rolls never had insurance for most of their lives. It's simply back to those pre-2009 days for them. OCare was a mirage, a sorry tune that Barack Obama played to entice millions to a gravy train he hoped to make too big to derail. All that's being proven wrong, the music to soon stop, those smart will scramble for chairs now.
Not perfect, but nothing not experienced before, and certainly not as perfectly imperfect as Obamacare.
Let's face it: for a failed program that barely survived the few years that it was forced down us, discussing replacement cannot be high on anyone's priority, and take its own sweet time and shape if at all. But that too only after repeal is done and dusted. Let's get with it, enough of the river-crying, turn lights off someone.
Not perfect, but nothing not experienced before, and certainly not as perfectly imperfect as Obamacare.
Let's face it: for a failed program that barely survived the few years that it was forced down us, discussing replacement cannot be high on anyone's priority, and take its own sweet time and shape if at all. But that too only after repeal is done and dusted. Let's get with it, enough of the river-crying, turn lights off someone.
3
TMK, the majority of Americans want Obamacare to stay as it is. Not bad for a "failed program." And your indifference to the people "who never had insurance for most of their lives" is chilling.
3
The battle is joined -- do we help people to avoid chronic disease or do we accept the loss of labor,, extended suffering and cost for decades of medical treatment.
This is not a choice to be made by for-profit health insurance companies -- every other developed country has already proved that. The facts continue to get in the way of those who can only believe in those ideas that put the most money in their own pockets.
Health insurance is the key issue which will allow Democrats to retake the House in 2018. But it will only happen if candidates forego campaign money from PACs, corporations, deep pockets as well as National and State DNC funds.
This is not a choice to be made by for-profit health insurance companies -- every other developed country has already proved that. The facts continue to get in the way of those who can only believe in those ideas that put the most money in their own pockets.
Health insurance is the key issue which will allow Democrats to retake the House in 2018. But it will only happen if candidates forego campaign money from PACs, corporations, deep pockets as well as National and State DNC funds.
2
If all members of Congress had to pay going prices for the level of insurance they enjoy at taxpayer expense, do we think they might wake up to the frightening realities soon to afflict so many Americans?
Even Paul Ryan may age; even his children or parents may get sick. Would anything like those eventualities make him think twice about the healthy not paying for insurance until they need it and cannot pay for it -- unless they have made so much money on the backs of the rest of us that they wouldn't care anyhow? Like the Trump/Bannon crew, laughing all the way to the bank -- but never to a place where people cannot get life-saving health services they need.
That's Ryan and his ilk -- I wish they could be made to walk a mile in the shoes of those they want to strip of health insurance (and for that matter so much of the protections society now have from pollution, degradation of the environment, and gun deaths). How ironic that those who voted for these heartless politicos are those most likely to suffer first.
Even Paul Ryan may age; even his children or parents may get sick. Would anything like those eventualities make him think twice about the healthy not paying for insurance until they need it and cannot pay for it -- unless they have made so much money on the backs of the rest of us that they wouldn't care anyhow? Like the Trump/Bannon crew, laughing all the way to the bank -- but never to a place where people cannot get life-saving health services they need.
That's Ryan and his ilk -- I wish they could be made to walk a mile in the shoes of those they want to strip of health insurance (and for that matter so much of the protections society now have from pollution, degradation of the environment, and gun deaths). How ironic that those who voted for these heartless politicos are those most likely to suffer first.
5
We assign value to companies that are too big to fail, and we save them with tax payer money. Shouldn't human life be far more valuable? Likewise with the defense budget. Why add $50B to make Americans safer, if we don't care enough about life to pay for medical care? Can we have a discussion about what we truly value in this life?
9
I am a 62-year-old middle-class earner, without the employer provided health care insurance, I would be really stretched financially to have a health savings account to pay for the health insurance. I cannot imagine how low-income people can afford health insurance under the Trump care, especially it will take away medicaid from these people. It is difficult for me to fathom what the Republican law makers are thinking, don't they think some people might die due to Trump care? Where is their compassion for their fellow citizens? They insist on the "free-market" ideology over human lives! Trump care they try to rush through the congress and the senate is a morally bankrupt health care system!
9
Thank you for this essay, and for the work you do.
Republicans talk about fiscal responsibility and about defending freedom from encroachment by the government -- which we'll now be taught to call "the administrative state" so as to make visions of socialism dance in our heads.
But the long-standing Republican animosity to any plan for universal health insurance really arises from selfish ire at the thought of paying for anything that will benefit others. Ironically, the more the beneficiaries tend to be poor people (including the numerous working poor), the greater the ire.
Does it come from a nagging sense of guilt about the existence of so many needy people in an economy that works so well for the rich?
Is it just proof that greed becomes addictive? I remember the extreme case of a wealthy woman who went out of her way to beggar her late son's widow and children -- her own grandchildren -- so that she could add their modest inheritance to her abundance.
Working-class Republicans might seem to have good reason to dislike paying taxes for the benefit of others. But if they worry about their economic security as we're told they do in explanation of their panic-voting for Donald Trump, they should foresee possible benefits for themselves in safety-net programs.
http://thefamilyproperty.blogspot.jp/
Republicans talk about fiscal responsibility and about defending freedom from encroachment by the government -- which we'll now be taught to call "the administrative state" so as to make visions of socialism dance in our heads.
But the long-standing Republican animosity to any plan for universal health insurance really arises from selfish ire at the thought of paying for anything that will benefit others. Ironically, the more the beneficiaries tend to be poor people (including the numerous working poor), the greater the ire.
Does it come from a nagging sense of guilt about the existence of so many needy people in an economy that works so well for the rich?
Is it just proof that greed becomes addictive? I remember the extreme case of a wealthy woman who went out of her way to beggar her late son's widow and children -- her own grandchildren -- so that she could add their modest inheritance to her abundance.
Working-class Republicans might seem to have good reason to dislike paying taxes for the benefit of others. But if they worry about their economic security as we're told they do in explanation of their panic-voting for Donald Trump, they should foresee possible benefits for themselves in safety-net programs.
http://thefamilyproperty.blogspot.jp/
3
The idea of relying on a market that does not exists is mind boggling. The market for health insurance policies has never been more than a niche market, one that served no more than 6-7% of well to do Americans. And the market itself collapsed decades ago. At one time all the major life insurers sold health insurance policies along with their life insurance business, but by the 1990s they began to drop away, so no more Pru Care, or NYL Care or any of the insurance based networks that were set up to provide the coverage that the policies promised.
Unlike working markets, new entrants did not appear, nor did overseas insurers step in. It would be good for Republicans to ask themselves why. After all, the US makes no consumer cameras, but Sony, Fuji, Nikon and Canon all have filled the breach. But with health insurance, there is simply no market for the bulk of Americans.
Is the Republican position immoral? Funny about that. Republicans go out of their way to define America as a Christian nation. If we were truly a nation with policies informed by Christ’s mercy, then surely we would unite to find a way to lower the premiums within the existing ACA, and every state would clamor to expand Medicaid. But if WWJD is on wrist bracelets, it certainly does not inform Congress.
Unlike working markets, new entrants did not appear, nor did overseas insurers step in. It would be good for Republicans to ask themselves why. After all, the US makes no consumer cameras, but Sony, Fuji, Nikon and Canon all have filled the breach. But with health insurance, there is simply no market for the bulk of Americans.
Is the Republican position immoral? Funny about that. Republicans go out of their way to define America as a Christian nation. If we were truly a nation with policies informed by Christ’s mercy, then surely we would unite to find a way to lower the premiums within the existing ACA, and every state would clamor to expand Medicaid. But if WWJD is on wrist bracelets, it certainly does not inform Congress.
7
"If we were truly a nation with policies informed by Christ’s mercy, then surely we would unite to find a way to lower the premiums within the existing ACA, and every state would clamor to expand Medicaid." I agree. It sounds reasonable to me that a bipartisan groups of politicians and medical personnel could look at all the universal healthcare systems around the world, select the best features from the plans which provide the best health outcomes for the lowest price and come up with a plan for the U.S. Unfortunately the ideology of those on the right prohibits a healthcare plan formulated and operated by the federal government. Only a "market-based" approach is acceptable to them. As long as conservatives are in charge of government there will be no universal healthcare plan.
2
The United States is the farthest thing from a "Christian Nation."
5
The first step to bringing down government provided health care costs in Medicaid and Medicare which should have bipartisan support, is to root out the fraud! Institute severe penalties and provide the "manpower" to get the job done.I was shocked when a local hematologist that my wife and I respect and admire had his firm fined over five million for government health care fraud. Also, get after those that have "cash businesses" or get paid off the books and qualify for subsidies and Medicaid. Let it be known that prison and financial recovery are included in any potential penalty. This would save billions.
6
oh, yeah, the old "waste and fraud" dodge, beloved of republicans.
3
Maybe now the truth of the matter is finally coming out. Now that the whole sorry lot of gops has been backed into the corner they painted for themselves, the dots will finally connect for even the most dimwitted. (My apologies for using that word, but honestly . . .)
They don't even understand how insurance works!
Paul Ryan said it himself on Friday, articulating the terrible injustice of the healthy being required to pay for the unhealthy. Rep. Shimkus of Illinois spilled the beans first, and exposed what he and his other gops surely discuss behind closed doors: how un-American it is for men to pay for the health care of women, and the children they helped to conceive.
They just admitted that they do not want people to pool their resources in order to get healthcare.
The only thing, then, that they approve of with our current healthcare insurance industry is that the healthcare insurance industry makes a profit. And with the opportunity to repeal ObamaCare, they are, by God, going to make sure they make even more!
I have long wondered how a party devoted to reigning in costs (so they say) can so totally ignore the math and the logic of a single payer system, Medicare for all, or mandates for the young and healthy.
I need wonder no more. They don't understand how insurance works, and the only thing they are working to protect are the insurance companies.
They finally admitted it this week.
They don't even understand how insurance works!
Paul Ryan said it himself on Friday, articulating the terrible injustice of the healthy being required to pay for the unhealthy. Rep. Shimkus of Illinois spilled the beans first, and exposed what he and his other gops surely discuss behind closed doors: how un-American it is for men to pay for the health care of women, and the children they helped to conceive.
They just admitted that they do not want people to pool their resources in order to get healthcare.
The only thing, then, that they approve of with our current healthcare insurance industry is that the healthcare insurance industry makes a profit. And with the opportunity to repeal ObamaCare, they are, by God, going to make sure they make even more!
I have long wondered how a party devoted to reigning in costs (so they say) can so totally ignore the math and the logic of a single payer system, Medicare for all, or mandates for the young and healthy.
I need wonder no more. They don't understand how insurance works, and the only thing they are working to protect are the insurance companies.
They finally admitted it this week.
16
Mike "Christian first" Pence just declared that "the nightmare" of Obamacare is about to end. Oh, those horrid enrollment numbers! The terrifying accounts of individuals whose coverage was previously rejected because they dared to have an illness, now able to be treated.
Now, we will have a real night mare in which individuals will not be able to obtain quality policies because of their conditions or medical history. People will again be disposable numbers to insurers. They will go bankrupt or left terminally untreated.
Pence, during last year's VP debate, said that the measure of a society was how they treated the infirm, aged and disabled. Well, here is our test. Repealing the ACA will again leave the infirm, aged and disabled to insurance companies' mercy. Now that is a nightmare we should not repeat.
Now, we will have a real night mare in which individuals will not be able to obtain quality policies because of their conditions or medical history. People will again be disposable numbers to insurers. They will go bankrupt or left terminally untreated.
Pence, during last year's VP debate, said that the measure of a society was how they treated the infirm, aged and disabled. Well, here is our test. Repealing the ACA will again leave the infirm, aged and disabled to insurance companies' mercy. Now that is a nightmare we should not repeat.
502
The backers of a so-called "free market" in health care are truly living in a fantasy land where the sky is purple and no facts which humans have learned about economic policy, health care and human behaviour in the last 400 years are accepted.
There are challenges to providing health care to the population of the world where natural barriers play a part. In the urban centers of the United States, all of the obstacles to providing health care to the entire population are artificial barriers created by policy-makers; most of whom wish to punish others for activities they find immoral or disgusting: women for participating in sexual activity outside of marriage; both men and women for sexual activity which exposes them to diseases; all humans for eating too much or too little, smoking, alcohol and drug use, athletes in dangerous sports; workers for doing jobs in dangerous workplaces; drivers, cyclists, bikers, boaters, walkers, skaters, etc.
Human beings do so many things just living that cause them to need health care whether they are 1 minute old or 100 years old. Punishing people for being human and needing care as the current Republican plan does is insane policy. It is exceptionally cruel when this plan is owned by the same Republican party that pretends to consider themselves the only "Pro-Life" party and demonizes the Democratic party for being pro-choice, pro-clean air, land, water and safe workplaces, food, autos
Reject the Ryan Death Plan. Vote Democratic 2018
There are challenges to providing health care to the population of the world where natural barriers play a part. In the urban centers of the United States, all of the obstacles to providing health care to the entire population are artificial barriers created by policy-makers; most of whom wish to punish others for activities they find immoral or disgusting: women for participating in sexual activity outside of marriage; both men and women for sexual activity which exposes them to diseases; all humans for eating too much or too little, smoking, alcohol and drug use, athletes in dangerous sports; workers for doing jobs in dangerous workplaces; drivers, cyclists, bikers, boaters, walkers, skaters, etc.
Human beings do so many things just living that cause them to need health care whether they are 1 minute old or 100 years old. Punishing people for being human and needing care as the current Republican plan does is insane policy. It is exceptionally cruel when this plan is owned by the same Republican party that pretends to consider themselves the only "Pro-Life" party and demonizes the Democratic party for being pro-choice, pro-clean air, land, water and safe workplaces, food, autos
Reject the Ryan Death Plan. Vote Democratic 2018
11
A point that never seems to land home in the false GOP/reagan doctrine of “personal responsibility” and “choice” mantra
There is no free market. It is a mental construct for use in an argument process that can never exist in reality. The GOP has used this mental construct to create great harm to us. By portraying responsibility and choice in false ways they lie by deception and intentional misuse of reason to create false arguments to support things that could not be supported by honest argument.
BTW the insurance model is meant for exactly the situation in which you pay less than the actual cost of the service you get because the costs are shared by the whole. It is rational to pay a fixed amount or slowly rising amount in premiums to be covered if something goes very wrong as well as for the routine medical care everyone has to get no matter what.
It works well and is very lucrative for insurers.
Most of our problems are due to their greed not the actual costs of things. A lot of them are working all ends of the system with ownership in insurance and medical supply and service delivery. There would be a good place to start getting control of costs, regulate the not free market they have rigged for themselves.
There is no free market. It is a mental construct for use in an argument process that can never exist in reality. The GOP has used this mental construct to create great harm to us. By portraying responsibility and choice in false ways they lie by deception and intentional misuse of reason to create false arguments to support things that could not be supported by honest argument.
BTW the insurance model is meant for exactly the situation in which you pay less than the actual cost of the service you get because the costs are shared by the whole. It is rational to pay a fixed amount or slowly rising amount in premiums to be covered if something goes very wrong as well as for the routine medical care everyone has to get no matter what.
It works well and is very lucrative for insurers.
Most of our problems are due to their greed not the actual costs of things. A lot of them are working all ends of the system with ownership in insurance and medical supply and service delivery. There would be a good place to start getting control of costs, regulate the not free market they have rigged for themselves.
2
Ryancare's guiding principles are economic and amoral:
(1) competition guarantees equilibrium among all market factors, including profits, prices, wages, rents, job availability, etc.;
(2) nonetheless, private monopolies--too-big-to-fail enterprises--are preferable to government regulation of the market, even if this greatly diminishes competition;
(3) corporations must pursue short-term profits, minimize the interests of employees and consumers, and thereby enhance quarterly shareholder value; within this scheme, the most efficient workers are robots, although human consumers, capable of taking on debt, still play an important role in economic growth;
(4) if it is politically expedient to put a public-private initiative in place--say for healthcare reform or infrastructure repair--make sure the initiative is complex, creates maximum voter dissatisfaction with governmental programs, and assures the socialization of all risks and the privatization of all benefits;
(5) always exaggerate the dangers associated with government debt and minimize the dangers associated with ballooning private sector debt;
(6) always minimize the threats to present and future generations posed by lack of healthcare, environmental degradation, etc.;
(7) privatization, financial and environmental deregulation, and massive tax reductions for the "makers" will guarantee trickle-down benefits for the "takers"--more than the manipulable peasants, in their lack of rational self-interest, deserve.
(1) competition guarantees equilibrium among all market factors, including profits, prices, wages, rents, job availability, etc.;
(2) nonetheless, private monopolies--too-big-to-fail enterprises--are preferable to government regulation of the market, even if this greatly diminishes competition;
(3) corporations must pursue short-term profits, minimize the interests of employees and consumers, and thereby enhance quarterly shareholder value; within this scheme, the most efficient workers are robots, although human consumers, capable of taking on debt, still play an important role in economic growth;
(4) if it is politically expedient to put a public-private initiative in place--say for healthcare reform or infrastructure repair--make sure the initiative is complex, creates maximum voter dissatisfaction with governmental programs, and assures the socialization of all risks and the privatization of all benefits;
(5) always exaggerate the dangers associated with government debt and minimize the dangers associated with ballooning private sector debt;
(6) always minimize the threats to present and future generations posed by lack of healthcare, environmental degradation, etc.;
(7) privatization, financial and environmental deregulation, and massive tax reductions for the "makers" will guarantee trickle-down benefits for the "takers"--more than the manipulable peasants, in their lack of rational self-interest, deserve.
3
My beloved youngest stepdaughter delayed seeing a physician despite increasingly alarming symptoms because she lacked health insurance. She did ultimately obtain coverage - but by then she had developed what turned out to be a virulently aggressive, rare form of kidney cancer which ultimately took her life at age 35. I have spent several decades in healthcare and human services, including, like Theresa Brown, hospice. This nation is shameful in its continued refusal to view access to healthcare as a right for everyone, and not a privilege for the wealthy or even for those who are employed. The GOTP's demonizing of their own healthcare reform platform had everything to do with obstructing our African American President, and those without access to care were and remain collateral damage. The PPACA was never a "government takeover of healthcare" - but it did attempt to level the playing field and prevent greedy insurance corporations from denying vital care to those most in need. That should be the hallmark of a civilized society, but to this venal, punitive and greedy GOTP, the least among us are "takers" or "lazy slackers," while the wealthiest are their personal benefactors. My stepdaughter lost her life in part due to these amoral people - who truly have neither compassion nor remorse. How they can look in the mirror is beyond me, 3/11. 5:17 PM
21
Don't forget how they call themselves "Christian."
I hate that.
Above all, I am sorry for your loss. My condolences.
I hate that.
Above all, I am sorry for your loss. My condolences.
8
The words “health care” and “free market” do not belong in the same sentence. The notion that one receives health care according to one’s ability to pay for it makes no sense to me. What kind of tribe, village, society, or country would deny health care to any class of its people?
The inconvenient fact (inconvenient for medical insurance companies, Big Pharma, etc.) is that a single payer system is the only logical solution. I’m fairly certain that’s how it worked in my distant ancestor’s tribe. If someone was ill, the medicine man came and did whatever he did. That was his role in the community. Perhaps he got an extra slice of mammoth haunch for his troubles. Health care was simply a matter of survival for the whole community, not a commodity to be bought and sold.
Yes, our society is more complex, but we cannot predict with certainty the course of our health. We all need medical insurance.
Since everyone needs medical insurance, the simple solution is a pool of insured people that includes everyone. I’m not skilled enough in math to figure out what it would cost each person for medical insurance if everyone was insured, but I suspect it would look something like Medicare and cost less since the healthy youth would be included.
Will doctors make less money? Probably. Will Big Pharma and medical equipment suppliers make less money? Probably. But how much money do they need? And what kind of society thinks its morally acceptable to make a fat profit from people’s illnesses?
The inconvenient fact (inconvenient for medical insurance companies, Big Pharma, etc.) is that a single payer system is the only logical solution. I’m fairly certain that’s how it worked in my distant ancestor’s tribe. If someone was ill, the medicine man came and did whatever he did. That was his role in the community. Perhaps he got an extra slice of mammoth haunch for his troubles. Health care was simply a matter of survival for the whole community, not a commodity to be bought and sold.
Yes, our society is more complex, but we cannot predict with certainty the course of our health. We all need medical insurance.
Since everyone needs medical insurance, the simple solution is a pool of insured people that includes everyone. I’m not skilled enough in math to figure out what it would cost each person for medical insurance if everyone was insured, but I suspect it would look something like Medicare and cost less since the healthy youth would be included.
Will doctors make less money? Probably. Will Big Pharma and medical equipment suppliers make less money? Probably. But how much money do they need? And what kind of society thinks its morally acceptable to make a fat profit from people’s illnesses?
5
While the immorality of denying Americans health care is very real, proponents of Obamacare are hardly exempt from blame. Many who are insured through the exchanges enroll in the cheapest options. These options include high deductibles, high co-pays and include exemptions from coverage. As a result, millions go bankrupt every year because of health care costs. I have always thought of insurance as protection against the worst case scenario. Countless folks insured by Obamacare are effectively uncovered when they learn they have cancer, heart disease, Alzheimers, ALS, and any other chronic condition that requires ongoing, expensive treatments. The folks hit hardest by the Republicans are the ones Obamacare leads to bankruptcy. The Republicans have great moral failings. But Democrats are hardly blameless.
1
The medical community has come out strongly against the Republicans' healthcare plan championed by Trump. S&P puts the number of people who would lose healthcare as possibly 10 million; the Brookings Institute analysts place it as at least 15 million people. This doesn't count the Medicaid time bomb where expanded Medicaid would be swept away, and even future Medicaid patients would lose or have their coverage greatly diminished. The loss of Planned Parenthood involves many poor women who lose their well woman check ups, cancer screenings and access to needed abortions (which are also eliminated in other ways even for women who pay for their insurance). It is not just individuals who will suffer and die unnecessarily.
There will be public health consequences, epidemics that could have been avoided, jobs lost due to health issues, and many other domino effects.
The compassion shown by Ms. Brown is, I'm sure, replicated every day in many thousands of hospitals by many thousands of nurses, doctors, and other caring individuals.
Heartless, cruel, mean spirited -- there are not enough synonyms to describe Trumpcare and those who target Americans in this way. Never again to be pro-life, Republicans. Your death panels are too harsh, and the consequences are Grim Reaper territory. No wonder Trump wants to invest in cemeteries next to his golf courses. He can admire the view.
There will be public health consequences, epidemics that could have been avoided, jobs lost due to health issues, and many other domino effects.
The compassion shown by Ms. Brown is, I'm sure, replicated every day in many thousands of hospitals by many thousands of nurses, doctors, and other caring individuals.
Heartless, cruel, mean spirited -- there are not enough synonyms to describe Trumpcare and those who target Americans in this way. Never again to be pro-life, Republicans. Your death panels are too harsh, and the consequences are Grim Reaper territory. No wonder Trump wants to invest in cemeteries next to his golf courses. He can admire the view.
7
The Congress cannot change the social obligation to provide emergency care, that would require society to reject that obligation. The provision of non-emergency care that prevents the need for emergency treatment and provides procedures and treatments that assure that people recover from serious injuries and illnesses and serious health problems that enable them to live healthy lives can be affected by the ability of patients to pay for them, and that is where the Republicans' attitude towards social support of health care becomes a conflict that could be consider moral or philosophical. Quite simply those who believe that society has no obligation to provide health care, food, and shelter to anyone except to preserve life see the challenges of life to be the problem for individuals not society, and so does not involve any moral dilemma for them.
3
And so many of these folks-politicians-are the loudest "Christians" of all.
Ryan's bill, should it pass, will eventually force millions of Americans once again to rely on emergency room care as their primary access to the medical system. This impact of the law will sharply increase the cost of care, since many people will wait until their health problem has become critical before seeking help. The price of the freedom promised by Ryan will be an early death or chronic medical disorder for patients whom early intervention could have saved.
Ayn Rand would be so proud of her acolyte.
Ayn Rand would be so proud of her acolyte.
6
The Republicans are set on "deconstructing" i.e. destroying the A.C.A. . They can call their plan what ever but in the end and by 2020 poor people are destined to loose their health care so their benefactors the rich can get their tax cut. Welcome to the new norm in America the land of the rich.
Rural hospitals will disappear and only mega city hospitals will survive. This simply because they have a large base of variably insured population of patients that will be, one way or another, managed to pay for those who can not pay. Before the A.C.A. that was exactly what was happening. I know that for sure because I was familiar with the billing practices of such hospitals whose patient mix was 25% Medicare, 25% Medicaid, 25% private insurance and 25% self pay which was called no pay.
So unless our citizens are willing to accept the scenario described by Ms Brown, we will go backward to the old days of messaging billing and the rich will have their tax cuts, the middle working class will have their premium raised and the poor will have to beg for health care.
Paul Ryan and his cronies are embarking on burning the house just because of their and there supporter extreme beliefs. They know little about health care and they better listen to those who know it otherwise millions of their voters will suffer because of their folly.
Rural hospitals will disappear and only mega city hospitals will survive. This simply because they have a large base of variably insured population of patients that will be, one way or another, managed to pay for those who can not pay. Before the A.C.A. that was exactly what was happening. I know that for sure because I was familiar with the billing practices of such hospitals whose patient mix was 25% Medicare, 25% Medicaid, 25% private insurance and 25% self pay which was called no pay.
So unless our citizens are willing to accept the scenario described by Ms Brown, we will go backward to the old days of messaging billing and the rich will have their tax cuts, the middle working class will have their premium raised and the poor will have to beg for health care.
Paul Ryan and his cronies are embarking on burning the house just because of their and there supporter extreme beliefs. They know little about health care and they better listen to those who know it otherwise millions of their voters will suffer because of their folly.
4
Having lived in the US for a while, I can vouch for the fact that Universal healthcare is the best solution.
Last year, my wife was diagnosed with a ruptured aneurysm when we rushed to emergency after she had a "thunder clap" headache and other symptoms. She was immediately taken to the best hospital for neuro surgery and cared for by specialists working on the latest research at the University of Toronto. I never had to worry about which doctors are in network which are not. She was automatically taken to the best centre based on her case. She was at the hospital for about 2 weeks with all expenses covered. Our only expense were the exhorbitant car parking fees.
She is thankfully fully recovered now and back at work. I wonder how this would have worked out if we were still in US.
The republicans trash Canadian Healthcare at every opportunity they get. They dont know what they are talking about.
Last year, my wife was diagnosed with a ruptured aneurysm when we rushed to emergency after she had a "thunder clap" headache and other symptoms. She was immediately taken to the best hospital for neuro surgery and cared for by specialists working on the latest research at the University of Toronto. I never had to worry about which doctors are in network which are not. She was automatically taken to the best centre based on her case. She was at the hospital for about 2 weeks with all expenses covered. Our only expense were the exhorbitant car parking fees.
She is thankfully fully recovered now and back at work. I wonder how this would have worked out if we were still in US.
The republicans trash Canadian Healthcare at every opportunity they get. They dont know what they are talking about.
46
And let's ask the question - why does this GOP program depend on employer-provided health care insurance as the panacea of solutions in a free market? The truth is that employer plans do, in many cases, offer better and more comprehensive insurance than one can obtain individually. But doesn't this inherently limit the "freedom and liberty" to change jobs and innovate so often touted by Republican leaders?
If workers are free to leave low paying or ill-fitting jobs for better opportunities, or free to pursue entrepreneurial dreams, isn't this far more in the spirit of "liberty" that being held to a future of underutilization and unhappiness? Surely freedom-loving Republicans can support the liberating and shackles-unleashing burden that ties people to employers and restrains innovation?
But unfortunately, the ideology that drives the action is far more beholden to the donor class tax cuts than the good of our citizens. Even those that don't realize that they voted for such ideas.
If workers are free to leave low paying or ill-fitting jobs for better opportunities, or free to pursue entrepreneurial dreams, isn't this far more in the spirit of "liberty" that being held to a future of underutilization and unhappiness? Surely freedom-loving Republicans can support the liberating and shackles-unleashing burden that ties people to employers and restrains innovation?
But unfortunately, the ideology that drives the action is far more beholden to the donor class tax cuts than the good of our citizens. Even those that don't realize that they voted for such ideas.
4
Partisan ideology is both murderously rigid & opportunistically flexible. 8 long years ago, everyone agreed that the situation was critical. Obamacare was essentially the ideologically Republican, free-market solution--until the Democrats controlled government & passed it. Then the Republicans wanted a political weapon and a fundraising issue more than they wanted a solution. Now, after 8 years of incessant campaigning and media propaganda on the issue, the GOP is in a different place. Half of them recognize the trap they've created for themselves, and have embraced the proposed sort-of-repeal, figuring that the resulting catastrophe can either be fixed piecemeal or blamed, as usual, on the victims. The other half of the party is out for blood. They want to use access to health care as yet another weapon with which to punish the poor and reward the rich. The rigidity of their free-market mania makes Stalinists look pragmatic. And no one, least of all the Democrats, is willing to stand up for a sensible, public insurance solution. Our entire country has become a moral failure.
10
Paul Ryan pointed at a two-toned pie chart the other day and said in horrified tones that under the Affordable Care Act the people represented by the blue section of the chart -- clearly the greater part of the circle -- are expected to pay for the health care of the sick people represented in red. As Stephen Colbert commented that night, that's how insurance works!
Surely he has auto insurance and homeowner's insurance. While it may be more likely that someone will become ill and need healthcare than it is that his or her house will burn down, the underlying logic is the same: everyone pays into a pool; only some people ever need to draw from that pool because of a car accident or home destruction. If my home burns down tonight, the amount my insurance company would pay to compensate me would be many times more than I've paid in premiums for the last 20 years. Again, that's how it works.
Surely he has auto insurance and homeowner's insurance. While it may be more likely that someone will become ill and need healthcare than it is that his or her house will burn down, the underlying logic is the same: everyone pays into a pool; only some people ever need to draw from that pool because of a car accident or home destruction. If my home burns down tonight, the amount my insurance company would pay to compensate me would be many times more than I've paid in premiums for the last 20 years. Again, that's how it works.
9
What you describe in the initial scenario, and the last paragraph, touches on the so-called "rule of rescue" in medical ethics, a predictable pattern of human behavior. However cruel or unforgiving a system might be, when faced with an actual individual who is actively suffering, there is an attempt to help despite that system. I see this all the time as a physician, where uninsured/undocumented patients get care; and in fact this behavior is also law. Though on the one hand we readily come up with legal systems where patients aren't insured, we also require that anyone coming to the ED get emergency care regardless of inability to pay. These are not consistent with each other, but the rule of rescue requires the second.
This human impulse is why personal tales of woe are more compelling in politics than statistics. It also drives what to a computer might be unjust distribution of resources (for example, spending lots of money on person A, who is here right now, even though it will deprive the system of resources for treating unknown others).
This human impulse is why personal tales of woe are more compelling in politics than statistics. It also drives what to a computer might be unjust distribution of resources (for example, spending lots of money on person A, who is here right now, even though it will deprive the system of resources for treating unknown others).
1
The author's experience presages what will happen to the uninsured once the Affordable Care Act is gone. People will go to the hospital emergency departments for treatment because emergency departments have to treat and stabilize. Then they will have no follow up unless they return to the emergency department. Many of them won't ever be able to pay for it. The rest of us will pay for it as we and our insurance companies are charged more and more to cover those emergency department's costs that are never paid. How does this make Trump's promise that more people will have affordable healthcare under Trump care. Maybe if the Republicans in Congress had been willing to work with Barack Obama on the Affordable Care Act, we'd have a better plan.
6
Equating health insurance with health care is a big mistake. Obamacare has added many to the Medicaid rolls. But those who are covered by Medicaid get coverage that is so substandard it's more like being uninsured than having good private insurance.
Cancer patients with Medicaid are 51% more likely to die than those with good private insurance. Far more Medicaid patients consider their insurance substandard than those who have good private insurance. Medicaid coverage leads to all kinds of immoral results. Surely, the same applies to those with the cheapest of exchange policies, that have high deductibles, high copayments, and treatment exemptions.
The poor have elevated health care costs -- we poison their water, our doctors refuse their insurance, and we have them service leaky oil pipelines. Yet most health care money is spent on the rich. Republican and Democrats are a little bit different in their policies. But enough that one can claim to be significantly more moral than the other.
Cancer patients with Medicaid are 51% more likely to die than those with good private insurance. Far more Medicaid patients consider their insurance substandard than those who have good private insurance. Medicaid coverage leads to all kinds of immoral results. Surely, the same applies to those with the cheapest of exchange policies, that have high deductibles, high copayments, and treatment exemptions.
The poor have elevated health care costs -- we poison their water, our doctors refuse their insurance, and we have them service leaky oil pipelines. Yet most health care money is spent on the rich. Republican and Democrats are a little bit different in their policies. But enough that one can claim to be significantly more moral than the other.
The moral failing can also be applied to the Democratic party as the ACA was passed by the Democrats over the objections of the GOP, and an estimated 28 million people under 65 are still uninsured per the CDC. For many it is due to the fact that health insurance is still too expensive, but there are obviously other reasons. One is that employer provided coverage is still the most prevalent and we've seen a loss of good paying jobs with benefits due to the offshoring of jobs, jobs which haven’t been replaced with similar ones as we've seen a shrinking middle and working class in the US. Both parties have supported globalization regardless of impacts for over four decades now.
So, since 28 million being uninsured can be laid at the feet of the Democrats as the ACA is their answer to the lack of health insurance coverage, and more estimated to join this pool due to plans by the GOP, like many issues the Democrats need to be careful about throwing stones.
A bi-partisan effort is needed to address the problem, but I don’t expect that to happen.
https://www.cdc.gov/nchs/fastats/health-insurance.htm
http://www.thefiscaltimes.com/2016/05/10/Even-Obamacare-29-Million-Peopl...
So, since 28 million being uninsured can be laid at the feet of the Democrats as the ACA is their answer to the lack of health insurance coverage, and more estimated to join this pool due to plans by the GOP, like many issues the Democrats need to be careful about throwing stones.
A bi-partisan effort is needed to address the problem, but I don’t expect that to happen.
https://www.cdc.gov/nchs/fastats/health-insurance.htm
http://www.thefiscaltimes.com/2016/05/10/Even-Obamacare-29-Million-Peopl...
3
In the presentation of his health insurance plan, Paul Ryan, the "smart Republican policy wonk", commented - and I believe this to be close to the actual quote - that the problem with the current system under the ACA is that "healthy people pay for the care of sick people" .
Well, Mr Ryan, the spreading of risk among the largest possible population is the very foundation of the insurance concept . Part of the premium paid by safe drivers to insure their cars is to pay for the unsafe drivers, part of your home insurance premium goes to pay for your neighbor's chimney fire . In many cases, males cannot opt out of the provision in their health policy covering prenatal and maternity care .
Does Mr. Ryan not understand the simple concept of actuarial tables ? Of course, being such a smart wonk, he knows everything about actuarial tables . A large part of his audience, however, does not . He is simply pandering to them and allowing them to think, either that only healthy people should have insurance (which, incidentally, was the way "cheap" policies were written before the ACA, so that policy holders found out, when they got sick, that their illness was never covered) or that they should subscribe to a policy only when becoming ill , a near impossibility .
Given the cost of health care in the US, nowhere would it make more sense to have universal health insurance . But that, of course, is another topic, but one that no one in power is willing to address at this time.
Well, Mr Ryan, the spreading of risk among the largest possible population is the very foundation of the insurance concept . Part of the premium paid by safe drivers to insure their cars is to pay for the unsafe drivers, part of your home insurance premium goes to pay for your neighbor's chimney fire . In many cases, males cannot opt out of the provision in their health policy covering prenatal and maternity care .
Does Mr. Ryan not understand the simple concept of actuarial tables ? Of course, being such a smart wonk, he knows everything about actuarial tables . A large part of his audience, however, does not . He is simply pandering to them and allowing them to think, either that only healthy people should have insurance (which, incidentally, was the way "cheap" policies were written before the ACA, so that policy holders found out, when they got sick, that their illness was never covered) or that they should subscribe to a policy only when becoming ill , a near impossibility .
Given the cost of health care in the US, nowhere would it make more sense to have universal health insurance . But that, of course, is another topic, but one that no one in power is willing to address at this time.
7
The fundamental problem is that Fox News, hate/outrage/grievance radio, and Republican politicians have successfully fooled 40+% of the American electorate into thinking that Republican policies are designed to help them when, in fact, they are designed to funnel ever more money to Republican politicians' plutocratic friends, some of which is then funneled back into Republicans’ campaign coffers, if not Republicans' pockets.
If this 40+% suddenly saw the light – if they suddenly became as knowledgeable and intelligent as the average reader of Ms. Brown’s article – there would no longer be any debate. They would now realize what the rest of us have known for a long time: (a) several hundred billion dollars a year are going not to people’s healthcare but to insurance companies, (b) these insurance companies are nothing more than greedy, unnecessary middlemen that make the healthcare system much less efficient and value their profits over their customers’ lives and well-being; and (c) Republican politicians similarly value their own privileged moneymaking opportunities and power over their less affluent constituents’ lives and well-being.)
Even with all of Republicans' (esp. Marco Rubio's) efforts to sabotage Obamacare, it is still far superior to Paul Ryan’s and Donald’s Don'tCare. But far superior to Obamacare would have been, and might still be, single-payer.
If this 40+% suddenly saw the light – if they suddenly became as knowledgeable and intelligent as the average reader of Ms. Brown’s article – there would no longer be any debate. They would now realize what the rest of us have known for a long time: (a) several hundred billion dollars a year are going not to people’s healthcare but to insurance companies, (b) these insurance companies are nothing more than greedy, unnecessary middlemen that make the healthcare system much less efficient and value their profits over their customers’ lives and well-being; and (c) Republican politicians similarly value their own privileged moneymaking opportunities and power over their less affluent constituents’ lives and well-being.)
Even with all of Republicans' (esp. Marco Rubio's) efforts to sabotage Obamacare, it is still far superior to Paul Ryan’s and Donald’s Don'tCare. But far superior to Obamacare would have been, and might still be, single-payer.
29
The wealthy get far more and far better health care than the poor. The trend has continued under the ACA. Not surprisingly, far more of the wealthy are satisfied with their health care than the poor. Not all insurance is alike. And counting the insured is misleading. Health insurance for the poor is low quality, decidedly inferior for chronic conditions, and less likely to prevent death.
Health care in the US is as unequal as everything else. Our existing health insurance system leads to what Ms. Brown labels immoral results. The difference between the ACA and the Republican proposal may have a marginal effect. But as long as there are some 75 million Americans on Medicaid, the proposals of both parties amount to tinkering with a system that drastically favors the wealthy.
Health care in the US is as unequal as everything else. Our existing health insurance system leads to what Ms. Brown labels immoral results. The difference between the ACA and the Republican proposal may have a marginal effect. But as long as there are some 75 million Americans on Medicaid, the proposals of both parties amount to tinkering with a system that drastically favors the wealthy.
2
I am astonished every time I hear a Republican mouthing off about how we need to return to a market-based approach.
We've already had that, and for millions of people it did not work. Unless you had work-based health benefits, it was virtually impossible for many individuals to find affordable health insurance. People "in between jobs" and divorcees were generally uninsured. My mother, after her divorce, went over 15 years without health insurance until she became eligible for Medicare.
So let's not pretend that insurance companies were competing to sign up individuals. Obamacare, for all its faults, was a well-intended and largely successful effort to address a huge blight of uninsured folks.
We've already had that, and for millions of people it did not work. Unless you had work-based health benefits, it was virtually impossible for many individuals to find affordable health insurance. People "in between jobs" and divorcees were generally uninsured. My mother, after her divorce, went over 15 years without health insurance until she became eligible for Medicare.
So let's not pretend that insurance companies were competing to sign up individuals. Obamacare, for all its faults, was a well-intended and largely successful effort to address a huge blight of uninsured folks.
14
The proponents of Speaker Paul Ryan’s mistitled American Health Care Act in the House of Representatives are as intentionally out of touch as EPA Secretary Scott Pruitt is with his global warming and carbon dioxide denials.
Ryan knows that big cuts in coverage and a large increase in premiums will effectively leave millions of Americans without any health care.
Ryan is fixated on the promised tax cuts for affluent Americans, so he pushes his bill forward.
Ryan knows that there will be many thousands of Americans who will die unnecessarily and prematurely by losing Obamacare.
Ryan and the other House Republicans simply don’t care. One gets the feeling that, even were these G.O.P. members of Congress on the healthcare front lines – as doctors, nurses, and paramedics – they would still be determined to deny care.
The Republicans might avert their cold eyes when an uninsured patient is dying from a refusal to render care, but they would not lift a finger to help.
The United States will be alone among highly developed countries in having the barbaric healthcare reimbursement system which Paul Ryan and Donald Trump wish to bring back after repealing Obamacare.
Ryan knows that big cuts in coverage and a large increase in premiums will effectively leave millions of Americans without any health care.
Ryan is fixated on the promised tax cuts for affluent Americans, so he pushes his bill forward.
Ryan knows that there will be many thousands of Americans who will die unnecessarily and prematurely by losing Obamacare.
Ryan and the other House Republicans simply don’t care. One gets the feeling that, even were these G.O.P. members of Congress on the healthcare front lines – as doctors, nurses, and paramedics – they would still be determined to deny care.
The Republicans might avert their cold eyes when an uninsured patient is dying from a refusal to render care, but they would not lift a finger to help.
The United States will be alone among highly developed countries in having the barbaric healthcare reimbursement system which Paul Ryan and Donald Trump wish to bring back after repealing Obamacare.
8
I believe in a single payer system--a national health system--which would limit profiteers (doctors, pharmaceutical companies, and hospitals) from the gravy train they have been exploiting.
That said, until we get such a system, I must reject the teary-eyed complaint of those regretful of the impending loss of Obamacare. The latter was not a reform...it was simply an expansion of the existing broken private care system. And because the Obama Administration feared to raise taxes (except a minor increase on dividends for the rich), it was carried out by hiding to the middle class and lower middle class the fact that many of them would be paying to expand coverage for the poor. Thus the reaction.
So now the Republicans come up with a totally unworkable bill which, if passed, would quickly self-destruct.
The dirty truth is that if we cannot agree on a national health system (the best solution) in order to squeeze out private exploitation and reduce costs, we might as well go back to where we started from: the uninsured go to emergency rooms, the hospitals absorb the costs, those costs get passed on in insurance premiums to the rest of us, and the general US public pay for this welfare, rather than having the federal government take on even more debt to pay for it. We cannot afford that debt, because the Congress is too cowardly to raise taxes to pay for it. So better the invisible (if highly inefficient) cost of lower class health care through emergency rooms.
That said, until we get such a system, I must reject the teary-eyed complaint of those regretful of the impending loss of Obamacare. The latter was not a reform...it was simply an expansion of the existing broken private care system. And because the Obama Administration feared to raise taxes (except a minor increase on dividends for the rich), it was carried out by hiding to the middle class and lower middle class the fact that many of them would be paying to expand coverage for the poor. Thus the reaction.
So now the Republicans come up with a totally unworkable bill which, if passed, would quickly self-destruct.
The dirty truth is that if we cannot agree on a national health system (the best solution) in order to squeeze out private exploitation and reduce costs, we might as well go back to where we started from: the uninsured go to emergency rooms, the hospitals absorb the costs, those costs get passed on in insurance premiums to the rest of us, and the general US public pay for this welfare, rather than having the federal government take on even more debt to pay for it. We cannot afford that debt, because the Congress is too cowardly to raise taxes to pay for it. So better the invisible (if highly inefficient) cost of lower class health care through emergency rooms.
84
What the ACA provided was health care access to 20 million people who didn't have it.
You may consider that no big thing, but for those of us about to lose this access, we beg to differ.
You may consider that no big thing, but for those of us about to lose this access, we beg to differ.
11
"no one would work ...no one would save the result would be moral decay financial bankruptcy and the collapse of the republic"
"Never in the history of the world has any measure been brought in here so insidiously designed as to prevent business recovery to enslave workers and to prevent any possibility of employers providing work for the people"
"This bill opens the door and invites the entrance into the political field of a power so vast so powerful as to threaten the integrity of our institutions and pull the pillars of the temple down upon the heads of our descendants"
"It will undermine our national life by destroying initiative discouraging thrift and stifling individual responsibility"
Were these comments made about ACA.
No.
They were made in the 1930's when Social Security and unemployment insurance were proposed.
see "The Coming of the New Deal" by Arthur Sclesinger pages 311-312
Compare to some of Reagan's comments against Medicare.
The present day reactionary House Republicans are refighting the battles of the 1930's.
They want to repeal FDR's New Deal and even reforms of the Woodrow Wilson and Theodore Roosevelt presidencies.
"Never in the history of the world has any measure been brought in here so insidiously designed as to prevent business recovery to enslave workers and to prevent any possibility of employers providing work for the people"
"This bill opens the door and invites the entrance into the political field of a power so vast so powerful as to threaten the integrity of our institutions and pull the pillars of the temple down upon the heads of our descendants"
"It will undermine our national life by destroying initiative discouraging thrift and stifling individual responsibility"
Were these comments made about ACA.
No.
They were made in the 1930's when Social Security and unemployment insurance were proposed.
see "The Coming of the New Deal" by Arthur Sclesinger pages 311-312
Compare to some of Reagan's comments against Medicare.
The present day reactionary House Republicans are refighting the battles of the 1930's.
They want to repeal FDR's New Deal and even reforms of the Woodrow Wilson and Theodore Roosevelt presidencies.
84
They want to remove all social negative feedback to the accumulation of wealth for raw feudal power.
They are narcissists on steroids.
They are narcissists on steroids.
7
In today's Times, there is an article on how various Americans would be affected by the Republican plan:
https://www.nytimes.com/interactive/2017/03/12/us/politics/republican-he...®ion=top-news&WT.nav=top-news
In a cruel reversal of Finley Peter Dunne famous quote, this plan want to afflict the afflicted and comfort the comfortable. Starting with the programmed destruction of Medicaid, the Republicans seem intent on grinding down the poor. Since many older Americans depend on Medicaid for nursing homes in old age, it seems aimed even at those who supported the president.
It should be no surprise that this plan is being rushed through the House before the CBO scores it, as it is a film flam job. We will see if there are enough Republicans who will heed the objections of Republican governors, but I expect Kabuki, ritualized theatre. A couple of senators will be allowed to buck the party but not enough to prevent a 50-50 tie to be broken by the vice president.
https://www.nytimes.com/interactive/2017/03/12/us/politics/republican-he...®ion=top-news&WT.nav=top-news
In a cruel reversal of Finley Peter Dunne famous quote, this plan want to afflict the afflicted and comfort the comfortable. Starting with the programmed destruction of Medicaid, the Republicans seem intent on grinding down the poor. Since many older Americans depend on Medicaid for nursing homes in old age, it seems aimed even at those who supported the president.
It should be no surprise that this plan is being rushed through the House before the CBO scores it, as it is a film flam job. We will see if there are enough Republicans who will heed the objections of Republican governors, but I expect Kabuki, ritualized theatre. A couple of senators will be allowed to buck the party but not enough to prevent a 50-50 tie to be broken by the vice president.
16
The Republican Party's Patient Abandonment is not just a repeal of President's Obama's humane and mostly effective healthcare plan.
The Republican Reverse Robin Hood plan is more accurately described simply as a Mt. Everest tax cut for the wealthy....which incidentally includes the savage elimination of affordable healthcare for millions and millions.
The Joint Committee on Taxation estimates repealing the ACA's taxes alone will cut the taxes of the mostly wealthy and corporations by nearly $600 billion through 2026 – and close to $700 billion through 2027.
In the Republican circle of hell that runs the United States Congress, a few dozen abandoned patients is another $50,000 in the psychopathic bank for a rich man - what's not to celebrate ?!
Speaker Paul Ryan, a real-live Grim Reaper, said the other day that young and healthy people shouldn't have to pay for sick and old people, essentially rejecting the basic idea of health insurance (and compassion) itself.
The Republican plan to fix the most expensive, inefficient and extortive healthcare system in the world is tell America's sick, dying, hospitalized and emergency room patients to "to take two tax cuts and call me from the morgue".
The Republican Tax Cut Health Plan is the work of sociopaths.
And they love to vote for these Republicans in America's fake heartland and fraudulent Bible Belt.
Could you imagine Jesus setting foot anywhere near these misanthropes ?
The Republican Reverse Robin Hood plan is more accurately described simply as a Mt. Everest tax cut for the wealthy....which incidentally includes the savage elimination of affordable healthcare for millions and millions.
The Joint Committee on Taxation estimates repealing the ACA's taxes alone will cut the taxes of the mostly wealthy and corporations by nearly $600 billion through 2026 – and close to $700 billion through 2027.
In the Republican circle of hell that runs the United States Congress, a few dozen abandoned patients is another $50,000 in the psychopathic bank for a rich man - what's not to celebrate ?!
Speaker Paul Ryan, a real-live Grim Reaper, said the other day that young and healthy people shouldn't have to pay for sick and old people, essentially rejecting the basic idea of health insurance (and compassion) itself.
The Republican plan to fix the most expensive, inefficient and extortive healthcare system in the world is tell America's sick, dying, hospitalized and emergency room patients to "to take two tax cuts and call me from the morgue".
The Republican Tax Cut Health Plan is the work of sociopaths.
And they love to vote for these Republicans in America's fake heartland and fraudulent Bible Belt.
Could you imagine Jesus setting foot anywhere near these misanthropes ?
528
Taxation is the only rational way to fund a universal health care plan.
Public spending is part of the domestic product. The Republicans will slash the whole economy.
Public spending is part of the domestic product. The Republicans will slash the whole economy.
9
This is not a true false test. The right answer is none of the above. Our insurance system gives far better care to the rich than the poor. Single payer or bust.
5
Yes! Imbeciles and hypocrites, the whole stinking lot of them -- the Republican politicians and the working-class/middle-class saps who keep voting for them in direct conflict with their own economic and political interests, yet, perhaps, not their twisted notions of religion. Absolutely disgraceful and disgusting that the majority of us are being held captive by the 1%, the politicos who do their bidding in Congress and religious extremists.
10
It makes no economic sense to keep people alive when the cost of doing so is far greater than they can pay or the potential economic rewards of keeping them alive. The Invisible Hand of the marketplace automatically acts on this information. No person or corporation wants to pay medical bills that they can avoid, and when all manage to avoid paying or eating the cos of the care, the care is not provided. So the Invisible Hand runs a very efficient death panel, whose decisions are sometimes overridden by charity and which can be overridden by making health care a right.
For those who worship the Invisible Hand, the logical thing is to be as economically rational as possible. In this case, naked economic rationality would disturb too many people, so its operation must be concealed behind some false facades and not discussed honestly, or better not at all. Economic rationality is disclosed in the drop in lifespan of working-class white males, but our mainstream reporting is careful not to make the connection.
In fact, the Invisible Hand is not human or even alive and should not have the last word on even the economic aspects of our society. It is basically a tool which we the people, acting through our governments, decide how much to use. At present, we have been talked into letting it have its way too often, but it is our right to limit it for good reasons and the common good, thereby promoting the general welfare.
For those who worship the Invisible Hand, the logical thing is to be as economically rational as possible. In this case, naked economic rationality would disturb too many people, so its operation must be concealed behind some false facades and not discussed honestly, or better not at all. Economic rationality is disclosed in the drop in lifespan of working-class white males, but our mainstream reporting is careful not to make the connection.
In fact, the Invisible Hand is not human or even alive and should not have the last word on even the economic aspects of our society. It is basically a tool which we the people, acting through our governments, decide how much to use. At present, we have been talked into letting it have its way too often, but it is our right to limit it for good reasons and the common good, thereby promoting the general welfare.
74
You point out that "the Invisible Hand of the Marketplace" "runs a very efficient death Panel" when people or corporations don't want to pay medical bills they can avoid. But think about this, what amount are we taxpayers expected to keep paying for the benefit of the Trump family when they don't pay taxes?
2
The invisible hand starts to seem more like the disembodied hand in old horror movies that strangles people.
2
If the "invisible hand" was put to scientific scrutiny, the childish cliche would be laughed out of the lab. Oh wait, Econ is a science.
The United States of America is experiencing a hostile takeover of OUR governments at all levels by The Global Robber Baron/Radical Religon Corporate Complex. We did not have an election. We had the culmination of a 40+ year war on us to launch a financial coup against democracy. It's "business" and they do not care who dies or suffers. Their insatiable greed knows no bounds and has no moral/social conscience. They are crazed with their greed.
Time for a civil suit to FIRE DONALD TRUMP AND HIS ADMINISTRATION for cheating stakeholders - WE the American people. Stock holders would stand still while the head of a company burned down their "investment".
The United States of America is OUR investment - WE pay the taxes and do the hard work that built/builds OUR country. These Robber Barons are nothing but thieves, trying to steal OUR lives with their insatiable greed.
Perhaps The Con Don cannot be impeached for years but WE - the millions of us who refuse to let him put his evil plans into place - can bring a civil lawsuit against he and his administrators and take back all the wealth they have stolen from us.
NOW is the time for some bright, democracy-loving top lawyers to use their talents to help us save America.
https://www.firedonaldtrump.net/
Time for a civil suit to FIRE DONALD TRUMP AND HIS ADMINISTRATION for cheating stakeholders - WE the American people. Stock holders would stand still while the head of a company burned down their "investment".
The United States of America is OUR investment - WE pay the taxes and do the hard work that built/builds OUR country. These Robber Barons are nothing but thieves, trying to steal OUR lives with their insatiable greed.
Perhaps The Con Don cannot be impeached for years but WE - the millions of us who refuse to let him put his evil plans into place - can bring a civil lawsuit against he and his administrators and take back all the wealth they have stolen from us.
NOW is the time for some bright, democracy-loving top lawyers to use their talents to help us save America.
https://www.firedonaldtrump.net/
210
I don't begrudge those who accumulate obscene amounts of wealth; however, the absurdly wealthy have advantages and opportunities that are simply not available to the rest of us. The exploitation of such advantages and opportunities that results in the accumulation of such vast wealth must come at a cost, and that cost must be the imposition of taxes that can actually be collected.
5
Obscene amounts of wealth are what causes global unrest and war, JMN. Wealth is fine but the obscene amounts that 83 people in the United States and a few hundred in the world control IS the problem. Billionaires know they cannot spend the money they have stolen from the rest of us in their lifetimes and we all know they can't take one penny of it with them. So they leave us with despicable people like The Con Don and his Robber Barons to try to destroy the world.
How stupid can we be if we don't regulate greed? How stupid can we be if WE let them start another World War to consolidate their power?
How stupid can we be if we don't regulate greed? How stupid can we be if WE let them start another World War to consolidate their power?
7
I have never quite understood how the so called religious right can support the GOP which seems the antithesis of what the gospels call for when it comes to other people.
Personally I find the GOP position to be obscenely immoral and socially, economically and politically destructive.
Personally I find the GOP position to be obscenely immoral and socially, economically and politically destructive.
702
Religion isn't about helping the poor and sick etc, it's about controlling people and passing the collection plate. Since Jerry Falwell;s time, it's been about helping Republican help the rich.
I like your Christ. I do not like your Christians. They are so unlike your Christ.
~Gandhi
~Gandhi
5
Had the Republicans had any intention to replace ACA, they'd have come up with some ideas in the past seven years.
Right now, their plan is a case of you-are-free-not-to-get-sick. Evidently, Speaker Ryan - having his family insured of the American government and ihis in-laws are well off anyway - doesn't seem to understand the idea of insurance is to pool the healthy and the sick together to share the burden at any given year.
As you point out, E.R. is the least effective way to treat the uninsured. Sadly, efficiency may be the least of our worry. E.R. might be so overwhelmed and understaffed that people might die waiting for services there, irrespective of their insurance status.
And let's not forget the sad cases of patient dumping. We have not heard that for a while. Well, welcome back when hospitals decide that they can no longer afford to treat the uninsured, law or not
So we have come a full circle. The Republicans have finally stalled long enough that now America is back to the survival of the healthy and wealthy
Right now, their plan is a case of you-are-free-not-to-get-sick. Evidently, Speaker Ryan - having his family insured of the American government and ihis in-laws are well off anyway - doesn't seem to understand the idea of insurance is to pool the healthy and the sick together to share the burden at any given year.
As you point out, E.R. is the least effective way to treat the uninsured. Sadly, efficiency may be the least of our worry. E.R. might be so overwhelmed and understaffed that people might die waiting for services there, irrespective of their insurance status.
And let's not forget the sad cases of patient dumping. We have not heard that for a while. Well, welcome back when hospitals decide that they can no longer afford to treat the uninsured, law or not
So we have come a full circle. The Republicans have finally stalled long enough that now America is back to the survival of the healthy and wealthy
348
Bos- The Guardian of the Plutocracy party is beyond despicable. Gov. Baker is scrambling to save Romneycare and Planned Parenthood. Will Massachusetts need to build a wall to keep out those seeking access to affordable health insurance? Institute minimum residency requirements before qualifying for Romneycare? So many will be affected by this vile Republican plan. I have zero pity for those who voted for the orange nightmare and gang: they are getting no more than what they deserve. My pity lies with those who voted against trump or the children of parents who were so filled with hatred that they voted for the party that would do irreparable harm to their loved ones. Poison water, poison air, cuts to public education, national "right to work" laws, no increases in the minimum wage, repealing Pres. Obama's changes to overtime laws and what qualifies as salary workers and more sinister policies will harm those who voted for trump as well as those who didn't. We will all suffer somewhat at the hands of the diabolical trump and his gang of sycophants. But the least among us will suffer the most.
10
We've gone from ObamaCare to the Republican "Don't Care" Plan, from affordable care to "only if you can afford it" care.
5
The pooling is the same for any insurance!
2
with apologies to G & S
Here's a Health Care bill
Filled with dubious swill
Lightens all the good provisions
Pressures folk to bad decisions
Benefits are nil
What a piece of swill.
Here is the Far Right
Shuns the poor man's plight
To a full repeal they're claquing
Empathy completely lacking
Workers will all rue
Healthcare they'll undo!
How will this all end
On you t'will depend
March and call, put on the squeeze
Pressure à la Trumpanese
Give the Repubs hell
Donald Trump as well!
Here's a Health Care bill
Filled with dubious swill
Lightens all the good provisions
Pressures folk to bad decisions
Benefits are nil
What a piece of swill.
Here is the Far Right
Shuns the poor man's plight
To a full repeal they're claquing
Empathy completely lacking
Workers will all rue
Healthcare they'll undo!
How will this all end
On you t'will depend
March and call, put on the squeeze
Pressure à la Trumpanese
Give the Repubs hell
Donald Trump as well!
215
The replacement of ACA, otherwise known as Obama Care, is so simple. It is a one page document, nay, a one paragraph document. It reads thus:
"The future Federal Healthcare system for all Americans shall be the same as that provided to Members of Congress, as declared a requirement in the US Constitution."
QED
"The future Federal Healthcare system for all Americans shall be the same as that provided to Members of Congress, as declared a requirement in the US Constitution."
QED
12
Larry, thank you for returning to our agora. Fight the good fight!
6
In one case, a young woman found herself in a desperate circumstance after a bad breakup. One night she drank far too much, and her family (out of state) contacted the police to check on her. The police were mandated to take her to a public hospital with which they had negotiated a contract. It wasn't the closest hospital (.5 miles from her home) nor the best (3 miles away). Both of those would have welcomed her family's premium insurance. Instead, she was driven to Long Beach, over 20 miles away in the back of a police car, to a public hospital. In the ER, she shared a room with a gun shot victim and someone suffering from an insect infestation before she was sent to a filthy psych unit.
She was put on a mat on a floor without a blanket in a room with 6 other "patients" for the next six hours.
Because of her home's zip code (90210) and of her family's excellent insurance, the hospital targeted them. It tried to bill the family nearly $6000 above what insurance had already covered for her 9 hour "treatment." She wasn't even administered an I.V. or given an aspirin during her visit, and was released before 8 am the next morning by a psychiatrist once his shift began.
If you think insured patients with assets aren't targeted by hospitals to cover the costs of the uninsured, think again. Healthcare for all means a fairer shake for all.